Hiding in Plain Sight: Age-Associated Cognitive Decline

Dr. Angela Gutchess, Ph.D.

Think about the times when you’ve commented on the superior mental feats of an older relative. Or perhaps you’ve heard another person describe a senior citizen as “just as sharp as ever.” How accurate are these observations? What can hide cognitive declines, putting older adults at risk of financial exploitation?

There is substantial research documenting age-related cognitive declines. Although there are differences in ability levels and the rates at which individuals decline, everyone is expected to show some losses compared to their younger selves in fluid cognitive abilities. Fluid cognition includes effortful, in-the-moment mental actions, including memory, computations and speeded decisions. Such changes are typical of aging, rather than being hallmarks of dementia or other disorders.

If pronounced cognitive changes characterize aging, then why do many of us have the impression that some older adults are doing just fine cognitively? Taken to the extreme, this can include anecdotal examples of older adults who seem to be navigating complex tasks just fine – driving around town and navigating circuitous routes, making decisions about investments, health, and other matters, and even working or babysitting grandchildren – only to receive a diagnosis of dementia. How is it possible for cognitive problems to be hidden, sometimes to an extreme degree?

One aspect is crystallized cognition, which remains intact with age or even increase across adulthood. This includes knowledge of facts and vocabulary, which is maintained in healthy aging. Sometimes it can be temporarily difficult to retrieve a particular piece of information from memory – like the name of an actor or a movie – but this experience is fleeting. The information is accessible in memory with the right cue.

Crystallized cognition contributes to expertise, which accumulates over a lifetime of experiences. For example, an older adult may continue to be a successful manager due to extensive prior experience solving a variety of different problems. In line with popular beliefs, some evidence shows that with age comes wisdom, which is marked by increased appreciation for multiple perspectives and compromise in problem solving. These skills starkly contrast those probed with neuropsychological tests, involving speeded judgments and new information kept in mind, manipulated, and tested in memory.

In addition, familiar everyday settings can bolster performance. Older adults can use environmental support to “offload” cognitive demands to their surroundings, rather than self-initiating processing. This includes setting alarms for reminders, organizing the kitchen or office so that items are always in the same place, and driving long-familiar routes.

Another aspect to consider is that many everyday decisions rely on abilities beyond cognition. Decisions of whether an investment opportunity represents a promising foray could be influenced by one’s tendency to seek out versus avoid risk, factors about the person presenting the investment opportunity, as well as the emotions felt about the situation. For example, perhaps it is a beloved relative who presents an investment opportunity, or one feels empathy for someone going through a rough patch who seeks a loan. In the case of an unfamiliar individual who claims to be an investment broker, perhaps that person appears trustworthy and shares stories of past successes.

These other sources of information engage social, emotional, and motivational processes. Emotional processing is more preserved with age than cognition. Furthermore, neuroscience research reveals that distinct brain circuits underlie these domains. To date, there has been relatively little research about how aging affects these brain regions. In some of my research we have shown that older adults can robustly recruit social network regions as well as younger adults when making judgments about oneself compared to others. This pattern contrasts age deficits in the response of these same regions during demanding cognitive tasks.

Moreover, younger and older adults may recruit the same brain region but in different situations. For example, a region can respond more to positive information in older adults but to negative information in younger adults, be it emotional pictures or forming impressions of other people.

Some age-related losses occur in these abilities, such as the dopamine system’s response to reward. Older adults’ weakened neural responses to losses occurring in tandem with robust responses to gains could contribute to impaired decision making.

Although there are promising starts to research on topics at the intersection of everyday life and raw cognitive abilities, such as wisdom and environmental support, far more work is needed. Furthermore, research bringing social, emotional, and motivational perspectives to the study of cognition is crucial for understanding what places older adults at risk for fraudulent financial decisions. Both of these directions will increase appreciation of what helps older adults to appear to be doing well when they are at risk from cognitive declines.

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