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Cognitive decline and dementia in older adults: epidemiology, pathophysiology, diagnosis, and management 

Cognitive decline and dementia in older adults: epidemiology, pathophysiology, diagnosis, and management
Source:
Oxford Textbook of Geriatric Medicine (3 edn)

Defining normative trajectories of cognitive ageing is essential to determine what is abnormal. Normative cognitive ageing, in itself, correlates highly with changes in everyday function, and thus impacts on the lives of the majority of older adults who do not develop dementia. What is normative depends on: 1) the degree of cognitive change; 2) the pattern of change across cognitive domains; and 3) the concurrence of non-cognitive features, such as changes in activities of daily living. Cognitive reserve influences the third of these predicates and comprises both static and dynamic components. Social context determines the dementia threshold, hence also contributing to the definition of what can be considered as normative cognitive change. Life course studies are essential for the identification of factors that influence normative cognitive ageing to avoid drawing false inferences due to reverse causation.

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