The Neuropsychology of HIV/AIDS in Older Adults

Highly active antiretroviral therapy is allowing increasing numbers of adults to age with HIV. The neuropsychological effects of aging with HIV are reviewed through three types of studies. First, the separate effects of HIV and aging on cognition are examined in studies that compare younger adults with HIV with neurologically normal older adults. Second, studies examine the impact of aging within samples of adults with HIV only. Third, providing the most critical evidence, are studies that assess cognition in younger and older adults with HIV relative to younger and older adults without HIV. In general research findings are inconclusive. Large individual differences among older adults with HIV as well as co-factors (APOE4 and detectable viral load) may account for inconsistent findings in the literature. A subgroup of older adults with HIV may be at greater risk for cognitive impairment, especially in attention functioning.     

Cortical and subcortical dynamics of aging with HIV infection

Given pharmaceutical advancements, more people with HIV will be living to old age. Cognitive declines have been observed both during normal aging and in people with HIV; whether there are cumulative cognitive declines in adults aging with HIV remains unknown. Based on current literature, adults aging with HIV may be at risk for psychomotor declines that resemble parkinsonianism.     

Initiating the formalization of theories of cognitive aging

Although the relevant knowledge base is still impoverished, the time may be appropriate to attempt to develop and investigate formal models of cognitive aging that incorporate explicit mechanisms to account for age differences frequently observed in measures of cognitive functioning. An initial model based on an associative network metaphor is described, in which age declines in fluid or process aspects of cognition are attributed to a reduction in either the number of simultaneously active nodes, the maximum allowable activation, or the rate of propagating activation between nodes. Results from a computer simulation are consistent at a first level of approximation with many cognitive aging phenomena, and the model is shown to provide a plausible account of age differences in an area that has previously resisted explanation. Although this particular model is only one of many that could be formulated at the present time, it is argued that more rapid progress in theoretical understanding of cognitive aging phenomena will be achieved by attempting to specify one's assumptions and hypotheses in a formal and explicit manner.     

Mental Exercise and Mental Aging

ABSTRACT— It is widely believed that keeping mentally active will prevent age-related mental decline. The primary prediction of this mental-exercise hypothesis is that the rate of age-related decline in measures of cognitive functioning will be less pronounced for people who are more mentally active, or, equivalently, that the cognitive differences among people who vary in level of mental activity will be greater with increased age. Although many training studies, and comparisons involving experts, people in specific occupations, and people whose mental activity levels are determined by their self-reports, have found a positive relation between level of activity and level of cognitive functioning, very few studies have found an interactive effect of age and mental activity on measures of cognitive functioning. Despite the current lack of empirical evidence for the idea that the rate of mental aging is moderated by amount of mental activity, there may be personal benefits to assuming that the mental-exercise hypothesis is true.     

On the specificity of face cognition compared with general cognitive functioning across adult age

Face cognition is considered a specific human ability, clearly differentiable from general cognitive functioning. Its specificity is primarily supported by cognitive-experimental and neuroimaging research, but recently also from an individual differences perspective. However, no comprehensive behavioral data are available, which would allow estimating lifespan changes of the covariance structure of face-cognition abilities and general cognitive functioning as well as age-differences in face cognition after accounting for interindividual variability in general cognition. The present study aimed to fill this gap. In an age-heterogeneous (18-82 years) sample of 448 adults, we found no factorial dedifferentiation between face cognition and general cognition. Age-related differences in face memory were still salient after taking into account changes in general cognitive functioning. Face cognition thus remains a specific human ability compared with general cognition, even until old age. We discuss implications for models of cognitive aging and suggest that it is necessary to include more explicitly special social abilities in those models.     

The relationship between Big-5 personality traits and cognitive ability in older adults – a review

It is well established that fundamental aspects of cognition such as memory and speed of processing tend to decline with age; however, there is substantial between-individual variability in levels of cognitive performance in older adulthood and in rates of change in cognitive abilities over time. Recent years have seen an increasing number of studies concerned with examining personality characteristics as possible predictors of some of this variability in cognitive aging. The purpose of this article is to review the literature, and identify patterns of findings regarding the relationships between personality (focusing on the Big-5) and cognitive ability across nonclinical populations of older adults. Possible mechanisms underlying associations of personality characteristics with cognition are reviewed, and assessed in the context of the current literature. Some relatively consistent relationships are identified, including positive associations between openness and cognitive ability, and associations of conscientiousness with slower rates of cognitive decline. However, the relationships between several personality traits and cognitive abilities in older adults remain unclear. We suggest some approaches to research design and analysis that may help increase our understanding of how personality differences may contribute to cognitive aging.     

