We reflect, using a vignette, on conceptual tensions and the value judgements that lie behind difficult decisions about whether or not the older person with dementia should return home or move into long-term care following hospital admission. The paper seeks, first, to expose some of the difficulties arising from the assessment of residence capacity, particularly around the nature of evaluative judgements and conceptual tensions inherent in the legal approach to capacity. Secondly, we consider the assessment of best interests around place (...) of residence, which demonstrates significant conceptual tensions. In addition, ‘best interests’ raise issues around the perception of risk and the perceptions of the family and crucially involve the notions of autonomy and trust. Finally, we not only gesture at some practical considerations based on insights from values-based medicine, but also make the suggestion that we require tighter functional assessments of residence capacity coupled with broader judgements about best interests. (shrink)

Definitions of the concept of mild cognitive impairment (MCI) and suggested therapies are controversial. There are no widely acknowledged therapies and the ethical implications and methodologic issues around identifying and defining people with MCI are important concerns. The psychosocial implications for the person being labeled as having MCI have not been widely explored. This paper addresses these issues and presents data from two contrasting case studies. Key analytical themes identified in the qualitative analysis include different views about the causes of (...) dementia ("normal aging" versus disease); fear and anxiety about dementia; how such factors influence presentation to health professionals; and the effect of a label of cognitive impairment on quality of life. Our conclusion is that the usefulness and justification for early identification of cognitive impairment in a situation that has not yet been recognized by those involved should be questioned. (shrink)

This innovative volume attempts to bridge the theoretical gulf between the two approaches by providing objective evidence for unconscious conflict in...

The core dimensions of cognitive fitness, such as attention and cognitive control, are emerging through a transdisciplinary expert consensus on what has been termed the Cognitive Fitness Framework. These dimensions represent key drivers of cognitive performance under pressure across many occupations, from first responders to sport, performing arts and the military. The constructs forming the building blocks of CF2 come from the RDoC framework, an initiative of the US National Institute of Mental Health aimed at identifying the cognitive processes underlying (...) normal and abnormal behavior. Similar to physical conditioning, cognitive fitness can be improved with deliberate practice. This paper reports the development of a prototype cognitive fitness training program for competitive athletes and the protocol for its evaluation. The program is focused on primary cognitive capacities and subtending skills for adjusting training rhythms and enhancing readiness for competition. The project is driven by the Australian Psychological Society’s College of Sport & Exercise Psychology and includes the development of a Cognitive Gym program for a smartphone app-enhanced implementation. Its key building blocks are training protocols connected by a periodized training plan. A website with background supporting resources has also been developed as part of the project. National-level training squads will participate in a three-week pilot evaluation protocol, assessing the program’s efficacy and usability through gamified cognitive assessment of participants’ training gains and coaching staff evaluations, respectively. Both near and far transfer of training effects will be examined. (shrink)

