![]() ![]() Although emotional processing and subsequent expressions may at times be exaggerated or inappropriate, it is clear that emotional attachments remain strong during the course of AD. Similar to procedural memory abilities, attachments and emotional processing also are highly resistant to AD's effects. Figure 1 shows that as cognitive reserves decline, declarative and episodic memory deteriorates faster than procedural memory (De Vreese, Neri, Fioravanti, Belloi, & Zanetti, 2002 Gabrieli, 1998 Hirono et al., 1997). Procedural memory abilities are better spared from AD because these abilities are less dependent on the affected regions of the brain such as the basal ganglia and the cerebellum (Poldrack & Gabrieli, 1997). Procedural memory abilities, often referred to as implicit memory, involve more rote or unconscious recollections (e.g., riding a bike, using utensils, turning a doorknob). ![]() These prefrontal and hippocampal areas decline much sooner than and are compromised with disease progression more than other abilities such as procedural memory ability. These memory abilities are dependent on the connections between the prefrontal cortex and the hippocampus, which are more negatively affected by the disease process (Grady, Furey, Pietrini, Horwitz, & Rapoport, 2001). These memory abilities often are referred to as explicit memory abilities and entail conscious recollection and information recall. ![]() Declines in episodic memory involve difficulties retrieving information about oneself (e.g., What did you have for breakfast yesterday?). Declines in declarative memory manifest as difficulty retrieving learned information (e.g., Who is the president of the United States?). Although in most cases they are able to function socially and interact with others, adults may become frustrated with declines in their cognitive ability during this stage.Ĭognitive declines occur in several areas, but most notably in attention and concentration, short-term memory, and declarative and episodic memory. AD compromises the brain and reduces cognitive reserve, resulting in early, middle, and late disease stages with various cognitive abilities declining at different rates (Fig 1).ĭuring the early stage of AD, adults begin to exhibit difficulty performing more complex instrumental activities of daily living (IADL) such as remembering to take medications, operating a vehicle, paying bills and negotiating finances, and executing other tasks requiring a high degree of cognitive ability. These disease processes translate into reduced cognitive efficiency and expressions of cognitive impairment of dementia at a certain threshold of damage. Someone with a great deal of cognitive reserve may build a strong network of neuronal connections that take longer to be compromised by AD's pathological features, delaying the cognitive symptoms of this illness (Vance & Crowe, 2006).Īs neurons become damaged due to the build-up of AD-associated amyloid plaques and neurofibrillary tangles, the physiological integrity of the brain becomes compromised (Yaari & Corey-Bloom, 2007). Cognitive reserve accumulates as neuronal connections are forged by lifelong learning, mentally stimulating and educational pursuits, interactive social supports, and health-promoting opportunities. Such activity translates into cognitive ability. Cognitive reserve is the amount of remaining neurological integrity that is viable to produce neural activity. ![]()
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