The Wiley Handbook on the Aging Mind and Brain

Matthew Rizzo, Steven Anderson, Bernd Fritzsch

• Publisher: Wiley-Blackwell
• Year: 2018
• ISBN:
  9781118772089
• Edition: 1
• Topic: Psychology
• Subtopic: Cognitive Psychology & Cognition
• Index: Psychology

A thought-provoking treatise on understanding and treating the aging mind and brain

This handbook recognizes the critical issues surrounding mind and brain health by tackling overarching and pragmatic needs so as to better understand these multifaceted issues. This includes summarizing and synthesizing critical evidence, approaches, and strategies from multidisciplinary research—all of which have advanced our understanding of the neural substrates of attention, perception, memory, language, decision-making, motor behavior, social cognition, emotion, and other mental functions.

Written by a plethora of health experts from around the world, The Wiley Handbook on the Aging Mind and Brain offers in-depth contributions in 7 sections: Introduction; Methods of Assessment; Brain Functions and Behavior across the Lifespan; Cognition, Behavior and Disease; Optimizing Brain Function in Health and Disease; Forensics, Competence, Legal, Ethics and Policy Issues; and Conclusion and New Directions.

• Geared toward improving the recognition, diagnosis, and treatment of many brain-based disorders that occur in older adults and that cause disability and death
• Seeks to advance the care of patients who have perceptual, cognitive, language, memory, emotional, and many other behavioral symptoms associated with these disorders
• Addresses principles and practice relevant to challenges posed by the US National Academy of Sciences and National Institute of Aging (NIA)
• Presents materials at a scientific level that is appropriate for a wide variety of providers

The Wiley Handbook on the Aging Mind and Brain is an important text for neurologists, psychiatrists, psychologists, physiatrists, geriatricians, nurses, pharmacists, social workers, and other primary caregivers who care for patients in routine and specialty practices as well as students, interns, residents, and fellows.

Part I
Introduction

1
The Aging Mind and Brain: Overview

Matthew Rizzo, Steven Anderson, and Bernd Fritzsch

Introduction

This is an opportune time for studying the aging mind and brain and translating the knowledge gained to improve the quality of life and prolong the independence of older people worldwide. Strategic national and international research efforts are gaining traction into molecules and mechanisms underpinning brain aging. Research programs leveraged by academic, government and industry partners have gained unprecedented insights into normal brain function, as a referent for detecting critical and potentially remediable cascades of dysfunction emerging much earlier in life, that may be harbingers of neurodegenerative diseases such as Alzheimer’s, Parkinson’s, and related disorders.

Strategic efforts to better understand brain aging need to be understood in view of demographic trends over the next few decades that favor more and longer‐living seniors, and relative decline in the proportion and fertility rates of younger people. These changes have huge implications for society. Living, working, spending, and income patterns of seniors differ markedly from juniors’, as do healthcare expenditures, ultimately straining government support programs and social networks to their limits. We need to address legislative issues and policies that advance discoveries and technologies and promote access and payment for needed care. We must educate ourselves on the pros and cons of new treatments by analyzing and reconciling moral issues that pit the Kantian wish to provide the greatest good for each person (for example, individualized medicine at some expense) with the Utilitarian goal of relieving disease and suffering as much as possible across the lifespan for the entire population. Personalized medicine (aka, precision, stratified, and P4 medicine) separates patients, putting individuals front and center for medical decisions, practices, or interventions based on predicted disease risk or therapeutic response¹. How can we afford to support these needs, and how can we afford not to?

Reaping the benefits of healthy aging requires mental health for a self‐directed life. The silver lining of the Grey Tsunami of aging societies worldwide is increased health of many more seniors, affording a potential “fourth phase” in their lives, inserted between ages 50 and 70 (and perhaps even up to age 100 years or more, should historic trends on increased lifespan continue). Such a phase could allow older individuals to refocus and rebalance their life plans, redefining life strategies in beneficial ways not predicted just a few years ago when expectations for productive workspan ended around age 65 years old, or a century ago, in 1920, when mean lifespan itself was merely 54 years for women and men. Increasing trends toward healthy aging offer personal opportunities to engage in productive life and promise reduced costs of age‐related disease to society, assuming medical gains keep pace to preserve the health of the superannuated.

