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How can we work with and around aging-related cognitive decline?
Roey
Posts: 160 XPRIZE
Hi everyone,
We have a very interesting (though a bit depressing) obstacle here: aging-related cognitive decline. Would love to know what you think of it, and how you think we can work with and around the obstacle.
Summary
The normal aging process is accompanied by some cognitive decline in areas and skills that include processing speed, motor responses, attention span, memory, and mental flexibility. This phenomenon can have an impact on the employment potential of the elderly, and affect their self-confidence.
Description
While there is much focus on neurodegenerative diseases like Alzheimer’s, an inevitable side-effect of aging (so far, at least) is that it is accompanied by a cognitive decline. In other words, even elderly folks who do not suffer from dementia or some other severe form of cognitive mental impairment, will still experience some changes to their cognitive capacity.
Not all cognitive abilities diminish with aging. Some, skills and abilities - especially ones that are well-practiced and well-known to the individual, like vocabulary or language - may actually improve with age. However, fluid cognitive abilities are subject to a significant decline.
These include:
It should be noted that not all elderly folks experience the same level or extent of cognitive decline, as there is great variability between individuals in this respect.
Impact
Age-related cognitive decline means that some common activities, like driving, are more difficult and pose more risk to the average elderly person.
Additionally, the cognitive decline may make it more difficult for the elderly to perform well in their workplace. Many elderly people in South Korea, Mexico, Japan, Switzerland and Turkey, choose to retire before the official pension age - possibly because of the cognitive decline they experience, and which may hinder them at work.
Additionally, workers in some professions in the U.S., like pilots and (in some states) judges, are required to retire upon reaching a certain age, mainly because of aging-related cognitive decline which could influence the individual’s ability of performing the task safely.
User Groups
While cognitive decline often starts at the third decade of life, its impact peaks towards the seventh decade or later. Therefore the user groups that suffer the most because of the consequences of cognitive decline are people aged 60+.
Difficulties
It is generally difficult to deal even with abnormal cognitive decline, caused by neurodegenerative diseases and strokes. Normal cognitive decline is not as insidious or devastating as Alzheimer’s disease or severe dementia, and thus is perceived as part of the normal aging process, which does not require treatment. Furthermore, the causes of cognitive decline are not yet well-understood.
We have a very interesting (though a bit depressing) obstacle here: aging-related cognitive decline. Would love to know what you think of it, and how you think we can work with and around the obstacle.
Summary
The normal aging process is accompanied by some cognitive decline in areas and skills that include processing speed, motor responses, attention span, memory, and mental flexibility. This phenomenon can have an impact on the employment potential of the elderly, and affect their self-confidence.
Description
While there is much focus on neurodegenerative diseases like Alzheimer’s, an inevitable side-effect of aging (so far, at least) is that it is accompanied by a cognitive decline. In other words, even elderly folks who do not suffer from dementia or some other severe form of cognitive mental impairment, will still experience some changes to their cognitive capacity.
Not all cognitive abilities diminish with aging. Some, skills and abilities - especially ones that are well-practiced and well-known to the individual, like vocabulary or language - may actually improve with age. However, fluid cognitive abilities are subject to a significant decline.
These include:
- Processing speed and speed of motor responses, which start to decline in the 30s, and are critical for driving and personal interactions;
- Selective attention, which indicates a person’s ability to concentrate on certain occurrences while filtering out irrelevant information, and which is critical for driving a car.
- Working memory, which indicates a person’s capacity to hold certain ideas in mind for a short duration. Elderly people with a decline in working memory can have difficulty performing mental calculations or working with long strings of numbers.
- Memory acquisition, encoding and retrieval, which can impact learning.
- Visual construction skills, which indicate a person’s ability to assemble parts together - for example, when assembling an Ikea piece of furniture.
- Mental flexibility, which declines significantly at the seventh decade of life.
- Response inhibition, which indicates one’s ability to consider an alternative and novel response to new stimuli, instead of repeating an old behavioral pattern.
