Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by developmentally inappropriate levels of hyperactivity, impulsivity, and/or inattention. ADHD is chronic, may persist into adulthood, and is associated with impairment in social and academic/work domains across the lifespan. Children and adolescents with ADHD often present with executive function deficits and emotion dysregulation, and these deficits may increase impairment and risk for co-occurring disorders. The etiology of ADHD is not yet understood, though research suggests that biological and environmental factors (e.g., family, community) contribute to its development and course. It should be noted that ADHD commonly co-occurs with additional psychiatric disorders, such as oppositional defiant disorder (ODD), conduct disorder (CD), and major depressive disorder.
Evidence-based assessment of ADHD requires information from multiple informants using multiple assessment methods to determine the presence of ADHD symptoms across settings and any co-occurring disorders. The evidence-based treatment options for ADHD are manifold. Pharmacotherapy for ADHD is common, although numerous behavioral interventions are also effective. Stimulant medications are commonly prescribed and are typically effective in ameliorating core ADHD symptoms. There is also evidence that the nonstimulant medication atomoxetine substantially decreases the symptoms of ADHD. Importantly, medication therapy works to reduce symptoms but typically does not alleviate the impairments associated with the disorder. Combined medication and behavioral interventions are more likely to reduce impairments and normalize behavior.
Article
ADHD in Children and Adolescents
Kelsey E. Woods, Christina M. Danko, and Andrea Chronis-Tuscano
Article
Aging and Cognitive Skill Learning
Jack Kuhns and Dayna R. Touron
The study of aging and cognitive skill learning is concerned with age-related changes and differences in how we gather, store, and use information and abilities. As life expectancy continues to rise, resulting in greater numbers and proportions of older individuals in the population, understanding the development and retention of skills across the lifespan is increasingly important. Older adults’ task performance in cognitive skill learning is often equal to that of young adults, albeit not as efficient, where older adults often require more time to complete training. Investigations of age differences in fundamental cognitive processes of attention, memory, or executive functioning generally reveal declines in older adults. These are related to a slowing of cognitive processing. Slowing in cognitive processing results in longer time necessary to complete tasks which can interfere with the fidelity of older adults’ cognitive processes in time-limited scenarios. Despite this, older adults maintain comparable rates of learning with young adults, albeit with some reduced efficiency in more complex tasks. The effectiveness of older adults’ learning is also impacted by a lesser tendency to recognize and adopt efficient learning strategies, as well as less flexibility in strategy use relative to younger adults. In learning tasks that involve a transition from using a complex initial strategy to relying on memory retrieval, older adults show a volitional avoidance of memory that is related to lower memory confidence and an impoverished mental model of the task. Declines in learning are not entirely problematic from a functional perspective, however, as older adults can often rely upon their extensive knowledge to compensate for certain deficiencies, particularly in everyday tasks. Indeed, domains where older adults have maintained expertise are somewhat insulated from other age-related declines.
Article
Aging Couples: Benefits and Costs of Long Intimate Relations
Victoria I. Michalowski, Denis Gerstorf, and Christiane A. Hoppmann
Aging does not occur in isolation, but often involves significant others such as spouses. Whether such dyadic associations involve gains or losses depends on a myriad of factors, including the time frame under consideration. What is beneficial in the short term may not be so in the long term, and vice versa. Similarly, what is beneficial for one partner may be costly for the other, or the couple unit over time. Daily dynamics between partners involving emotion processes, health behaviors, and collaborative cognition may accumulate over years to affect the longer-term physical and mental health outcomes of either partner or both partners across adulthood and into old age. Future research should move beyond an individual-focused approach to aging and consider the importance of and interactions among multiple time scales to better understand how, when, and why older spouses shape each other’s aging trajectories, both for better and for worse.
