Aging Brain Flashcards
How does Merriam-Webster define cognition?
“The activities of thinking, understanding, learning and remembering.”
What are key components of cognition?
• Awareness of, and attentiveness to, one’s environment
• Capacity to absorb and interpret information
Actively and selectively engaging with information
• Ability to process information with good memory function
• Mental abilities related to knowledge and “how one knows”
• Utilizing existing knowledge and acquiring new knowledge
• Ability to amalgamate and integrate information, knowledge and mind skills
• Language, literacy, and ability to communicate knowledge and concepts
• Pattern recognition, numeracy, and computation
• Mental abilities related to creativity and expression
• Perception, discernment, judgment, planning, and problem-solving
• Ability to introspect and integrate feelings and values with information
• Cognitive components of language and communication
• Factors related to “intelligence”
• Learning functions associated with these capabilities
Why is it hard to separate cognition and memory?
Because they are so intertwined, especially with attentional and executive functions.
What is the most significant normal-aging change in cognition?
Changes related to memory.
Does normal aging greatly impair cognitive abilities?
Not greatly—aside from slower processing and need for more memory support, many cognitive abilities remain intact, and some (like those associated with experience and wisdom) may improve.
How are learning and memory related, according to Kilstrom, Dorfman, Park (2007)?
Learning presupposes memory, and memory stores the background for new learning.
What are the components of learning?
• Acquisition of knowledge or skills
• Use of cognitive processes on new information
• Building on prior information, knowledge, and skills
• Acquiring/modifying/reinforcing values and preferences
• Recognizing the importance of experiences for future function
• Learning through experience, study, or being taught
How does normal aging affect learning?
It poses adaptive challenges due to changes in cognition and memory, but the capacity to learn is not lost.
Why is it important to keep learning as we age?
Continuing to learn keeps the brain maximally functional.
What makes learning potentially more enjoyable for older individuals?
Prior learning/life experience, self-mastery, and less stress about outcomes.
Are older brains worse at all kinds of learning?
No—while they may be less adept at some types, they can be stronger at others.
Is it okay if an older person doesn’t learn the same way they did when younger?
Yes—that’s not always a negative thing.
What is personality?
• About 50% genetic
• The embodiment of distinctive traits of mind/being
• Enduring behavior patterns in various situations
• Patterns in interests and pursuits
• How a person reacts, interacts, and is experienced by others
• Emotional sustenance the person engages in
• Response to adversity and stress
• Use of learning
• The essential character of a person
• A unique set of history and memories
• Reflects psychological mechanisms behind behaviors that help or hinder success
What are the Big Five components of personality in psychology?
- Openness to experience
- Conscientiousness
- Extroversion
- Agreeableness
- Emotional stability
Do the Big Five traits change much with normal aging?
No—personality is seen as largely stable over time, even with brain changes from normal aging.
Do life experiences change fundamental personality traits?
No, they enhance who we are but don’t much alter our fundamental orientations.
How do Salovey & Mayer (1990) define emotional intelligence?
“The subset of social intelligence that involves the ability to monitor one’s own and others’ feelings and emotions, to discriminate among them and to use this information to guide one’s thinking.”
What are the components of emotional intelligence?
• Social cognition
• Understanding group dynamics and interpersonal forces
• Discriminating and labeling emotions (includes reading facial expressions/body language)
• Self-awareness and emotion control
• Honest and wise emotional expression
• Perceiving, interpreting, and responding to others’ emotions
• Understanding role of emotions in a circumstance/dynamic
• Good emotional reactivity
• Using emotional info to guide thinking/behavior
• Managing emotions with self- and other-respect
• Understanding emotions in cognition, right thinking, and decision-making
• Navigating interpersonal/social/work/relationship complexities
• Handling situations with insight, compassion, finesse, and integrity
• Respecting interpersonal boundaries and privacy
• Applying personal/professional values to interactions
Does emotional intelligence correlate with intellectual intelligence (IQ)?
No—someone can have high IQ and low EQ, and vice versa.
How does emotional intelligence change with age?
It tends to improve, due to life experience and increased focus on others and community.
Do the brain areas involved in emotional intelligence stay intact with normal aging?
Yes, allowing for more consistent emotional self-regulation, empathy, and common sense.
What is dementia?
Dementia is a general term for a decline in mental ability severe enough to interfere with daily life. It involves progressive impairment or loss of memory, cognition, learning capacity, personality/identity, and emotional intelligence.
What cognitive and functional abilities are diminished or lost with dementia?
• Ability to focus, pay attention, and maintain a thought pattern
• Ability to plan, organize, decide, and implement
• Reasoning, discernment, judgment, and prioritization
• Capacity for learning
• Memory function (some sensory memory and priming may be retained)
• Recognition of self and others
• Familiarity with people, contexts, and environments
• Emotional perception and contextual understanding
• Ability to read people and scenarios
• Social interaction
• Emotional regulation and interpersonal boundaries
• Orientation in time and space
• Sense of confidence, safety, and security
• Effective communication
Is dementia a disease itself?
