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Changes in the Cognitive System

This is an excerpt from FallProof! 3rd Edition With HKPropel Access by Debra J Rose,Elizabeth White.

Similarly to age-related declines in the sensory and motor systems, age-associated changes in the cognitive system can adversely affect older adults’ balance and mobility. At least 10 percent of all people older than 65 years and 50 percent of those older than 80 years have some form of cognitive impairment, ranging from mild deficits to dementia (Yaffe et al., 2001). According to Murman (2015), age-related changes in cognition are most apparent when performing decision-making tasks that require the rapid processing and transformation of information, working memory, executive cognitive function, and speed of processing. Age-associated declines may also be evident when older adults are required to perform complex attentional tasks that require sustained attention (Vallesi et al., 2021) or divided attention (Lezak et al., 2012).

Vallesi and colleagues (2021) found that when compared to young adults, healthy older adults exhibited a decline in the ability to maintain their attentional focus when performing a response task requiring sustained attention. Differences in speed of processing were evident between the age groups, with older adults demonstrating longer reaction times. However, greater response accuracy was demonstrated by the older adults. Based on these results, Vallesi and colleagues suggested that older adults may adopt a prudent strategy when performing these types of tasks—that of trading speed for accuracy.

The results of some of the earliest studies to investigate whether aging influences an individual’s ability to divide attention between multiple tasks demonstrated clear age-associated differences that became more pronounced as task complexity increased (Bernard-Demanze et al., 2009; Shumway-Cook et al., 2007; Shumway-Cook & Woollacott, 2000). The requirement to divide attention between tasks, particularly when one of the tasks involves balance, is even more problematic when older adults with known balance impairments are compared with healthy younger and older adults (Brauer et al., 2002; Shumway-Cook et al., 1997).

Although age-associated changes are evident across a number of important cognitive functions, it is important to understand that older adults, even those with the same level of brain pathology, differ in their resilience to age-related cognitive decline. The theoretical concept of cognitive reserve posits that older adults can rely on cognitive abilities built over the course of the lifespan to recruit protective mechanisms that will allow them to compensate for changes in cognitive pathology. The theory further suggests that cognitive reserve can be enhanced through exercise, education, cognitively stimulating occupations or activities, and participation in social and other stimulating activities (Evans et al., 2018).

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KEY POINT

Problems with dividing attention between tasks, particularly when one of the tasks involves balance, are even more apparent when older adults with known balance impairments are compared with healthy younger and older adults.

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KEY POINT

Cognitive reserve can be enhanced through exercise, education, cognitively stimulating occupations or activities, and participation in social and other stimulating activities.

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