Cognitive and Intellectual Decline

With age, cognitive functions may remain stable or decline. In general, cognitive functions that remain stable include attention span, everyday communication skills, many language skills (eg, syntax), the ability to comprehend discourse, and simple visual perception. Vocabulary can improve even in persons in their 80s. Cognitive functions that decline include selective attention, naming of objects, verbal fluency, complex visuospatial skills, and logical analysis. Learning complex new tasks and foreign languages becomes more difficult with age.

Age-related memory changes vary depending on the type of memory function; the ability to acquire, store, and retrieve new memories may be reduced, whereas the ability to retrieve memories that have been stored and consolidated over long periods remains stable. Reduced memory performance can be improved using adaptive strategies.

Intellectual abilities peak during the 30s, plateau throughout the 50s and 60s, and variably decline during the late 70s. Elderly persons may have difficulty with activities requiring a quick reaction time or high degree of precision, although they maintain the ability to understand their situation and learn from new experiences. Reduced reaction time can be compensated for by allocating more time for tasks.

Depression, anxiety, and other psychiatric disorders can also interfere with cognition. Pseudodementia (eg, depression or psychosis mimicking dementia) is an extreme form of such interference.