Cognitive health refers to the ability to learn, remember, and reason effectively. It is a cornerstone of functional independence in later life, influencing whether an individual can live independently, manage finances, drive safely, and adhere to prescribed medication regimes. As people age, gradual changes in certain cognitive functions are expected, including slower processing speed, reduced working memory, and increased difficulty with multitasking.
However, cognitive ageing is not uniform. Factors such as genetics, lifestyle, and medical conditions—including diabetes, depression, and stroke—can accelerate cognitive decline. Over time, this may increase the risk of neurocognitive disorders such as Mild Cognitive Impairment (MCI) and dementia.
Local epidemiological data highlight the scale of this issue. The Well-being of the Singapore Elderly (WiSE) study conducted by the Institute of Mental Health found a 10% prevalence of dementia among adults aged 60 years and above. Risk was notably higher among individuals aged 75 years and older, those with no formal education, retirees, and individuals with a history of stroke (Subramaniam et al., 2015). These findings are particularly salient given Singapore’s rapidly ageing population, with projections suggesting that one in four residents will be aged 65 or older by 2030.
Against this backdrop, psychologists play an important role in promoting cognitive health and reducing the risk of cognitive decline. This article outlines three key areas where psychological interventions may be especially impactful: managing mid-life and late-life depression, enhancing subjective perceptions of ageing, and building cognitive reserve through targeted interventions.
Managing Geriatric Depression
The 2024 update of the Lancet Commission on Dementia Prevention, Intervention, and Care reported that nearly half of global dementia cases may be preventable through the elimination of 14 modifiable risk factors. Depression alone accounted for approximately 3% of total modifiable risk (Livingston et al., 2024). Despite this, depression in older adults remains frequently under-recognised and under-treated. Contributing factors include reluctance to seek mental health care, overlapping physical illnesses, and diagnostic complexity arising from comorbid conditions (Faisal-Cury et al., 2022).
In later life, major depressive disorder often co-occurs with physical illness, frailty, Mild Cognitive Impairment, and social determinants such as retirement-related role transitions, bereavement, social isolation, and polypharmacy. These factors collectively increase vulnerability to poorer health outcomes and elevated suicide risk (Reynolds et al., 2022). When left untreated, depressive symptoms can reduce adherence to medical treatment, limit engagement in health-promoting behaviours, and contribute to a higher risk of subsequent cognitive decline and dementia.
Emerging evidence suggests that persistently elevated or worsening depressive symptoms may independently increase dementia risk, underscoring the importance of repeated depression screening and early psychological intervention in older adults (Kua, 2024). Brief, learning-based psychotherapies—including cognitive behavioural therapy, interpersonal therapy, problem-solving therapy, and behavioural activation—have been shown to reduce the incidence of major depressive disorder by approximately 20% over one to two years when compared with usual care or waitlisted controls.
Psychologists working with older adults are well-positioned to deliver these evidence-based interventions, while also addressing depression-related impairments in cognitive control that affect decision-making and problem-solving. By targeting these mechanisms, therapy can help reduce feelings of hopelessness and psychological entrapment that commonly accompany late-life depression (Reynolds et al., 2022).
Enhancing Positive Perceptions of Ageing
Subjective ageing refers to how individuals perceive and make sense of their own ageing process. Research consistently shows that positive self-perceptions of ageing are associated with better physical health, improved mental well-being, higher quality of life, and increased longevity (Velaithan et al., 2023). Importantly, subjective ageing is a core component of successful ageing. Older adults frequently report that maintaining a positive outlook, adapting to change, and coping effectively with life transitions contribute more to their sense of well-being than the absence of illness or physical limitations (Depp & Jeste, 2006).
Neuroscience research further supports this perspective. Studies demonstrate ongoing neuroplasticity in later life, including the formation of new synapses, dendrites, and blood vessels among older adults who remain physically, cognitively, and socially active. These findings provide a neurobiological basis for successful ageing, even in the presence of age-related neurodegenerative changes (Reynolds et al., 2022).
Psychologists can support more positive perceptions of ageing by addressing several modifiable domains. These include helping older adults manage subjective stress through mindfulness-based stress reduction, exploring meaning and purpose following retirement, strengthening social connections through evaluation of social networks, and fostering psychological strengths such as resilience and wisdom that support adaptation to ageing-related changes (Hazlett-Stevens et al., 2019; Bentley et al., 2022; MacLeod et al., 2016).
Cognitive Interventions
Multi-domain interventions have demonstrated growing promise in the prevention of cognitive decline. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) showed improvements in longitudinal cognitive outcomes, even among individuals with genetic susceptibility to Alzheimer’s disease (Ngandu et al., 2015). Cognitive training is a key component of such interventions.
Computerised cognitive training—structured, repetitive practice of tasks designed to target specific cognitive processes—has been shown to improve global cognition, attention, working memory, and learning in both cognitively healthy older adults and those with Mild Cognitive Impairment (Hill et al., 2017).
Given the heterogeneity of cognitive ageing and the diverse needs of older adults—including those with a history of stroke, Parkinson’s disease, or traumatic brain injury—psychologists play an important role in designing personalised cognitive interventions. Following comprehensive neuropsychological assessment, interventions can be tailored to an individual’s cognitive profile, targeting both strengths and areas of vulnerability.
For older adults experiencing subjective cognitive concerns or objective impairment, regular engagement in cognitively stimulating activities should be encouraged. Psychologists can also teach practical compensatory strategies—such as the use of calendars, written reminders, and checklists—to support daily functioning. In addition, evidence-based memory strategies, including chunking, spaced retrieval, and visualisation, may be introduced to enhance encoding and recall of information.
Cognitive changes in later life can be complex, multifactorial, and deeply personal. Early assessment and evidence-based psychological support can play a meaningful role in preserving cognitive health, emotional well-being, and independence as one ages.
At Private Space Medical, our experienced team of psychiatrists and psychologists works closely with older adults and their families to provide careful assessment, personalised intervention, and clinically grounded guidance. If you or a loved one have concerns about memory, mood, or cognitive functioning, a professional consultation may offer clarity—and a constructive way forward.
Ms Zaylea Kua
Senior Psychologist
Senior Psychologist