Cognitive function in older adults according to current socioeconomic status

Cognitive function may be influenced by education, socioeconomic status, sex, and health status. Furthermore, aging interacts with these factors to influence cognition and dementia risk in late life. Factors that may increase or decrease successful cognitive aging are of critical importance, particularly if they are modifiable. The purpose of this study was to determine if economic status in late life is associated with cognition independent of socioeconomic status in early life. Cross-sectional demographic, socioeconomic, and cognitive function data were obtained in 2592 older adults (average age 71.6 years) from the Center for Disease Control’s National Health and Nutrition Examination Survey (NHANES) and analyzed with linear regression modeling. Cognitive function, as measured with a test of processing speed, was significantly associated with poverty index scores after adjusting for educational attainment as an estimate of childhood socioeconomic status, ethnic background, age, health status, and sex (P < 0.001). Our findings suggest that current economic status is independently associated with cognitive function in adults over age 60 years.     

CRITICAL REMARKS ON THE COGNITIVE SCIENCE OF RELIGION

Cognitive explanations of religious beliefs propose an evolutionary past in which humans had to possess certain cognitive adaptations to survive. The aim of this article is to show that some cognitive accounts may overvalue the putative role of cognition. One such cognitive idea is an assumption that cognition has been evolutionarily shaped only, or most importantly, in the Pleistocene. This idea seems common among writers on the cognitive science of religion (CSR), but is mistaken. Cognition has been shaped throughout evolution. Another idea is that components of religion could not have been produced by natural selection (the hypothesis that religion is a by-product). But the article suggests that there are some domains in the field of religion and religious components that could be acquired and transmitted despite or even against alleged cognitive biases. The aim of this article is to argue for an extended approach that combines a cognitive account with functional naturalistic approaches, including an adaptationist one. Such distinction could imply that cognition is not functional. Obviously, this is not the case since cognition is the process of knowing, and surely knowledge is functional. However, the main argument for such a distinction lies in the key idea of the cognitive account that as far as cognition is functional and adaptive, religious components are not. Functionalism or “adaptivism” concerning cognition contradicts functionalism concerning religion. Numbers of scholars who consider themselves part of CSR seem also to consider both cognition and religion adaptive. However, in regard to components of religion, their adaptive, functional power is only secondary. The article concludes that the study of religion—as the study of cultural evolution in general—should include a pluralistic methodology combining cognitive and evolutionary accounts with the specificity of cultural evolution.     

Cognitive Therapy: Nature and Relation to Behavior Therapy – Republished Article

Recent innovations in behavior modification have, for the most part, detoured around the role of cognitive processes in the production and alleviation of symptomatology. Although self-reports of private experiences are not verifiable by other observers, these introspective data provide a wealth of testable hypotheses. Repeated correlations of measures of inferred constructs with observable behaviors have yielded consistent findings in the predicted direction.Systematic study of self-reports suggests that an individual’s belief systems, expectancies, and assumptions exert a strong influence on his state of well-being, as well as on his directly observable behavior. Applying a cognitive model, the clinician may usefully construe neurotic behavior in terms of the patient’s idiosyncratic concepts of himself and of his animate and inanimate environment. The individual’s belief systems may be grossly contradictory; i.e., he may simultaneously attach credence to both realistic and unrealistic conceptualizations of the same event or object. This inconsistency in beliefs may explain, for example, why an individual may react with fear to an innocuous situation even though he may concomitantly acknowledge that this fear is unrealistic.Cognitive therapy, based on cognitive theory, is designed to modify the individual’s idiosyncratic, maladaptive ideation. The basic cognitive technique consists of delineating the individual’s specific misconceptions, distortions, and maladaptive assumptions, and of testing their validity and reasonableness. By loosening the grip of his perseverative, distorted ideation, the patient is enabled to formulate his experiences more realistically. Clinical experience, as well as some experimental studies, indicate that such cognitive restructuring leads to symptom relief.     

