Research Paper - Technologies for Treatment of Cognitive Decline (Part I)

 

In this series of two posts I will present results of research on the subject. The first part shows the statements for various scholarly papers and news reports. In the second part several of technology solutions will be exhibited.

From “Ageing and Cognitive Function: A Mini-Review”. Naghmeh Mokhber., et al. EC Neurology 11.7 (2019): 475-480.

In the seventeenth century, B.C. Pythagoras, a Greek physician and philosopher proposed the age milestones as 7, 21, 49, 63 and 81 years. He put the last two under the term “senium” (old age) meaning the time when “the scene of mortal existence close” with a significant decline in the human body and mental abilities. Later, Aristotle [384-322 B.C.] stated that old citizens do not deserve high administrative positions, because ageing often leads to mental failure. Nevertheless, about three centuries later, Cicero [106 - 143 B.C.], a Roman philosopher, mentioned that cognitive decline might happen in those with a “weak will.” He proposed that “old men can retain their mental abilities if they preserve their interests.” In other words, this statement implies the “use it or lose it” motto/hypothesis.

This is a good illustration of Cognitive Functions development during the life course by Dorina Cadar:

The Big Window® Consulting Ltd produced a report: The Ageing Population: Ageing Mind Literature Review Report 2017

From early adulthood, subtle and incremental changes occur in the way the brain handles information. This process is known as ‘normal cognitive ageing’. This is not the same as pathological cognitive change, which involves the onset of dementia, such as Alzheimer’s disease, usually after the age of 65. Between normal cognitive ageing and age-related pathological change lies a condition that is known as ‘mild cognitive impairment’ (‘MCI’). People with MCI have difficulties with their mental abilities that are more marked than would normally be expected for a healthy person of their age, yet the symptoms do not meet the criteria for dementia.11 MCI is recognised as a risk factor for dementia although a large proportion of people with MCI do not go on to develop dementia.

National Academy of Sciences published an informative material: COGNITIVE AGING - An Action Guide for Individuals and Families that among other valuable information has the following:

One of the key notions in the science is a definition of “fluid intelligence” (ability to reason) and “crystallized intelligence” (ability to use learned skills). So here are some citations on this.

Scientists at the Center for Retirement Research at Boston College note:

Two cognitive factors explain why most workers remain productive despite a decline in fluid intelligence: 1) crystallized intelligence – knowledge that accumulates with age – can offset declines in fluid intelligence; and 2) cognitive reserves, or fluid intelligence that exceeds job demands, can provide workers with a buffer. The first factor tends to particularly help skilled workers, while the second factor tends to benefit unskilled workers more.

 University of California Television (UCTV) produced this video Thinking and Doing: Cognitive Aging and Function where they examine the subject.

U.S. CDC in its pamphlet CDC: Cognitive Impairment: A Call for Action, Now! provides this illustration:

Most of the people do not realize the fact that some aspects of age-related cognitive decline begin in healthy educated adults when they are in their 20s and 30s. An impressive 2012 report shows data from Whitehall II prospective cohort study:

Whitehall II prospective cohort study, which was established in 1985 on 10,308 British civil servants (73% of those invited), ages 35 to 55. In men ages 45 to 49 at baseline, the 10-year decline rate in reasoning (change/range of test x 100) was –3.6%, while men ages 65 to 70 at baseline showed a 10-year decline rate of –9.6%. Women in the corresponding age categories had a –3.6% decline rate and –7.4% rate, respectively.

Neuroscientists at MIT and Massachusetts General Hospital (MGH) found that different components of fluid intelligence peak at different ages, some as late as age 40:

The researchers gathered data from nearly 50,000 subjects and found a very clear picture showing that each cognitive skill they were testing peaked at a different age. For example, raw speed in processing information appears to peak around age 18 or 19, then immediately starts to decline. Meanwhile, short-term memory continues to improve until around age 25, when it levels off and then begins to drop around age 35. For the ability to evaluate other people’s emotional states, the peak occurred much later, in the 40s or 50s.

 

Fluid intelligence refers to the ability to reason and think flexibly. Crystallized intelligence refers to the accumulation of knowledge, facts, and skills that are acquired throughout life.

Here are some interesting slides:

In their Dementia and Cognitive Decline Evidence Review Oct 2014 Sujata Ray and Dr Susan Davidson from the Age UK Research note:

Cognitive interventions are usually separated into three categories (although some people use them interchangeably, especially in non-academic literature): Cognitive Stimulation, Cognitive Training, and Cognitive Rehabilitation. Simon and colleagues90 define these as: Cognitive stimulation comprises involvement in group activities that are designed to increase cognitive and social functioning in a nonspecific manner. Cognitive training is a more specific approach, which teaches theoretically supported strategies and skills to optimize specific cognitive functions. Cognitive rehabilitation involves an individualised approach using tailored programs centred on specific activities of daily life. Personally relevant goals are identified, and the therapist, patient and family work together to achieve these goals (e.g., joining a social group).