Wednesday, April 18, 2018
The National Center on Law & Elder Rights has released an issue brief, Drafting Advance Planning Documents to Reduce the Risk of Abuse or Exploitation. The issue brief offers 4 key lessons:
- Extra care in the creation of advance care planning documents can reduce the risk of abuse and exploitation.
2. Requiring accountability, additional checks and balances, and limited authority are drafting tools lawyers can utilize to limit risk of abuse.
3. Attorneys should advise clients to be extra diligent when selecting the agent(s) named in advance planning documents.
4. Authorizing revocation by third parties can help to limit the damage done by named agents who start to abuse or exploit the client.
I was intrigued by #4-the idea of naming a third party who could step in. The section, Five Safeguards to Consider Adding to a Financial POA discusses that among others. Here's how the issue brief explains the third party revocation provision: "Grant a power to revoke the agent’s authority to a trusted third person. This is a serious power to give any third person, so it requires an exceptional level of trust and reliability in the third person. But, if the agent’s actions prove seriously out of line, this can be a last resort. Some powers of attorney also authorize law enforcement or adult protective services to revoke the authority of the agent if they believe abuse or exploitation is taking place." Sample language is also included for each of the 5 Safeguards.
The brief discusses selection of agents and drafting health care directives in addition to drafting POAs. Practice tips are included as well as case examples. The issue brief is available here.
To learn more about the corresponding webcast click here. To download the PowerPoint for the webcast, click here.
April 18, 2018 in Advance Directives/End-of-Life, Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Other, Programs/CLEs, Property Management, State Statutes/Regulations, Webinars | Permalink
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Wednesday, April 11, 2018
The Alzheimer's Association has released their annual facts and figures report. 2018 Alzheimer's Disease Facts & Figures also includes a special report on the benefits (personal and financial) of early diagnosis. Here are some highlights of topics covered in the report:
Brain changes that occur with Alzheimer’s disease …
Revised guidelines for diagnosing Alzheimer’s disease …
Number of Americans with Alzheimer’s dementia nationally … and for each state …
Proportion of women and men with Alzheimer’s and other dementias …
Lifetime risk for developing Alzheimer’s dementia …
Number of deaths due to Alzheimer’s disease nationally … and for each state … and death rates by age …
Number of family caregivers, hours of care provided, and economic value of unpaid care nationally and for each state …
The impact of caregiving on caregivers …
National cost of care for individuals with Alzheimer’s or other dementias, including costs paid by Medicare and Medicaid and costs paid out of pocket …
Medicare payments for people with dementia compared with people without dementia
Benefits of earlier detection of Alzheimer's disease …
Cost savings of diagnosing during the earlier mild cognitive impairment stage rather than the dementia stage …
There is a lot of helpful information and statistics in the report. The chart showing the numbers of those with Alzheimer's in 2018 compared to the projections for 2025 is very useful. (Just fyi, my state is expected to have a 33.3% increase). Consider this from page 21 of the report:
“[B]etween 2018 and 2025 every state across the country is expected to experience an increase of at least 13 percent in the number of people with Alzheimer’s. These projected increases in the number of people with Alzheimer’s are due to projected increases in the population age 65 and older in these states. The West and Southeast are expected to experience the largest percentage increases in people with Alzheimer’s between 2018 and 2025. These increases will have a marked impact on states’ health care systems, as well as the Medicaid program, which covers the costs of long-term care and support for some older residents with dementia.”
April 11, 2018 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Other, Science, Statistics | Permalink
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Tuesday, April 10, 2018
According to the New York Times, late last month, the House of Representatives passed the right to try bill on their second attempt. House Passes Bill That Would Give Patients Access to Experimental Drugs explains that "[s]upporters said the bill would give dying patients a chance to obtain potentially helpful prescription drugs without waiting for the completion of clinical trials or going through a process established by the Food and Drug Administration to allow the use of “investigational drugs” outside clinical trials." There were supporters as well as opponents of the bill.
The House and Senate bills would establish a new pathway providing access to unapproved medicines for certain patients who had exhausted other treatment options. To qualify under the House bill, a patient would have to have some kind of terminal illness: a condition that is likely to cause death “within a matter of months” or “irreversible morbidity that is likely to lead to severely premature death.”
Nothing in the bill would require pharmaceutical companies to provide experimental drugs to patients who requested them. Drug manufacturers sometimes turn down requests because they have only a limited supply or they are concerned about legal and medical risks.]
