The population is aging in most industrialized nations around the world, and this trend is anticipated to continue well into the future. This demographic shift impacts the workforce in that the average age of workers is increasing, and the workplace is becoming more age diverse, meaning different generations of employees are working side by side now more than ever before. Increasing age diversity can be problematic if misguided age-related attitudes, biases, and behaviors lead to ageism—the stigmatization of, and discrimination against, people based on age. Evidence of the impact of ageism in the workplace is being observed in increasing age-related discrimination claims as well as increased time for older people to find employment. Workplace ageism manifests from cognitive, affective, and behavioral components. Age stereotypes are associated with the cognitive component, age-related prejudice is related to the affective component, and age discrimination is aligned with the behavioral component. There is an abundance of research identifying age-related stereotypes and it is thought that these stereotypes influence how workplace decisions are made. Age-related prejudice research indicates that older workers are generally viewed more negatively than younger workers which can result in lower performance appraisals or older workers’ receiving harsher consequences for lower performance. Finally, age-discrimination research has identified that older workers struggle to find employment, to receive training and development opportunities, and to advance their careers. Although the majority of research on workplace ageism has focused on older individuals, younger workers also face challenges related to their age and this is a line of research that needs further exploration. Nevertheless, the accumulating evidence supports claims that workplace ageism has wide-ranging effects on individuals, groups/teams, organizations, and society.
Ageism in the Workplace
David M. Cadiz, Amy C. Pytlovany, and Donald M. Truxillo
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.
Erythrocyte Sedimentation Rate as a Biomarker for Stress and Aging Research
Carolyn M. Aldwin and Ritwik Nath
Erythocyte sedimentation rate (ESR) is one of the oldest measures of inflammation. It is used extensively in clinical medicine and has shown some utility in biomedical research. It is a nonspecific inflammation assay, and although it is less sensitive than more modern measures such as C-reactive protein, it is a useful measure in chronic illnesses. In general, ESR increases with age and appears to be a biomarker of aging in general. It predicts both cardiovascular disease (CVD) and cancer and is elevated in autoimmune disorders such as rheumatoid arthritis. Further, it predicts mortality both in the general population and in those with chronic illnesses such as CVD and cancer, independent of other indicators of illness severity. Interestingly, ESR is not associated with anxiety or general measures of distress but is consistently associated with measures of depression and suicidal ideation. Further, the effect of depressive symptoms on mortality appears to be mediated through increases in ESR. Studies of the relationship between stress and ESR have been less consistent, primarily because early studies were largely cross-sectional and in small samples. Studies using more modern, longitudinal analyses in larger samples may show more consistent results, especially if multilevel modeling was used that examined within-person changes in ESR in response to stress. Given that other large, longitudinal studies, such as the Baltimore Longitudinal Study on Aging, the Rotterdam Study, The Reykjavik Cohort Study, and Women’s Healthy Ageing Study have included ESR in their biomedical assays, it should be possible to analyze existing data to examine how psychosocial factors influence inflamm-aging in humans.
Aging Workforce Issues from a Multilevel Approach
Lale M. Yaldiz, Franco Fraccaroli, and Donald M. Truxillo
The proportion of older people in the industrialized workforce is increasing owing to the aging of the baby-boom generation, improved health in industrialized countries, changing retirement laws, need for additional income by older workers, and entry of fewer younger people into the workforce in some countries. This “graying” trend of the workforce raises a number of issues such as the needs, motivation, job attitudes, and behaviors of older workers; how to manage age diversity issues at work; late career issues; and preparing the worker and the organization for retirement. Specifically, older worker issues as a research topic includes work-relevant changes taking place within individuals as they age (e.g., physical, cognitive, and personality changes); how older workers are affected by their physical and social environments; the sources of age stereotyping and discrimination and how to combat them; and how these factors affect outcomes such as older workers’ well-being, health, attitudes, motivation, performance, and desire to continue working.
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.
