Question

I need an outline in APA format for Cognitive Decline and Aging.

The format is as follows:

I. Introduction

II. Body: Main points and articles you will use to support your point

1. Main Point 1

a. minor point b.

minor point

2. Main Point 2

a. minor point

b. minor point

ETC.

Answer 1

1. Introduction:

2. Body:

The normal aging process is associated with declines in certain cognitive abilities, such as processing speed and certain memory, language, visuospatial, and executive function abilities.

While these declines are not yet well understood, promising developments in neurology research have identified declines in grey and white matter volume, changes in white matter, and declines in neurotransmitter levels that all may contribute to observed cognitive changes with aging.

These changes are small and should not result in impairment in function, nonetheless, driving and certain other activities may be compromised, and it is important to detect safety issues early.

Participation in certain activities, building cognitive reserve, and engaging in cognitive retraining may all be approaches to achieving successful cognitive aging.

While research in the area of normal cognitive aging may seem less pressing than research in the area of pathologic brain disease, a more complete understanding of normal brain aging may shed light on abnormal brain processes.

The majority of adults over the age of 65 will not develop dementia or MCI, and more work is needed to better understand how we can maximize cognitive function and quality of life for these individuals.

Summary of Neurocognitive Changes with Age

	Crystallized vs. Fluid	Declines with age?
Processing speed	Fluid	Yes
Attention	Fluid	Simple tasks- no Complex tasks- yes
Memory	Fluid	Mixed
Language	Crystallized > Fluid	In general- no Visual confrontation naming, verbal fluency- yes
Visuospatial	Mixed	Simple tasks- no Complex tasks- yes
Executive Function	Fluid	Mixed

Memory and Aging

Declines with age	Remains stable with age
Delayed free recall: spontaneous retrieval of information from memory without a cue24,25 Example: Recalling a list of items to purchase at the grocery store without a cue	Recognition memory: ability to retrieve information when given a cue Example: Correctly giving the details of a story when given yes/no questions
Source memory: knowing the source of the learned information Example: Remembering if you learned a fact because you saw it on television, read it in the newspaper, or heard it from a friend	Temporal order memory: memory for the correct time or sequence of past events Example: Remembering that last Saturday you went to the grocery store after you ate lunch with your friends
Prospective memory: remembering to perform intended actions in the future26 Example: Remembering to take medicine before going to bed	Procedural memory: memory of how to do things Example: Remembering how to ride a bike

METHODOLOGICAL ISSUES WITH STUDIES OF BRAIN AGING

Before discussing normal age-related changes, it is necessary to mention a few common methodological challenges that plague the study of normal brain aging. As with all studies of aging, selection bias is a challenge- many potential study participants decline enrollment because they are either too healthy (and busy) or too ill. Additionally, people with limited social or financial support and functional limitations may be less likely to enroll in studies.3 This results in study findings that may not be generalizable to all older adults.

Because results can be generated more quickly, most studies rely on cross-sectional design, comparing subjects from different age groups. These studies, however, are subject to confounding due to cohort differences. A cohort that was born in the 1920’s had a very different life experience than a cohort born in the 1980’s. These cohorts may differ greatly in terms of culture, lifestyle, education, and requirements for success in life. Subjects from one age cohort may perform very poorly on any given cognitive or neurological test compared to subjects from a different age cohort irrespective of cognitive capacity, simply because of vastly different life experiences and skill sets. Cohort differences can confound cross-sectional studies by potentially overestimating effects of aging.

Longitudinal studies are likely better, but these studies also are subject to bias. Study populations will undergo attrition over time, and since those subjects who are most likely to remain in the study tend to be the healthiest, best educated, wealthiest, and have the highest scores on cognitive tests at baseline, the study findings may cease to represent the original study group. Longitudinal studies of cognition also are subject to practice effects: because subjects are required to repeat the same tests multiple times, they may be able to improve or maintain their test scores in spite of a cognitive decline.

