Practice effects refer to the improvement in cognitive test scores over repeated administrations of cognitive tests. ![]() While previous studies have confirmed the existence of terminal decline, 3– 7 they have inadequately addressed practice or learning effects in cognitive test performance. ![]() 8 Understanding terminal decline among older adults who remain free from dementia can potentially help distinguish normal cognitive aging from the cognitive decline associated with pathologic aging. The concept of terminal cognitive decline refers to the relatively precipitous drop in cognitive function occurring in the years preceding death. 1– 7 Therefore, cognitive decline could reflect biological aging independently of dementia. However, even in the absence of clinically diagnosed dementia, and after accounting for other illnesses, declining cognitive function is also associated with mortality. Dementia is a well-known risk factor for mortality.
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