Cognitive Changes in Healthy Aging Adults

by Joan DiGiovanni and Jan Simpson


Joan:After spending time with an elderly adult, have you ever wondered if that perhaps he or she is showing signs of dementia? How do you know if it is a form of dementia or just a sign of the normal aging process?

I recently attended a lecture at Boston College given by Prof. Elizabeth Kensinger from their Psychology Department. The lecture focused on memory changes in healthy aging adults and the neurological changes in the brain that occur. The 3 most common cognitive changes in healthy seniors include:

1. The speed of mental processing: as we age, the speed that we absorb and process information declines. (It’s important to realize, however, that given extra time, seniors can process information about as well as younger people.)

2. Slower response in storing and recalling new information. This is often observed when an older individual, even those in middle age, try to learn to play the piano or learn to speak a new language.

3. Decline in reaction time especially when it comes to complex choices. Implications with certain tasks such as driving a car or cooking on a hot stove can become significant.

The changes listed here are normal to the healthy aging process; they are gradual and typically do not interfere with daily tasks. Dementia, on the other hand, is not a normal part of aging. A proper diagnosis is critical as there are many ailments that look like dementia but are not; start with a thorough physical exam. Often, forgetfulness is simply a result of new medication — in fact, the most common form of reversible dementia is a side effect from meds. With the help of a general practitioner, proper diagnosis can be made.

Jan: Yes, but if one is concerned, your parent or older loved one should be tested for potential memory impairment.  My 79-year-old father was prescribed a medication that affected his cognition: he began to hallucinate. Alarmed that this might be the start of his cognitive decline, my sister, a learning specialist, made arrangements for him to be evaluated by a neuropsychologist.  Physicians typically focus first on finding an organic cause of  memory loss, such as a stroke; a neuropsychologist, on the other hand, tests for memory, concentration, reasoning, and language function. Read more here. By the time my dad was evaluated, his medication had been changed and he behaved normally. We went ahead with the evaluation anyway and was comforted by the report: all was well.

How do you find a  neuropsychologist?  Ask a physician for a referral to a neuropsychologist, a memory clinic,  or a geriatric psychiatrist who can arrange for an assessment. (Note: a neuropsychologist is different than a neurologist; the former is a phD, the latter an M.D.) A list of memory clinics in the United States may be found here. Or, call the help line at the Alzheimer’s Association. Do not hesitate to have your loved one assessed. At the age of 65, the prevalence of dementia is just 5-7 percent and only rises to approximately 40 percent by the age of 90. My father’s test results gave us the peace of mind we needed to keep him and my mother at home.


Have you had any experience with memory loss in your loved ones?  Let us know in the comments section.

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Money Management & the Cost of Getting Old

Do you know how much money your parents will need to cover health care costs over the rest of their lives?

The New York Times recently reported research by the Center for Retirement Research at Boston College ( on health care costs.  The typical married couple at age 65 will spend $197,000 on insurance premiums, out-of-pocket costs, and home care, assuming neither spends time in a nursing home; if they do, lifetime health care costs may exceed $260,000.  And these are just average estimates; true out-of-pocket costs could reach or exceed $311,000 without nursing home care, and up to $570,000 with nursing home costs.  What’s the likelihood of one of your parents needing nursing home care?  The researchers estimate that about one-third of people turning 65 in 2010 will need at least three months of nursing home care, one-quarter will need more than a year, and about 9% will need more than five years of care. Unsurprisingly, 85% of Americans do not have the financial resources to cover these expenses.

So, how should your parents plan for old age? Among the recommendations is the purchase of long-term care insurance, to be discussed in a follow-up post.  Do your parents have long-term care insurance?

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