Neuropsychology of Aging and Dementia
Lecture 1: Aging part I, 13-11-2024
Stairs of age → quality of life increases with age and then starts to decline after a certain
point
With healthcare and living conditions improving people become older
Definitions of age
Chronological age: measured in units of time (months or years) that have elapsed since birth
Biological age: where people stand relative to the number of years they will live (in terms of
the body’s organ system and physical appearance)
Functional age: person’s competence in carrying out specific tasks
- In comparison with chronological age peers
Psychological age: refers to how well a person adapts to changing conditions
Social age: views held by most members of a society about what individuals in a particular
chronological age group should do and how they should behave
What is old can be defined by chronological age and functional age → The Third and Fourth
Age
- Third Age: between retirement from work force and start of age-imposed limitations
- Fourth Age: cognitive and physical impairments interfering with everyday functioning
o Some people skip the Third Age and go straight to the Fourth age
Normative Aging: What is considered a usual, normal, or average outcome
Successful Aging: What is considered an ideal rather than average outcome
Positive Aging: The ability to find happiness and well-being even in the face of physical
and/or psychological challenges
The Selective Optimization with Compensation Model of Aging (Baltes & Baltes, 1990):
Individuals engage in adaptation throughout their lives. They are capable of learning and
changing and calling upon extra (reserve) capacity that they might not need to use under
ordinary circumstances.
Selection: a strategy of
concentrating efforts on
domains in which effective
functioning is most likely to
remain high
Optimization: is a strategy of
focusing on behaviors that
maximize not only the quantity
but also the quality of life
Compensation: refers to substituting new strategies when losses occur
,The Ecological Model of Aging (Lawton &
Nahemow, 1973): The interaction between a
person competence and environmental
pressures, resulting in some level of adaptation
- Marginally adaptive behavior: high
competence, low environmental
challenge
- Maladaptive behavior: high
environmental press, lower
competence
Biology of aging: gradual and cumulative, peak in early adulthood, decline after early
adulthood (rate of decline differs strongly between individuals)
Aging in the absence of any disease is rare. The likelihood of many diseases increases with
age
Morbidity: refers to illness and disease
Mortality: refers to death
These two terms are related: Illness and disease can result in death, death is often preceded
by illness and disease, morbidity does not necessarily result in mortality
Life span: the maximum longevity, or extreme upper limit of time, that members of a species
can live (max ≈ 120 years)
- Has stayed the same over time
Life expectancy: the average number of years that individuals in a particular birth cohort can
be expected to live
- Has increased over time
- More and more people will approach the maximum life span → compression of
mortality
Primary aging theories: aging is unavoidable (inevitable) biological process that affects all
members of a species (universal). It is a process that is set in motion early in life and progress
gradually over time. It is intrinsic → determined by factors within the organism
Secondary aging theories: aging is experienced by most, but not necessarily all members of
a species (neither inevitable nor universal) and results from hostile environmental influences
(disease, disuse, abuse)
,Time Clock Theory: The effectiveness of the body's homeostatic adjustments declines with
aging—leading to the failure of adaptive mechanisms, aging, and death
Immune Theory: immune system is programmed to maintain its efficiency for a certain
amount of time, after which it starts to decline
- Insufficient antibodies
- Inferior antibodies: mistakenly attack and destroy normal cells
- Linked to cancer
Evolutionary Theory: Members of species are genetically programmed to bear and rear their
young. Once they reproduce and raise their offspring to independence, they have fulfilled
their service in perpetuating the species. Depending on levels of energy organism coast along
for a period of time. Once excess of energy is used up, susceptibility to disease increases
Stochastic Theories of Aging: Focus on random damage to our vital systems that occurs with
the process of aging. As damage accumulates, we cease to function efficiently and eventually
life becomes impossible to sustain
Error Theory: Errors occur at cellular level resulting in the production of faulty molecules.
Cells have a repair mechanism but may not keep up with damage created by faulty
molecules. Over time: unrepaired damage builds up resulting into metabolic failure
Wear and Tear Theory: We begin life with a fixed amount of physiological energy and use it
up. If we expend it quickly, aging begins early and proceeds rapidly
- Rejected by studying people working in physically strenuous job. They did NOT show
signs of aging any earlier than those who work in less physically demanding jobs
Stress Theory: Stress triggers physiological activation that results in secretion of stress-
related hormones (glucocorticoids). Stress-related damage to the biological system can
accelerate the aging process.
