Memory, Aging and the Brain: A Festschrift in Honour of Lars-Göran Nilsson

By Lars Bäckman; Lars Nyberg | Go to book overview

9
An epidemiological approach to
cognitive health in aging

Roger A. Dixon

The purpose of this chapter is to explore the foundations and implications of an epidemiological approach to understanding the multiple change trajectories and outcome patterns in the field of cognitive aging. Whereas it is reasonably apparent that there are multiple trajectories of cognitive changes with aging (ranging, in principle, from gains to losses), there is a correspondingly large range of functional outcomes of these trajectories (ranging, colloquially, from successful to normal to pathological cognitive aging). Well known, as well, is the fact that these trajectories and outcomes are often multiply-determined, with influential precursors, moderators, and mediators originating in levels of analyses from the neurobiological to the cognitive and to the sociocultural (Cabeza, Nyberg, & Park, 2004; Dixon, Bäckman, & Nilsson, 2004; Hess & Blanchard-Fields, 1999; Park, Nisbett, & Hedden, 1999). The present goal is to explore the development of a framework for considering multiple precursors, profiles, and patterns of cognitive health in aging. The framework is broadly epidemiological and includes both theoretical and methodological implications, but this is not primarily a theoretical or a methodological chapter. Rather, the focus is on exploring and illustrating the concept of cognitive health and how it can be approached in an epidemiological framework.

I am pleased to acknowledge that this chapter is inspired by the opportunity to honour the influential research career and seminal ideas of Lars-Göran Nilsson. Although broadly active in a variety of fields in the cognitive and health sciences, Nilsson’s large body of research on cognitive aging and cognitive neuroscience is pivotal for this chapter. Specifically, in his role as director of the Betula project (BP), one of the most internationally prominent epidemiological studies of cognitive aging, Nilsson has sponsored research that has covered the gamut of the field (see Nilsson et al., 1997, 2004). The BP has produced momentous publications charting many descriptive characteristics of cognitive aging, neurobiological underpinnings, health moderators, and genomic precursors of individual differences in cognitive decline. Notably for the present chapter, Nilsson and BP colleagues have also generated novel perspectives on the possibility of healthy or stable cognitive changes with aging. For example, Nilsson’s multidisciplinary BP group has

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