Three Phases of Age-Related Cognitive Impairments

The brain’s cognitive energy is what keep us thinking clearly and remembering. Cognitive energy is directly related to the number of neurons and the speed of neurons being fired together. The formula for this thinking and information processing cognitive activities is: cognitive energy = voltage (number of neurons) X processing speed (the speed at which neurons are fired). Brain ages as part of the chronological aging process during which time brain processing speed and voltage declines. However this process is not completely irreversible and brain aging can be significantly delayed or prevented through care, maintenance and training because the brain is such an adaptable, malleable organ with the most flexibility of neuroplasticity and lasting capability for regeneration – neurogenesis. Invisible brain aging could begin as early as 30s. Brain processing speed loses 7-10 milliseconds for each decade. An initial change in brain speed is the sign of a potential ongoing development of mild cognitive impairment. However, this condition is reversible and preventable. What is important is to prevent MCI from deteriorated into the advanced stage of irreversible cognitive impairment – Alzheimer’s or other forms of dementia that inflicts 50% of the people between 80-85s. While Alzheimer’s disease usually progress gradually spanning 15-20 years, it always begins with MCI which can start during 30s or 40s. However, Alzheimer may not be the destiny, because through maintenance and training, the gradual progressive trajectory continuum of cognitive impairments associated with an aging brain can be stopped at the pre-MCI and MCI stages. see post “A 7- Step Action Plan For Preventing And Treating Memory Loss”.

Brain aging may not be noticeable while the aging of other parts of the body start to manifest itself. This preclinical stage of the age-related decrease in cognitive function at the start of the trajectory is known as preclinical MCI or pre-MCI. Pre-MCI is so mild that there is no evidence of observable changes in social or occupational functioning. Very subtle cognitive alternations that may be detected years before the first sign of most basic symptoms of MCI begin to emerge. Studies have shown that pre-MCI could begin a full 20 years before any significant MCI symptoms occur. Research also demonstrated that by the age of 40, 25-50% of the people are already affected by MCI, even though only 1% will show any symptoms. This is why brain health maintenance is not a task for elders, prevention and training should start as early as 30s.

The next stage of the progression of age-related cognitive impairment is Mild Cognitive Impairment (MCI). One or two small changes in thinking might be noticeable in people with early MCI, most of whom remain this way for the rest of life without treatment. At the earliest stages of MCI, people rarely exhibit any severe symptoms. The only change to complain is they are not doing complex tasks as comfortably and effortlessly as they can do before. Most people with MCI still function well in daily activities with less efficient or accuracy. The standard progression of MCI symptoms are grouped into 3 categories – alterations in personality/temperament, memory, attention and focus. Neurological and psychological symptoms often occur and reinforce each other at the same time. Changes in personality and temperament can be the emerging signs of MCI such as agitation, anger, anxiety, depression, fear of being alone, frustration, mood swing, paranoia, self-neglect. Mild memory and/or cognitive problems starts to emerge during MCI stage such as:

  • occasionally not remembering things a few minutes ago
  • declining spatial perception
  • decreased creativity
  • difficulty learning new tasks
  • difficulty store new memory
  • difficulty decision making
  • past memory loss
  • impaired abstract thinking
  • slower response time
  • difficulty in intellectual growth

Attention is the crucial component for working memory (see post “The Role of Attention For Working Memory”). Deficiency in attention and focus is associated with MCI. Symptoms of attention loss are linked to decreased brain chemicals – dopamine, acetylcholine, GABA, and serotonin:

  • less able to concentrate and focus
  • commission errors
  • complex attention errors
  • omission errors

When cognitive impairment is sufficiently severe to the extent that it significantly interfere with daily functions, the third final stage of cognitive impairment – Alzheimer’s disease or other forms of dementia may be diagnosed. (see post “Age-Related Memory Loss DiseasesAmnesia With Age”). Physical characteristics of Alzheimer’s disease can be traced back to pre-MCI and MCI stage. Several brain anatomical and bio-neurological alterations mark the presence of Alzheimer’s disease. Nerve fibers become tangled and neurofibrillary tangles may seriously damage neurons. There are accumulations of insoluble beta-amyloid protein plagues in the brain that cause healthy brain tissue to degenerate and interferes brain cells communication. Blood flow to the brain also significantly decreased in Alzheimer’s. Earliest signs of Alzheimer’s are:

  • verbal memory loss (e.g. repeatedly ask the same question)
  • unfamiliarity with simple daily routines
  • Dysphasia
  • unawareness of location, time
  • confusion about familiar places
  • difficulty with abstract thinking
  • placing objects in unsuitable places
  • extreme mood swing
  • more pronounced personality disorder

Through a maintenance, screening, and treatment program outlined in “A 7- Step Action Plan For Preventing And Treating Memory Loss”, the progression of Alzheimer’s disease can be slowed and risk of progression into Alzheimer’s can be reduced.

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