How can we work with and around aging-related cognitive decline?

Hi everyone,

We have a very interesting (though a bit depressing) obstacle here: aging-related cognitive decline. Would love to know what you think of it, and how you think we can work with and around the obstacle.


The normal aging process is accompanied by some cognitive decline in areas and skills that include processing speed, motor responses, attention span, memory, and mental flexibility. This phenomenon can have an impact on the employment potential of the elderly, and affect their self-confidence.


While there is much focus on neurodegenerative diseases like Alzheimer’s, an inevitable side-effect of aging (so far, at least) is that it is accompanied by a cognitive decline. In other words, even elderly folks who do not suffer from dementia or some other severe form of cognitive mental impairment, will still experience some changes to their cognitive capacity.

Not all cognitive abilities diminish with aging. Some, skills and abilities - especially ones that are well-practiced and well-known to the individual, like vocabulary or language - may actually improve with age. However, fluid cognitive abilities are subject to a significant decline.

These include:

    Processing speed and speed of motor responses, which start to decline in the 30s, and are critical for driving and personal interactions; Selective attention, which indicates a person’s ability to concentrate on certain occurrences while filtering out irrelevant information, and which is critical for driving a car. Working memory, which indicates a person’s capacity to hold certain ideas in mind for a short duration. Elderly people with a decline in working memory can have difficulty performing mental calculations or working with long strings of numbers. Memory acquisition, encoding and retrieval, which can impact learning. Visual construction skills, which indicate a person’s ability to assemble parts together - for example, when assembling an Ikea piece of furniture. Mental flexibility, which declines significantly at the seventh decade of life.
  • Response inhibition, which indicates one’s ability to consider an alternative and novel response to new stimuli, instead of repeating an old behavioral pattern.

It should be noted that not all elderly folks experience the same level or extent of cognitive decline, as there is great variability between individuals in this respect.


Age-related cognitive decline means that some common activities, like driving, are more difficult and pose more risk to the average elderly person.

Additionally, the cognitive decline may make it more difficult for the elderly to perform well in their workplace. Many elderly people in South Korea, Mexico, Japan, Switzerland and Turkey, choose to retire before the official pension age - possibly because of the cognitive decline they experience, and which may hinder them at work.

Additionally, workers in some professions in the U.S., like pilots and (in some states) judges, are required to retire upon reaching a certain age, mainly because of aging-related cognitive decline which could influence the individual’s ability of performing the task safely.

User Groups

While cognitive decline often starts at the third decade of life, its impact peaks towards the seventh decade or later. Therefore the user groups that suffer the most because of the consequences of cognitive decline are people aged 60+.


It is generally difficult to deal even with abnormal cognitive decline, caused by neurodegenerative diseases and strokes. Normal cognitive decline is not as insidious or devastating as Alzheimer’s disease or severe dementia, and thus is perceived as part of the normal aging process, which does not require treatment. Furthermore, the causes of cognitive decline are not yet well-understood.

In the Netherlands, if you’re 75 or older, you need a statement from your doctor attesting to your health in order to get your driver’s license renewed.

That doesn’t seem too unreasonable, for the reasons you’ve outlined, but people are still assessed on an individual basis and that is the fair thing to do.

As the population ages, policies that do not discriminate – for example, mandatory retirement for all pilots at 60 or 65 – may become unsustainable.

@NickOttens ,
That’s great. Thanks for the information. I definitely agree with your thinking on the issue.

I would suspect there are a ton of societal biases at play contributing to people “choosing to retire before the official pension age.” It is common practice in societies such as South Korea for employers to force retirement upon aging employees, as early as those in their fifties.

What, if any, activities or practices, societal or individual, have shown to contribute to slowing down that cognitive decline as we age? Ritual exercise, repetitive activities, adult continuing education, for example. What do we know already works and why wouldn’t those things be adopted by groups or individuals?

@LisaCovington One tricky thing with proving the efficacy of interventions related to aging, whether lifestyle- or medically-oriented, is the time it takes to demonstrate their impact. Through my research, though, I’ve learned that some companies like BioAge conduct tests by analyzing samples from biobanks that, amazingly, are linked with actual retrospective electronic health records. Pretty neat!

@LisaCovington - There are some lifestyle treatments. We’ll go into those remedies in length in a few weeks. I can’t wait to learn more about them, though, as I’m starting to get concerned for myself: third decade of life is where the cognitive decline starts, after all. :wink:

@JessicaYoon - agreed. Do you think there is another kind of evidence to put there?

who’s working on synthetic biology to create a mico-organism to eat the plaque in the brain?

@Jerome the Washington University School of Medicine is!

Antibody removes Alzheimer’s plaques, in mice: Potential therapy removes APOE and plaques from brain

Plaques of a brain protein called amyloid beta are a characteristic sign of Alzheimer’s disease. But nestled within the plaques are small amounts of another Alzheimer’s protein: APOE. Now, researchers have shown that an antibody not only targets APOE for removal but sweeps away plaques in mice. The findings could lead to a way to halt the brain damage triggered by amyloid plaques while the disease is still in its early stages, perhaps before symptoms appear.

@Jerome - Good to see you here! I was going to approach you and ask that you invite the Millennium Project’s members to join the community. What do you think about that?

And thanks for the heads-up on the bacteria. I’ll add that to the potential remedies list we’re creating, and we’ll delve into it more deeply in a few weeks, when we reach the remedy analysis stage.

I already suggested Jose Cordeiro and Aubrey de Gray who would know the most , but you are welcome to send a note to

@JoseCordeiro just joined us today! :slight_smile:

Welcome, @JoseCordeiro !

I think that once we better understand the interplay between metabolic processes (microBiome), the immune system and the brain, we will be able to control those aging symptoms, coginitive and/or physical much better.
The current rate of failure of new drugs to treat AD (Alzheimer Disease) is a clear indication to the lack of understanding of the underlying mechanisms and/or root causes.

Hey Yoav (@ymedan) - great to have you here with us!

I absolutely agree with your approach. Let’s hope AI can come up with better models for metabolic processes and intertissue communication than the ones we have today.

@henry_bro, you might have insights here, based on your areas of expertise. Please feel free to share your thoughts with the community.

In this interview and collection I question the dominant view in Alzheimer disease

@GeorgePerry -
Thanks! Are you also involved in the XPRIZE Alzheimer Prize Design ?

I was as a consultant-- but the path they took was distinct from my views.