Editing Geriatrics (section)

===Cognition===

Cognitive aging is characterized by declines in fluid abilities like processing speed, working memory, and executive function, while crystallized abilities such as knowledge remain stable (Anstey & Low, 2004; Murman, 2015). Age-related changes in brain structure and function correlate with these cognitive declines (Murman, 2015). Older adults show weaker occipital activity and stronger prefrontal and parietal activity during cognitive tasks, possibly reflecting compensation (Cabeza et al., 2004). Subjective cognitive complaints are common among older adults, particularly regarding working memory (Newson & Kemps, 2006). Various factors influence cognitive aging, including genetics, lifestyle, and health (Bäckman et al., 2004). Cognitive impairments can progress to [[Mild cognitive impairment|mild cognitive impairment (MCI)]] or [[dementia]] (Mendoza-Ruvalcaba et al., 2018).

MCI is a transitional state between normal aging and Dementia, affecting 10-20% of adults over 65 (Schwarz, 2015). Geriatricians encounter MCI patients in various care settings, with '''diagnoses''' relying on clinical assessment and mental status examinations (Tangalos & Petersen, 2018). MCI is highly prevalent among older adults with depression and may persist after depression remits (Lee et al., 2006). While MCI is considered a high-risk condition for developing [[Alzheimer's disease]], there is heterogeneity in its presentation and outcomes (Petersen et al., 2001).

Dementia is a prevalent condition in geriatric populations, affecting cognitive function and daily activities (Talawar, 2018; Mirzapure et al., 2022). Alzheimer's disease is the most common cause, accounting for 40-80% of cases (Mirzapure et al., 2022; Chulakadabba et al., 2020). Geriatric patients with dementia often have comorbidities and other geriatric syndromes, requiring holistic and integrated care (Chulakadabba et al., 2020; Nguyen et al., 2023). Geriatricians play a crucial role in dementia care, but many feel current training is inadequate and seek more structured experiences (Mayne et al., 2014). Improving access to geriatricians and enhancing general practitioners' diagnostic skills could improve timely and accurate dementia diagnosis (Mansfield et al., 2022). However, there are significant shortages of dementia specialists, particularly in rural areas (Liu et al., 2024; Christley et al., 2022). Geriatricians support comprehensive post-diagnosis information provision, including sensitive topics like advance care planning (Mansfield et al., 2022). Collaboration between specialists and family physicians is essential, with specialists often handling contentious issues like driving competency (Hum et al., 2014). Geriatric training may influence end-of-life care patterns for dementia patients (Gotanda et al., 2023). A geriatrics perspective emphasizes prevention, considering lifestyle factors that promote healthy cognitive aging (Steffens, 2018).

There are various tests to assess cognition.
These include the [[Mini–mental state examination|MMSE]], the [[Montreal Cognitive Assessment]], and GERRI (geriatric evaluation by relative's rating instrument), which is a diagnostic tool for rating [[cognitive function]], [[social function]] and [[Mood (psychology)|mood]] in geriatric patients.<ref>{{cite journal |doi=10.2466/pr0.1983.53.2.479 |title=Development and Validation of the Geriatric Evaluation by Relative's Rating Instrument (Gerri) |year=1983 |last1=Schwartz |first1=Gerri E. |journal=Psychological Reports |volume=53 |issue=2 |pages=479–88 |pmid=6647694|s2cid=46265352 }}</ref>