- Young organism: stress system quickly returns to normal levels
- Older organism: stress system needs more time to return to normal levels
, Nature cannot fully account for the rate at which people age and how long they live. Nurture
also plays a role
Nurture: Environmental influences
Caloric restriction and longevity: people with reduced caloric intake have a lower incidence
of some forms of cancer
Marital status: married people are more likely to have normal habits such as physical
activity, eating breakfast, wearing seatbelts and abstaining from smoking
Nun studies have shown striking variability between sisters that all lived under the same
circumstances. Indicating that aging is the result of an interaction between both nature and
nurture
Age-related physical changes: first visible signs are texture and appearance of skin and hair,
skin becomes drier, begins to sag and shows wrinkles, hair becomes thinner and grey. Muscle
mass and strength gradually decrease with age. Older adults often take longer to recover
from exertion than young adults
- Arthritis: degeneration of joints, causes pain and loss of movement
- Osteoporosis: extreme loss of bone mass and deterioration of bone tissue
- Cardiovascular system: atherosclerosis, hypertension, aneurysm, stroke
Lecture 2: Aging part II, 20-11-2024
We can look into the brain in multiple ways
- Post-mortem: use real brains of dead people, limitation is therefore limited sample
sizes
- Neuroimaging techniques: Computerized Tomography, (Functional) Magnetic
Resonance Imaging, Positron Emission Tomography
The weight of the brain increases a lot with age, though it decreases in comparison to total
body weight
Brain volume:
- Cerebral cortex as a whole declines, more in older adults than younger adults
- Strong differences between regions
Grey matter: The frontal lobe has the steepest decline, the parietal lobe has the second
steepest decline. Decline becomes steeper with age. There are no differences between males
and females. The areas decline, but they still function
White matter: Greatest white matter loss is in the frontal regions of the brain. White matter
loss is more extensive that grey matter loss. Anterior to posterior gradient
Lecture 1: Aging part I, 13-11-2024
Stairs of age → quality of life increases with age and then starts to decline after a certain
point
With healthcare and living conditions improving people become older
Definitions of age
Chronological age: measured in units of time (months or years) that have elapsed since birth
Biological age: where people stand relative to the number of years they will live (in terms of
the body’s organ system and physical appearance)
Functional age: person’s competence in carrying out specific tasks
- In comparison with chronological age peers
Psychological age: refers to how well a person adapts to changing conditions
Social age: views held by most members of a society about what individuals in a particular
chronological age group should do and how they should behave
What is old can be defined by chronological age and functional age → The Third and Fourth
Age
- Third Age: between retirement from work force and start of age-imposed limitations
- Fourth Age: cognitive and physical impairments interfering with everyday functioning
o Some people skip the Third Age and go straight to the Fourth age
Normative Aging: What is considered a usual, normal, or average outcome
Successful Aging: What is considered an ideal rather than average outcome
Positive Aging: The ability to find happiness and well-being even in the face of physical
and/or psychological challenges
The Selective Optimization with Compensation Model of Aging (Baltes & Baltes, 1990):
Individuals engage in adaptation throughout their lives. They are capable of learning and
changing and calling upon extra (reserve) capacity that they might not need to use under
ordinary circumstances.
