Cognitive Changes In Aging Research Articles

Mild Cognitive Impairment Should Be Considered for DSM-V

Mild cognitive impairment is a topic of great activity from both clinical and research perspectives. It represents a transitional state between the cognitive changes of aging and the earliest clinical manifestations of dementia. We present a case for its inclusion in the Diagnostic and Statistical Manual of Mental Disorders (5th ed; DSM-V) based on clinical, outcome, epidemiological, neuroimaging, and pathophysiological data. The strongest case for inclusion can be made for the amnestic subtype, which is likely a clinical precursor of Alzheimer's disease. Arguments are presented as to why mild cognitive impairment can be considered as an entity distinct from normal aging and from clinically probable Alzheimer's disease and why it deserves consideration as a separate construct. In many respects, mild cognitive impairment fulfills criteria for inclusion more adequately than many other conditions currently codified in DSM-IV. Future research directions to help clarify some of the remaining uncertainties are proposed.

Mild Cognitive Impairment: Is it Alzheimer's disease or Not?

In this discussion, the status of mild cognitive impairment (MCI) will be addressed from several perspectives. While some investigators maintain that MCI or its equivalent states actually represent fully developed Alzheimer’s disease (AD), others suggest that there must be an intermediate stage between the cognitive changes of aging and the very earliest manifestations of AD. Since AD is a degenerative disorder, by definition, it likely evolves over a period of months to years, or perhaps even longer. As such, there must be a prodromal state during which some of the clinical features of the disease are manifested but the fully developed syndrome is not present. Even if these mild features turn out to be related to neuritic plaques and neurofibrillary tangles, by current definitions, these persons do not yet meet accepted criteria for AD. We will address this topic from several different perspectives: clinical, neuroimaging, biomarkers, and neuropathology. We contend that this transitional state exists and the several lines of evidence demonstrated in the literature are consistent with this position.

Written language clues to cognitive changes of aging: an analysis of the letters of King James VI/I.

Reductions in language complexity normally occur in older adults because of decreased working memory and rate of language processing. Comparative measures can reveal whether linguistic change is due to normal aging or dementia. Linguistic analysis of a series of letters of King James, 1566-1625, investigate whether he exhibited a normative or atypical pattern of change. Fifty-seven letters from the years 1604 to 1624 were analyzed. Data modeling reveals a quadratic pattern of decline in written language complexity with increased diversity of vocabulary corresponding to historical reports of illness around 1618-1619. This investigation demonstrates how language analysis can provide valuable insight to normal and pathological cognitive changes of aging as well as to the understanding of historical figures.

Design of institutions: cognitive functioning and social interactions of the aged resident.

Older people experience sensory, cognitive, and social deficits that adversely affect their interaction with the environment. Design of institutions for the elderly resident should be prosthetic to ensure that environments optimally accommodate the functioning of the residents. The sensory and cognitive state of the residents should be considered in every facility. This review discusses how sensory and cognitive changes in aging affect orientation and wayfinding as well as how the physical aspects of the environment can accommodate these changes to reduce confusion and disorientation. Environmental features that promote social interaction are reviewed. Because the environmental needs and unique characteristics of the cognitively impaired resident differs from that of the nonimpaired resident, special issues in the design of facilities for demented residents are reviewed. Conclusions are offered with regard to research needs and applied problems.