According to a study from the Alzheimer’s Society, over 62% of people believe that a dementia diagnosis would mean that “their life is over.” Despite the fact that early intervention is an important factor in cognitive care, fear of dementia keeps patients from talking to their doctors about their cognition.
According to the Alzheimer's Association, 13.2% of people age 75 to 84, and 33.4% of people age 85 or older have Alzheimer’s dementia. When it comes to supporting these senior patients, it's critical for healthcare providers to be able to distinguish between symptoms of cognitive impairment versus normal aging.
Measuring cognitive function with scientifically-backed cognitive screens can provide essential data and give healthcare providers a starting point for educating senior patients about preventing and managing cognitive decline in their 80s—which can start with routine testing and encouraging good brain health practices in their 60s and 70s.
In this article, we'll discuss the prevalence of dementia among seniors, as well as strategies and tools that healthcare providers can use to help discuss cognitive decline and introduce practices for better brain health.
Measuring and Delivering Care for Cognitive Decline
Under Medicare, an annual wellness visit is a requirement for patients over 65, and a great opportunity to implement routine cognitive testing. With assessment tools that can generate reports in minutes, providers have more time to get to know patients and understand their unique needs.
Here are our tools and tips for measuring patient cognition, building collaborative treatment plans, and keeping up with preventative care:
Assessing Older Adults’ Cognitive Ability
Some of the most common cognitive tests for dementia, Alzheimer’s disease, and mild cognitive impairment include:
- Mini Mental State Examination (MMSE) to identify difficulties with cognitive function.
- Mini-Cog for dementia patients, which combines a memory test and clock drawing test.
- Montreal Cognitive Assessment (MoCA) to assess spatial awareness, naming, short-term memory, language abilities, executive function, and attention.
- Saint Louis University Mental Status (SLUMS) to measure attention, delayed and immediate recall, calculation, executive function, and visuospatial response.
Many cognitive screeners—including the MMSE, Mini-Cog, MoCA, and SLUMS—are administered by pen and paper. While they provide quick results, they’re often limited in how much data they can provide about a patient’s ability to perform simple tasks.
- Instrumental Activities of Daily Living (IADL) Questionnaire, which measures a patient’s capacity to complete daily tasks that let them live independently. A digital version of the IADL is available in Creyos alongside other behavioral questionnaires.
- Creyos Dementia Protocol, which can be completed remotely or in office in under 10 minutes, and produce instant reports that are easy for patients and providers to understand. It includes a cognitive screener that is sensitive to potential early signs of dementia, detailed information about DSM-5 diagnostic guidelines, and can track symptoms over time.
Should the test results reveal signs of cognitive decline, providers may have the patients take blood tests, get brain imaging, or go in for neurological testing. Once a diagnosis is made, measurement-based care helps track how patients’ cognitive ability changes over time.
Delivering Care for Cognitive Impairment
If a patient is displaying signs of mild cognitive impairment or progressing dementia, it may be time to set up a cognitive care plan. This plan helps give patients better quality treatment while also taking the needs and capabilities of caregivers into account.
For about 75% of dementia parents in the United States, unpaid family members are the primary caregivers, with 60% of that work belonging to wives, daughters, daughters-in-law, granddaughters, and other female relatives (Brodaty and Donkin, 2009). In order to avoid caregiver burnout, understanding caregivers’ work schedules, health needs, and emotional state helps doctors determine which treatment plans are realistic.
Along with this, in the U.S. nearly 20% of caregivers are age 65+ themselves (National Alliance for Caregiving and AARP, 2020). When patients are experiencing cognitive decline in their 80s, it’s likely that their spouses or aging children will be looking after them, possibly while struggling with their own cognitive impairment.
Preventative Care for Patients in Their 80s
While there is no 100% guaranteed way to prevent dementia, there are many lifestyle strategies that can reduce the risk factors, including:
- Controlling blood pressure. Hypertension is associated with increased risk of vascular dementia, which is the second most common dementia in the world (Emdin et al., 2026). Regular exercise, stopping smoking, and following a healthy diet such as the MIND (Mediterranean–DASH Intervention for Neurodegenerative Delay) are several ways to reduce high blood pressure.
- Consistent sleep. One study found that people in their 50s-60s who got less than 6 hours of sleep per night were 30% more likely to be diagnosed with dementia (Sabia, 2021). Another study using Creyos cognitive testing found that getting 4 hours of sleep per night was equivalent to being 8 years older, compared to individuals who get a more typical 7-8 hours (Wild et al., 2018).
- Keeping up with social activities. Social isolation is associated with a 50% increased risk of dementia. This is alarming, as almost 25% of adults aged 65+ are socially isolated (Guarnera et al., 2023).
