To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
This chapter traces the development of the character of Odette in Marcel Proust’s In Search of Lost Time. If in “Swann in Love” Odette functions as an ekphrastic projection of Swann’s desire (a Botticelli fresco), in “At Mme Swann’s” she reclaims her face, creating a “new, personal style of face.” The text describes a process of facialization as a mode of self-invention, with the help of photography. Thus reinvented, Odette is the only character in the novel who does not age, providing a narrative continuity for the arc of the novel. A reading of the concluding scene in which a gallery of aged characters appear as masks of their younger selves foregrounds Proust’s preoccupation with time and memory. The conclusion: the paradigmatic object of memory retrieval for Proust is the face.
This study aimed to identify the associations between possible sarcopenia (p-sarcopenia) and fall risk, depression, and quality of life (QOL) in middle-aged (age ≥ 45 years) and older (age ≥ 65 years) adults. In this study, we analyzed a total of 10,181 men and women aged 45–85 years from the initial survey sample of the 2006 Korean Longitudinal Study of Aging. Among middle-aged men (women) adults, fall risk and depression were 4.09 (1.34) and 2.25 (2.05) times higher in the p-sarcopenia group than in the non-possible sarcopenia (np-sarcopenia) group, respectively (p < 0.05). Middle-aged and older men and women all showed low QOL-related scores, especially middle-aged men and women in the p-sarcopenia group (p < 0.05). Therefore, adequate management of sarcopenia is necessary in both older and middle-aged adults to reduce its burden as a public health concern.
Driving enables older adults to maintain independence and community mobility. Driving plays a pivotal role in the ability to engage in activities, socialize, run errands, and access health care services; yet many people eventually stop driving. This study investigates factors that contribute to transitions from driver to non-driver (i.e., driving status) using data from the Canadian Longitudinal Study on Aging (CLSA). Among participants aged 45–85 who reported driving at baseline (n = 30,901), 1.65 percent (n = 510) had stopped driving at follow-up (three years later). Logistic regression identified predictors of this transition, including older age, female sex, lower income, urban residence, poorer self-rated health, difficulties with activities of daily living, low memory scores, and vision problems. These findings highlight the interplay of physical, cognitive, and environmental factors in driving cessation. This research advances understanding of mobility transitions in later life and informs targeted strategies to support older adults as they plan for driving retirement.
Despite recent attention to the increased risk of cognitive impairment in older adults with essential tremor (ET), there are only limited data on the trajectories of cognitive change in ET or the demographic and motor predictors of such change.
Method:
This study included 148 cognitively normal individuals with ET (mean age = 76.7 ± 9.7 years) at baseline and had at least one follow-up evaluation (mean years of observation = 5.2 ± 1.6). Generalized Estimating Equations examined rates of change in six composite cognitive outcomes as a function of time, as well as demographic (age, sex, and education) and motor predictors (tremor severity, age of tremor onset, presence of rest tremor, cranial tremor, intention tremor, tandem gait) of rates of change. Demographics, medication use, and mood symptoms at baseline were covariates for all models.
Results:
Participants evidenced a decline in global cognition, executive function, and attention (prange = <0.001–0.044) over time. Older age predicted faster decline in all cognitive outcomes except attention (prange=<0.001–0.025). Tremor severity predicted faster decline in executive function (p = 0.011). Rest tremor predicted faster decline in executive function and attention (p = 0.033, 0.017). Tandem gait missteps predicted faster decline in memory and visuospatial ability (p = 0.026, 0.028).
Conclusions:
Results point to a dissociation in the predictive value of different motor features for specific aspects of cognitive decline. These results shed light on the earliest manifestations of cognitive impairment in older adults with ET and implicate different pathways by which heterogeneous cognitive changes emerge.
Positive health outcomes are realized when individuals receive interprofessional care, which also includes collaboration with family and care providers. We used social network analysis to explore interprofessional care networks and experiences of independent, community-dwelling older adults and how they perceive collaboration between different medical and non-medical network members. Twenty-three participants were interviewed and asked to name individuals contributing to their health and well-being (network of care) and position them in a concentric circle to reflect the relative strength of relationships. The average network size was 11. Closest relationships were with spouses, children, and family physicians. Relationship strength with network members was marked by frequency, accessibility, longevity, and impact of interactions. Participants were ardent self-advocates for their care, but reported few apparent episodes of collaboration between network members. Our study highlights that coordinated and collaborative care for independent community-dwelling older adults is lacking and does not routinely engage non-medical network members.