Article
Aging Societies and the Ethical Challenges of Long Life
Allison R. Heid and Steven H. Zarit
Individuals are living longer than they ever have before with average life expectancy at birth estimated at 79 years of age in the United States. A greater proportion of individuals are living to advanced ages of 85 or more and the ratio of individuals 65 and over to individuals of younger age groups is shrinking. Disparities in life expectancy across genders and races are pronounced. Financial challenges of sustaining the older population are substantial in most developed and many developing countries. In the United States in particular, employer-based pension programs are diminishing. Furthermore, Social Security will begin taking in less money than it pays out as early as 2023, and the debate over its future in part entails discussions of equitable distribution of resources for the young in need and the old. Living longer is associated with a greater number of chronic health conditions—over two-thirds of Medicare beneficiaries in the United States have two or more chronic health conditions that require complex self-management regimes partnered with informal and formal care services from family caregivers and institutional long-term services and supports. Caregiver burden and stress is high as are quality care deficiencies in residential long-term care settings. The balance of honoring individuals’ autonomous wishes and providing person-centered care that also addresses the practicalities of safety is an ever-present quandary. Furthermore, complex decisions regarding end-of-life care and treatments plague the medical and social realms, as more money is spent at the end of life than at any other point and individuals’ wishes for less invasive treatment are often not accommodated. Yet, despite these challenges of later life, a large percentage of older individuals are giving financial support, time, and energy to younger generations, who are increasingly strained by economic hardship, the pressures on dual earner parents, and the problems faced by single parenthood. Older individuals’ engagement in society and the help they provide others runs counter to stereotypes that render them helpless and lonely. Overall, the ethical challenges faced by society due to the aging of the population are considerable. Difficult decisions that must be addressed include the sustainability of programs, resources, and social justice in care, as well as how to marshal the resources, talents, and wisdom that older people provide.
Article
Analysis of Dyadic Data in Lifespan Developmental Research
Gizem Hülür and Elisa Weber
Lifespan development is embedded in multiple social systems and social relationships. Lifespan developmental and relationship researchers study individual codevelopment in various dyadic social relationships, such as dyads of parents and children or romantic partners. Dyadic data refers to types of data for which observations from both members of a dyad are available. The analysis of dyadic data requires the use of appropriate data-analytic methods that account for such interdependencies. The standard actor-partner interdependence model, the dyadic growth curve model, and the dyadic dual change score model can be used to analyze data from dyads. These models allow examination of questions related to dyadic associations such as whether individual differences in an outcome can be predicted by one’s own (actor effects) and the other dyad member’s (partner effects) level in another variable, correlated change between dyad members, and cross-lagged dyadic associations, that is, whether one dyad member’s change can be predicted by the previous levels of the other dyad member. The choice of a specific model should be guided by theoretical and conceptual considerations as well as by features of the data, such as the type of dyad, the number and spacing of observations, or distributional properties of variables.
Article
Anxiety Disorders in Late Life
Jonathan S. Gooblar and Sherry A. Beaudreau
Anxiety disorders are among the most prevalent and understudied mental health problems in late life. Specific phobia, social anxiety disorder, and generalized anxiety disorder are the most prevalent anxiety disorders in older adults among the 11 disorders identified by the Diagnostic and Statistical Manual of Mental Disorders (fifth edition). Anxiety disorders lead to significant functional burdens and interface with physical health problems and cognitive impairment, concerns frequently experienced in adults over age 65. Additional contextual factors should be considered when assessing and treating late-life anxiety, including the effects of polypharmacy, other mental health conditions, role changes, and societal attitudes toward aging. The relationship between anxiety and physical health problems in older adults can be causal or contextual, and can involve poorer estimates of subjective health and lower ratings of functioning. These factors present unique challenges to the detection, conceptualization, and treatment of late-life anxiety, including the tendency for older adults to focus on somatic symptoms and the potential for long-term behaviors that can mask distress such as substance use. Researchers are increasingly incorporating a gerodiversity framework to understand the contributions of cultural, individual, and other group differences that may affect the presentation of anxiety symptoms and disorders. Older adults in general are less likely to be treated for anxiety disorders, and intersecting individual and group differences likely further affect how anxiety disorders are perceived by healthcare providers. Cognitive behavioral therapy and its variants have the most empirical support for treatment. Newer evidence lends support to acceptance and commitment therapy and problem-solving therapy, which tend to address some of the contextual factors that may be important in treatment.