Alcoholism,Aging, and Cognition: A Review of Evidence for Shared or Independent Impairments

Little is known about the combined effects of aging and alcoholism on cognitive function, in spite of the potential importance of this knowledge. Studies reported to date have focused on whether aging and alcoholism have shared mechanisms (i.e., the premature aging hypothesis) or independent mechanisms. Most have concluded that the effects of aging and alcoholism on cognition operate through independent mechanisms. However, there are reasons to doubt this conclusion. Many of the studies were not optimally designed to discover shared mechanisms because they used a limited range of ages, included several different groups in their analyses, or had low statistical power. Furthermore, interpretation of the patterns of main effects and interactions between aging and alcoholism is not straightforward. Assumptions must be made about the nature of the impairments in order to interpret the data. This review uses several theories of cognitive aging as an organizing heuristic for interpreting the extant data on aging, cognition, and alcoholism. Some potential shared mechanisms for cognitive deficits in aging and alcoholism are identified, such as information processing speed and proactive interference in working memory. In contrast, some potential independent mechanisms are also identified, such as decay from working and long-term memory. These mechanisms should be used as a base to guide necessary further research.     

语义认知的习得、发展和老化及其神经机制

作为语言系统的重要组成部分, 探究语义认知发展机制及其神经机理对揭示人类语言发展、认知机制有着重要意义。以语义认知能力的习得、发展、老化认知机制为主线, 在系统阐释词汇-语义系统的习得、语义认知能力和策略发展的基础上, 进一步探讨了语义认知老化的认知机制及其神经机理。最后, 围绕儿童和成人的语义认知差异、句法和语义认知老化的差异、语义认知老化的影响因素等问题上进行了思考和展望。     

Accuracy of self-reported arrests among a forensic SPMI population

Self-reports are prone to response error even in the most structured and standardized environment, but the highly stigmatizing nature of illegal behavior and the possible cognitive problems inherent to the SPMI population increase the likelihood of such error. Using administrative data as the gold standard, the validity of self-reported arrests was examined among 85 mentally ill substance-abusing individuals with justice involvement. The overall accuracy of self-reported arrests during a three-month recall period was 84.7%. Validity was higher among individuals who at the time of the follow-up interview were either in a jail diversion program or incarcerated. Individuals with a mood disorder appeared to be somewhat less accurate in their self-reports than subjects with schizophrenia, despite the implication of cognitive distortion accompanying this latter diagnostic category. Further research on issues such as the accuracy of self-reports over longer recall periods, or the accuracy of self-reported frequency of arrest, is necessary, given the reliance on self-report methodology in outcome studies.     

Frontal-Striatal Circuits in Cognitive Aging: Evidence for Caudate Involvement

Changes in cognition with aging have been claimed to be due in large part to a decline in frontal lobe function. However, at our present state of knowledge, the emphasis on the frontal lobes to the exclusion of the rest of the frontal-striatal circuits of which they are a part is unwarranted. To argue this point, I consider another anatomical candidate within these circuits, the caudate. Evidence is presented that the caudate decreases in size with age as much as the frontal lobes and that damage to either the frontal lobes or the caudate is accompanied by declines in inhibitory processes, executive control, and cognitive speed similar to those seen in normal aging. Separating the unique contributions of the frontal lobes and the caudate to these circuits is difficult but should be the focus of future studies of the biological basis of cognitive aging.     

Aging, Training, and the Brain: A Review and Future Directions

As the population ages, the need for effective methods to maintain or even improve older adults’ cognitive performance becomes increasingly pressing. Here we provide a brief review of the major intervention approaches that have been the focus of past research with healthy older adults (strategy training, multi-modal interventions, cardiovascular exercise, and process-based training), and new approaches that incorporate neuroimaging. As outcome measures, neuroimaging data on intervention-related changes in volume, structural integrity; and functional activation can provide important insights into the nature and duration of an intervention’s effects. Perhaps even more intriguingly, several recent studies have used neuroimaging data as a guide to identify core cognitive processes that can be trained in one task with effective transfer to other tasks that share the same underlying processes. Although many open questions remain, this research has greatly increased our understanding of how to promote successful aging of cognition and the brain.     