The primary policy response to population aging in advanced economies has been to raise the mandatory retirement age. However, these policies have reignited calls for differentiated retirement ages that take into account variations in work intensity. This paper utilises microdata to examine the relevance and feasibility of this concept in Europe. It first quantifies career arduousness using SHARE wave 7 retrospective ISCO4-digit data on careers in combination with US O*NET working conditions data. Then, using SHARE follow-up data collecting (bad)health and death information about wave 7 respondents, it estimates (healthy) life expectancy by career arduousness decile, combining econometrics and life table methods. Findings reveal a life expectancy gap between the least and most arduous careers of 4to 4.2 years. Healthy life expectancy differences are slightly larger, ranging from 6.9 to 9.1 years. Also, women’s healthy life expectancy seems to be somewhat more impacted by arduousness.
Loneliness is a major health concern for immigrant older adults. This study explores social influences on loneliness in neighbourhoods among immigrant older adults across five major urban centres in Ontario and Alberta, Canada. Data were collected from 435 older immigrants who participated in the Inclusive Communities for Older Immigrants (ICOI) Project. Data were analysed using multiple linear regression (MLR) to identify the influences of neighbourhood factors, family support, duration of residency in Canada, English proficiency, and gender. Results indicate that increased engagement in ethnic enclaves, not being reliant on transportation for social interactions, and perceptions of neighbourhood cohesion are associated with a significant reduction in loneliness. These associations remain significant after accounting for family support and language proficiency. This calls for further research into the interconnections among interpersonal factors, neighbourhood-level factors, and family and community-level support to address key influences on loneliness in this population.
Pension systems play a crucial role in providing economic security and supporting well-being in later life. However, as governments implement reforms to ensure financial sustainability—such as raising the retirement age, reducing benefits, and shifting to defined-contribution schemes—these measures often overlook their psychological and social consequences. Pension insecurity has been linked to heightened stress, anxiety, and depression, as well as increased social isolation, particularly among vulnerable populations, including those in physically demanding jobs, low-income workers, and individuals with existing health conditions. Despite clear evidence of these effects, mainstream pension reform discourse prioritises fiscal concerns over social and mental health implications. This article examines pension reform through the Human Rights–Public Health Pension Framework (HRPHPF), integrating legal, public health, and policy perspectives to assess its impact on mental well-being. It situates pension rights within international human rights law, explores the psychological risks associated with pension insecurity, and advocates for a human rights-based approach to pension policymaking. The article calls for integrating mental health impact assessments into pension reforms to prevent adverse outcomes and ensure that policies promote dignity, social inclusion, and economic security in old age. A more balanced approach is necessary to align financial sustainability with broader well-being and human rights principles.
The Connecting People and Community for Living Well initiative recognizes that communities, specifically multisector community teams, are a critical part of the provision of programs and supports for those affected by dementia. Effective collaboration and building and supporting the collective well-being of these multisector community teams is key to their success and sustainability. This research sought to understand what supports the well-being of community teams. Focus groups were conducted with multisector community teams who support those impacted by dementia from across four rural communities. The research team used thematic analysis to identify patterns emerging within and across focus groups. The findings highlighted three areas of importance: the need for a resource to support teams to measure, monitor, and describe the impact of their actions; ongoing support from a system-level team; and the development of local and/or provincial policy and infrastructure that supports sustaining collaborative community-based work.
Falls account for 95 percent of hip fractures in older adults. Wearable hip protectors reduce hip fracture risk in long-term care settings, but their use is low among community-dwelling older adults. We conducted interviews to explore how hip protectors are perceived by 27 community-dwelling older adults who visited the Fraser Health Fall Prevention Mobile Clinic in British Columbia. Directed content analysis focused on perceived benefits, design preferences, and cost as a barrier to use of hip protectors. Most participants acknowledged the benefits of hip protectors in reducing the risk of hip fracture, enhancing physical activity, and reducing the fear of falling. However, most participants did not perceive they were at high enough risk to warrant the use of hip protectors. Participants also discussed how willingness to wear depended on design features, including style, pad thickness, appearance, ease of use, fit, comfort, and laundering. Participants also noted the cost, ranging from $60 to $120, as a barrier.