Article
Attachment Theory and Research
Pehr Granqvist and Robbie Duschinsky
Attachment theory was founded by John Bowlby (1907–1990), a British child psychiatrist and psychoanalyst. The theory builds on an integration of evolutionary theory and ethology, cybernetics and cognitive science, as well as psychoanalytic object relations theory. The theory postulates that an attachment behavioral system evolved via natural selection processes. Bowlby conceived of the attachment system as a behavioral control system that continuously monitors the offspring’s proximity to caregivers, which has in turn been associated with protection from dangers and thus increased chances of survival and reproduction in humans’ and many other mammals’ ancestral environments. Attachment is a species-wide phenomenon denoting the strong bonds that children form to their caregiver(s), seeking to maintain proximity and communication, protesting separations, and using the caregiver(s) as a safe haven to return to for comfort and protection and as a secure base to explore the environment from. Attachments take time, maturation, and repeated sequences of interaction to form and are typically observed from the second half of children’s first year of life onward. According to the theory, attachment-related experiences with the caregiver(s) become internalized in the form of cognitive-affective representations of self and others (internal working models [IWMs]) that organize the child’s behavior and displays of affect in relation to the caregiver(s). Although malleable, such IWMs display a certain measure of continuity across time and situations and may generalize to affect the individual’s expectancies and behavioral inclinations in other and later interpersonal relationships. As pioneered by Mary Ainsworth and colleagues, attachments vary in quality, largely depending on the caregiver’s behaviors (e.g., responsivity and sensitivity to the child’s signals), whereas evidence for a direct influence of genetic heritability is limited. Variations in attachment are typically described using two dimensions (secure–insecure, organized–disorganized) subsuming four categories (secure, insecure–avoidant, insecure-resistant–ambivalent, disorganized–disoriented). Much of the empirical research regarding attachment has focused on these variations and their measurement. Ainsworth and colleagues’ Strange Situation Procedure (SSP), applicable for children aged 10–18 months, is often heralded as the “gold standard” attachment measurement tool. The concerted body of research indicates that secure attachment (or associated factors), marked by confidence in the caregiver’s availability, is generally a protective factor in socioemotional development. In contrast, insecure (avoidant and resistant) attachment, characterized by lack of confidence in the caregiver’s availability, is generally a vulnerability factor in development. Disorganized attachment, reflecting confused, conflicted, or apprehensive child behaviors in the presence of the caregiver (in the SSP), is a risk factor in development, most notably for externalizing behavior problems. Notably, the effect sizes observed have typically been small to moderate, and much is unknown about linking mechanisms and moderating influences. Although most readily observed in early childhood, humans form attachments throughout the lifespan. Accordingly, much research has also focused on adult (e.g., spousal) attachment and the intergenerational transmission of attachment from caregivers to their children.
Article
Attachment Theory from Ethology to the Strange Situation
Marga Vicedo
In psychology, the term “attachment” has been made popular by British psychiatrist and psychoanalyst John Bowlby’s theory about the adaptive value of the mother–infant bond. Bowlby was not the first to use the term “attachment” or to study the significance of close emotional relationships for infants and young children. Anna Freud and other psychoanalysts had used the term to refer to the mother–child relationship. Bowlby’s views, however, departed from psychoanalysis because he appealed to the science of ethology, the biological study of behavior, for support. According to Bowlby, the mother–infant attachment has a biological basis.
The operationalization of the ethological theory of attachment through the work of American- Canadian child psychologist Mary Ainsworth played a key role in the rise of the ethological theory of attachment to paradigmatic status toward the end of the 20th century. Ainsworth carried out observational studies of the attachment between mothers and infants. She also designed an experiment, the strange situation procedure (SSP), to measure and categorize attachment relationships between infants and mothers. Ainsworth and her students argued that their experimental work in the SSP supported Bowlby’s views about the instinctual nature of the child’s attachment to the mother and the importance of a secure attachment in infancy for a person’s adequate emotional development.
Attachment theory has become one of psychology’s most influential theories about early child development and its impact on an individual’s subsequent emotional life and adult relationships. Supporters claim its universal validity and its prescriptive character. For them, attachment theory establishes the norm of what is considered healthy emotional and psychological childhood development, and it sets the standards for good parenting. In the Western world, attachment theory has an impact in various realms, including childcare, adoption policies, education, and therapy. Many schools of early childhood education identify children at risk for poor learning in the classroom as a result of attachment problems at home. Pediatricians often rely on attachment theory to encourage specific practices in parent–child interactions. Therapeutic approaches for children, families, and couples are sometimes based on attachment theory, as are decisions about adoption, parental rights, and child custody. Furthermore, some intervention programs in family and educational practices implemented by international NGOs rely on attachment theory.