Subjective Aging and Health
Gerben J. Westerhof and Susanne Wurm
Aging is often associated with inevitable biological decline. Yet research suggests that subjective aging—the views that people have about their own age and aging—contributes to how long and healthy lives they will have. Subjective age and self-perceptions of aging are the two most studied aspects of subjective aging. Both have somewhat different theoretical origins, but they can be measured reliably. A total of 41 studies have been conducted that examined the longitudinal health effects of subjective age and self-perceptions of aging. Across a wide range of health indicators, these studies provide evidence for the longitudinal relation of subjective aging with health and longevity. Three pathways might explain this relation: physiological, behavioral, and psychological pathways. The evidence for behavioral pathways, particularly for health behaviors, is strongest, whereas only a few studies have examined physiological pathways. Studies focusing on psychological pathways have included a variety of mechanisms, ranging from control and developmental regulation to mental health. Given the increase in the number of older people worldwide, even a small positive change in subjective aging might come with a considerable societal impact in terms of health gains.
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.
New Directions in Theories of Emotion and Aging
Joseph A. Mikels and Nathaniel A. Young
The adult life span is characterized as a time of divergent trajectories. It is a time of compounding losses (such as physical, sensory, and cognitive declines) and is also a time of surprising growth (such as improvements in well-being and emotion regulation). These divergent trajectories present theorists with the paradox of aging: in the face of accumulating losses, how is it that as people age, they generally feel good and experience greater well-being? Theorists have grappled with this paradox and have focused on how motivational, cognitive, control, and social factors impact emotional development across the adult life span. These foundational theories have paved the way to a deeper understanding of adult life-span development, but they do not draw as deeply from theories in affective science. Some of the latest perspectives on emotion and aging offer integrative views, such as how older adults may experience different discrete emotion (i.e., anger versus sadness) from an evolutionary functional perspective. Other perspectives consider how an array of appraisal processes may change across adulthood (such as shifts in evaluations of self-control versus other-control for younger versus older adults). These newer approaches dig deeper into mechanistic explanations and underscore the need for greater theoretical integration. Later life is clearly a time of increased well-being, but the field is only on the cusp of understanding the mysteries of emotional experience in later life.
Cultural Values and the Nature of Successful Aging
Ideas regarding what it means to age well date back centuries. Gerontological scholarship includes countless conceptual, theoretical, and empirical contributions to how to make sense of these ideas. The construct of successful aging is therefore one of the most debated operationalizations of what it means to age well. Empirical research on successful aging taps into either understandings of successful aging or the strategies that people use to age well. The very essence of the construct of successful aging is, however, sociocultural. This is why this chapter proposes that exploring the cultural values that underpin the understandings of successful aging that inform this scholarship is a theoretically profuse approach to making sense of the controversy that surrounds this construct. Two decades ago, a culture-relevant framework for the study of understandings of successful aging was formulated to address the disregard for cultural values that lie at the very core of this controversy. This framework proposes that there is congruence between the value orientations that people prefer and the understandings of successful aging that they hold, and that if we are to make sense of this congruence, we need to acknowledge that the foundations of value orientations (i.e., political, economic, and religious systems) shape what we deem to be necessary for aging well. From this it follows that there are bound to be more understandings of successful aging than what the scholarship in this area tends to acknowledge. After all, gerontological scholarship relies most heavily on contributions made on the basis of data from highly industrialized societies in the part of the world referred to as “the West.” In other words, gerontological scholarship on successful aging is extremely ethnocentric in its take on this construct, since only a handful of cultural understandings of what it means to age well are regarded as the norm. A failure to acknowledge this very fact leads gerontologists to disregard or downplay (often inadvertently) understandings of what it means to age well that do not resonate well with their own value paradigms or to impose (sometimes unintentionally) the Western template on findings about successful aging that do not rhyme well with what this scholarship assumes to be a given (i.e., a future, activity, independence, and mastering of nature orientation to what aging well means).