Respite for individuals caring for family living with dementia is a common way to take personal time away from caregiving. Other than respite, there is little indication that caregivers receive adequate support from community and healthcare services. As a result, caregivers tend to experience a decline in well-being, due, in part, to a reduction in meaningful leisure experiences. The purpose of this article is to share findings from research aimed at discovering ways to enhance caregiver participation in meaningful leisure. Findings highlight how participants sacrificed their leisure time in favour of caregiving responsibilities and experienced a diminished sense of social connection. Findings also highlight how participants can have their own care needs met through leisure programming that lets them know they matter. We draw from these findings to suggest ways to direct more attention and resources to meeting caregiver needs.
Postprandial hypotension (PPH) is defined as a postprandial decline in systolic blood pressure (SBP) of 20 mm of Hg. Some have recommended the use of acarbose (an alpha-glucosidase inhibitor) as a potential therapy for PPH based exclusively on studies of older adults with diabetes. Using a randomized placebo-controlled design, 43 older adults (23 women, 20 men, mean age 77.1 ± 0.9 years) were recruited from geriatric medicine outpatient clinics in an academic centre. Although the average decrease in SBP during the meal test was significantly attenuated in the acarbose group (standardized β = 0.724 ± 0.286, p = 0.017), the acarbose group experienced significantly more PPH events (standardized β = 0.593 ± 0.279, p = 0.040). Although acarbose attenuated the mean decrease in SBP during the meal test, it did not reduce the actual number of PPH events recorded in a general population of older adults.
The cognitive trajectory of aging individuals with childhood-onset epilepsy is poorly understood. Our aim was to examine cognitive change over a 7-year period in aging individuals with epilepsy, originally recruited for prospective follow up in the early 1960’s.
Method:
36 participants with childhood-onset epilepsy from a prospective population-based cohort and 39 controls participated in the 50-year and 57-year follow-up data collections. Eight participants had active epilepsy, 28 were in remission. Eleven neuropsychological tests were used to measure language/semantic function, episodic memory and learning, executive function, visuomotor function, and working memory. Regression-based standardized change scores were used to control for sources of error in test-retest assessments.
Results:
Participants with epilepsy lacked a test-retest effect in language functions. A significant decline was found in participants with active epilepsy in episodic memory functions overall, and in those with remitted epilepsy in learning, immediate recall and set-shifting. The risk of clinically significant general cognitive decline was higher in participants with active epilepsy (OR 61.25, 95% CI 5.92–633.81, p = .0006). Among those with remitted epilepsy the risk was lower and non-significant (OR 2.19, 95% CI 0.58–8.23, p = .24).
Conclusions:
Our results demonstrate poorer cognitive trajectories in participants with childhood-onset epilepsy compared to controls, particularly in those with active epilepsy. The risk of general cognitive decline was lower in participants with remitted epilepsy, but a decline in episodic memory functions was observed. Our findings likely reflect faster brain aging in childhood-onset epilepsy, even in individuals with early remission.
Normative data of neuropsychological tests in the Vietnamese population is considerably lacking. We aim to evaluate the effects of age, education, and sex on the performance of common neuropsychological tests, and to generate normative data for these tests in cognitively normal Vietnamese adults.
Method:
Participants were recruited from two hospitals in Ho Chi Minh City, with inclusion criteria as follows: age ≥ 40 years, normal cognition and function, and Mini-Mental State Examination (MMSE) scores ≥ 26. Neuropsychological tests were administered in a paper-and-pencil format, including the CERAD Word List, Trail Making Tests, Digit Span, Animal Naming, and Clock Drawing Test. Effects of age, education, and sex on test performance were evaluated using multiple linear regression analyses. Normed scores were reported as regression-based and discrete norms tables.
Results:
Participants included 385 cognitively normal Vietnamese, with age 61.4 ± 10.9 years (range 40 – 89), female 56%, who were relatively highly educated (42% attended college and beyond, 36% attended high school or equivalent institutions, 22% had less than high school education), and had MMSE scores 27.8 ± 1.0. Trail Making Test Part B was completed within 300 s by only 204/385 (53%) participants. Regression analyses demonstrated significant associations between age and education with performance on all or most tests, and between sex and all CERAD Word List measures and Clock Drawing Test.
