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| LETTERS TO EDITOR |
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| Year : 2017 | Volume
: 4
| Issue : 1 | Page : 69 |
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Normal aging and cognition
Himanshi Khanna1, Vikram Singh Rawat2, Ravikesh Tripathi1
1 Department of Clinical Psychology, IBS, Gujarat Forensic Sciences University, Gandhinagar, Gujarat, India
2 AIIMS, Rishikesh, Uttarakhand, India
| Date of Web Publication | 20-Jun-2017 |
Correspondence Address:
Ravikesh Tripathi
Department of Clinical Psychology, IBS, Gujarat Forensic Sciences University, Gandhinagar - 382 007, Gujarat
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jgmh.jgmh_7_17
How to cite this article:
Khanna H, Rawat VS, Tripathi R. Normal aging and cognition. J Geriatr Ment Health 2017;4:69 |
Sir,
We wish to draw attention to a recently published article in your journal on memory, verbal fluency, and response inhibition in normal aging.[1] Authors deserve appreciation for the work done with the population that lies on the latter end of the continuum and needs attention. There is a paucity of research in the field of geriatric cognition wherein the authors' contribution is invaluable. However, the article has raised several concerns which we would like to highlight.
Cognitive decline due to normal aging is a universal phenomenon and widely reported in literature. Age-related cognitive declines are more pronounced in speed of processing, working memory, and long-term memory.[2],[3] However, it is regarded as part of aging and distinguished from dementia and mild cognitive impairment.[4],[5] Cognitive impairment or dysfunction (memory or other domains) in the elderly could be due to mild cognitive impairment (MCI) or a dementing illness and these are to be distinguished from age-related cognitive decline.[4],[5] Term like “age-related decline” should be appropriate for the current findings (provided that one must rule out cognitive impairment in healthy elderly) and this would reflect the slow deterioration in cognitive capacities of aging individuals, especially when normative data are lacking for comparison.
In the article, authors have consistently used the term impairment and dysfunction to denote the age-related cognitive decline, observed on the selected tests, which might be due to several reasons.
First, authors used Mini-Mental State Examination (MMSE) to screen participants with cognitive impairment. However, sensitivity of MMSE is questionable when it comes to screening MCI patients, especially when population is highly educated. Moreover, educated participants with mild dementia often perform adequately on MMSE as items are easy and responses can be right due to rote learning. Therefore, one can argue that the dysfunction reported by the authors could be due to MCI or mild dementia rather than normal aging.
Second, there is a lack of normative data for older adults in India. To the best of our knowledge, NIMHANS Battery [6] provides norms till 65 years and there is a lack of norms for other neuropsychological tests. Authors have used a sample age ranging between 60 and 70 years and compared their scores with norms available only up to 65 years (NIMHANS norm for fluency). In the absence of adequate norms, dysfunction/impairment may not be actually present in the sample studied.
Judicious use of terms such as dysfunction or impairment for healthy elderly normal population is warranted in the absence of normative data.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Thapliyal G, Halder S, Mahato A. Memory, verbal fluency, and response inhibition in normal aging. J Geriatr Ment Health 2016;3:145-9.  [Full text] |
| 2. | Salthouse TA. The processing-speed theory of adult age differences in cognition. Psychol Rev 1996;103:403-28. [ PUBMED] |
| 3. | Park DC, Lautenschlager G, Hedden T, Davidson NS, Smith AD, Smith PK. Models of visuospatial and verbal memory across the adult life span. Psychol Aging 2002;17:299-320. [ PUBMED] |
| 4. | Petersen RC, Negash S. Mild cognitive impairment: An overview. CNS Spectr 2008;13:45-53. |
| 5. | Salmon DP, Bondi MW. Neuropsychological assessment of dementia. Annu Rev Psychol 2009;60:257-82. [ PUBMED] |
| 6. | Rao SL, Subbakrishna DK, Gopukumar K. NIMHANS Neuropsychological Battery-Manual. Bangalore: National Institute of Mental Health and Neurosciences; 2004. |
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