- Education and lifelong learning. Early education and keeping a cognitively active lifestyle through reading, playing games, and learning new activities may help build up a person’s “cognitive reserve” and reduce their risk of dementia (Gottlieb, 2003).
As patients start getting older, and especially if they’re showing signs of cognitive impairment, creating an advance care plan can identify lifestyle factors to slow decline. Even for patients who cannot fully prevent cognitive decline, this gives them an opportunity to advocate for their wishes while it’s still possible.
Healthcare Considerations for Patients 80+
Delivering cognitive healthcare to older adults comes with some unique considerations for providing an accessible patient experience:
- Technological barriers: Since COVID-19, more adults over 65 have begun to use virtual primary care in their medical care (Mace, 2022). However, Baby Boomers use technology differently than the older Silent Generation, and patients experiencing cognitive decline in their 80s may be intimidated by remote, entirely digital healthcare, and could benefit from familiar in-person appointments.
- Stigma: Despite the rising prevalence of dementia, there is still significant social stigma for seniors with cognitive impairment (Rewerska-Juśko and Rejdak, 2020). Normalizing cognitive testing in primary care is one way to take the fear out of conversations about cognitive decline and get patients on track for treatment.
- Hearing and vision loss: Vision and hearing-based disabilities in older adults can add an additional challenge to cognitive testing. For example, struggling to recognize loved ones could either be a sign of cognitive decline or a need for stronger glasses. Performing hearing and vision tests alongside cognitive screens is one way to identify the source of a patients’ symptoms (Alzheimer’s Society), and treating hearing and vision problems can in fact prevent some cases of dementia (Livingston et al., 2024).
- Mobility challenges: Approximately one-third of 70 year olds and most people over 80 report having challenges with mobility (Maresova et. al, 2023). Seeking accessible home modifications is one way to encourage patient safety if cognitive decline is beginning to interfere with their physical abilities.
How Can You Tell the Difference Between Dementia and Aging?
Misunderstandings about the symptoms of normal aging versus cognitive decline often keep patients from talking to their doctors about their cognitive health. In one study, 37% of people said they would put off talking to their primary doctor about memory problems because they assumed that dementia was a normal part of aging (Alzheimer’s Society).
Cognitive assessments can objectively assess if a patient is experiencing cognitive impairment. However, there are a few immediate differences between symptoms of dementia and normal aging.
Normal Aging
According to the World Health Organization, almost 40% of people will experience some sort of memory loss after the age of 65 (Alzheimer Society). Normal age-related memory problems shouldn’t dramatically interfere with peoples’ ability to live their daily lives. Along with this, they shouldn’t get in the way of problem-solving or the ability to pick up new skills.
However, while memory problems are often seen as a normal part of aging, there are some “superagers” whose brain structures in their 60s–80s are anatomically comparable to those of young adults (Sun et al., 2016).
This study’s researchers believe that consistent physical activity and embracing challenging mental activities—such as learning an instrument, trying out new technology, or teaching skills to others—are key to becoming a superager (Harvard Health Publishing, 2017). Encouraging aging patients to keep their minds active may help reduce the likelihood of cognitive decline in their 80s.
Mild Cognitive Impairment (MCI)
Mild cognitive impairment can resemble the normal signs of aging, but the decline is severe enough to be noticeable and measurable. If symptoms begin to affect the patient or become noticed by others, but are not interfering with daily activities, they might be dealing with MCI.
An estimated 10–15% of people with MCI develop dementia each year, which makes catching symptoms early all the more important (Alzheimer’s Association). Sensitive, scientifically-backed cognitive screens are key to catching the early stages of cognitive impairment.
Not all MCI progresses to dementia, so it is important to identify potential temporary and reversible causes, such as certain nutritional deficiencies (Silva et al., 2013). Cognitive screeners, alongside physical biomarkers, can give clinicians a full look at the source of cognitive impairment and help identify appropriate treatment plans.
Dementia
Dementia is the escalation of cognitive impairment symptoms to the point where they significantly impact a patient’s capacity to safely carry out their instrumental activities of daily living (IADLs). While patients with MCI might forget they’ve already told a story a couple of times, patients with dementia might forget information such as what year it is.
Along with memory loss, dementia impacts a patient’s behavior, mood, language abilities, and sense of judgment (National Institute on Aging). Challenges with executive function can also be an early sign of dementia, and plays a part in struggles with working memory (Stopford, 2010).
The Alzheimer’s Society identifies several different types of dementia, the most common of which include:
- Alzheimer’s disease
- Lewy body dementia
- Vascular dementia
- Frontotemporal dementia
Because there is currently no way to fully reverse dementia, symptoms will often become worse for patients as they get older. For example, patients with cognitive decline in their 80s may exhibit more extreme symptoms than patients in their 70s. Comparing patients to age-specific normative data can help distinguish normal aging from MCI or dementia, providing crucial information for clinicians and caregivers to take the appropriate next steps.
