5. Mental Health and Aging

Dementia Worry

• people fear that memory loss could lead to a loss of independence

• older people fear memory loss more than almost any other aging effect

Dramatic decline in mental functioning are not due to normal aging

What are they due to?

Due to physiological disorders or distress

Memory

The recall of information after learning has taken place

Information-Processing Model:

Sensory Memory

Perception of information

Information-Processing Model:

Short-Term Memory

Person acts on this information and stores it while it is being processed for a short time afterwards

Information-Processing Model:

Long-Term Memory

Storehouse of knowledge that also includes the rules of organizing said knowledge

Non-Episodic Memory

• info with no reference to the time at which it was acquired

• decline occurs less/ not at all here

• i.e. general knowledge of the world

Episodic Memory

• memory acquired at a specific time and place

• decline shows more significantly here

• i.e. recollection of a vacation

Encoding

The process where a person puts new bits of information together with already stored information

Work put into encoding (making meaning from random words) leads to better ______

Response at recall

Working Memory

• stores and manipulates recent information

• older people show deficits here

• guides “ongoing behaviour, intended actions, and long-term plans”

Reported losses of ___ in the brain

Grey and white matter

What does loss in grey matter cause?

Reduced performance on “frontally mediated executive tasks”

What does loss in white matter cause?

Decline in cognitive performance and decreased speed of episodic memory retrieval — supports the idea that a loss of brain structure leads to declines in mental function

MRI Technology

• used to conduct tests of the relationships between age changes in behaviour and brain changes during normal and pathological aging

• allows for non-invasive study of the brain (changes in blood flow and O2 levels)

What part of the brain declines with age?

Hippocampus

Plasticity

Long-lasting alterations in the brain’s chemistry, grey matter, and structural connectivity in support of behaviour

Neurogenesis

The body not only preserves brain cells, but it can also create new neurons and new neuronal connections at every age

Cognitive Reserve

Original Defintion

Originally referred to people with dementia who performed better than expected in everyday life

Cognitive Reserve:

Stern (2002) - expansion of the original view

The concept of reserve should be extended to encompass variation in healthy individuals’ performance, particularly when they must perform at their maximum capacity

4 Patterns of Psychological Aging:

Successful Aging

• small subgroup of older people, often with socioeconomic/ genetic advantage

• continue developing throughout life

• maintain a high level of mental function until shortly before death

4 Patterns of Psychological Aging:

Normal Aging

• mental peak in early mid-life and maintain abilities until 50-60s

• modest decline in 80s to steeper decline just before death

4 Patterns of Psychological Aging:

Mild Cognitive Impairment

• in early old age, people begin to experience greater than normal mental decline

• some may develop dementia, but not all

4 Patterns of Psychological Aging:

Dementia

• dramatic decline in mental function

• physical cause (brain leisons or disease)

• Alzheimer’s disease is the most common cause of dementia

Stereotype Threat

Older person’s fear of failure on memory tests leads to poor performance

How well do the results of memory research predict an older person’s ability to remember details in everyday life?

Not very well

Memory studies done under lab conditions have poor ecological validity (transferability of knowledge from lab to life)

The Contextual Approach:

Contextual View of Memory

The idea that many conditions influence memory, including physical, psychological, and social contexts and knowledge, abilities, and characteristics of the individual, as well as the situation in which the individual is asked to remember

The Contextual Approach:

Semantic Memory

• facts and information we have stored in memory

• shows little decline with age

The Contextual Approach:

Episodic Memory

• refers to memory acquired at a specific time and place

• shows greater decline with age

Semantic vs. Episodic Memory:

Which one shows more decline with age?

Episodic memory

Strandberg (2019):

Aerobic exercise leads to ______

• increased grey and white matter in the brain

• improved executive function (planning, decision making)

Voss (2018):

___ minutes a week of moderate aerobic activity benefits mental performance

150 minutes

Executive Function

Higher order thinking (decision making)

Cognitive Control

More complex thinking (making choices among items)

Intelligence:

Global vs. Pragmatic View

Global: ability to negotiate environmental demands successfully

Pragmatic: that which intelligence tests measure — what a person taking a test can do now

Intelligence:

Fluid

• reasoning, abstracting, concept formation, and problem solving

• things learned in school, performance testing

Intelligence:

Crystallized

• use of stored information, acculturation, and learning

• verbal tests (vocab or historical events)

Functional Disorders

• interfere with how a person functions (paranoia, anxiety, neurosis, schizophrenia)

• no clear organic cause, some people suffer throughout all life

Organic Brain Disorders:

Intellectual Disability

• disorders that lead to limited mental capacity and problems with daily activities such as managing money and social interaction

• begins before age 18 — often comes from a physical cause (autism, cerebral palsy)

Organic Brain Disorders:

Developmental Disability

• effects of diseases such as Down syndrome

• usually begin at birth and affect a person’s function throughout whole life

Causes of Dementia

• variety of illnesses lead to dementia in old age

• decreased blood supply after stroke = vascular dementia (memory loss, confusion, mood changes)

• Alzheimer’s disease (about 63% of dementia cases)

What is the leading cause of dementia?

Alzheimer’s disease

Stages of Decline in Alzheimer’s Disease:

First Stage

• showing changes in memory

• forgetting keys, wallet, etc.

• forgetting recent events

• forgetfulness gets worse over time

Stages of Decline in Alzheimer’s Disease:

Second Stage

• memory decline

• loss of speaking ability

• end to normal daily activity

• loss of bladder/ bowel control

• threatening others

Stages of Decline in Alzheimer’s Disease:

Third Stage

• institutionalization and 24-hour nursing care

• no speaking/ communication

• constant movement

• seizures are a possibility

• death ensues (2-19 years after initial diagnosis)

The 3 Ds of Psychological Distress

1) delirium

2) depression

3) diagnose

Depression

• the most prevalent psychiatric disorder in the older population

• 44% of older people in long-term care home have this diagnosis

• risk of depression decreases in later life (but many cases still exist)

Stages of Decline in Alzheimer’s Disease:

Stage 1

• changes in memory (forgetfulness, etc.)

• forgetfulness will worsen over time

Stages of Decline in Alzheimer’s Disease:

Stage 2

• memory decline

• loss of speaking ability

• end to normal daily activity

• loss of bowel control

• threatening others

• caregivers can feel additional stress in this stage

Stages of Decline in Alzheimer’s Disease:

Stage 3

• institutionalization

• person can no longer speak/ communicate

• wandering

• seizures are possible

• death between 2-19 years of initial diagnosis

Where does death associated with Alzheimer’s disease often come from?

• pneumonia or heart disease

• death rarely mentions Alzheimer’s disease as the cause