Aging - Notes 2024 PDF

Aging Natalie Denburg PSY:2930  Normal and Pathological Aging At what age is someone an “older adult”? What makes someone “old”? Do you associate getting older as a positive or negative thing, and why? How are you grandparents aging? -Do they seem happy? -Do they seem worried...

Aging Natalie Denburg PSY:2930  Normal and Pathological Aging At what age is someone an “older adult”? What makes someone “old”? Do you associate getting older as a positive or negative thing, and why? How are you grandparents aging? -Do they seem happy? -Do they seem worried or otherwise negative in their affect? -Any evidence of dementia (significant cognitive loss)  Old Age Statistics Defined by society Everyone over 65 years 36 million people are ‘old’ in the US 12% of the population Currently on the rise, with a projection of 20% by 2030 Over 85 is the fastest growing population Women : Men = 3 : 2  Maximum Lifespan Jeanne Calment - 122 years old Smoked: 21 years old (1896) to 117 years old -2 cigarettes/day Poured olive oil on all of her food and skin Drank 2 glasses of port per week Ate one kilo of chocolate per week An Impressive Graph Iowa Older Adult Demographics Cognitive Changes in Normal Aging Overall, the changes are mild. There is slowed speed of processing. Novel tasks may be more difficult. Recalling names can be particularly difficult. *Often referred to as benign senescent forgetfulness or age-associated memory impairment  The “Paradox of Aging” Well-being increases with age https://www.youtube.com/watch?v=7gkdzkVbuVA Hartshorne & Germine (2015) Socioemotional Selectivity Theory (Carstensen & colleagues) Motivational theory: suggests that secondary to an understanding of constraints on life longevity, older adults alter their strategies for emotional regulation. Older adults focus on and demonstrate a bias towards positively- valenced material. Data from several cognitive domains supports this theory (memory, attention, decision making). Positivity Bias: Emotional Memory (Denburg et al., 2003)  Older Adults Catch Up To Younger Adults on a Learning and Memory Task that Involves Collaborative Social Interaction Derksen, Duff, Weldon, Zhang, Zamba, Tranel, & Denburg 2014 Barrier Task Example 1: Trial 1 Example 2: Trial 9  Conclusions and Importance of Research Our study demonstrates that older adults are capable of learning and retaining new information, on par with younger adults, when the task involves collaborative, social interaction. The BT approximates real-world communication (e.g., interaction with familiar partners across multiple days, free-flowing conversation, use of facial expressions, gestures) and encourages participants to problem-solve collaboratively. Practical significance: to teach older adults in milieus that emphasize collaborative social interactions, rather than rote, verbatim learning.  Normal Aging of the Brain Aging ≠ Dementia Increased age is primary risk factor for dementia. Starting ~age 65 (5% prevalence); prevalence doubles in each decade (10% at age 75);is about 17% by 85 years of age. (It levels off after ~age 85.) Normal” aging is associated with variable degrees of cognitive weakness, cortical atrophy, accumulation of Alzheimer-type pathology, and reduced cerebral blood flow. Cognitive Reserve Multiple studies have Individuals with higher identified Alzheimer’s cognitive reserve make disease neuropathology more efficient use of in the brain of high- the brain’s resources in functioning individuals the presence of who have never pathology. exhibited Alzheimer’s disease symptomatology (SantaCruz et al., 2011).  Mild Cognitive Impairment Amnesic MCI is the transitional stage of cognitive impairment preceding Alzheimer’s dementia Characterized by subjective and objective memory problems, but otherwise intact cognition and daily activities (ADLs) MCI progresses to dementia at a rate of approximately 15-20% per year. Cumulative rate of AD about 80% by 6 years Theoretical Progression of MCI to AD (Petersen et al., 2001)  Dementia Refers to acquired impairments in multiple aspects of cognition (e.g., memory, language, problem-solving). The impairments must be severe enough to interfere with normal activities. Dementia is not a specific disease; rather, it reflects the consequences of several diseases. AD comprises the majority.  