The ethological theory of attachment, however, has also been contested since its inception. Several psychologists critiqued the empirical studies about maternal deprivation on which it was erected. Other scholars challenged the notion that biological science supports its claims. Finally, numerous cross-cultural psychologists and anthropologists challenged the universality of several of its central tenets. They call for recognizing the cultural assumptions embedded in attachment theory, in the instruments and constructs used to measure it, and in the expectations it promotes about good parenting.
Article
Attention in Early Development
Stefania Conte and John Richards
Attention is a complex construct that shows development throughout the life span and undergoes significant changes over the first years of life. The complexity of attentional processes is described by the different systems and brain network theorized to describe the construct (i.e., alerting, orienting, executive attention, and sustained attention).
Evidence of the development of attention in infancy comes from several behavioral paradigms—primarily focused on the analysis of infants’ eye gaze—physiological measures, and neuroimaging techniques. Many of the changes in attention rely upon the structural and functional development of brain areas involved in attention processes. Behavioral and physiological signs mark the development of attention and are identifiable very early in life.
The investigation of the typical development of attention is pivotal for the understanding of atypical trajectories that characterize many neurodevelopmental disorders. The individuation of alterations in early visual attention processes may be utilized to guide intervention programs aimed at improving attention and other cognitive domains.
Article
Autism Spectrum Disorders in Later Life
Ye In (Jane) Hwang, Kitty-Rose Foley, Samuel Arnold, and Julian Trollor
Autism spectrum disorder (ASD), or autism, is a neurodevelopmental disorder that is typically recognized and diagnosed in childhood. There is no established biological marker for autism; rather, the diagnosis is made based on observation of behavioral traits, including (a) persistent deficits in social interaction and communication, and (b) restricted, repetitive patterns of behavior, interests, or activities. Because autism is a spectrum disorder, autistic individuals are a highly heterogeneous group and differ widely in the presentation and severity of their symptoms. The established prevalence of ASD is approximately 1% of the population.
Information about autism in adulthood is limited; most of the literature examines childhood and adolescence. While the term “later life” has traditionally been associated with those over the age of 65, a dire lack of understanding exists for those on the autism spectrum beyond early adulthood.
Individuals remain on the spectrum into later life, though some mild improvements in symptoms are observed over time. Autistic adults experience high levels of physical and mental health comorbidities. Rates of participation in employment and education are also lower than that of the general population. Quality of life is reportedly poorer for autistic adults than for nonautistic peers, though this is not affected by age. More robust studies of the health, well-being, and needs of autistic adults are needed, especially qualitative investigations of adulthood and aging and longitudinal studies of development over the lifespan.
Article
Awareness of Aging Processes
Anne Josephine Dutt, Hans-Werner Wahl, and Manfred Diehl
The term Awareness of Aging (AoA) incorporates all aspects of individuals’ perceptions, behavioral experiences, and subjective interpretations related to their process of growing older. In this regard, AoA goes beyond objective descriptions of the aging process, such as calendar age or biological age. Commonly used AoA constructs referring to the ongoing experience of the aging process encompass concepts such as subjective age, attitudes toward one’s own aging, self-perceptions of aging, and awareness of age-related change. AoA also incorporates elements that are more pre-conscious in nature, such as age stereotypes and culturally held notions about the aging process. Despite their theoretically broad common foundation, AoA constructs differ according to their specific frames of reference, such as whether and how they take into account the multidimensionality and multi-directionality of development. Examining the existing body of empirical work identifies several antecedents of AoA, such as sociodemographic “background” variables, physical health and physical functioning, cognition, psychological well-being and mental health, psychological variables (e.g., personality, anxiety), and life events. In general, more positive manifestations on these variables are accompanied by a more positive perception and evaluation of the aging process. Moreover, AoA is longitudinally linked to important developmental outcomes, such as health, cognition, subjective well-being, and mortality. Overall, the study of AoA has developed as a promising area of psychological aging research that has grown in its conceptual and empirical rigor during recent years.
