Senior Moment - Libby Deege

Seniors may be just as mentally agile as younger people. The reason their thinking appears sluggish is they mull things over longer, a new study shows.

Researchers have found that when people aged 60 and older are asked to make quick decisions, they respond as slowly as young children. And both groups react much more slowly than young adults, according to the study published in Child Development.

The slow response times in children are the sign of brains that are still maturing, said Roger Ratcliff, a study co-author and professor of behavioral and social sciences at Ohio State University. But the apparent sluggish thinking in the elderly may simply be the result of seniors emphasizing accuracy over speed when they deliberate.

The new research could have important repercussions for seniors worried that their thinking has become too slow to allow them to continue driving safely or performing other tasks that occasionally require quick reaction times. 

Ratcliff and his colleagues have been studying the impact of aging on mental agility for the last decade. In their new study, they looked at how seniors and other adults compare to children.

They ran several experiments designed to rate mental ability and agility across all ages. In one, for example, more than 300 study volunteers watched as a group of asterisks flashed up on a computer screen. The number of asterisks ranged anywhere from 31 to 70. The volunteers were told to quickly decide whether they’d been shown a small number (31 to 50) or a large number (51 to 70) of the star shaped marks.

When the researchers looked over the responses they found that response times and accuracy both improved with age, up to a point. Accuracy remained good even among older volunteers, but response times in general suffered as people got older. Of course, in some cases, early dementia or the effects of medication may be the cause of slowing mental agility, but in healthy seniors, slow reaction times among the elderly can often be improved, Ratcliff said. In another set of experiments, he and his colleagues coached older volunteers to obsess less about accuracy and to focus more on speed.  In the end, his seniors were able to react just as quickly as college students.

Ratcliff suspects that other age related deficits, such as declining memories, make seniors less sure of themselves and that makes them want to deliberate longer so they won’t make mistakes.

“Older people don’t want to make errors, so what they do is adopt a more conservative decision criteria and that slows them down,” he explained.

By Linda Carroll

What's the Difference Between Alzheimer's Disease & Dementia?

On a cold, snowy winter day, a bowl of soup sounds good.

"What’s the soup of the day?" you ask the waitress at your favorite restaurant. A few minutes later you are enjoying a steaming cup of clam chowder.

"Soup" is a general term for a category of food. Soup comes in dozens of flavors, like chicken noodle, tomato, clam chowder, or mushroom. Every can of mushroom or tomato soup is soup—but not every can of soup is mushroom or tomato.

This simple example, first used by Canadian dementia expert Carol Bowlby Sifton, is an elegant way to describe the differences between dementia and Alzheimer's disease.

Like "soup," the word "dementia" is an umbrella term for anything that can cause issues with brain functioning such as confusion, memory loss, or loss of problem solving ability. While Alzheimer’s disease is the most common form of dementia in older persons, there are many more varieties, including Lewy Body dementia, vascular dementia, or frontal lobe dementia.

Families often say that they struggle to understand what doctors mean by dementia. That's why it's important to ask the doctor what type of dementia is being diagnosed. David Troxel, a noted dementia expert who worked with Home Instead Senior Care to develop its Alzheimer's and Other Dementias Training Program, emphasizes that the doctor should be able to tell you the specific diagnosis and the reason for that diagnosis, just like the waitress should be able to tell you the soup of the day and how that is different from other soups.

"It's important to know the type of dementia being diagnosed," Troxel said, "because different dementias have different characteristics, and family members need to know what to expect." Persons with frontal lobe dementia, for example, often undergo profound personality changes and can get very disinhibited and outrageous. Persons with Lewy Body dementia may have profound visual hallucinations, including talking to little people in the room or seeing animals that are not really present. "It can be very helpful and reassuring for families to know that a particular behavior is part of the disease process, not just 'bad behavior'," Troxel noted.

In addition, different dementias may call for different medicines. Individuals with pure frontal lobe dementia often don't do well on the typical memory medications like Aricept, Exelon & Razadyne, but they may respond to an anti-depressant. Persons with Lewy Body dementia seem to be very sensitive to mood-altering medications like anti-psychotics. In fact, an old nursing phrase says, "start low and go slow" when giving psychotropic medications to a person with Lewy Body dementia.

Finally, when the physician gives you a specific diagnosis it's a sign that you’ve seen a medical provider who understands the contemporary best practices surrounding diagnosis. You can feel that you and your family member are in good hands.

Likewise, other professionals you may work with to care for your family member, such as professional in home caregivers, should be trained to understand the distinctions between various dementias. Paul Hogan, chairman of Home Instead Senior Care, says "Our CAREGivers are trained to understand the differences between Alzheimer's disease and other forms of dementia. We want our clients' families to know that we are here for them no matter which dementia diagnosis they face."

Family caregivers can form a care team with the senior's doctors, pharmacists, and other care providers focused on providing the best possible care and that focus needs to include an accurate understanding of the diagnosis, its symptoms, and its possible treatments. "Until we find a cure, the best approach to any of these dementias is engagement, activities, communication and loving care," says Hogan