Warning Signs of Dementia Memory loss that affects normal activities. Excessive word finding problems. Difficulty performing familiar tasks. Disorientation to time or place. Changes in mood, behavior, personality. Poor judgment and decision-making.  Common Causes of Dementia Alzheimer’s disease Vascular disease Parkinson’s disease Pick’s disease Medication side effects* Depression* Alcohol/Drugs* Brain tumors* Hydrocephalus* Young Onset vs. Late Onset Dementia (van der Flier & Scheltens, 2005)  Alzheimer’s Disease An age-related, irreversible brain disorder that develops gradually and results in memory loss, decline in thinking abilities, and changes in behavior and personality. These deficits and changes are due to the breakdown and death of brain cells.  Neurofibrillary Tangles Twisted protein fibers (tau) found within cells Causes abnormal neuronal functioning TOMBSTONE CELLS  Neuritic (senile) Plaques Deposits of beta-amyloid protein that form in spaces between cells Interfere with communication between cells Without communication neurons breakdown or die BRIEF VIDEO Patient with Alzheimer’s disease Neuronal Death The brain on the left is from a patient with AD.  Treating Alzheimer’s (or any other dementia) Current treatments slow decline but do not stop the brain degeneration No treatment has been proven to arrest, reverse or prevent Alzheimer’s disease New pharmaceutical development usually takes 10-15 years and costs $800 million Forms of Long-Term Memory Declarative: memory for facts and events (e.g., repeating what you read in the newspaper this morning) Anterograde: learning and memory formation of new material (Retrograde: recall of previously acquired memories) Procedural: memory for a behavioral response (e.g., bike riding) Word List Learning and Recall in Alzheimer’s Disease 10 9 8 7 6 5 Alzheimer 4 Controls 3 2 1 0 trial 1 trial 2 trial 3 trial 4 trial 5 delay  Rotor Pursuit Mirror Tracing Rotor Pursuit in Alzheimer’s Disease 14 12 10 8 Alzheimer 6 Controls 4 2 0 trial 1 trial 2 trial 3 trial 4 trial 5 delay Long-Term Memory Long-Term Memory, cont.  Procedural Memory Involves a behavioral response, not conscious recall Learned through repeated exposure or practice Preserved in amnesia and Alzheimer’s disease Based on different brain structures than declarative memory Progressive muscle relaxation (PMR) in the management of behavioral (non-cognitive) disturbances in Alzheimer’s disease _____________________________________ 34 patients with DAT (mild to moderate dementia) and their spouses (75 y/o and 15 years education, on average) Randomized to PMR or control treatment (imagery) 5 training sessions and 38 home practice sessions over 5 weeks Significant improvement for PMR group in frequency of caregiver-rated behavioral problems (anger outbursts, wandering, fidgeting, anxiety symptoms; 17.2 v. 30.8) AND neuropsychological performance (COWAT: 34.2 v. 21.8) J. Suhr, S.W. Anderson, D. Tranel (1999) Neuropsychological Rehabilitation. Evidence for the Will a mood sustained persist once experience of the memory for what emotion beyond declarative memory in induced the mood has amnesia disappeared??? Feinstein et al. (2010) An Empirical Question Test a group of patients with severe anterograde amnesia Induce a mood that can be sufficiently sustained and measured for ~10-15 minutes  Timeline of the Experiment (2 inductions: Positive/Amusement and Negative/Sadness) Feinstein J S et al. PNAS 2010;107:7674-7679 ©2010 by National Academy of Sciences  Recollection of film clips and postfilm emotion ratings following the sadness induction. Feinstein J S et al. PNAS 2010;107:7674-7679 ©2010 by National Academy of Sciences  Recollection of film clips and postfilm emotion ratings following the happiness induction. Recollection of film clips and postfilm emotion ratings following the amusement induction. Feinstein J S et al. PNAS 2010;107:7674-7679 ©2010 by National Academy of Sciences  Conclusions Each mood induction (sadness, amusement) elicited the appropriate mood for well over 15 minutes In patients with severe amnesia, the mood endured beyond their ability to consciously recall the preceding film clips Direct evidence that neither normal declarative memory nor an intact hippocampus are necessary for the sustained experience of emotion Important clinical implications for how society treats patients with memory impairments