Selection: a strategy of
concentrating efforts on
domains in which effective
functioning is most likely to
remain high
Optimization: is a strategy of
focusing on behaviors that
maximize not only the quantity
but also the quality of life
Compensation: refers to substituting new strategies when losses occur
,The Ecological Model of Aging (Lawton &
Nahemow, 1973): The interaction between a
person competence and environmental
pressures, resulting in some level of adaptation
- Marginally adaptive behavior: high
competence, low environmental
challenge
- Maladaptive behavior: high
environmental press, lower
competence
Biology of aging: gradual and cumulative, peak in early adulthood, decline after early
adulthood (rate of decline differs strongly between individuals)
Aging in the absence of any disease is rare. The likelihood of many diseases increases with
age
Morbidity: refers to illness and disease
Mortality: refers to death
These two terms are related: Illness and disease can result in death, death is often preceded
by illness and disease, morbidity does not necessarily result in mortality
Life span: the maximum longevity, or extreme upper limit of time, that members of a species
can live (max ≈ 120 years)
- Has stayed the same over time
Life expectancy: the average number of years that individuals in a particular birth cohort can
be expected to live
- Has increased over time
- More and more people will approach the maximum life span → compression of
mortality
Primary aging theories: aging is unavoidable (inevitable) biological process that affects all
members of a species (universal). It is a process that is set in motion early in life and progress
gradually over time. It is intrinsic → determined by factors within the organism
Secondary aging theories: aging is experienced by most, but not necessarily all members of
a species (neither inevitable nor universal) and results from hostile environmental influences
(disease, disuse, abuse)
,Time Clock Theory: The effectiveness of the body's homeostatic adjustments declines with
aging—leading to the failure of adaptive mechanisms, aging, and death
Immune Theory: immune system is programmed to maintain its efficiency for a certain
amount of time, after which it starts to decline
- Insufficient antibodies
- Inferior antibodies: mistakenly attack and destroy normal cells
- Linked to cancer
Evolutionary Theory: Members of species are genetically programmed to bear and rear their
young. Once they reproduce and raise their offspring to independence, they have fulfilled
their service in perpetuating the species. Depending on levels of energy organism coast along
for a period of time. Once excess of energy is used up, susceptibility to disease increases
Stochastic Theories of Aging: Focus on random damage to our vital systems that occurs with
the process of aging. As damage accumulates, we cease to function efficiently and eventually
life becomes impossible to sustain
Error Theory: Errors occur at cellular level resulting in the production of faulty molecules.
Cells have a repair mechanism but may not keep up with damage created by faulty
molecules. Over time: unrepaired damage builds up resulting into metabolic failure
Wear and Tear Theory: We begin life with a fixed amount of physiological energy and use it
up. If we expend it quickly, aging begins early and proceeds rapidly
- Rejected by studying people working in physically strenuous job. They did NOT show
signs of aging any earlier than those who work in less physically demanding jobs
Stress Theory: Stress triggers physiological activation that results in secretion of stress-
related hormones (glucocorticoids). Stress-related damage to the biological system can
accelerate the aging process.
- Young organism: stress system quickly returns to normal levels
- Older organism: stress system needs more time to return to normal levels
, Nature cannot fully account for the rate at which people age and how long they live. Nurture
also plays a role
Nurture: Environmental influences
Caloric restriction and longevity: people with reduced caloric intake have a lower incidence
of some forms of cancer
Marital status: married people are more likely to have normal habits such as physical
activity, eating breakfast, wearing seatbelts and abstaining from smoking
Nun studies have shown striking variability between sisters that all lived under the same
circumstances. Indicating that aging is the result of an interaction between both nature and
nurture
Age-related physical changes: first visible signs are texture and appearance of skin and hair,
skin becomes drier, begins to sag and shows wrinkles, hair becomes thinner and grey. Muscle
mass and strength gradually decrease with age. Older adults often take longer to recover
from exertion than young adults
- Arthritis: degeneration of joints, causes pain and loss of movement
- Osteoporosis: extreme loss of bone mass and deterioration of bone tissue
- Cardiovascular system: atherosclerosis, hypertension, aneurysm, stroke
Lecture 2: Aging part II, 20-11-2024
We can look into the brain in multiple ways
- Post-mortem: use real brains of dead people, limitation is therefore limited sample
sizes
- Neuroimaging techniques: Computerized Tomography, (Functional) Magnetic
Resonance Imaging, Positron Emission Tomography
The weight of the brain increases a lot with age, though it decreases in comparison to total
body weight
Brain volume:
- Cerebral cortex as a whole declines, more in older adults than younger adults
- Strong differences between regions
Grey matter: The frontal lobe has the steepest decline, the parietal lobe has the second
steepest decline. Decline becomes steeper with age. There are no differences between males
and females. The areas decline, but they still function
White matter: Greatest white matter loss is in the frontal regions of the brain. White matter
loss is more extensive that grey matter loss. Anterior to posterior gradient
