THE AGING BRAIN-cognition-

Presented byRonald Lucchino, PhD

Di f P li Al h i ’ A i i NMDirector of Policy, Alzheimer’s Association, NMrvluc@pop.net

OBJECTIVESObjective 1: To be able to describe the age related j g

cognitive changes in the aging brain

Objective 2: To be able to describe age associated j g(negative) cognitive changes in the brainbrain

Objective 3: To be able to describe how to improve the brain’s cognitive function as we gage

G l O i HGeneral Overview -How the Brain Works

-Cognition-g

Anatomy and Function of the Brain yInvolved in Cognition

Inside the Human Brain

The Brain’s Vital Statistics

• Adult weight: about 3 dpounds

• Adult size: a medium cauliflower

Number of neurons: • Number of neurons: 100,000,000,000 (100 billion)

• Number of synapses (the y p (gap between neurons): 100,000,000,000,000 (100 trillion)

Slide 8

Inside the

Neurons

Human BrainNeurons

• The brain has billions of h i hneurons, each with an axon

and many dendrites.

T t h lth• To stay healthy, neurons must communicate with each other, carry out , ymetabolism, and repair themselves.

• Neurotransmitters carry the message between synapse.

Slide 14

id h iMajor Cognitive Functioning areas of the brain

Inside the Human BrainMajor Cognitive Functioning areas of the brain

1 Cerebral Hemispheres where sensory information1. Cerebral Hemispheres – where sensory information received from the outside world is processed; this part of the brain controls voluntary movement andof the brain controls voluntary movement and regulates conscious thought and mental activity:• accounts for 85% of brain’s weight• accounts for 85% of brain’s weight • consists of two hemispheres connected by the corpus callosum

i d b t l ll d th b l t• is covered by an outer layer called the cerebral cortex

Slide 9

•Hippocampus: where short-term memories are converted to long-term memories•Thalamus: receives sensory and limbic information and sends to cerebral cortex•Hypothalamus:: monitors certain activities and controls body’s internal clock

(pituitary gland)•Limbic system:: t l ti d i ti ti b h i (i l d th•Limbic system:: controls emotions and instinctive behavior (includes the

hippocampus and parts of the cortex)•Prefrontal cortex: high executive function - attention span, perseverance,

planning, judgment, impulse control, organization, self-monitoring and supervision, problem solving, critical thinking, forward thinking, learning from

experience and mistakes, ability to feel and express emotions, influences the limbicexperience and mistakes, ability to feel and express emotions, influences the limbic system, empathy

•Frontal cortex: Attach significance to external stimuli form provisional•Frontal cortex: Attach significance to external stimuli, form provisional plan, monitor performance, use feedback to alter behavior

•Broca’s area: is the area in the left frontal lobe specialized for the production of language - speech.

•Wernicke’s area: the region of the cortex in the superior and posterior region of the left temporal lobe that helps mediate language comprehensionthe left temporal lobe that helps mediate language comprehension.

Working memory - self order pointed task memories (both shortWorking memory - self order pointed task, memories (both short-term and long-term declarative) held briefly in mind that enable a

particular task to be accomplished (e.g., efficiently searching a room for pa t cu a tas to be acco p s ed (e.g., e c e t y sea c g a oo olost keys).

i diEpisodic memory - is a neurocognitive (brain/mind) system, uniquely different from other memory systems, that enables human

b i t b t ibeings to remember past experiences

Long term memory paired associate learning and recallLong term memory- paired associate learning and recallof past events, names, faces places

Inside the Human Brain

Cognitive Activity in the Brain

Hearing Words Speaking Words Seeing Words Thinking about Words

Different mental activities take place in different parts of the brain. Positron emission tomography (PET) scans can measure this activity Chemicals tagged with a tracer “light up” activatedthis activity. Chemicals tagged with a tracer light up activated regions shown in red and yellow.