Finally, studies of “normal” aging can be complicated when subjects are misdiagnosed as cognitively normal during study enrollment or when subjects develop cognitive impairment during the course of the study. This is a concerning problem because dementia onset tends to be insidious, and early symptoms can be easily missed.

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NEUROCOGNITIVE CHANGES IN AGING

Cognitive change as a normal process of aging has been well documented in the scientific literature. Some cognitive abilities, such as vocabulary, are resilient to brain aging and may even improve with age. Other abilities, such as conceptual reasoning, memory, and processing speed, decline gradually over time. There is significant heterogeneity among older adults in the rate of decline in some abilities, such as measures of perceptual reasoning and processing speed. We will provide a current, brief overview of the neuropsychology of normal cognitive aging. Interested readers are directed to other sources for a more comprehensive review of this topic.

Crystallized and Fluid Intelligence

Concepts of crystallized and fluid intelligence are used to describe patterns of cognitive change over the lifespan. Crystallized intelligence refers to skills, ability, and knowledge that is overlearned, well-practiced, and familiar.4 Vocabulary and general knowledge are examples of crystallized abilities. Crystallized abilities remain stable or gradually improve at a rate of 0.02 to 0.003 standard deviations per year through the sixth and seventh decades of life. Because crystallized intelligence is due to accumulation of information based on one’s life experiences, older adults tend to perform better at tasks requiring this type of intelligence when compared to younger adults. In contrast, fluid intelligence refers to abilities involving problem-solving and reasoning about things that are less familiar and are independent of what one has learned. Fluid cognition includes a person’s innate ability to process and learn new information, solve problems, and attend to and manipulate one’s environment. Executive function, processing speed, memory, and psychomotor ability are considered fluid cognitive domains. Many fluid cognitive abilities, especially psychomotor ability and processing speed, peak in the third decade of life and then decline at an estimated rate of −0.02 standard deviations per year.13

Cognitive ability can be divided into specific cognitive domains. We will discuss processing speed, attention, memory, language, visuospatial abilities, and executive functioning/reasoning.

Processing speed

Processing speed refers to the speed with which cognitive activities are performed as well as the speed of motor responses. This fluid ability begins to decline in the third decade of life and continues throughout the lifespan. Many of the cognitive changes reported in healthy older adults are the result of slowed processing speed. This “slowing” can negatively impact performance on many neuropsychological tests designed to measure other cognitive domains (e.g., verbal fluency). Thus, a decline in processing speed can have implications across a variety of cognitive domains.

Attention

Attention refers to the ability to concentrate and focus on specific stimuli. Simple auditory attention span (also known as immediate memory) as measured by repetition of a string of digits shows only a slight decline in late life. A more noticeable age effect is seen on more complex attention tasks, such as selective and divided attention. Selective attention is the ability to focus on specific information in the environment while ignoring irrelevant information. Selective attention is important for tasks such as engaging in a conversation in a noisy environment or driving a car. Divided attention is the ability to focus on multiple tasks simultaneously, such as talking on the phone while preparing a meal. Older adults also perform worse than younger adults on tasks involving working memory which refers to the ability to momentarily hold information in memory while simultaneously manipulating that information. For example, older adults may have difficulty ordering a string of letters and numbers in the correct alphanumerical sequence or calculating a tip on a restaurant bill.

Memory

One of the most common cognitive complaints among older adults is change in memory. Indeed, as a group older adults do not perform as well as younger adults on a variety of learning and memory tests. Age-related memory changes may be related to slowed processing speed18, reduced ability to ignore irrelevant information and decreased use of strategies to improve learning and memory.

Two major types of memory are declarative and nondeclarative memory. Declarative (explicit) memory is conscious recollection of facts and events. Two types of declarative memory include semantic memory and episodic memory. Semantic memory involves fund of information, language usage, and practical knowledge, for example, knowing the meaning of words. Episodic memory (also known as autobiographical memory) is memory for personally experienced events that occur at a specific place and time. It can be measured by memory of stories, word lists, or figures. While declines in semantic and episodic memory occur with normal aging, the timing of these declines is different. Episodic memory shows lifelong declines while semantic memory shows late life decline.