No, dementia is a manifestation of brain damage and deterioration caused by various underlying conditions.
How many Canadians were living with Alzheimer’s or other dementias in 2011?
747,000 Canadians, or 14.9% of those aged 65+, and about 50% of those over 85.
Why is the term “senile dementia” no longer used?
Because it implies dementia is a normal part of aging, which it is not.
What percentage of dementia cases are caused by Alzheimer’s Disease?
60–80%, depending on the classification system.
What is known about the causes of AD?
The exact cause is unclear. Genetics, lifestyle, and environmental factors play a role. Genetics are determinative in only 5% of cases, especially in early-onset AD (age 30–60). Down Syndrome almost always leads to AD by age 40.
What are key risk factors for developing Alzheimer’s Disease?
• Age
• Gender (slightly more common in women)
Poorly controlled diabetes
• Head injury or whiplash (especially multiple instances)
• Hypertension, heart disease, high cholesterol
• Smoking, obesity
• Estrogen hormone replacement therapy
• Sleep disorders (especially sleep apnea)
• Long-term use of benzodiazepines
• Poor diet and lifestyle
What is Mild Cognitive Impairment (MCI)?
A condition that causes impairments between normal aging and dementia. Not all with MCI progress to AD, but many do.
What causes vascular dementia?
Damage or disease affecting the brain’s blood vessels—e.g., strokes, small infarcts, heart disease, diabetes.
What are major risk factors for vascular dementia?
Smoking, hypertension, atherosclerosis, poor diet, and sedentary lifestyle.
What are features of “pure” vascular dementia?
More pronounced psychomotor slowness, depression, and specific dysfunction due to focal lesions. Personality is often better preserved than in AD.
How are Lewy Body Dementia and Parkinson’s Disease related?
They’re often considered part of a spectrum; ~20% of people with PD develop dementia.
What causes these conditions?
Abnormal Lewy body deposits in neurons (substantia nigra in PD, memory/cognition areas in LBD).
What are features of Lewy Body Dementia?
Memory/cognition decline, sleep disturbances, parkinsonian symptoms, and visual hallucinations.
What causes WKS?
Thiamine (Vitamin B1) deficiency, often from chronic alcoholism; also occurs with cancer, AIDS, dialysis.
What are characteristics of WKS?
• Diplopia, impaired eye control, nystagmus
• Ataxia, peripheral neuropathies
• Autonomic issues (BP, heart rate)
• Confusion, memory problems, difficulty with abstract thinking
• Confabulation and hallucinations
• Intact social and everyday thinking skills
What brain regions are affected in FTD?
Primarily the frontal and temporal lobes.
What are key features of FTD?
• Extreme changes in personality and behavior (e.g., disinhibition, apathy)
• Aphasic language impairments
• Fewer microscopic lesions but visible atrophy
• Equal gender distribution
• Onset between ages 35–75
What causes Huntington’s Disease?
An autosomal dominant genetic mutation causing neuronal death in basal ganglia and reduced GABA & acetylcholine.
When does Huntington’s Disease typically present?
Between ages 30–50.
What are symptoms of Huntington’s Disease?
• Involuntary movements
• Basal ganglia motor dysfunction
• Cognitive decline (memory, reasoning, judgment, planning)
• Mood changes (anxiety, depression, OCD, anger/irritability)
What happens to brain mass in AD?
Up to 40–50% brain mass loss due to neuron death and brain atrophy.
What is the progression pattern of AD in the brain?
Lesions begin in anterior cortical areas and progress posteriorly and more globally.
What are neuritic plaques?
Extracellular deposits of beta-amyloid protein, a breakdown product of amyloid precursor protein (APP), especially around synapses.
What is the effect of neuritic plaques?
They impede synaptic activity, cause inflammation, and accelerate neuron degeneration.
What are neurofibrillary tangles?
Aggregates of tau protein that become abnormally phosphorylated, leading to microtubule dysfunction and neuron death.
How do neurofibrillary tangles affect neurons?
They block internal transport, collapse microtubules, and lead to neuron death. The tangles remain as insoluble debris.
What are the 7 warning signs of Alzheimer’s Disease according to CLEAR?
- Asking the same question repeatedly
- Repeating the same story word for word
- Forgetting how to do routine tasks (e.g., cooking, repairs)
- Losing ability to manage finances
- Getting lost in familiar places or misplacing items
- Neglecting hygiene, wearing same clothes while insisting they’re clean
- Relying on others for decisions they previously handled independently
How long does the Early/Mild phase of Alzheimer’s Disease typically last?
2–4 years on average, although exact onset is difficult to determine due to slow, subtle symptoms.
How is Alzheimer’s Disease diagnosed in the early phase?
Through a combination of memory/cognition tests and eliminating other possible conditions.
What are the key cognitive and emotional features of early/mild Alzheimer’s Disease?
• Forgetfulness and recent memory issues
• Difficulty learning new things
• Disorientation (time, date, destination)
• Planning and organization problems
• Anxiety, frustration, confusion in complex situations
• Moodiness and changes in social skills
• Stress/embarrassment about deficits
• Beginning of personality change (loss of spontaneity, volatility)
• No physical health change yet
According to Gwyther, what are additional symptoms seen in early/mild Alzheimer’s?
