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      Operationalized definition of older adults with high cognitive performance Translated title: Definição operacionalizada de idosos com alto desempenho cognitivo

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          ABSTRACT

          Recently, there has been an increasing number of studies on exceptional cognitive aging. Herein, we aim to objectively provide the operationalized characterization of older adults with unusually high memory ability. Some authors have defined them as “SuperAgers”, individuals aged 80 years or older with memory ability similar or superior to middle-aged subjects. On the other hand, the terminology “high-performing older adults” (HPOA) seems to appropriately conceptualize these individuals without exaggeration. A threshold for age is not a reliable criterion, but may be defined as 75 and 80 years of age for developing and developed countries, respectively. We propose that HPOA may exhibit episodic memory test scores equal to or greater than those of individuals aged 50-60 years, according to the validated tables for the respective country. This group must also have global cognition scores within expected average values for age and education. Executive functioning may play a central role in the exceptional memory performance of this group. Further studies are essential to confirm existing findings and may provide important evidence for cognitive aging theory and the neurobiology of dementia.

          RESUMO

          O número de estudos sobre envelhecimento cognitivo acima da média vem crescendo recentemente. Neste trabalho, nosso objetivo é fornecer a caracterização operacionalizada de idosos com capacidade de memória excepcionalmente alta. Certos autores definem-nos “Superidosos”, indivíduos com 80 anos ou mais com habilidade de memória similar a adultos de meia-idade. No entanto, a terminologia “idosos de alto desempenho” parece definir de maneira apropriada esses indivíduos, sem restrição excessiva. Apesar de um limite de idade ser imperfeito, ele pode ser definido como 75 ou 80 anos, em países em desenvolvimento ou desenvolvidos, respectivamente. Nós propomos que os idosos de alto desempenho devam ter escores em testes de memória episódica de indivíduos entre 50 a 60 anos, de acordo com tabelas validadas para o país. Esse grupo também deve ter escores de cognição global dentro da média para idade e educação. O funcionamento executivo pode ter um papel central no desempenho excepcional de memória desse grupo. Mais estudos são essenciais para confirmar a existência desses achados e podem fornecer evidência importante para teoria de envelhecimento cognitivo e a neurobiologia das demências.

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          Normal cognitive aging.

          Even those who do not experience dementia or mild cognitive impairment may experience subtle cognitive changes associated with aging. Normal cognitive changes can affect an older adult's everyday function and quality of life, and a better understanding of this process may help clinicians distinguish normal from disease states. This article describes the neurocognitive changes observed in normal aging, followed by a description of the structural and functional alterations seen in aging brains. Practical implications of normal cognitive aging are then discussed, followed by a discussion of what is known about factors that may mitigate age-associated cognitive decline.
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            Aging gracefully: compensatory brain activity in high-performing older adults.

            Whereas some older adults show significant cognitive deficits, others perform as well as young adults. We investigated the neural basis of these different aging patterns using positron emission tomography (PET). In PET and functional MRI (fMRI) studies, prefrontal cortex (PFC) activity tends to be less asymmetric in older than in younger adults (Hemispheric Asymmetry Reduction in Old Adults or HAROLD). This change may help counteract age-related neurocognitive decline (compensation hypothesis) or it may reflect an age-related difficulty in recruiting specialized neural mechanisms (dedifferentiation hypothesis). To compare these two hypotheses, we measured PFC activity in younger adults, low-performing older adults, and high-performing older adults during recall and source memory of recently studied words. Compared to recall, source memory was associated with right PFC activations in younger adults. Low-performing older adults recruited similar right PFC regions as young adults, but high-performing older adults engaged PFC regions bilaterally. Thus, consistent with the compensation hypothesis and inconsistent with the dedifferentiation hypothesis, a hemispheric asymmetry reduction was found in high-performing but not in low-performing older adults. The results suggest that low-performing older adults recruited a similar network as young adults but used it inefficiently, whereas high-performing older adults counteracted age-related neural decline through a plastic reorganization of neurocognitive networks.
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              Que PASA? The posterior-anterior shift in aging.

              A consistent finding from functional neuroimaging studies of cognitive aging is an age-related reduction in occipital activity coupled with increased frontal activity. This posterior-anterior shift in aging (PASA) has been typically attributed to functional compensation. The present functional magnetic resonance imaging sought to 1) confirm that PASA reflects the effects of aging rather than differences in task difficulty; 2) test the compensation hypothesis; and 3) investigate whether PASA generalizes to deactivations. Young and older participants were scanned during episodic retrieval and visual perceptual tasks, and age-related changes in brain activity common to both tasks were identified. The study yielded 3 main findings. First, inconsistent with a difficulty account, the PASA pattern was found across task and confidence levels when matching performance among groups. Second, supporting the compensatory hypothesis, age-related increases in frontal activity were positively correlated with performance and negatively correlated with the age-related occipital decreases. Age-related increases and correlations with parietal activity were also found. Finally, supporting the generalizability of the PASA pattern to deactivations, aging reduced deactivations in posterior midline cortex but increased deactivations in medial frontal cortex. Taken together, these findings demonstrate the validity, function, and generalizability of PASA, as well as its importance for the cognitive neuroscience of aging.
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                Author and article information

                Journal
                Dement Neuropsychol
                Dement Neuropsychol
                dn
                Dementia & Neuropsychologia
                Associação de Neurologia Cognitiva e do Comportamento
                1980-5764
                Jul-Sep 2018
                Jul-Sep 2018
                : 12
                : 3
                : 221-227
                Affiliations
                [1 ]Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre RS, Brazil.
                [2 ]Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Faculdade de Medicina de Universidade Federal de Minas Gerais, Belo Horizonte MG, Brazil.
                [3 ]Department of Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo USP, Brazil.
                Author notes
                Jaderson Costa da Costa. Brain Institute of Rio Grande do Sul (BraIns) / Pontifical Catholic University of Rio Grande do Sul - Av. Ipiranga, 6690 - 90610-000 Porto Alegre RS - Brazil. E-mail: jcc@ 123456pucrs.br

                Disclosure: The authors report no conflicts of interest.

                Author contributions. Wyllians Vendramini Borelli, Karoline Carvalho Carmona and Adalberto Studart-Neto contributed to study concept and design, acquisition of data, analysis and interpretation of data, drafting of the manuscript and critical revision of the manuscript for important intellectual content. Ricardo Nitrini, Paulo Caramelli and Jaderson Costa da Costa contributed to drafting and critical revision of the manuscript for important intellectual content.

                Article
                10.1590/1980-57642018dn12-030001
                6200160
                30425784
                5186ec2f-0eb8-4730-8fd6-212b84bf6ca3

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 01 March 2018
                : 04 July 2018
                Categories
                Views & Reviews

                memory,aging,neuropsychology,older adults,youthful cognition,memória,envelhecimento,neuropsicologia,idosos,cognição juvenil

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