Nondeclarative (implicit) memory is the other major type of memory. This type of memory is outside of a person’s awareness. An example of implicit memory is remembering how to sing a familiar song, such as “Happy Birthday.” Procedural memory is a type of nondeclarative memory and involves memory for motor and cognitive skills. Examples of procedural memory include remembering how to tie a shoe and how to ride a bicycle. Unlike declarative memory, nondeclarative memory remains unchanged across the lifespan.

Memory can also be broken down into different stages. Acquisition is the ability to encode new information into memory. Rate of acquisition declines across the lifespan. However, retention of information that is successfully learned is preserved in cognitively healthy older adults. Declines also occur in memory retrieval, which is the ability to access newly learned information.

Language

Language is a complex cognitive domain composed of both crystallized and fluid cognitive abilities. Overall language ability remains intact with aging. Vocabulary remains stable and even improves over time. A few exceptions to the general trend of stability with age are worth mentioning. Visual confrontation naming, or the ability to see a common object and name it, remains about the same until age 70, and then declines in subsequent years. Verbal fluency, which is the ability to perform a word search and generate words for a certain category (e.g., letters, animal names) in a certain amount of time, also shows decline with aging.

Visuospatial Abilities/Construction

This group of cognitive functions involves the ability to understand space in two and three dimensions. Visual construction skills, which involves the ability to put together individual parts to make a coherent whole (for example, assembling furniture from a box of parts) declines over time. In contrast, visuospatial abilities remain intact. These abilities include object perception, the ability to recognize familiar objects such as household items or faces, and spatial perception, the ability to appreciate the physical location of objects either alone or in relation to other objects.

Executive Functioning

Executive functioning refers to capacities that allow a person to successfully engage in independent, appropriate, purposive, and self-serving behavior. This includes a wide range of cognitive abilities such as the ability to self-monitor, plan, organize, reason, be mentally flexible, and problem-solve. Research has shown that concept formation, abstraction, and mental flexibility decline with age, especially after age 70 , as older adults tend to think more concretely than younger adults. Aging also negatively affects response inhibition, which is the ability to inhibit an automatic response in favor of producing a novel response. Executive abilities requiring a speeded motor component are particularly susceptible to age effects. The Whitehall II study also found declines in inductive reasoning, as measured by verbal and mathematic reasoning tasks, beginning around age Reasoning with unfamiliar material also declines with age. Other types of executive function, such as the ability to appreciate similarities, describe the meaning of proverbs, and reason about familiar material, remain stable throughout life.

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STRUCTURAL AND FUNCTIONAL BRAIN CHANGES WITH AGING

Promising developments in neuroscience research may help to explain observed age-related cognitive changes. Studies vary significantly in design, including study population and variables examined, and more research in this area is needed. In this section we will describe some of the age-related changes that have been identified and present theories for how these changes may relate to neurocognitive aging.

Grey matter volume decline

Grey matter volume begins to decrease after age 20. The amount of atrophy is most prominent in the prefrontal cortex.

Age-related changes in the temporal lobes are more moderate and involve decreases in the volume of the hippocampus. The entorhinal cortex, which serves as a relay center between the hippocampus and association areas, has been reported to undergo early decreases in volume in Alzheimer’s dementia (AD), but not in normal aging.

Possible Causes of Grey Matter Volume Loss in Normal Aging

The death of neurons themselves has been implicated as a possible cause of grey matter volume loss. Neuronal death is particularly detrimental given infrequent cell division and opportunity for mutations to therefore accumulate.

Conclusion:

Aging does cause cognitive decline. It's better to keep one self healthy mentally fit for the cognitive abilities to work better atleast the cognitive decline will happen a little later than normal.