Article
Binocular Vision
Suzanne McKee and Preeti Verghese
This article describes human binocular vision. While it is focused primarily on human stereopsis, it also briefly tells about other binocular functions, including binocular summation, rivalry, and vergence, the eye movement that is driven by stereopsis. Stereopsis refers to the depth perception generated by small differences in the locations of visual features in the two retinal images; these differences in retinal location are called disparities. Disparities are detected by special binocularly driven cortical neurons whose properties are outlined here; the article also describes studies that have used fMRI imaging to show that many areas of human cortex respond to depth based on disparity. The development of stereopsis in human infants, as well as clinical abnormalities in stereopsis, is also documented.
Article
Biodiversity Metrics in Lifespan Developmental Methodology
Lizbeth Benson and Nilam Ram
In ecological sciences, biodiversity is the dispersion of organisms across species and is used to describe the complexity of systems where species interact with each other and the environment. Some argue that biodiversity is important to cultivate and maintain because higher levels are indicative of health and resilience of the ecosystem. Because each species performs functional roles, more diverse ecosystems have greater capability to respond, maintain function, resist damage, and recover quickly from perturbations or disruptions. In the behavioral sciences, diversity-type constructs and metrics are being defined and operationalized across a variety of functional domains (socioemotional, self, cognitive, activities and environment, stress, and biological). Emodiversity, for instance, is the dispersion of an individual’s emotion experiences across emotion types (e.g., happy, anger, sad). Although not always explicitly labeled as such, many core propositions in lifespan developmental theory—such as differentiation, dedifferentiation, and integration—imply intraindividual change in diversity and/or interindividual differences in diversity. For example, socioemotional theories of aging suggest that as individuals get older, they increasingly self-select into more positive valence and low arousal emotion inducing experiences, which might suggest that diversity in positive and low arousal emotion experiences increases with age. When conceptualizing and studying diversity, important considerations include that diversity (a) provides a holistic representation of human systems, (b) differs in direction, interpretation, and linkages to other constructs such as health (c) exists at multiple scales, (d) is context-specific, and (e) is flexible to many study designs and data types. Additionally, there are also a variety of methodological considerations in study of diversity-type constructs including nuances pertaining theory-driven or data-driven approaches to choosing a metric. The relevance of diversity to a broad range of phenomena and the utility of biodiversity metrics for quantifying dispersion across categories in multivariate and/or repeated measures data suggests further use of biodiversity conceptualizations and methods in studies of lifespan development.
Article
Blood Pressure as a Biomarker in Gerontological Research
Thomas M. Hess, Erica L. O'Brien, and Claire M. Growney
Blood pressure is a frequently used measure in studies of adult development and aging, serving as a biomarker for health, physiological reactivity, and task engagement. Importantly, it has helped elucidate the influence of cardiovascular health on behavioral aspects of the aging process, with research demonstrating the negative effect of chronic high blood pressure on various aspects of cognitive functioning in later life. An important implication of such research is that much of what is considered part and parcel of getting older may actually be reflective of changes in health as opposed to normative aging processes. Research has also demonstrated that situational spikes in blood pressure to emotional stressors (i.e., reactivity) also have implications for health in later life. Although research is still somewhat limited, individual differences in personal traits and living circumstances have been found to moderate the strength of reactive responses, providing promise for the identification of factors that might ameliorate the effects of age-related changes in physiology that lead to normative increases in reactivity. Finally, blood pressure has also been successfully used to assess engagement levels. In this context, recent work on aging has focused on the utility of blood pressure as a reliable indicator of both (a) the costs associated with cognitive engagement and (b) the extent to which variation in these costs might predict both between-individual and age-related normative variation in participation in cognitively demanding—but potentially beneficial—activities. This chapter elaborates on these three approaches and summarizes major research findings along with methodological and interpretational issues.