Using Creyos’ Cognitive Assessments for Patients 80+
The Creyos Dementia Protocol includes a sensitive cognitive screener, a detailed assessment, and care planning tools to assist in the identification and management of MCI or dementia. Alongside cognitive tasks to objectively identify deficits, questionnaires, including the IQCODE, IADL, PHQ-9, GAD-7, give a more complete look at patients’ behavioral health and help identify comorbidities.
Creyos cognitive tasks measure cognitive impairment across multiple domains to support diagnostic standards required by the DSM-5. Advanced tracking features monitor patients’ cognitive function over time, and produce reports that are easy for patients and providers to understand—and which integrate into patients’ electronic health records.
As of 2024, Creyos has added new accessibility features that make it appropriate for assessing patients in the 80+ age range who may be dealing with physical challenges. Accessibility features include:
- Multilingual audio-visual guides for patients with different abilities and learning styles. These are currently available in English, Spanish, and French, with more languages to come.
- Simple instructions and components to reduce anxiety, distractions, and confusion.
- Optimized colors and contrast for colorblind users.
- Large text and clear fonts for patients with visual impairments.
- Dark tasks to accommodate patients with light sensitivities.
- Large buttons with user-friendly placements for patients with mobility challenges.
For researchers, Creyos has become a trusted measurement tool in cognitive health studies. For example, the Maintain Your Brain study used Creyos cognitive tasks as primary outcome measures in studying the use of online interventions in preventing cognitive decline. And in positive news, the intervention group appears to have improved significantly on cognitive measures after the three years of personalized coaching to address dementia risk factors (Brodaty et al., 2025).
Contact Creyos today to learn about how our cognitive tasks can efficiently and effectively measure your patients’ brain health.
Common Patient Questions About Cognitive Decline
Here are a few frequently asked questions from patients about cognitive impairment:
What are the First Signs of Cognitive Decline?
According to the Alzheimer’s Association, some of the earliest signs of cognitive decline include:
- Memory loss
- Struggles with problem-solving and judgment
- Difficulty completing familiar tasks
- Confusion with time and place
- Difficulty understanding visuals and spatial relationships
- New problems with words in speaking or writing
- Frequently losing items
- Social withdrawal
- Mood changes such as increased anxiety or irritability
What Causes Rapid Decline in the Elderly?
Rapid decline can come from many sources. Research in The Lancet identified 14 modifiable risk factors that contribute to cognitive decline, as well as non-modifiable risk factors (e.g. genetics).
A common contributor is loneliness and social isolation (National Institute on Aging, 2019). The death of a partner, a loss of mobility, and lack of access to transportation are some of the most common sources of loneliness. In fact, driving cessation was associated with a 51% decrease in a patients’ social network when they lacked access to other forms of transportation (Chihuri et. al, 2016).
Practicing whole person care gives providers a full look at individual patients, and can identify when arranging transportation or connecting patients with social groups can improve health outcomes.
At What Age Does Cognitive Decline Begin?
Typically, women first begin experiencing any cognitive impairment and dementia at 73 and 83 years, respectively; for men, those numbers are closer to 70 and 79 years (Hale et al., 2020).
Experiencing some form of cognitive decline is common in a patient’s 80s, but there are many lifestyle and risk factors that play into how it impacts people on an individual level.
What is Normal Memory Loss at Age 80?
Women have a 71% risk and men have a 61% risk of experiencing any cognitive impairment in their lifetimes (Hale et al., 2020). Cognition problems are a normal part of aging, but the impact they have on patients’ daily lives are indicators of whether they are a sign of mild or severe cognitive decline. Objective cognitive testing can compare a patient’s performance to other people in the same age group, providing evidence of whether or not cognition is within a normal range for their age.
Measuring Cognitive Decline as Patients Age
For patients in their 80s, it is normal to see some signs of memory loss and reduced cognitive function. By keeping up with routine cognitive assessments, providers can identify when these problems are signs of a more serious condition, and set up the treatment plans that will give them the best quality of life as they continue to age.
Connect with us today to learn about how Creyos’ scientifically-backed cognitive assessment tools can be incorporated into your medical practice.
Updated: March 10, 2025
Reviewed by Mike Battista, Director of Science & Research at Creyos
Mike Battista specializes in brain health, cognition, and neuropsychological testing. He received his PhD in personality and measurement psychology at Western University in 2010 and has been doing fun and useful stuff in the intersection between science and technology ever since.