Methodology for Twin Studies of Aging
Michael J. Lyons, Chandra A. Reynolds, William S. Kremen, and Carol E. Franz
The rapidly increasing number of people age 65 and older around the world has important implications for public health and social policy, making it imperative to understand the factors that influence the aging process. Twin studies can provide information that addresses critical questions about aging. Twin studies capitalize on a naturally occurring experiment in which there are some pairs of individuals who are born together and share 100% of their segregating genes (monozygotic twins) and some pairs that share approximately 50% (dizygotic twins). Twins can shed light on the relative influence of genes and environmental factors on various characteristics at various times during the life course and whether the same or different genetic influences are operating at different times. Twin studies can investigate whether characteristics that co-occur reflect overlapping genetic or environmental determinants. Discordant twin pairs provide an opportunity for a unique and powerful case-control study. There are numerous methodological issues to consider in twin studies of aging, such as the representativeness of twins and the assumption that the environment does not promote greater similarity within monozygotic pairs than dizygotic pairs. Studies of aging using twins may include many different types of measures, such as cognitive, psychosocial, biomarkers, and neuroimaging. Sophisticated statistical techniques have been developed to analyze data from twin studies. Structural equation modeling has proven to be especially useful. Several issues, such as assessing change and dealing with missing data, are particularly salient in studies of aging and there are a number of approaches that have been implemented in twin studies. Twins lend themselves very well to investigating whether genes influence one’s sensitivity to environmental exposures (gene-environment interaction) and whether genes influence the likelihood that an individual will experience certain environmental exposures (gene-environment correlation). Prior to the advent of modern molecular genetics, twin studies were the most important source of information about genetic influences. Dramatic advances in molecular genetic technology hold the promise of providing great insight into genetic influences, but these approaches complement rather than supplant twin studies. Moreover, there is a growing trend toward integrating molecular genetic methods into twin studies.
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.
Inflammation As a Biomarker Method in Lifespan Developmental Methodology
Stephanie J. Wilson, Alex Woody, and Janice K. Kiecolt-Glaser
Inflammatory markers provide invaluable tools for studying health and disease across the lifespan. Inflammation is central to the immune system’s response to infection and wounding; it also can increase in response to psychosocial stress. In addition, depression and physical symptoms such as pain and poor sleep can promote inflammation and, because these factors fuel each other, all contribute synergistically to rising inflammation. With increasing age, persistent exposure to pathogens and stress can induce a chronic proinflammatory state, a process known as inflamm-aging. Inflammation’s relevance spans the life course, from childhood to adulthood to death. Infection-related inflammation and stress in childhood, and even maternal stress during pregnancy, may presage heightened inflammation and poor health in adulthood. In turn, chronically heightened inflammation in adulthood can foreshadow frailty, functional decline, and the onset of inflammatory diseases in older age. The most commonly measured inflammatory markers include C-reactive protein (CRP) and proinflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α). These biomarkers are typically measured in serum or plasma through blood draw, which capture current circulating levels of inflammation. Dried blood spots offer a newer, sometimes less expensive collection method but can capture only a limited subset of markers. Due to its notable confounds, salivary sampling cannot be recommended. Inflammatory markers can be added to a wide range of lifespan developmental designs. Incorporating even a single inflammatory assessment to an existing longitudinal study can allow researchers to examine how developmental profiles and inflammatory status are linked, but repeated assessments must be used to draw conclusions about the associations’ temporal order and developmental changes. Although the various inflammatory indices can fluctuate from day to day, ecological momentary assessment and longitudinal burst studies have not yet incorporated daily inflammation measurement; this represents a promising avenue for future research. In conclusion, mounting evidence suggests that inflammation affects health and disease across the lifespan and can help to capture how stress “gets under the skin.” Incorporating inflammatory biomarkers into developmental studies stands to enhance our understanding of both inflammation and lifespan development.