Functional Consequences of HIV-Associated Neuropsychological Impairment

This review focuses on the “real world” implications of infection with HIV/AIDS from a neuropsychological perspective. Relevant literature is reviewed which examines the relationships between HIV-associated neuropsychological impairment and employment, driving, medication adherence, mood, fatigue, and interpersonal functioning. Specifically, the relative contributions of medical, cognitive, psychosocial, and psychiatric issues on whether someone with HIV/AIDS will be able to return to work, adhere to a complicated medication regimen, or safely drive a vehicle will be discussed. Methodological issues that arise in the context of measuring medication adherence or driving capacity are also explored. Finally, the impact of HIV/AIDS on mood state, fatigue, and interpersonal relationships are addressed, with particular emphasis on how these variables interact with cognition and independent functioning. The purpose of this review is to integrate neuropsychological findings with their real world correlates of functional behavior in the HIV/AIDS population.     

The place of appraisal in emotion

Abstract

The concept of “appraisal” has been used in the literature in a dual way: to refer to the content of emotional experience, as well as to the cognitive antecedents of emotions. I argue that appraisal in the former sense is what is contained in information in self-reports and that this information is of limited use for making inferences on emotion antecedents. This is so because emotional experience may contain appraisals that are part of the emotional response rather than belonging to its causes. They often result from elaboration of the experience after it has begun to be generated. Although in most or all emotions some cognitive appraisal processes are essential antecedents, these processes may be much simpler than self-reports (and the semantics of emotion words) may suggest. The appraisal processes that account for emotion elicitation can be assumed to be of a quite elementary kind.     

Limitations to the deficit attenuation hypothesis: Aging and decision making

The deficit attenuation hypothesis is the proposal that age related declines in basic cognitive functions often result in compensatory changes in decision making strategies. However, the patterns of cognitive changes across the adult life span are complex: Many cognitive abilities change across the adult life span while others do not. Some of the cognitive changes will be detrimental to decision making, others will have no impact and still others may actually improve decision making. We illustrate the complexity of the impact of cognition on aging and decision making with examples from working and long-term memory and use these to suggest boundary conditions for the deficit attenuation hypothesis.     

认知年老化与执行衰退假说

在认知年老化领域,执行衰退假说是近年来新兴的一种理论。执行衰退假说在理论上具有很强的吸引力,但在实证研究中却存在很多困难,如执行功能的可分离性问题,执行功能测量的信度和效度问题,以及执行功能与加工速度的关系问题。目前,该领域研究的焦点是：在行为学水平上,控制一般性因素（加工速度）后,执行功能是否仍对认知年老化起重要的中介作用;在神经水平上,执行（额叶）功能随龄的变化情况,以及在认知年老化过程中,额叶在大脑功能重组中扮演的角色。最终实现对认知年老化的理解,需要将认知功能与大脑结构联系起来;既看到广泛存在的共同的基本机制,又不能忽略不同认知结构的选择性变化。     

Decline and Compensation in Aging Brain and Cognition: Promises and Constraints

Age-related cognitive declines are common and inevitable, but life trajectories of brain and cognitive functions are variable and plastic. To identify the mechanisms of decline, the prospects for improvement, and the constraints on the remedial approaches, the contributors of this special issuer examine several diverse areas of cognitive and brain aging: from structural and metabolic brain aging to genetics, and from age-sensitive cognitive domains to those that resist aging. In spite of such thematic diversity, several common threads are clear. To achieve better compensation for age-related changes in cognition, we need to understand their brain substrates, telling cognitively relevant from epiphenomenal. We also need to understand the sources of profound individual variability in aging trajectories, and to learn to tailor interventions to specific individual profiles of decline.     

生成认知：理论基础与实践走向

生成认知是具身认知思潮中的一个新取向。它主张认知是通过身体活动“生成的” (enacted)。认知的起点不是一个怎样精确表征世界的信息加工问题, 而是行动者在情境中怎样利用知觉来指导自己的行动。认知不是通过精确的心理表征“恢复”世界, 而是通过知觉引导的行动“生成”或“造就”一个自己的世界。认知是具身的行动, 认知结构形成于经常和反复出现的感觉运动模式, 与身体构造和身体活动具有深刻连续性。梅洛·庞蒂的身体现象学对生成认知具有深刻影响。同时, 詹姆斯、杜威等人的实用主义哲学对于实践行动的强调也深刻影响了生成认知。这种认知观强调了“行动”对心智的意义, 引发许多争议, 也促进了心理学研究范式的转变。