COGNITIVE ASPECTS OF AGEING

          Cognitive abilities are the mental skills that we need to carry out any task from the most simple to the most complex. These mental skills include awareness, information handling, memory and reasoning. As we get older, our cognitive abilities gradually deteriorate. A certain amount of cognitive decline is a normal part of ageing. Some people, however, will experience a severe deterioration in cognitive skills, leading to dementia. This can make it impossible to cope with ordinary day-to-day tasks. The normal cognitive decline associated with aging are:

PERCEPTION

• It is the ability to interpret the environment. If the aging person's senses are impaired, the ability to perceive the environment and react appropriately is diminished.
• The brain loses mass with aging. Blood flow to the brain decreases the meninges thicken and brain metabolism slows. Changes in the nervous system may also affect perceptual capacity.
• Cognitive ability
• Overall, older adults maintain intelligence, problem solving, judgment, creativity & other well-practiced cognitive skills.
• Memory impairment is more prevalent in persons over age 85. Cognitive impairment that interferes with normal life is not considered part of normal ageing.
• Family members should be advised to seek prompt medical evaluation.

MEMORY

• Sensory memory – It is the momentary perception of stimuli from the environment
• Short-term memory - Information held in the brain for immediate use, also referred recent memory.
• Long-term memory - Information stored for periods longer than 72 hrs. & usually weeks & years.
• The retrieval of information from long-term memory can be slower. Older adults, tend to forget the recent past. Nurse can help by providing memory aids, making notes, and placing object in consistent locations.

LEARNING

• Needs additional time for learning, largely because of the problem of retrieving information. Have more difficulty than younger ones in learning information they do not consider useful.
• Moral Reasoning Changes
• The value and belief patterns that are important to elders may be different from those held by younger people because they developed during a time that was very different from today.
• Cultural background, life experiences, gender, religion and socioeconomic status all influence one's values.
• The nurse must identify and consider the specific values of the older client when nursing care is planned.

SPIRITUALITY CHANGES

• Many elders take their faith and religious practice very seriously and display a high level of spirituality. Involvement in religion often helps the older adult to resolve issues related to the meaning of life to adversity or to good fortune.
• It is an important coping resource leading to enhanced well-being.
• Assisting the older person to participate in religious and spiritual practices is an important nursing responsibility.

BIBLIOGRAPHY

1. Berman A, Snyder S.J, Kozier, Erb G; Promoting health in elders, Fundamentals of nursing. 8^thed. 2008; Pearson education. Pp 406-427.
2. Potter P. A., Perry A.G; Older Adults, Fundamentals of nursing. 6^th ed.2005;Elsevier publications. Pp 234-276.
3. Taylor Carol, Lillis Carol, LeMone Priscilla; The aging adult, Fundamentals of nursing. 4^th ed. 2001; Lippincott publication. Pp 155-172
4. Dey A.B; A Manual for trainers for nurses, Health care of older people; 2003.
5. Lawson, C. (2006) Planning to improve the hospital experience for older inpatients. Nursing times; 102:39, 30-31.
6. O’Dowd, A. (2007) Recognising and preventing the abuse of older people. Nursing times; 103:27, 21-22.
7. Baker W.M., Heitkemper M.M.(2005) The roles of nurses on interprofessional teams to combat elder mistreatment. Nurs outlook; 53:253-259.
8. Kohlenberg etal,(2007) Infusing gerontological nursing content into advanced practice nursing education. Nurs outlook; 55:38-43.
9. Bephage, G. (2006) Meeting the health care needs of older homeless people. Nursing Times; 102: 10, 38-41.