Article
Boris Ananiev’s Theory of Self-Determination of Human Development
Irina A. Mironenko
Ananiev’s approach shares the Activity Theory (AT) paradigm, dominant in Soviet psychology. Ananiev builds on the main fundamentals of the AT paradigm, considering psyche as a special procreation of the matter, engendered by the active interaction of the individual with the environment. The unique feature of his approach to AT is that he turned it “toward the inside,” focusing on the relation of the human individual to his own physicality, to his own bodily substrate. Ananiev sought by his intention to keep a holistic vision of a human being, considering the latter in the context of his real life, that is, the bodily substrate in its biological specificity in context of the concrete sociohistorical life course of the personality. Like no other psychologist, Ananiev did not limit his research to the sphere of narrowly defined mental phenomena. He conducted a special kind of research, labeled as “complex,” in the course of which characteristics of the same subjects: sociological, socio-psychological, mental, physiological, and psychophysiological indicators—life events of the subjects—were monitored for many years. He focused on ontogenetic development in adulthood, which he, ahead of his time, considered as a period of dynamic changes and differentiated development of functions. The focus of his attention was on individual differences in the ontogenetic development of mental and psycho-physiological functions, especially those deviations from general regularities that resulted from the impact of the life course of the individual. Individualization, the increase of individual singularity, is the main effect of human development and its measure for Ananiev.
Ananiev developed a number of theoretical models and concepts. The best-known of Ananiev’s heritage is his theoretical model of human development, often named the “individuality concept.” According to this model, humans do not have any preassigned “structure of personality” or “initial harmony.” The starting point of human development is a combination of potentials—resources and reserves, biological and social. The human creates himself in the process of interaction with the world. Specialization, individually specific development of functions, appears here not as a distortion of the pre-set harmony of the whole but as the way of self-determining progressive human development. The most important practical task of psychology he viewed as psychological support and provision in the process of developing a harmonious individuality, based on the individual potentials.
Article
Cerebral Palsy From a Developmental Psychology Perspective
Karen Lidzba
Cerebral palsy (CP) is defined as non-progressive damage to the brain at or around birth, which leads to varying symptoms depending on the extent and location of damage. The leading symptom is sensory-motor impairment of varying expression, but additional perceptual, cognitive, and socio-emotional symptoms are common. CP can be divided into four types, with bilateral spastic being by far the most frequent, followed by the unilateral spastic, the dyskinetic, and the ataxic variants. The intellectual, linguistic, and cognitive profile of CP is extremely variant, but all qualities correlate more or less with CP type and motor impairment. Early diagnosis is important since early intervention may promote all developmental dimensions. Generally, individuals with unilateral spastic CP have the best (almost normal) intellectual, linguistic, and cognitive outcomes, while those with bilateral spastic CP fare the worst. Language perception is often an individual strength, while language expression, and particularly speech, may be heavily impaired. Attention and executive functions are often impaired as compared to typically developing controls, even in those children with normal intellectual functioning. The same holds true for visual perceptual functions, which are impaired in almost half of all children and adolescents with CP. The potential neuropsychological dysfunctions are a risk factor for arithmetic functions and literacy. Obstacles to participate in society are high for individuals with CP and heavily dependent on their motor, language, intellectual, and cognitive functions. However, quality of life is good for most children and adolescents, and they develop a sound self-concept. On the other side, bully experience is more common than amongst typically developing children and is associated with behavior problems and executive dysfunction. The development of children and adolescents with CP is determined by a complex interplay between physical, intellectual, and neuropsychological functions.
Article
Clinical Training Concerns in Mental Health Service Provision to Older Persons
M. Lindsey Jacobs and Patricia M. Bamonti
The field of geropsychology has grown worldwide since the 1990s, particularly in the United States. In the early 21st century, professional geropsychology was recognized by the American Psychological Association as a clinical specialty. Despite this growth, there is a shortage of practicing psychologists proficient in geropsychology to meet the mental health needs of older adults. Moreover, the need for psychologists with geriatric training is continuing to grow as healthcare increasingly shifts to integrated care, creating a demand for psychologists in clinical settings such as nursing homes, hospice and palliative care, primary care, and home-based primary care. The widening gap between supply and demand requires strategic recruitment and educational initiatives to grow the number of providers with competency in working with older adults. Recruitment strategies emphasize increasing supply by “priming the pipeline” through the creation of early exposure opportunities at the secondary, undergraduate, and graduate school level, strategic recruitment of underrepresented students, and expanding financial incentives for practice.
Training and education in geropsychology have advanced considerably. The Pikes Peak Model for Professional Geropsychology Training provides the structure to gauge competency development. A framework for obtaining competency at the generalist, generalist with proficiency, and specialist levels has been created. In future years, there will be greater demand for post-licensure training in geropsychology, and geropsychologists will increasingly function as clinical educators. Technological advances will play a vital role in disseminating geropsychology education to generalist providers and related disciplines interested in gaining geropsychology exposure.