Social Gerontology Theories: Past, Present, and Future
Jill Suitor, Megan Gilligan, Marissa Rurka, Yifei Hou, and Gulcin Con
Theories of social gerontology have progressed from a focus on individuals’ later-life decline to theories that emphasize the intra- and interindividual variability of later-life experiences and the ways in which such heterogeneity is conditioned by social structural, cultural, and interpersonal factors that often begin in childhood and continue to shape individuals and members of their social networks across the life course. Consistent with theories across the sciences, theories of social gerontology predict and explain real-world experiences. In the case of social gerontology, the goals of theory address a wide array of phenomena, ranging from individuals’ attitudes and motivations, social networks and social support, the actions and functions of formal organizations, the embodiment of cultural norms and stereotypes, social determinants of health, and sources of inequality throughout the life course.. As the field of social gerontology has developed, theories in the field have shown increasing complexity, particularly regarding the roles of early life course experiences, social structural positions, and interpersonal relations in explaining variations in well-being, longevity, and the quality of life across the lifespan. As part of this increased complexity, social gerontology has become increasingly cross-disciplinary, spanning disciplines such as sociology, psychology, biology, anthropology, public health, medicine, and engineering, with a strong emphasis on how each discipline can contribute to developing principles that transcend individual fields. These integrative theories of social gerontology are crucial to developing comprehensive approaches to improving the health and well-being of individuals throughout the life course. Theories of social gerontology help us comprehensively understand the aging process by emphasizing individual characteristics, social relationships, and the larger cultural contexts in which individuals’ lives are embedded.
Successful Aging: History and Prospects
John W. Rowe and Dawn C. Carr
While the factors that influence the well-being of individuals in late life have long been a major concern of research in aging, they have been a particularly active area of research and debate since the 1980s and continue to have a prominent role in gerontological research and debate. Early research on aging (from the 1920s to the 1960s) focused largely on examining typical problems that come with aging. The term successful aging was initially used to describe those who aged better than expected. In the 1980s, the MacArthur Network on Successful Aging, concerned that the field of gerontology had become preoccupied with disease and disability to the neglect of studies of the factors that fostered doing well in late life, conducted a series of studies of high-performing older persons and formulated the MacArthur theory of successful aging, which included three principal components: avoidance of disease, maintenance of physical and cognitive function, and engagement with society. Since its initial publication, the concept of successful aging has been applied to many subpopulations of older persons based on geography (East vs. West), socioeconomic status, race and ethnicity, religion, cognitive or physical function, and disease states.
Speech Comprehension and Cognition in Adult Aging
Nicole D. Ayasse, Alexis R. Johns, and Arthur Wingfield
The comprehension of spoken language is a complex skill that requires the listener to map the acoustic input onto the meaningful units of speech (phonemes, syllables, and words). At the sentence level, the listener must detect the syntactic structure of the utterance in order to determine the semantic relationships among the spoken words. Each higher level of analysis is thus dependent on successful processing at the prior level, beginning with perception at the phoneme and word levels. Unlike reading, where one can use eye movements to control the rate of input, speech is a transient signal that moves past the ears at an average rate of 140 to 180 words per minute. Although seemingly automatic in young adults, comprehension of speech can represent a greater challenge for older adults, who often exhibit a combination of reduced working memory resources and slower processing rates across a number of perceptual and cognitive domains. An additional challenge arises from reduced hearing acuity that often occurs in adult aging. A major concern is that, even with only mild hearing loss, the listening effort required for success at the perceptual level may draw resources that would ordinarily be available for encoding what has been heard in memory, or comprehension of syntactically complex speech. On the positive side, older adults have compensatory support from preserved linguistic knowledge, including the procedural rules for its use. Our understanding of speech perception in adult aging thus rests on our understanding of such sensory-cognitive interactions.
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.
Ever-Emerging Theories of Aging
W. Andrew Achenbaum
Edmund V. Cowdry’s Problems of Ageing (1939), the first U.S. handbook in gerontology, spurred efforts to systematize and communicate data and hypotheses in a “discouragingly difficult field,” as one of the volume’s contributors put it. Researchers, educators, and practitioners subsequently published handbooks of aging to share basic concepts, norms, and metaphors—and eventually to construct theories. Compared to theoretical constructs that animate African American studies, paradigms that inform inquiries into sex and gender, and queer theory-building, research on aging is sustained by few evidence-based, methodologically robust, heuristic theories. No single construct yet seizes the gerontological imagination. Analyzing notable handbooks reveals that the modern history of ever-emerging gerontological theory building went through three phases. First, attempts to formulate Big Theories of Aging resulted in more disappointments than scientific advances. In the second phase, researchers on aging set more modest aims, often giving priority to methodological innovation, but failed to promote consilience in a data-rich, theory-poor arena. Psychological theories, pertaining to lifespan development, merit special attention in the third phase, because they proved useful to biomedical and social scientists doing research on aging.