Slide 13

id h iMinor Cognitive Functioning areas

Inside the Human BrainMinor Cognitive Functioning areas

of the brain

2. Cerebellum – in charge of balance and coordination:• takes up about 10% of brain • consists of two hemispheres• receives information from eyes, ears, and muscles and joints

b b d ’ d i iabout body’s movements and position

Slide 10

id h iMinor Cognitive Functioning areas

Inside the Human BrainMinor Cognitive Functioning areas

of the brain

3. Brain Stem – connects the spinal cord with the brain

• relays and receives messages to and from muscles, skin, and other organs

• controls automatic functions such as heart rate, blood pressure, and breathing

Slide 11

Wh t i A i ?What is Aging?

1. inevitable

2. irreversible

3. variable3. variable

4 linear we are continuously age year after year4. linear - we are continuously age year after year

5 l ti it ( t ) th b d h th5. plasticity (compensatory) - the body has theability to compensate for lossability to compensate for loss

AGING CURVEMaximum vitality

100

vitality vitality

% vitality

y

deathminimumvitality

30birth senescence

vitality

ageconception

\What is Vitalityy

• The ability to respond to stress, the amount of reserve capacityreserve capacity

Th t b f f ti i ll• The greater number of functioning cells per organ the greater the ability to respond to stress

• Maximum vitality is 100%.Maximum vitality is 100%.

L f it lit i 0 8% ft 30• Loss of vitality is 0.8% per year after age 30

DETERMINANTS OF AGING

INTERACTION BETWEEN THE FOLLOWING:

1. GENETICS - AT BIRTH 100% OF FUNCTION IS DETERMINED BY GENETICS, REDUCING IN IMPORTANCE WITH AGING

P i i f l lif l• Positive gene - few to none early, lifelong or late-onset genetic diseases

• Neutral to negative genes increase vulnerability to• Neutral to negative genes- increase vulnerability to early, lifelong or late-onset genetic diseases

• possible cardiovascular dysfunction

• possible mild osteoporosis

• possible rheumatoid disease

• sensory impairment

• possible diabetes

• marked decline in cognition

• Negative genes- early, lifelong or late-onset genetic g g y, g gdiseases

• inherited diseases • developmental disabilitiesp• Alzheimer’s disease

d ti ( d li i iti )• dementia (severe decline in cognition)• severe cardiovascular disease• severe osteoporosis• cancer• cancer• neuro-muscular (Parkinson)• Rheumatoid diseases

2. LIFESTYLE - INCREASES IN IMPORTANCE TO 7O% BY AGE 60

• Diet

• Physical exercise

• Mental exercise

• Attitude/self-esteem

3. ENVIRONMENT

• Air and water

• Home

• Society

• Physical barriersPhysical barriers

DESCRIPTORS OF AGING

SUCCESSFUL AGING

USUAL AGING

PATHOLOGICAL AGING

SUCCESSFUL AGING deleterious effects of aging are minimized, preserving function

P itig g , p g

until senescence increases vulnerability to loss (e.g.,memory decline)

• Positive genes)

• Positive lifestyle• good diet• physical exercise• mental exercise• positive attitude• positive attitude

USUAL AGING Physical or mental functional decline from the interaction ofPhysical or mental functional decline from the interaction of

neutral or negative genes and poor lifestyle from birth to about age 70 causing a loss of some independenceage 70 causing a loss of some independence

• Neutral to negative genes

P lif t l• Poor life style• poor diet

• little physical exercise

• little mental exercise

t l t ti ttit d• neutral to negative attitude

PATHOLOGICAL AGINGSerious functional limitations from the interaction of

either genetically inherited or developmental traits with poor lifestyle causing a substantial reduction in daily p y g y

activities

Negative gene• Negative gene• Negative lifestyle

• poor diet

• no physical exercise

• no mental exercise

ttit d• very poor attitude

TERMS TO DESCRIBE AGINGTERMS TO DESCRIBE AGING

Age related changes- changes that every one will experience as they age (time and magnitude may vary)

Age associated changes -changes that are not age related and not experienced by everyone. The types and magnitude of changes depend on the interaction of not positive: genes, lifestyle, environment