Article
Cognitive Reserve in the Aging Brain
Michael J. Valenzuela
Cognitive reserve refers to the many ways that neural, cognitive, and psychosocial processes can adapt and change in response to brain aging, damage, or disease, with the overarching effect of preserving cognitive function. Cognitive reserve therefore helps to explain why cognitive abilities in late life vary as dramatically as they do, and why some individuals are brittle to degenerative pathology and others exceptionally resilient. Historically, the term has evolved and at times suffered from vague, circular, and even competing notions. Fortunately, a recent broad consensus process has developed working definitions that resolve many of these issues, and here the evidence is presented in the form of a suggested Framework: Contributors to cognitive reserve, which include environmental exposures that demand new learning and intellectual challenge, genetic factors that remain largely unknown, and putative G × E interactions; mechanisms of cognitive reserve that can be studied at the biological, cognitive, or psychosocial level, with a common theme of plasticity, flexibility, and compensability; and the clinical outcome of (enriched) cognitive reserve that can be summarized as a compression of cognitive morbidity, a relative protection from incident dementia but increased rate of progression and mortality after diagnosis. Cognitive reserve therefore has great potential to address the global challenge of aging societies, yet for this potential to be realized a renewed scientific, clinical, and societal focus will be required.
Article
Comorbidities of Physical and Psychiatric Syndromes in Later Life
Lydia K. Manning, Lauren M. Bouchard, and James L. Flanagan
There is a great deal of concern about the increasing number of older adults who suffer from chronic disease. These conditions result in persistent health consequences and have an ongoing and long-term negative impact on people and their quality of life. Furthermore, the probability that a person will experience the onset of multiple chronic conditions, known as comorbidities, increases with age. Despite the prevalence of comorbidity in later life, scant research exists regarding specific patterns of disease and the co-occurrence and complex interactions of the chronic conditions most closely associated with aging. It is important to review the body of literature on comorbidities associated with physical and psychiatric syndromes in later life to gain an overview of some of the most commonly seen disorders in older adults: hypertension, diabetes, cardiovascular disease, chronic obstructive pulmonary disease, arthritis, depression, and dementia. Specific patterns of disease and the co-occurrence and complex interactions of chronic conditions in later life are explored. In conclusion, we consider the need for a more informed understanding of comorbidity, as well as a related plan for addressing it.
Article
Critical Role of Social–Cognitive Age Representations
Alison Chasteen, Maria Iankilevitch, Jordana Schiralli, and Veronica Bergstrom
In 2016, Statistics Canada released the results of the most recent census. For the first time ever, the proportion of Canadians aged 65-plus years surpassed the proportion aged 15 and under. The increase in the proportion of older adults was viewed as further evidence of the faster rate of aging of Canada’s population. Such demographic shifts are not unique to Canada; many industrialized nations around the world are experiencing similar changes in their populations. Increases in the older adult population in many countries might produce beneficial outcomes by increasing the potential for intergenerational contact and exposure to exemplars of successful aging. Such positive intergenerational contact could counter prevailing age stereotypes and improve intergenerational relations. On the other hand, such increases in the number of older adults could be viewed as a strain and potential threat to resources shared with younger age groups. The possibility of increased intergenerational conflict makes it more important than ever before to understand how older adults are stereotyped, how those stereotypes can produce different kinds of biased behavior toward them, and what the impact of those stereotypes are on older adults themselves.
Social-cognitive age representations are complex and multifaceted. A common stereotype applied to older people is one of warmth but incompetence, often resulting in paternalistic prejudice toward them. However, such benevolent prejudice, characterized by warm overtones, can change to hostile bias if older adults are perceived to violate prescriptive norms about age-appropriate behavior. In addition to coping with age prejudice, older adults also have to deal with the deleterious effects of negative age stereotypes on their day-to-day function. Exposure to negative aging stereotypes can worsen older adults’ cognitive performance in a number of contexts. As well, age stereotypes can be incorporated into older adults’ own views of aging, also leading to poorer outcomes for them in a variety of domains. A number of interventions to counteract the effects of negative aging stereotypes appear promising, but more work remains to be done to reduce the impact of negative aging stereotypes on daily function in later life.