Even with dramatically improved health in the elderly, the growing burden of increased elder care will be a defining issue of all industrialized nations over the next 50–100 years.² In the US, the population of centenarians will rise from 16,000 (2015) to over 1 million (2050) and to even higher numbers by 2100. The number of seniors combined with their increased longevity will strain social security and healthcare systems as senior dependents require caretaking by public and private hands. Society needs alternative strategies to engage seniors in a productive way to maintain the standard of living our society currently enjoys (in line with ongoing efforts in Japan, home perhaps of the world’s oldest population). An added benefit of such engaged seniors is to maintain social and intellectual engagement for healthy mind and brain aging, and avert an older and ever‐growing cohort of the impoverished, isolated, sick, bored, and despairing.

Goals of this Handbook

This handbook recognizes the critical issues surrounding mind and brain health by tackling overarching and pragmatic needs for better understanding of these multifaceted issues through a convenient source. This includes summarizing and synthesizing critical evidence, approaches and strategies from multidisciplinary research that has advanced our understanding of the neural substrates of attention, perception, memory, language, decision‐making, motor behavior, social cognition, emotion, and other mental functions. Basic scientists are discovering molecular, cellular, and genetic underpinnings of neural changes that affect cognitive capabilities over the lifespan. Behavioral researchers are classifying and measuring cognitive functions in multiple domains, tracking specific changes in these over the lifespan, and uncovering factors and treatments that can maintain and improve these functions in aging brains until later in life than ever before. Explanatory models and theories of cognitive processes are being developed to interpret these changes and link them to changes in brain systems that support aging minds. Social scientists and legal experts are demonstrating the key role of cultural supports and life experiences in shaping cognitive content and processes to extremes of the lifespan. These combined advances are furthering our understanding of how aging affects cognitive functioning and informing interventions to maintain cognitive performance to the extremes of superaging.

Popular efforts continue to raise public awareness of the science and opportunities to improve aging brains⁴. To understand and improve the health of the aging mind and brain, a silo‐spanning team of interdisciplinary experts in research, teaching, outreach, community engagement, public policy, and the law, has collaborated to write a book on changes in neural health and in behavioral context that occur with aging, understanding differences in cognitive function within and between individuals at baseline and over time, and advancing mind and brain health across the lifespan. The authors tackle principles and practice relevant to “evergreen” challenges posed by the US National Academy of Sciences and National Institute on Aging (NIA)³:

• Build the scientific basis for promoting neural health in the aging brain.
• Improve the understanding of the structure and function of the aging mind, including behavioral and neural mechanisms, and their impact on diseases and their management.
• Evaluate current methods of assessment of higher brain function and behavior and related factors across the lifespan.
• Determine how behavioral, social, cultural, and technological context affect cognitive functioning and real‐world performance of aging individuals and how to intervene effectively to augment individual functioning and performance in context.
• Address legal and policy implications for promoting safety and care of persons with cognitive challenges
• Analyze practice and policy issues that impact advancing science, models of care, treatment, outreach, access to care, and quality of life.

Overview of Contents

The evidence assembled in this unique handbook is geared toward improving the recognition, diagnosis, prevention, and treatment of many brain‐based disorders that occur in older adults and that cause premature disability and death. Our primary aim is to advance the care and quality of life of patients who present with perceptual, cognitive, language, memory, emotional, and many other behavioral symptoms associated with these disorders, as well as aging adults who do not meet criteria for a neurological diagnosis. Materials are presented at a scientific level that is appropriate for a wide variety of learners.

To address the critical topics and challenges in mind and brain aging we have organized this handbook into eight parts (I–VIII) comprising 36 chapters. Between part I. Introduction (containing this chapter) and part VIII. Conclusion (chapter 36), are several sections (II–VII). These are summarized below.

