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cognition (intelligence)

The process of knowing, including awareness, perception, reasoning, remembering, & problem solving. Cognitive domains include: 1) attention 2) language 3) memory 4) visuospatial function 5) executive function Cognitive changes with normal aging: 1) attention: diminished attention, divided & sustained 2) language: a) diminished fluency, word finding & confrontation naming b) vocabulary largely unchanged - vocabulary may increase with advanced age, provided there is opportunity & exposure to new words - increased vocabulary is accompanied by enhanced comprehension [14] 3) memory: a) diminished episodic memory b) diminished working memory [14] c) remote memory generally remains intact [14] d) no change in ability to retain learned information 4) visuospatial function: diminished visuospatial skills 5) executive function a) cognitive processing speed decreases b) abstractions become more concrete neuroprotective benefits of 1) exercise - high-intensity exercise confers benefit [6] - exercise improves cognitive performance in older adults with & without cognitive impairment [10] - aerobic, resistance (strength) training, mind-body exercises, or combinations of benefit [10] - 1 hour 3 times per week [10] 2) healthy diets a) plasma B vitamins (thiamine, riboflavin, vitamin B6, folate, vitamin B12), vitamin C, vitamin D, vitamin E associated with better global cognitive function [4] b) plasma trans fatty acids associated with worse cognitive function [4] c) higher plasma omega-3 fatty acids associated with 1] better executive function 2] fewer white-matter hyperintensities (only in individuals without depression) d) Mediterranean diet in combination with exercise, reduces risk of cognitive impairment & dementia [17,18,19] d) a single study found that MIND diet did not reduce risk of dementia or brain MRI changes in subjects > 65 years with family history of dementia but without cognitive impairment over 3 years vs control diet with mild caloric restriction [16] 3) social & intellectual pursuits [3] 4) purpose in life [5] 5) computer-based videogame training [8] 6) cognitive training (Tai-chi) improves iADL* in the elderly [9] 7) late-life participation in intellectual activities decreases odds of developing dementia (RR=0.7) [11] 8) prolonged maintenance of cognition may be facilitated by mechanisms of resilience to risk factors of cognitive decline, including neuropathologic hallmarks of Alzheimer's disease [12] 9) playing a musical instrument enhances maintenance of later-life cognition [13] * instrumental activities of daily living cost of cognitive effort - cost may relate to the necessity of recycling potentially toxic substances accumulated during cognitive control exertion - high-demand cognitive work results in higher glutamate concentration & glutamate/glutamine diffusion in cognitive control brain regions (lateral prefrontal cortex & primary visual cortex) - cost manifested by a reduction of pupil dilation during decision-making after hours of high-demand cognitive work [15] Also see cognitive impairment

Related

cognitive assessment cognitive impairment

Specific

abnormal cognition artificial intelligence (AI) attention cognitive resilience collective intelligence executive function language memory SuperAger (exceptional cognition in the elderly) visuospatial function