This chapter focuses on documenting the changes in life expectancy and human lifespan and reviewing current understandings of demographic and epidemiological transitions. It allows assumption of shared understandings of the meaning of human aging and old age. A key policy indicator of changes in health and life expectancy is the concept of healthy active life expectancy and associated concept of disability‐free life expectancy. From a social gerontological perspective, aging is a concept that is less contested than the idea of old (...) age. The biomedicalization of aging has been a major influence across social spaces. Vincent has described four categories of anti‐aging medicine: symptom alleviation; life expectancy extension; lifespan extension; and abolition. The development of anti‐aging technology, science, and practice challenges us to think about the enhancement of human aging and the future of later life. Attitudes to aging remain essentially negative with little evidence to suggest that institutionalized ageism will disappear. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Mild Cognitive Impairment:Where Does It Go From Here?John Bond (bio) and Lynne Corner (bio)Keywordsbiomedicalization, dementia, mild cognitive impairment, subjectivityThe joy of formal interdisciplinary discussion of this kind is the way that ideas presented through the gaze of social scientists stimulate such exciting thoughts and responses from other disciplines such as philosophy and psychology. We would like to thank Sabat and Thornton for their supportive and provocative reactions to our (...) paper. In the spirit of their responses, it is not our intention to respond to their thoughts directly; rather, we take the opportunity to theorize sociologically about this new category of psychiatry that has come to be known simply as mild cognitive impairment (MCI). In reviewing the responses of Sabat and Thornton, three thoughts emerged. First, together we have covered ontologic, epistemologic, methodologic, and theoretical questions about MCI, but none of us has posed basic political questions, such as: Why has MCI emerged as a new psychiatric label at this particular time? Second, this discussion brings together social scientists with a psychologist and a philosopher, but important constituents are missing. Consequently we are missing "insider" views on the importance of MCI to clinical practice. Third, this discussion highlights for us even more acutely the central question: Is MCI a real entity? In the following, we reflect on the first of these because our response also addresses the third. We first revisit the "evidence" about the importance of MCI for clinical practice.The notion of MCI as the transitional state between normal aging and Alzheimer's disease and other dementias has existed in a number of guises for many years, with benign senescent forgetfulness (Kral 1962) being the forerunner of a number of other terms, including questionable dementia, incipient dementia, isolated memory impairment, mild neurocognitive decline, age-associated memory impairment, age-associated cognitive decline, and cognitive-impairment-not-demented (Geda et al. 2004). Given that psychiatric labels implying the existence of MCI have been part of the practice landscape for over forty years, it is perhaps not surprising that its reinvention in the form of MCI has not, it appears, raised much attention outside specialist centers in North America and Europe. The reaction from grassroots clinical practice has been similar in intensity to their subdued reaction to the antipsychiatry movement in the 1960s. But for specialist clinics like the Mayo Clinic in Rochester, Minnesota, it has been an expanding [End Page 29] industry with numerous published papers, international conference presentations, and research funding opportunities.MCI can be distinguished from similar diagnostic categories that preceded its appearance in 1991. A key diagnostic criteria is the requirement for a subjective memory complaint by the person subsequently diagnosed as having MCI. Other diagnostic criteria include normal general cognitive function, normal activities of daily living, and memory being impaired for age, but not being demented (Petersen et al. 1999; Petersen and Morris 2003). To our knowledge, the idea of subjectivity being an important diagnostic criterion, as opposed to a means of identifying signs and symptoms, is a first in medical science. We know of no other medical category or diagnosis where subjectivity plays such a significant role, other than perhaps severe health phobias. Broadly speaking, two kinds of clinical evidence for MCI exist: first, that originating from studies (some quite small) applying the diagnostic criteria in specialist clinic populations; and, second, that found in large population studies. The main distinction between these two sets of evidence is that one is based on selected clinic populations and the other on unselected community populations. Most studies conclude that people whose memory is impaired for their age, as measured by similar cognitive tests such as the Mini-Mental State Examination, show decline in cognition that often leads to Alzheimer's disease and other kinds of dementia in the future. This finding is not remarkable given that it has long been known that age is a predictor of cognitive impairment. However, the population studies suggest a lower conversion rate than those for specialist clinics (Ritchie, Artero, and Touchon 2001).Petersen (2005) provides a robust defense as to why MCI might be a useful category in research and also indicates the potential benefits of treating MCI... (shrink)

Compiles the photographs taken by Leonard Freed of the 1963 March on Washington for Jobs and Freedom, during which Dr. Martin Luther King Jr. delivered his "I Have a Dream" speech.

Mature rats were kept on protein-deficient diets to test the hypothesis that late-onset protein restriction results in deficits and to determine the feasibility of doing nutrition-behavior research with old naive animals. A 3% low-protein (LP) group and a 24% adequate-protein (AP) pair-fed control were used. Body weights and plasma protein concentrations were lower and exploratory behavior and motor coordination were poorer for LP rats. Both groups preferred the 24% protein diet. LP rats habituated slower and failed to overcome an initial (...) black preference on an oddity discrimination learning task. Nutrition-behavioral research with older rats is feasible, and late-onset protein restriction produces psychobiological deficits. (shrink)