Helping Relationships With Older Adults. Adelle M. Williams

in cognitive developmental change can be seen when distinguishing between fluid and crystallized intelligence. Crystallized intelligence refers to general knowledge developed through a lifetime of experiences (accumulated knowledge) (Sternberg, Grigorenko, & Oh, 2001). In contrast, fluid intelligence refers to the “creative and flexible thinking” required to solve novel problems (e.g., anagrams, memory tests).

      Generally, fluid intelligence declines with age, but crystallized intelligence remains stable or even increases (such as when one becomes specialized in a career, hobby, etc.) across the life span. It is important to distinguish between fluid intelligence pertaining to the solving of more practical problems versus more traditional (academic) problem-solving tasks. Performance on traditional problem-solving tasks peaks around the age of 20 and then declines, whereas performance on practical problem-solving tasks peaks in midlife, suggesting that it is at this time that individuals are best at practical problem solving (Sternberg et al., 2001).

      Fluid cognition or fluid reasoning, the capacity to think logically and solve problems in novel situations, independent of acquired knowledge, has been shown to decline from midlife onward as a result of normal aging (Richards, Shipley, & Fuhrer, 2004; Singh-Manoux, Kivimaki, & Glymour, 2012), while cognitive decline of functional or clinical significances is generally not detected until much later in life, often as a result of significant neurologic morbidity such as cerebrovascular disease (Richards et al., 2004). Given that changes in cognitive and physical functioning probably result from interactions between aging and disease, their effects may not be fully distinguishable (Blumenthal, 2003). As people age, some individuals experience normal declines in physical and cognitive functioning that increase their risk of dependence on others and premature death (Cooper, Kuh, & Cooper, 2011; Cooper, Kuh, & Hardy, 2010; Dewey & Saz, 2001; Studenski, Perera, & Patel, 2011). There are, however, remarkable individual differences in rates of age-associated decline in the age at which these declines begin to accelerate.

      In their related dual-processing model, Baltes and colleagues (1999) distinguish between the mechanics of intelligence that generally refer to processing abilities (information-processing strategies and problem-solving functions) independent of specific content and the pragmatics of intelligence that typically refer to knowledge about facts and procedures, including practical thinking, expertise, wisdom, and knowledge accumulated across the life span.

      While the pragmatics of intelligence are expected to grow into adulthood and then remain stable into old age, there is abundant evidence of age-related decline in the mechanics of intelligence (Salthouse, 2003). This decline compromises individual capacities beginning in midlife only under conditions of multitasking and time pressure (Lindenberger et al., 2000). Thus, the implications of these declines for everyday functioning in midlife are constrained to time-sensitive multitasking in everyday behavior (e.g., talking on the phone while merging into freeway traffic) and select professions (e.g., air traffic controllers). Strategies that are part of the pragmatics of intelligence (e.g., sequence activities to avoid multitask overload) in midlife can compensate for the weaknesses in the mechanics of intelligence. Such strategies may become increasingly insufficient as cognitive decline progresses in advanced old age. Guided Practice Exercise 1.4 provides the opportunity to examine physiological changes and one’s personal adaptation to inevitable changes.

      Guided Practice Exercise 1.4

      Numerous physiological changes occur as people age. Identify two of the major systems that change as one ages and discuss ways to adjust to these changes. What modifications in your current behavior will enable you to adjust more positively to these natural and inevitable changes?

      Attention

      Healthy aging is associated with relatively little cognitive decline. An examination of cognition in aging includes attention, learning and memory, language, and intelligence. Sustained attention is very good in healthy older adults, and there is a mild decline in overall accuracy beginning in the 60s that progresses slowly. Older adults are more easily distracted, especially if irrelevant information is presented with important material. A good suggestion is to give instructions directly and simply, encourage encoding strategies, and refer them to reputable memory training (Besdine & Wu, 2008). When counselors provide critical information to older patients, they should stick to core data, repeat it, and write it down (Besdine & Wu, 2008).

      Cid-Fernandez, Lindin, and Diaz (2014) tested attentional performance in three age groups: young (21–29 years old), middle-aged (51–64 years old), and older adults (65–84 years old). The task used in this study involved presenting both visual and auditory cues to the participants, who were required to focus on the visual cues while ignoring the auditory cues. The results showed that there was an increase in distractibility and changes in motor selection in the middle-aged and older groups compared to the younger groups. It is thus suggested that these cognitive working memory changes in aging lead to the slowing of motor response selection. This study also has implications for understanding motor and cognitive problems associated with age-related neurodegenerative disorders, including Parkinson’s and Alzheimer’s diseases. This study helps us understand the changes that occur in neurodegenerative disorders by increasing our knowledge of what happens in the brain as symptoms are manifested in diseases such as Parkinson’s and Alzheimer’s disease. These diseases are characterized by slow reaction time to stimuli, slowed working memory, and slowed movements. Attention in later life remains an important function for older adults, and learning and memory are important concerns for adults as they age.

      Learning and Memory

      Learning and memory involve the encoding, storage, and retrieval of information. Sensory memory is the earliest stage (i.e., visual, auditory, tactile), which is inherently unstable and decays rapidly. There is no age-related change. Primary (short-term) memory occurs after transfer of sensory memory. There is no loss with age. Secondary (long-term) memory persists for hours, days, and years. There is a decline with age, mostly in free recall; however, recognition is well preserved. The universal temporary decline in the ability to retrieve names generally begins early in middle age and worsens over time. The lost name is almost always retrieved soon after the episode. The phenomenon does not predict any neurodegenerative disorder, such as Alzheimer’s disease. Encoding strategies such as mnemonics, mental hierarchies, and clusters help with retrieval; however, older adults use them less frequently. Training provides long-lasting improvements.

      The most widely seen cognitive change associated with aging is that of memory. Memory function can be divided into four sections: episodic memory, semantic memory, procedural memory, and working memory. Episodic and semantic memories are most important with regard to aging. Episodic memory is a unique memory of a specific event or a personal memory of an experience. An example of an episodic memory would be a memory of the first day at school, last week’s important meeting, or learning that Paris is the capital of France. Episodic memory is thought to decline from middle age onward. This is particularly true for recall in normal aging and less so for recognition (Nyberg & Blackman, 2004).

      Semantic memory refers to general facts and knowledge. Examples of this type of memory include knowing that Paris is the capital of France, that 10 millimeters make up a centimeter, or that Mozart composed The Magic Flute. Semantic memory increases gradually from middle age (30–45 years) to the young elderly (46–60 years) but then declines in the very elderly (61–75 and 76–90 years) (Nyberg & Blackman, 2004). It is unclear why these changes occur, and it has been hypothesized that the very elderly have fewer resources to draw from and that their performance may be affected in some tasks by slower reaction times, lower attention levels, slower processing speeds, detriments in sensory and/or perceptual functions, or potentially a lesser ability to use strategies (Cabeza, 2004; Cabeza, Daselaar, & Dolcos, 2004; Lustig & Buckner, 2004; Nyberg & Blackman, 2004).

      Davis and colleagues (2003) examined memory performance in four age groups (30–45 years, 46–60 years, 61–75 years, and 76–90 years) on a multitrial verbal recall task with 20-minute and 1-day delay free recall and recognition trials. The rate of acquisition across five learning trials was similar for all ages except the youngest group. Despite the similarities, the level of acquisition achieved was lower in the