It should be noted that not all elderly folks experience the same level or extent of cognitive decline, as there is great variability between individuals in this respect.
Impact
Age-related cognitive decline means that some common activities, like driving, are more difficult and pose more risk to the average elderly person.
Additionally, the cognitive decline may make it more difficult for the elderly to perform well in their workplace. Many elderly people in South Korea, Mexico, Japan, Switzerland and Turkey, choose to retire before the official pension age - possibly because of the cognitive decline they experience, and which may hinder them at work.
Additionally, workers in some professions in the U.S., like pilots and (in some states) judges, are required to retire upon reaching a certain age, mainly because of aging-related cognitive decline which could influence the individual’s ability of performing the task safely.
User Groups
While cognitive decline often starts at the third decade of life, its impact peaks towards the seventh decade or later. Therefore the user groups that suffer the most because of the consequences of cognitive decline are people aged 60+.
Difficulties
It is generally difficult to deal even with abnormal cognitive decline, caused by neurodegenerative diseases and strokes. Normal cognitive decline is not as insidious or devastating as Alzheimer’s disease or severe dementia, and thus is perceived as part of the normal aging process, which does not require treatment. Furthermore, the causes of cognitive decline are not yet well-understood.
2
Comments
That doesn't seem too unreasonable, for the reasons you've outlined, but people are still assessed on an individual basis and that is the fair thing to do.
As the population ages, policies that do not discriminate -- for example, mandatory retirement for all pilots at 60 or 65 -- may become unsustainable.
That's great. Thanks for the information. I definitely agree with your thinking on the issue.
Antibody removes Alzheimer's plaques, in mice: Potential therapy removes APOE and plaques from brain
https://www.sciencedaily.com/releases/2018/03/180326161000.htm
Plaques of a brain protein called amyloid beta are a characteristic sign of Alzheimer's disease. But nestled within the plaques are small amounts of another Alzheimer's protein: APOE. Now, researchers have shown that an antibody not only targets APOE for removal but sweeps away plaques in mice. The findings could lead to a way to halt the brain damage triggered by amyloid plaques while the disease is still in its early stages, perhaps before symptoms appear.
And thanks for the heads-up on the bacteria. I'll add that to the potential remedies list we're creating, and we'll delve into it more deeply in a few weeks, when we reach the remedy analysis stage.
The current rate of failure of new drugs to treat AD (Alzheimer Disease) is a clear indication to the lack of understanding of the underlying mechanisms and/or root causes.
I absolutely agree with your approach. Let's hope AI can come up with better models for metabolic processes and intertissue communication than the ones we have today.
http://blog.scienceopen.com/2017/08/scienceopen-interview-series-prof-george-perry/
Thanks! Are you also involved in the XPRIZE Alzheimer Prize Design ?
The work of Dr. Dale Bredesen is one of the most important one around reversing dementia and Alzheimer's, in my opinion. He identified 36 factors including lifestyle, micronutrients and many more which can reverse AD in patients. See https://www.ahnphealth.com/dr-bredesen.html Still early but very promising.
Finally, we need to study the root causes of brain dysfunction, on a physical level. Are environmental toxins partially to blame? Accumulation of waste, biological debris and heavy metals? What about the brain's main clearance system called the glymphatic system, which has been discovered in 2015 and might be underworking and preventing normal brain detoxification?
A lot more science needs to be done about root causes, although an approach which clears out brain plaque might also be a good idea.
I think that we need to get away from the very myopic view that one drug will fix all of our problems. Dr. Dale Bredesen's approach and doctors who practice functional medicine are getting closer to a real "cure" to Alzheimer's than pharmaceutical approaches.
On Bredesen's approach, my understanding is that it is based on good science but is not scientifically proven! We donot know whether Bredesen's approach works and if it does, it is better than other approaches! So far we have only seen anecdotal evidence for it that may not prove much!