Di i t d h hDisease associated changes - When age associated changes results in a reduced functional capacity with a loss of independence (home carecapacity with a loss of independence (home care, hospital care, nursing home)

Wh t i C itiWhat is Cognition

Three components of Cognitionp g

Input - sensory

P i I f tiProcessing Information

Output - motor

Sensory Input ( l d f )Sensory Input (type, location and intensity of input)

• vision vision• hearing/balance/orientation

ll/t t• smell/taste• pain• touch

• temperaturep• thirst

• muscle tone muscle tone• blood pressure

Information Process (speed) -(neurons and synaptic connections)

• identify input (different regions of brain)fy p ( ff g f )

type, intensity and location

• interpret input p p

• integrate response ( l b )• integrate response (multi brain)conscience, memory, behavior, emotions, movement

Motor ResponseMotor Responseappropriate (type and intensity)app op iate (type and intensity)

directed

reflexreflex

h h bhigher brain

\

The brain can only make an appropriate respond if:

it f th t d i t it f i t i l• acuity of the type and intensity of input in clear (no multi sensory overload)

• neurons and synaptic connections are intact• neurons and synaptic connections are intact

Cognitive Functionsg• memory - learning or training new information

• higher executive skills- handling complex tasks, abstract thought, planning, problem solvingg , p g, p g

• reasoning ability - respond to problems, judgment

• spatial and orientation ability- organizing objects, finding way in familiar surroundings

• language finding words following conversation• language - finding words, following conversation

Moderators Influencing Cognitiong g• Genetics• Education• Fitness• Expertise skills

Lif t l• Lifestyle• Occupation• Occupation• Leisure time activitiesLeisure time activities

Major Cognitive Developmentj g p

• Process rate or speed of input

• Memory transfer

• Inhibitors of irrelevant information

Phylogeny and Ontogeny Development of Cognition

Development of Cognition Expression of CognitionDevelopment of Cognition Expression of Cognition

Evolution - genetics nerve net g(phylogeny) (basic behavior)

Developmental influences- endocrine E i f /h ( t ) (h l b h i )Expression of genes/hormones (ontogeny) (hormonal behavior)

Environment influences cortical behaviorEnvironment influences cortical behavior (External modification of genes) (cognition)

Cognitive Abilitiesg

Crystalline/pragmatic abilities –lifelong acquisition of learning and acculturation verbal knowledgelearning and acculturation– verbal knowledge, comprehension

Fluid/mechanical abilities (innate) – the biological ( ) gconstrained of genetic hardwiring of the cognitive system - process based, - reasoning, speed of processing - not p , g, p p gaffected by experience or knowledge

Aging Changes in the BrainAging Changes in the Brain -Cognition-Cognition

Less than 30 years ago, the prevailing medical

wisdom declared that "senility" was the result of

i h l i h d i f h ieither normal aging or hardening of the arteries.

Today we are closer to truly understanding theToday we are closer to truly understanding the

aging brain for which one of the benchmarks ofaging brain, for which one of the benchmarks of

the decline in cognitive reserve capacity isthe decline in cognitive reserve capacity is

memory.y

C i i R C iCognitive Reserve Capacity -

the developmental plasticity of

cognitive function in older adults g

occurs within a limited rangeoccurs within a limited range

Three Determinants that InfluencesThree Determinants that Influences Cognitive Reserve Capacity Over g p y

Lifespan1. Evolution selects benefits for humans over time - declines

with reproductive fitness.

2. Age related increase in need for culture knowledge acquisition – crystalline cognition (knowledge acquisition)

3. Age related decrease in fluid intelligence (nerve net)

Ontogeny moves from growth (youth) to maintenance (adult) to reduction of loss older adult)

CognitionCognitionInput - sensory

ProcessingProcessing

Output - motor

Sensory InputSensory InputDifferential reduction in acuity in theDifferential reduction in acuity in the type and intensity of sensory input -yp y y p

starting at about the age of 30

Sl i iti f i t• Slower in recognition of input

• Slower in processing speed of input