Part II. Theoretical, animal models, social, and humanistic perspectives

Chapter 2. Ashida and Schafer: Social networks, social relationships, and their effects on the aging mind and brain

People, like cells in a person’s body, are parts of dynamic systems and a network of support. Ashida and Schafer explore how social interactions at various levels affect healthy aging, much as cells in a body depend on functions of other parts. Mechanistic details of how such social interactions affect mind and brain health remain unclear, and individual variations tend to buck trends, yet common themes of social dependency emerge. Evidence strongly supports that caregiver and care receiver form dyads driven, for better or worse, by interactive dynamics at multiple levels. Social networks and interactions benefit healthy aging, but few attempts have been made to measure these interactions and harness their potential for improving healthy mind and brain aging in a rapidly changing society––where family interactions are progressively replaced by distant social networks in cyberspace. The effects of these dynamic changes on healthy aging of an ever‐increasing population of seniors ready and willing to maintain social engagement are critical areas to be explored.

Chapter 3. Prahlad and Chikka: Aging and the brain

This chapter reviews molecular and cellular aspects of aging in the context of the evolution of aging. What is the advantage to humankind of long living? Organismal aging as a postreproductive process is not under strong reproductive selection. Extensions of lifespan may even correlate with reduced reproduction. The oldest known person ever, Jeanne Calment, died at age 122 and had only one daughter. Hers is a prominent human example of a broader inverse relationship between longevity and fertility across species, whose foundations remain unclear. A central theme of aging is the molecular and cellular instability and the role of the brain in regulating these processes. Some proteins are surprisingly long lived and resist proteasome decay, leading in pathological cases to prion disorders such as Creutzfeldt‐Jakob disease. The authors review how this works at molecular levels and relates to age‐related cellular burden in neurons that never “rejuvenate” through cell division. Parabiosis, or sharing of blood circulation of two organisms of different age, is the best known example of how blood‐born molecules can affect organism vitality and longevity, possibly through additional trophic factors in the brain. This chapter lays biological foundations for interpreting findings on the aging mind and brain covered throughout this book.

Chapter 4. Emmons, Kim, and Narayanan: Animal models of pathological aging

This detailed overview provides insights into the strengths and weaknesses offered by certain model organisms for studying the molecular basis of neuronal aging. Valuable invertebrate model organisms are described first (flies and worms), and their strengths and weaknesses for studying the effects of certain genes/proteins on longevity are provided, including the limits of transfer to humans. Skipping nonmammalian vertebrate organisms (zebrafish, frogs, chickens), the utility of nonprimate and primate model organisms for studying age‐related brain disorders is reviewed. This chapter concludes that no single model organism provides access to all the factors affecting human brain aging. Each is valuable in its own right for gaining insights not obtainable in human studies and, with proper additional testing, may prove applicable to humans.

Chapter 5. Charise and Eginton: Humanistic perspectives: Arts and the aging mind

This overview of humanistic perspectives on aging gives examples of late‐life creativity, artistic portrayals of aging and the aging mind, and therapeutic applications of the arts for older persons. With reference to literature and writing, visual arts, and film, we consider how these art forms have given rise to therapeutic practices aimed at improving the lives of older people, especially those with age‐related illness or disability. Given the early state of research into arts‐based interventions, where possible we refer to effectiveness studies undertaken by humanities and social‐science researchers and/or artist practitioners (often in collabo...

Table of contents

• Cover
• Title Page
• Table of Contents
• List of Contributors
• Acknowledgments
• List of Abbreviations
• Glossary
• Part I: Introduction
• Part II: Theoretical, Animal Models, Social, and Humanistic Perspectives
• Part III: Methods of Assessment
• Part IV: Brain Functions and Behavior Across the Lifespan
• Part V: Brain Disease and Dysfunction
• Part VI: Optimizing Brain Function in Health and Disease
• Part VII: Legal and Ethical Issues
• Part VIII: Conclusion
• Index
• End User License Agreement