Cognitive Wellness in Aging: An Introduction to Normal Cognitive Aging

The body ages, as anyone with newly graying hair or aching knees and back can well attest. 

As a big body part, the brain ages, too, but most of us are less familiar with the signs of brain aging than we are with gray hair and bad knees, and sometimes it's hard to know the difference between normal aging and what is abnormal - or a problem.

It is important to understand how thinking changes with age under usual circumstances—and what might be a sign that something more is taking place.

Key Takeaways

• “Senior moments” can be unnerving, but they do not necessarily mean the brain is sick.
• As the brain ages, subtle changes in thinking emerge, mostly related to the speed of mental processing, word finding, and the ability to sustain attention and multitask. These changes are considered part of normal cognitive aging.
• Repetitive questioning, attention lapses, mood changes, and getting lost in familiar areas can be warning signs that something more could be taking place.
• If you think your cognition is changing in ways beyond what is expected or normal, the best step is to get evaluated by an experienced medical professional. 

So, just what is cognition, anyway?

At its root, “cognition” is the ability to perceive and react to the world. Cognition helps us process and understand information and store and retrieve knowledge. We need cognition to make decisions and produce appropriate responses. For example, imagine trying to read a map: you must first know what a map is and how to use it, then you must translate the two-dimensional map to the three-dimensional world you see around you and follow the map to get to that cool new restaurant, whose name you naturally recall in full, along with the time you expect your table to be ready. Cognition allows us to do all of those things (and so much more, obviously). 

All that is oh-so-very general. Let’s get more precise.

“Cognition” can also be thought of as a group of related and overlapping mental functions. Each of us relies on these abilities to:

• Pay attention.
• Think about things.
• Understand and learn.
• Remember previously acquired information.
• Solve problems.
• Do more than one thing at a time.
• Weigh the pros and cons to arrive at a good decision.

We rely on our cognitive abilities to accomplish our goals and negotiate our way through the world. When we start to notice changes in our cognition, it can be alarming.

What is normal cognitive aging? 

Normal cognitive aging occurs, and it is not a disease. This means that if you happen to misplace your car keys or you cannot recall the name of a movie or a book, it does not necessarily mean that you have started a long, slow decline into a disease that causes dementia. Just as our knees tend to start creaking once we reach our mid-60s, after years of taking us from Point A to Point B, our brain demonstrates its own form of “creakiness.” With aging,  most of us notice an overall slowness creeping into our thinking. We find it harder to sustain attention and multitask. The amount of information we can hold in mind at any one time goes down. We grope to find the word that we want when we need it.  Most of us laugh these changes off, ruefully attributing them to “senior moments.”

 “Senior moments” can be unnerving. In a 2015 report, the Institute of Medicine commented that “What is dismissed as a minor inconvenience at 25 years of age can evolve into a momentary anxiety at 35, and a major source of personal worry at age 55 or 60.¹” But should we worry?

• The brain is finally physically mature only around the time a person needs to blow out 30 candles on their birthday cake.
• By middle adulthood, subtle changes begin to occur, most noticeable in how fast we process information and the time it takes to retrieve something from memory.
• By the seventh decade, cognitive changes continue to occur. Some tasks take longer to do than they did 25 years ago, and for most of us, it takes longer to learn new things. Perhaps it's slower, but most of us can still get where we need to be in the end.

These changes are normal. Though sometimes annoying, they do not mean the brain is sick. Some changes are even for the better, such as vocabulary, reading, and verbal reasoning, which can remain unchanged or even improve during the aging process.

Keep in mind that the world—with all its blinking lights, exploding information, and constant change—evolves faster than any individual can hope to keep pace. Someone who turns 65 this year faces a world teeming with radically more cognitive demands than someone who turned 65 in, say, the late 1950s. 

The good news is that, for most people, the changes of normal cognitive aging are counterbalanced by a wealth of knowledge and experience accumulated over a lifetime. We call that wisdom.

When should I worry? When is it maybe not normal cognitive aging?

The following are warning signs that thinking has begun to change in ways beyond normal cognitive aging:

• Repetitive questioning. Asking someone the same question multiple times in a day or even in a single conversation can be a warning sign of cognitive decline. Telling the same person the same story over and over again is similar.  
• Attention lapses. New struggles to follow the plot of a television program or a novel may herald change. Sometimes, people become less aware of changes in the world around them, like current affairs or impending weather events.
• Getting lost, especially in familiar areas. The hippocampus, the part of the brain that helps us remember things, is also involved in supporting our navigational abilities, meaning that getting lost can be a warning sign.
• Mood changes. Sometimes, impending impairment reveals itself via mood changes. Some people develop depression and others anxiety. Irritability can also indicate that changes are occurring. 

Noticing any of these changes can be alarming, just as the Institute of Medicine said. That said, they do not necessarily mean that one has a neurodegenerative disease.

If you notice changes that concern you, the best step is to get evaluated by an experienced medical professional. Sometimes, changes are reversible. In other cases, the cognitive change may respond to early interventions.

An early trip to the doctor is always a good idea: it can help determine what is happening and what the best treatment approaches may be.

Interested in learning what you can do for your cognitive wellness?

Sunday Health’s clinical care team provides a convenient, clinically proven checkup, which is crucial for early detection, personalized care, and proactive management of cognitive well-being.

To learn more, click here to schedule an introductory call with our care navigator or call (571) 517-1564.

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Do you have another question that the Sunday Health brain health experts can answer? We invite you to send your questions to hello@sundayhealth.com.

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Sources:

1. Institute of Medicine (IOM). 2015. Cognitive aging: Progress in understanding and opportunities for action. Washington, DC: The National Academies Press.

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