Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, March 10, 2025

Age and cognitive skills: Use it or lose it

 I probably need to start doing Ken-Ken puzzles for the numeracy portion. Your doctor better cure your aphasia so you can read as needed.

This really tells me nothing. Nothing on what reading and amounts to do or types of math problems to do. Useless!

Age and cognitive skills: Use it or lose it

Science Advances
5 Mar 2025
Vol 11, Issue 10
  • Abstract

    Cross-sectional age-skill profiles suggest that cognitive skills start declining by age 30 if not earlier. If accurate, such age-driven skill losses pose a major threat to the human capital of societies with rapidly aging populations. We estimate actual age-skill profiles from individual changes in literacy and numeracy skills at different ages. We use the unique German longitudinal component of the Programme of the International Assessment of Adult Competencies (PIAAC-L) that retested a large representative sample of adults after 3.5 years. Our empirical approach separates age from cohort effects and corrects for measurement error from reversion to the mean. Two main results emerge. First, average skills increase strongly into the forties before decreasing slightly in literacy and more strongly in numeracy. Second, skills decline at older ages only for those with below-average skill usage. White-collar and higher-educated workers with above-average usage show increasing skills even beyond their forties. Women have larger skill losses at older age, particularly in numeracy.

    INTRODUCTION

    The commonly accepted conclusion that cognitive skills decline with age starting rather early in adult life (1) has increasingly important potential economic implications. Cognitive skills measured by literacy and numeracy are closely related to individual earnings (24) and national growth rates (5, 6), implying that the steady and marked changes in the age composition of societies (7) might directly affect the economic well-being of nations. However, this assumed skill pattern has largely come from cross-sectional data that necessarily incorporate not only aging patterns but also cohort differences in skills. If the negative age pattern is simply due to conflating age and cohort effects, the economic concerns are considerably lessened. Recently developed individual longitudinal skill tests for a representative population of adults allow us to provide evidence on actual changes in skills with age and on their relationship with adult skill usage.
    We study the inevitability of age-driven skill decline using exceptional longitudinal data for the German adult population. Administered by the Organization for Economic Co-operation and Development (OECD), the Programme for the International Assessment of Adult Competencies (PIAAC) tested literacy and numeracy skills that are relevant for participation in social life and work, and surveyed economic and social conditions for random samples of the population aged 16 to 65 in 39 countries (8). Germany, unique among all participating countries, created a panel of participants from the PIAAC sample who were re-surveyed and retested 3.5 years after the original survey.
    We use the panel dimension of the data to estimate credible average age-skill profiles for the adult population. Observing actual changes in adult skills over the full age spectrum allows us to break the confounding of age and cohort patterns that has been ubiquitous in general cross-sectional analyses of adult skills. We estimate the average annualized marginal changes in skills for each age and concatenate them across individuals of different ages to derive full age-skill profiles. However, the panel data introduce new methodological problems that must be addressed before the analysis of age-skill patterns.
    Creating reliable age-skill patterns based on individual aging requires addressing the bias from measurement errors that inevitably accompany testing of skills over time. Observations of test scores include a combination of true scores and measurement errors, leading to systematic errors when looking at individual changes with age. Intuitively, low observed test scores are more likely to include negative errors. When we observe another assessment for an initially low-scoring individual, the measurement error is unlikely to be as negative as the first time, implying that the change in true test scores is biased upward for low-scoring individuals. For initially high-scoring individuals, the opposite will be true. This reversion to the mean will bias the overall age-skill relationship when skills vary by age. Thus, we correct the observed change in test scores throughout for reversion to the mean (9) to obtain error-adjusted age-skill patterns.
    We find that average (error-corrected) skills increase substantially into the forties for both literacy and numeracy. Subsequently, average skills decline slightly in literacy and strongly in numeracy. The averages, however, mask important heterogeneity.
    With the appropriately adjusted age-skill profiles, we can further investigate the role of skill usage. Previous analyses have considered whether individual background or occupations influence the evolution of age-skill patterns. These investigations of heterogeneity in age patterns are generally motivated by assumed differences in skill usage across groups, but data on skill usage have not typically been available. Because the background data from the PIAAC survey provide information on the detailed nature and frequency of participants’ skill usage at work and at home, we are able to explore the demographic aging patterns in greater depth.
    Individuals with above-average skill usage at work and home on average never face a skill decline (at least until the limit of our data at age 65). Consistent with the assumptions of prior studies, usage interacts closely with a variety of background characteristics. Thus, both literacy and numeracy skills keep increasing for white-collar and tertiary-educated workers in the second half of their working life if they have above-median skill usage, but not if skill usage is below the median. Skill evolution also varies by gender: Women show steeper skill decline at older ages, especially in numeracy.
    The primary contribution of our analysis to the literature on cognitive aging is the development of rich age-skill profiles for literacy and numeracy skills, skills which have been shown to have economic payoffs in the labor market, using longitudinal variation in a large representative sample. The data allow us to go beyond averages to consider important dimensions of heterogeneity and to describe the connection of profile differences with individual behavior and background. The studies closest to our analysis use different large-scale representative surveys with literacy and numeracy skills (1, 10), but these do not track actual skill changes of individuals over time. A parallel set of psychological and neuroscience studies offer related estimates of age patterns and their sources, albeit for different dimensions of skills and for nonrepresentative samples (1116), but evidence on their relationship to the economic outcomes that motivate our work is lacking.

    RESULTS

    Average age-skill profiles

    The starting point for our analysis comes from the cross-sectional picture of how cognitive skills vary with age. Figure 1Opens in image viewer depicts adult literacy and numeracy skills by age in the PIAAC test for representative population samples of all participating OECD countries [see also (8, 17)]. In the cross section, average literacy and numeracy scores start declining in the late twenties to early thirties. This pattern is duplicated qualitatively for Germany, our analysis country, where average literacy scores steadily fall from age 20, while numeracy scores rise slightly before beginning to decline in the late thirties (fig. S1).
    Fig. 1. Cross-sectional age-skill profiles (OECD countries).
    Cross-sectional association between age and skills in PIAAC (2012). Dots: Average skills by age. Line: Quadratic fit (estimated over 21 to 65 age range). Skills measured in SD units. Sample: 25 OECD countries with continuous age data; full population, ages 16 to 65, weighted by sampling weights (N = 147,667). Data source: PIAAC.
    However, it is difficult to interpret these cross-sectional patterns because they conflate age and cohort effects. Individuals across different ages also come from different cohorts and have thus experienced different histories of skill determinants, implying that these charts fail to describe the true patterns of the age-skill relationship over time for any individual. As a result, they also cannot reliably be used to understand the factors that feed into skill changes by age without introducing strong assumptions about the nature of cohort and individual time patterns.
    The changes in observed numeracy and literacy skills for individuals over time show a very different pattern than suggested by the cross-sectional data. Figure 2BOpens in image viewer depicts the annualized marginal changes in scores with age for individuals at each age for the full German population sample (3263 observations). The analysis corrects for reversion to the mean, and it includes a quadratic fit and 95% confidence intervals. The quadratic prediction indicates increases in skills for individuals up to age 45 in literacy and up to age 40 in numeracy. Skill changes turn negative beyond these ages, with notably stronger declines for numeracy than for literacy. In both subjects, the marginal change in skills declines steadily with age. Initially, this decline is close to linear but ultimately gets flatter.

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