Chapter 18 - Cognitive Rehabilitation in Healthy Aging

Summary

Healthy aging is accompanied by decline in a broad range of functions, including episodic learning and memory, working memory, attention, processing speed, and executive functioning. Significant efforts have therefore been made to augment these functions in healthy older adults. Two principal rehabilitation approaches have been employed: restorative and compensatory. Restorative approaches aim to repair the affected cognitive processes by repeated, adaptive practice. The majority of these restorative approaches have proved to be efficacious, and there is considerable evidence for maintenance of training effects weeks or months after the intervention was concluded. Transfer of restorative training approaches has been more elusive, although recent work has shown training effects on aspects of everyday life such as driving and instrumental activities of daily living. Compensatory approaches strive to bypass the impairment by teaching people strategies to bolster performance. Multimodal compensatory approaches that combine strategy training with counseling about other factors that affect cognition have been shown to help older adults learn new strategies, implement them to the benefit of cognitive performance, and adjust their views and expectations to better cope with the changes that occur during healthy aging.