Neuropsychology of Aging Lectures A.E.M. van Wordragen
Lecture 1: What is successful aging?
Aging, why should we care?
o People are getting older. There are getting more old people. People live longer.
o Aging is the strongest risk for multimorbidity.
Dementia and high blood pressure are the most prominent multimorbid chronic
diseases.
Other examples: heart failure, diabetes, eye diseases, cancer, epilepsy,
Parkinson, migraine, depression etc.
o Dementia prevalence increases exponentially with age. This increases dramatically
around the age of 70-75 years.
What is successful aging?
o It depends on who askes the question to the patient or the family/caregivers.
Did the neuropsychologist ask or for example a health insurance giver.
o There are more than 104 models about successful aging.
The most models look at: life satisfaction, social functioning, and
psychological resources.
o The Rowe & Kahn ‘Biomedical model of successful aging’ looks at usual aging versus
successful aging
Successful aging following Rowe and Kahn depends on: avoiding disease and
disability, engagement with life, and high cognitive and physical function.
This model is one of the most used models in the literature but this model
makes it almost impossible to achieve successful aging. They got a lot of
criticism because of this.
This resulted in a phase where aging was seen as a disease itself.
They recreated their model a few years later.
How to define successful cognitive (memory) aging
o There are different ways to compare individuals.
Individual differences withing older adults.
Comparing people to the performance of younger adults.
Comparing scores of the patient themselves at different period of time.
o Successful aging can also be an absence of longitudinal decline.
o There are huge inter-individual differences in cognition.
o There are different risk factors for inter-individual differences.
o There are different compensatory mechanisms. For example: physical
therapy/exercising.
,Neuropsychology of Aging Lectures A.E.M. van Wordragen
Different factors influencing the inter-individual differences in cognitive decline.
Model of life course paths to pathological, usual and successful memory aging.
o Scientific theorizing needs to reflect and be linked to reality to have societal impact
and relevance.
o There are different factors that are mentioned by patients when asked about successful
aging.
Mental, psychological, physical and social health
Life satisfaction
Having a sense of purpose
Financial security
Learning new things
Accomplishments
Psychical appearance
Productivity
Contribution to life
Sense of humor
Spirituality
, Neuropsychology of Aging Lectures A.E.M. van Wordragen
Models that try to combine all the constructs (von Faber et al., 2001)
o When looked at the theoretical model, only 10% were classified as successfully aged.
o When look at the layperson model, almost all rated themselves as successfully aged.
o Defining successful aging is a challenge
It depends on authorities
Criteria of assessment
Societal, historical, and environmental contexts
Personal prerequisites, preferences, and resources.
o Success is on a continuum: individuals can be more or less successful on multiple
dimensions.
o Success is the ability to adapt to age-related losses and challenges and to make optimal
use of their psychological, mental, physical, and social potentials.
Part 2
o Clinical neuropsychology: the study of brain/behavior relationship & impact of
injury/disease on cognitive, emotional, and general adaptive capacities of the
individual.
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