Psychological Stress and Cellular Aging
Idan Shalev and Waylon J. Hastings
Stress is a multistage process during which an organism perceives, interprets, and responds to threatening environmental stimuli. Physiological activity in the nervous, endocrine, and immune systems mediates the biological stress response. Although the stress response is adaptive in the short term, exposure to severe or chronic stressors dysregulates these biological systems, promoting maladaptive physiology and an accelerated aging phenotype, including aging on the cellular level. Two structures implicated in this process of stress and cellular aging are telomeres, whose length progressively decreases with age, and mitochondria, whose respiratory activity becomes increasingly inefficient with advanced age. Stress in its various forms is suggested to influence the maintenance and stability of these structures throughout life. Elucidating the interrelated connection between telomeres and mitochondria and how different types of stressors are influencing these structures to drive the aging process is of great interest. A better understanding of this subject can inform clinical treatments and intervention efforts to reduce (or even reverse) the damaging effects of stress on the aging process.
Interprofessional Training and Practice: The Need for More Engagement, Training, and Research in Geropsychology
Nancy A. Pachana and Gwen Yeo
Interdisciplinary teams consisting of a variety of health professionals working toward common patient goals have become an important innovation in clinical practice. In many parts of the world interdisciplinary teams have become part of practice, including in geriatrics. However, many gaps and the need for further empirical research and translation into practice remain. This is particularly true for the discipline of psychology, as much of the extant literature in engagement, training and practice in geriatric settings or educational settings does not include psychologists. Many advances in interprofessional teams, in acute settings in particular, do not include psychologists as part of the team. With respect to training, educating trainee health professionals, including psychologists, in interdisciplinary practice has still not become a standard part of training curricula internationally. Several excellent models of interprofessional and interdisciplinary training, including international models of interdisciplinary team competencies, have been developed. However, both the empirical testing of these models and their implementation in educational and practice settings is lacking. Within the geriatric healthcare context, the evidence base for both interprofessional care and the need for enhanced training models incorporating interprofessional skills is evolving, and further research on efficacy in evolving clinical contexts and translation into educational contexts worldwide is required. Ultimately, psychology must increase its presence within both interprofessional research and applied contexts.
Memory Rehabilitation in Healthy Aging
Nicole D. Anderson
Healthy aging is accompanied by decrements in episodic memory and working memory. Significant efforts have therefore been made to augment episodic and working memory in healthy older adults. Two principal approaches toward memory rehabilitation adults are restorative approaches and compensatory approaches. Restorative approaches aim to repair the affected memory processes by repeated, adaptive practice (i.e., the trained task becomes more difficult as participants improve), and have focused on recollection training, associative memory training, object-location memory training, and working memory training. The majority of these restorative approaches have been proved to be efficacious, that is, participants improve on the trained task, and there is considerable evidence for maintenance of training effects weeks or months after the intervention is discontinued. Transfer of restorative training approaches has been more elusive and appears limited to other tasks relying on the same domains or processes. Compensatory approaches to memory strive to bypass the impairment by teaching people mnemonic and lifestyle strategies to bolster memory performance. Specific mnemonic strategy training approaches as well as multimodal compensatory approaches that combine strategy training with counseling about other factors that affect memory (e.g., memory self-efficacy, relaxation, exercise, and cognitive and social engagement) have demonstrated that older adults can learn new mnemonics and implement them to the benefit of memory performance, and can adjust their views and expectations about their memory to better cope with the changes that occur during healthy aging. Future work should focus on identifying the personal characteristics that predict who will benefit from training and on developing objective measures of the impact of memory rehabilitation on older adults’ everyday functioning.