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iBSC Health and Illness Across the Lifespan > Session Six (Healthy Ageing) > Flashcards

Session Six (Healthy Ageing) Flashcards

1
Q

What is the effect on healthcare of an ageing population?

A
  • Increased spending on health and social services
  • Multi-morbidity risks
  • Changes in priorities and function of health services
  • Cognitive decline, both normal and abnormal
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2
Q

What can protect against the cognitive decline seen in older age?

A
  • Exercise
  • Healthy diet
  • Brain stimulating exercises
  • Social engagement

Some research has suggested that practicing fluid tasks may help.

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3
Q

What is the main cause of cerebral volume loss in older age?

A

Synapse loss (not neuronal loss)

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4
Q

What is ‘cognition’?

A

A set of different abilities we use every day to process, manage and recall information.

Includes; Attention, Memory, VS abilities, Language abilities, Executive functioning, Processing…

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5
Q

What are the components of ‘Attention’ and how do they change with age?

A
  • Simple attention (e.g. repetition of a string of digits) remains stable as we age.
  • Complex attention (e..g following a conversation in a noisy environment or driving) declines with age
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6
Q

What are the components of ‘Memory’ and how do they change with age?

A
  • Semantic memory (knowing the meaning of words) remains stable as we age, may improve
  • Episodic and autobiographical memory (the memory of personal experiences and events) declines as we age
  • Non-declarative or implicit memory (how to sing a song, ride a bike) remains stable.
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7
Q

What are the components of ‘Visuospatial Abilities’ and how do they change with age?

A
  • VS abilities (recognising familiar objects, identifying the location of an object in space) remains stable as we age
  • Visual construction skills (e.g. assembling an object) declines with age
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8
Q

What are the components of ‘Language’ (as a cognitive ability) and how do they change with age?

A
  • Vocabulary (outright word knowledge) remains stable or increases with age
  • Visual confrontation naming (naming an object in front of you) remains stable
  • Verbal fluency (generating words within a category) declined with age
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9
Q

What are the components of ‘Executive Function’ (as a cognitive ability) and how do they change with age?

A 
Wide range of abilities, hard to separate them.
Includes:
- Planning
- Organising
- Information
- Problem solving
Generally, goal-directed behaviour.

Involved in most other cognitive abilities somehow.

Declines with age

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10
Q

How does Processing Speed change as we age?

A

PS = The speed with which any cognitive ability is performed.

It declines with age.

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11
Q

Give some examples of Cognitive tasks?

A
  • Trail making tasks test the ability to follow a set of stimuli, pay attention and process information. Can be made more complicated by adding a switching component to the task.
  • Rey-Osterrieth complex figure task tests a wide range of abilities such as attention, memory, executive function and VS understanding.
  • Animal naming tests immediate and delayed recall
  • Digit tests can be sued to test short term memory
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12
Q

What is an issue with cognitive function tests?

A

Very hard to test one specific cognitive ability in absentia.

Question as to how useful this is when in reality they all overlap and work together.

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13
Q

Explain the difference between crystallised and fluid cognitive abilities?

A

Crystallised = Stable knowledge, previously accumulated. Things we’ve learned over the course of our lives that remains stable with age and may even improve.
Sometimes considered a PRODUCT of cognition.

Fluid = The ability to flow between tasks, generating and manipulating new information, solving problems etc. Begins to decline once we reach our mid 20s.
Sometimes considered a PROCESS of cognition.

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14
Q

What evidence exists to support the Crystallised vs Fluid model of cognitive ageing?

A

Salthouse (2012):

  • Compared scores across age groups in crossword puzzles and in analytical reasoning tasks
  • Found that as we age, we get worse at AR (which requires fluid abilities) and better at crossword puzzles (which rely on crystallised abilities)
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15
Q

Other than the Crossword vs AR task test, what other research has Salthouse done into cognitive ageing?

A

2010 study into a variety of cognitive abilities (IQ?):

  • Vocabulary increases with age
  • Every other ability falls (Reasoning, Spatial Visualisation, Memory, Speed)
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16
Q

What are the issues with Cognitive Ageing research, such as that performed by Waterhouse?

A
  • Hard to pick stimuli that is truly neutral, likely will have a greater emotional link to one age group over another and therefore create an attention bias.
  • Hard to test generations that likely received very differing levels of education in cognitive areas.
  • Often these tests are done many times over a few months, causing inevitable learning bias that may favour younger people.
  • Commonly see the standard types of bias, such as selection bias, attrition bias, practice effect bias, misclassification bias
  • There is also an IMMENSE degree of individual variation, may account for as much as 64-96% of differences run cognitive scores.
17
Q

What did the Ronnlund study tell us about cognitive ageing studies?

A
  • Looked into why we see a decline in fluid cognition tests with age in cross-sectional studies, but an increase in longitudinal studies.
  • So he did both tests at the same time and compared them.
  • Shows a very strong practice effect in these sorts of studies.
  • Brings into the question the validity of all off this research.
18
Q

Why is selection bias an issue in cognitive research?

A

People more able at cognitive tasks are more likely to volunteer for research.

19
Q

Why is attrition bias an issue in cognitive research?

A

Over the course of a study people will always drop out, and there is always a reason why they drop it. If this reason is shared between participants you introduce an element of bias into the research e.g. poor people may have to drop out due to the time demands of the study.

20
Q

Why is practice effect bias an issue in cognitive research?

A

People’s scores improve the more times they perform the task being studied (issue with longitudinal research)

21
Q

When do we start to think of cognitive changes as abnormal?

A

Functional problems with performing every day activities.

22
Q

What are some potential causes of abnormal cognitive decline with ageing?

A
  • Dementia
  • Delirium
  • Depression, anxiety
  • Thyroid disease
23
Q

What are some clinical assessments used on patients with a suspected cognitive decline?

A
  • Clinical dementia rating
  • Clock drawing test
  • Global deterioration scale
  • MMS
  • IADL used for assessing activities of daily living
24
Q

What changes in the brain are associated with cognitive decline?

A
  • Drop in synaptic density
  • White matter loss (myelin) (begins at around age 70)
  • Dorsolateral PFC tends to experience these changes first therefore tasks associated with this area tend to drop first (last area to develop, associated with executive functioning)

Pathological causes:

  • Strokes
  • Infection
  • Brain Injuries
  • Drugs
  • Alcohol
  • Dementia
25
Q

Outline the finding of the Nun study?

A
  • Looked into the cognitive abilities of a group of very elderly nuns
  • None showed any signs of cognitive decline
  • On biopsy, over a third of their brains showed signs of severe Alzheimer’s, that should have been extremely symptomatic.
  • Suggests that through constant learning, memorisation, study, organisation of church activities and just generally keeping their brain active they may have been able to build up a significant Cognitive Reserve.
  • CR is the theory that as we age we can strengthen and lay down new connections in the brain, and when one area of the brain becomes affected by the disease the others may be able to step in.
  • Promising new area of preventative research for Alzheimer’s.

iBSC Health and Illness Across the Lifespan (12 decks)

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