References

  1. nlmpubs.nlm.nih.gov/hstat/ahcpr/
  2. McPherson, S. Director, Neuropsychology Laboratory UCLA ADRC
  3. Deary IJ et al. Genetic contributions to stability and change in intelligence from childhood to old age. Nature 2012 Jan 18; 482:212. PMID: 22258510
  4. Bowman GL et al. Nutrient biomarker patterns, cognitive function, and MRI measures of brain aging. Neurology 2012 Jan 24; 78:241. PMID: 22205763 - Tangney CC. The good, bad, and ugly? How blood nutrient concentrations may reflect cognitive performance. Neurology 2012 Jan 24; 78:230. PMID: 22205762
  5. Boyle PA et al. Effect of purpose in life on the relation between Alzheimer disease pathologic changes on cognitive function in advanced age. Arch Gen Psychiatry 2012 May; 69:499. PMID: 22566582
  6. Brown BM et al. Intense physical activity is associated with cognitive performance in the elderly. Transl Psychiatry 2012 Nov 20; 2:e191 PMID: 23168991 http://www.nature.com/tp/journal/v2/n11/full/tp2012118a.html
  7. Karama S et al. Childhood cognitive ability accounts for associations between cognitive ability and brain cortical thickness in old age. Mol Psychiatry 2013 Jun 4 PMID: 23732878 http://www.nature.com/mp/journal/vaop/ncurrent/full/mp201364a.html
  8. Anguera JA et al. Video game training enhances cognitive control in older adults. Nature 2013 Sep 5; 501:97 PMID: 24005416
  9. Rebok GW et al Ten-Year Effects of the Advanced Cognitive Training for Independent and Vital Elderly Cognitive Training Trial on Cognition and Everyday Functioning in Older Adults. Journal of the American Geriatrics Society. Jan 13, 2014 PMID: 24417410 http://onlinelibrary.wiley.com/doi/10.1111/jgs.12607/abstract - Wayne PM et al. Effect of tai chi on cognitive performance in older adults: Systematic review and meta-analysis. J Am Geriatr Soc 2014 Jan; 62:25 PMID: 24383523 http://onlinelibrary.wiley.com/doi/10.1111/jgs.12611/abstract
  10. George J 1-Hour Exercise, 3 Times a Week Boosts Cognition in Older Adults, But no improvement in memory. MedPage Today. May 30, 2018 https://www.medpagetoday.com/neurology/dementia/73179 - Gomes-Osman J, Cabral DF, Morris TP et al Neurology Clinical Practice. May 30, 2018
  11. Lee ATC, Richards M, Chan WC et al Association of daily intellectual activities with lower risk of incident dementia among older Chinese adults. JAMA Psychiatry. 2018 May 30 PMID: 29847678 - Blacker D, Weuve J. Brain exercise outcomes: Does cognitive activity really work to maintain your brain? JAMA Psychiatry. 2018 May 30 PMID: 29847611
  12. George J High Cognitive Performance at Age 100 - Some centenarians show resilience to cognitive decline, despite brain pathology. MedPage Today January 15, 2021 https://www.medpagetoday.com/neurology/dementia/90720 - Beker N, Ganz A, Hulsman M et al Association of Cognitive Function Trajectories in Centenarians With Postmortem Neuropathology, Physical Health, and Other Risk Factors for Cognitive Decline. JAMA Netw Open. 2021;4(1):e2031654. Jan 15 PMID: 33449094 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2775218
  13. Walsh S, Luben R, Hayat S, Brayne C. Is there a dose-response relationship between musical instrument playing and later-life cognition? A cohort study using EPIC-Norfolk data. Age & Ageing. 2021. Jan. 50(1):220-226 PMID: 33206939 PMCID: PMC7793595 https://academic.oup.com/ageing/article-abstract/50/1/220/5981905?redirectedFrom=fulltext
  14. Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
  15. Wiehler A, Branzoli F, Adanyeguh I et al A neuro-metabolic account of why daylong cognitive work alters the control of economic decisions. Curr Biol. 2022 Aug 4:S0960-9822(22)01111-3 PMID: 35961314 https://www.cell.com/current-biology/pdf/S0960-9822(22)01111-3.pdf
  16. Harris E MIND Diet No Better Than Control for Adults at Risk of Dementia. JAMA. Published online July 26, 2023. https://jamanetwork.com/journals/jama/fullarticle/2807897 - Barnes LL et al. Trial of the MIND diet for prevention of cognitive decline in older persons. N Engl J Med 2023 Jul 18 PMID: 37466280 https://www.nejm.org/doi/10.1056/NEJMoa2302368
  17. Scarmeas N et al Physical Activity, Diet, and Risk of Alzheimer Disease JAMA. 2009;302(6):627-637. PMID: 19671904 http://jama.ama-assn.org/cgi/content/full/302/6/627 - Feart C et al Adherence to a Mediterranean Diet, Cognitive Decline, and Risk of Dementia JAMA. 2009;302(6):638-648 PMID: 19671905 - Knopman DS et al Mediterranean Diet and Late-Life Cognitive Impairment A Taste of Benefit JAMA. 2009;302(6):686-687 PMID: 19671912
  18. Lourida I, Hannon E, Littlejohns TJ et al Association of Lifestyle and Genetic Risk With Incidence of Dementia. JAMA. Published online July 14, 2019. PMID: 31302669 https://jamanetwork.com/journals/jama/fullarticle/2738355
  19. Chowdhary N, Barbui C, Anstey KJ et al Reducing the Risk of Cognitive Decline and Dementia: WHO Recommendations. Front. Neurol. 2022. January 10. PMID: 35082745 Free PMC article. https://www.frontiersin.org/articles/10.3389/fneur.2021.765584/full