Conclusions:
The present work provides the first known normative data for a relatively comprehensive neuropsychological battery in Vietnamese adults. Performance on all tests was significantly influenced by age and education.
Word frequency has long been considered an essential aspect of psycholinguistic theory. However, research has shown that measures of contextual and semantic diversity provide a better fit to lexical decision and naming data than word frequency. The current study examines the role of contextual and semantic diversity in picture naming ability across aging and bilingualism. A picture naming experiment was conducted with six groups of participants: younger monolinguals, older monolinguals, younger L1 English bilinguals, older L1 English bilinguals, younger L2 English bilinguals and older L2 English bilinguals. Consistent with previous findings, the contextual diversity measure accounted for more variance in the picture naming data than word frequency. Furthermore, older adults and L1 English bilinguals were more sensitive to semantic diversity information, while younger adults and L2 English bilinguals relied more on age of acquisition in their lexical organization.
There is considerable data suggesting that the gut microbiota (GM) contributes to health and regulates host immunity and influences brain function, findings with implications for neurodegenerative diseases, such as Alzheimer’s Disease (AD).
In the present study, using three non-fat diets with different ratios of unsaturated ω-6/ω-3 fatty acids (FAs)(high or low), we analyzed how minor differences in diet can affect the microbiota of amyloid precursor protein/Presenilin 1 transgenic (APP/PS1 [TG]) mice, a mice model of AD, next, we studied how the levels of sex hormones may affect the GM. The data obtained show that sex hormones in males fed our standard diet (S) modified alpha and beta diversity, whereas no differences were observed in TG mice compared with wild-type mice. Moreover, there were significant differences in both alpha or beta diversity in mice fed with an H or L diet compared with an S diet.
In conclusion, our data indicate that the levels of sex hormones or differences in the ω-6/ω-3 FA ratio alter the GM more than expected. Thus, it is tantalizing to propose that low levels of ω-3 FAs in APP/PS1 mice fed an “H” diet may be responsible for modifying some bacterial genera, exacerbating the basal neuropathology in this AD model.
Fully updated for the second edition, this text remains a comprehensive and current treatment of the cognitive neuroscience of memory. Featuring a new chapter on group differences in long-term memory, areas covered also include cognitive neuroscience methods, human brain mechanisms underlying long-term memory success, long-term memory failure, implicit memory, working memory, memory and disease, memory in animals, and recent developments in the field. Both spatial and temporal aspects of brain processing during different types of memory are emphasized. Each chapter includes numerous pedagogical tools, including learning objectives, background information, further reading, review questions, and figures. Slotnick also explores current debates in the field and critiques of popular views, portraying the scientific process as a constantly changing, iterative, and collaborative endeavor.
Abstract: Because of the characteristics shared by neurodegenerative diseases such as intracellular protein inclusions, genetic factors, aging, metabolic stress and progressive loss of specific subpopulations of nerve cells, Anne and Jack began to wonder whether they could put all the neurology laboratories working on neurodegenerative disorders in one space where they could all collaborate. They hoped that the new center would be designed to accelerate the development of new therapies. Anne wrote a proposal to set up a new center. A wealthy man with Huntington’s disease in his family approached Anne about trying to speed up the hunt for a cure for the disease. They became friends and Anne told him about her plans for a center that would help get to a cure more quickly. He said he would donate $2 million to get the center up and running. Anne detailed a whole plan with various lab moves. While Jack was at a conference in Aspen, Anne called him to report that the meetings had gone well and their plan for the center had been approved. Jack returned two days later, and he died an hour after getting home.
This chapter considers how expanded longevity should impact the law’s response to aging and the needs of older adults. Countries have long responded to old age by creating social welfare policies that use chronological age to target interventions at older adults. This chapter argues that, as life expectancy increases, the use of such age-based criteria will become more problematic: Chronological age will be an increasingly poor predictor of need, and age-based criteria will increasingly result in inequitable distribution of resources. Accordingly, it argues that polities should respond to enhanced longevity not merely by recalibrating age-based criteria to ensure efficient allocation of resources but by reducing reliance of age-based criteria. It concludes by considering whether vulnerability can serve as an alternative targeting mechanism.