• Loss of zest for life
• Memory loss without changes in appearance or casual talk
• Poor judgment with money
• Word-finding difficulty or word substitution
• May stop talking to avoid errors
• Short attention span, less motivation
• Easily lost even in familiar places
• Resists change
• Difficulty thinking logically
• Repetitive questions
• Social withdrawal, irritability, emotional insensitivity
• Indecisiveness
• Upset by being rushed or by unexpected events
• Issues with eating (forgets to eat, eats one food, or constantly eats)
• Misplaces items in odd places (e.g., clothes in dishwasher)
• Hoarding or constant checking/searching
How long does the Moderate phase of Alzheimer’s Disease usually last?
It’s the longest phase, lasting from 4–10 years and varies widely from person to person.
What are the cognitive and behavioural features of moderate Alzheimer’s Disease?
• More intense memory and learning issues
• Poor insight, abstract thought, reasoning, and judgment
• Loss of familiar references and routine skills
• Increasing need for help with tasks like dressing or eating
• Social errors, repetitive/compulsive behaviours
• Confusion, anxiety, paranoia
• Emotional outbursts, sadness, withdrawal
• Disinhibition, inappropriate behaviours or speech
• Sundown syndrome (anxiety/agitation in late afternoon/evening)
• Wandering
• Apraxia (loss of understanding of tool/body part usage)
• Significant communication issues
• Appetite changes, strange food preferences
• Sleep pattern deterioration
• Hallucinations, delusions
• Incontinence, reduced mobility
According to Gwyther, what behaviours may appear in moderate Alzheimer’s?
• Neglect of appearance, hygiene, sleep
• Confuses identities (e.g., son as brother)
• Unsafe to be left alone (risk of wandering, falls, poisoning)
• Doesn’t recognize people or their belongings
• Repetitive stories, motions (e.g., tearing tissues)
• Restless late-day behaviours (pacing, doorknob fiddling)
• Poor logical thinking, can’t follow notes
• Makes up stories to cover memory gaps
• May read but can’t respond appropriately
• Aggressive/inappropriate behaviour (hitting, cursing, grabbing)
• Loss of manners, hallucinations
• Paranoia (e.g., accusing spouse of cheating)
• Frequent naps or wakes at night thinking it’s time for work
• Trouble using the toilet or sitting properly
• Needs help with basic hygiene, dressing, and hydration
• Inappropriate sexual behaviour or public disrobing/masturbation
How long does the Severe/Terminal phase of Alzheimer’s typically last?
Around 6–18 months.
What are key characteristics of severe/terminal Alzheimer’s Disease?
• Severe cognitive decline and total dependency
• Verbal communication lost (aphasia)
• No sense of time/place or recognition of self/others
• Makes non-verbal sounds or gestures for needs
• Highly sensitive to environment (noise, chaos)
• Startle response to touch
• Repetitive movements (rocking, hand-wringing)
• Increased sundowning
• Disrupted sleep-wake cycle
• Anorexia, loss of swallow reflex, weight loss
• Risk of choking/aspiration
• Doesn’t recognize thirst
• Motor function loss: may be bed-bound, can’t hold head up
• Weak, frail, high fall risk
• Rigidity and contractures in limbs
• Loss of facial expression
• Skin breakdown, decubitus ulcers
• Unstable BP, heart and respiratory stress
• Complete incontinence
• Seizures may develop
• High infection risk, even from small wounds
• Causes of death: pneumonia/infection, starvation/dehydration, organ failure
What sensory and emotional experience might someone with Alzheimer’s have when trying to complete routine tasks like brushing their teeth?
They may feel confused, unsure if the task was completed, and even laugh or become frustrated/agitated, especially in early stages where they recognize their forgetfulness.
How might a massage therapist approach someone with Alzheimer’s Disease for a treatment?
By gently introducing themselves, explaining the process in simple terms, using a calm, caring tone, and offering a familiar, safe environment—like staying in a chair or bed—while applying gentle massage with soothing lotion.
What does the literature suggest about the effects of massage therapy for people with dementia?
• Reduces anxiety, panic, agitation
• Provides calm, comfort, and relaxation
• Slows heart rate and reduces blood pressure
• Helps counter isolation and depression
• Promotes short-term appetite and willingness to eat
• Improves sleep
• Makes the body more comfortable
• Enhances physical function and mobility
• Supports skin health
• Aids communication and environmental awareness
• Improves short-term behaviour (even during medical procedures)
• Provides non-verbal connection and emotional bonding
• Can reduce the need for medications/restraints
• May enhance medication delivery
• Mitigates negative effects of institutionalization
• Educates caregivers in effective touch techniques
• Supports caregiver well-being
• May slow cognitive decline in the long-term
Why is massage therapy especially valuable in Alzheimer’s care according to Cynthia Bologna?
Because it uniquely addresses both emotional and physical needs, building rapport, and creating meaningful connections that enhance quality of life.
