Jacqueline Zöllig, Mike Martin, and Vera Schumacher
Cognitive development in ageing is a multidimensional and multidirectional phenomenon characterized by age-related changes in the plasticity of different dimensions of cognitive functions. Gains, stability, and losses can be observed across abilities and across persons as they age. Although with the closeness to death losses are predominant, several cognitive abilities on average show stability and even increases well into extreme old age. Importantly, the individually differing uses of the ability to learn, and cognitive as well as neural plasticity can explain the heterogeneity of cognitive ageing. Based on different approaches to cognitive ageing, different training methods have been introduced over the past years focusing on cognitive processes, primary mental abilities, higher-order cognitive constructs, and global cognition involving multiple cognitive domains. They demonstrate the possibilities to improve cognitive functioning and to extend the phase of autonomous living for several years. A more recent and promising concept is the integration of the existing approaches within a functional approach to cognitive development framing elementary cognitive ability use within the context of their functional value for independent living and autonomy. Due to its applicability to resource orchestration at all levels of functioning it has implications for the understanding of everyday cognitive performances and clinical practice.
Roberta F. White
This chapter provides an overview on cognitive disorders in adults from a neuropsychological perspective. It begins with a critical review of existing taxonomies for these disorders, especially those contained in the DSM-IV and continues with a summary of neuropsychological terminology used in the chapter and the effects of focal brain lesions. A number of medical and neurological disorders are described, and their cognitive correlates are reviewed using data from clinical case studies and epidemiologic research. The conditions summarized include a brief consideration of medical disorders that do not involve primary central nervous system pathology, followed by extensive review of brain insults (trauma, infections, exposures) and primary neurological disorders (dementias, cerebrovascular disease, motor system disorders, structural lesions, epilepsy, autoimmune disorders). A concluding section describes current issues in understanding cognitive disorders and likely future approaches to research on them.
Holly A. Tuokko and Colette M. Smart
The aim of this chapter is to examine the disability (or functional impairment) associated with changes in cognition in later life. In so doing, we examine the ways in which the terms ‘functional impairment’ and ‘disability’ are used in the context of cognitive decline and how they relate to everyday competence. We explore the ways in which everyday functioning has been conceptualized and measured in the extant literature. We then examine the influence age-related cognitive changes may exert on everyday functioning. Finally, we examine the measurement of cognitive functions relevant to everyday behaviours. In this context, we address intervention to maintain or improve daily functioning in both healthy older adults as well as those with cognitive impairment.