Neuropsychological changes in frontal functions with aging

Abstract

Psychological and neuropsychological assessment of the older patient remains hampered by the lack of adequate norms for this age group. Our understanding of changes normative with aging and changes secondary to pathological processes is still rather limited and affects the manner in which the older patient is diagnosed and treated. This article reports on three groups of the elderly given a battery of neuropsychological tests. The specific aim is to explore changes with aging in functions attributed to frontal lobes in contrast to other higher cortical functions. The groups consisted of 31 cognitively intact young‐old, 48 cog‐nitively intact old‐old, and 67 cognitively impaired old‐old. The results suggest that there are in fact decrements in frontal functions with age in the absence of other cognitive impairment and that these functions are further impaired in the cognitively impaired old‐old. Various hypotheses for this reverse in the typical pattern of “hyperfrontality” are presented and practitioners are cautioned that these changes in cognitively intact old‐old may perhaps be normative rather than reflective of pathology.