To address such concerns, the legislation would shield drugmakers, doctors and hospitals from some of the legal risks of providing unapproved drugs to patients. Doctors and hospitals would generally be protected unless they engaged in gross negligence or willful, reckless or criminal misconduct.
April 10, 2018 in Advance Directives/End-of-Life, Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Other, Science | Permalink
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Sunday, April 8, 2018
A while back we published a post about Swedish Death Cleaning and I'll hazard a guess that after you read that post, many of you went through your stuff and disposed of things. So here's another thought-when you don't have kids, to whom do you leave your stuff? The New York Times tackled that issue in this article, If You Don’t Have Children, What Do You Leave Behind?
The author's essay explains her dilemma as she puzzles through who of her relatives get what, and in what amount, offering her view that "wills are easier for parents because they have a natural push — the need to name guardians for their children and provide financially for them after they are gone. On the surface it’s about who gets your stuff, but it got me thinking about ways people without children create a legacy. Who will remember us?"
The author did a lot of homework, casting a wide net of inquiries and carefully considering her catch. She discovered "patterns and creative thinking [and] saw a lot of worry, too, mostly about who will take care of us when we’re old. When it comes to legacy and relationships with young people, people start close to home. Nieces, nephews and godchildren came up in nearly every response. As did the idea of meaningful work. And that’s true for [the author]."
This is an interesting piece and I think it would be useful for our students to read. It will help remind them that estate planning is not a "one-size-fits-all" exercise.
Thanks to Professor Naomi Cahn for sending this our way.
April 8, 2018 in Consumer Information, Current Affairs, Estates and Trusts, Other, State Statutes/Regulations | Permalink
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Friday, April 6, 2018
The Aging & Law Section of AALS has issued a call for papers for its meeting in January, 2019 in new Orleans as part of the 2019 AALS annual meeting. The program is being co-sponsored by the Family & Juvenile Law, Minority Groups, Trusts & Estates, and Women in Legal Education Sections.
The topic for the program (and papers) is The Legal Consequences of Living a Long Life: The Differential Impact on Marginalized Communities
Here's a brief description, prepared by Section Secretary Naomi Cahn.
Thanks to advances in health care people are living longer. Longevity has legal consequences. People can outlive their family, friends, and finances. Longevity has differing impacts for women, people of color, low-income people, and LGBT individuals. Statistically, women make less money than men and they live longer than men. People of color are less financially secure than Americans as a whole. In the United States, approximately 80 percent of long-term care for older people is provided by family members, such as spouses, children, and other relatives. This places an undue financial burden on low-income persons. LGBT individuals may face conscious and unconscious discrimination when seeking long-term care and other assistance, and they have historically formed various kinds of family structures. This panel will explore the intersection of the legal system and longevity, examining systems that are in place or should be in place to help people plan for living longer. Topics might include: paying family caregivers, working conditions of nursing home assistants, and differential patterns of wealth accumulation. This call for paper seeks authors of published or unpublished papers that consider law and longevity.
To be considered, submit a one-two page proposal by email to Naomi at firstname.lastname@example.org Deadline is May 1, 2018. BTW, those accepted to present may also have their papers published in the Journal of Health Law and Policy at Cleveland State University.
Don't wait-submit your proposal!!!
April 6, 2018 in Consumer Information, Current Affairs, Other, Programs/CLEs | Permalink
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Sunday, April 1, 2018
Those ubiquitous peeps appear like clockwork on the shelves of grocers, drug stores and confectioners along with the chocolate Easter bunnies and those other candies destined for someone's Easter basket. An article last week in the Washington Post. Trouble in candy land:How Peeps, pensions and a lawsuit threaten to upend the American retirement system discusses the issues regarding the company's pension coverage for workers. The company participates in a multi-employer pension plan and offers current workers (who are members of a union) a traditional pension plan. The company wants to leave that system and offer new works a 401(k) without paying a $60 million fee imposed pursuant to federal law. This $60 million fee does have a specific purpose: "to ensure future retirees’ benefits are covered, and if [the company] succeeds in escaping it, union officials fear the unprecedented ruling would prompt thousands of other firms to do the same. This chain reaction could divert workers and money at a time when new employees are seen as crucial to ensure ample funding for the wave of retiring baby boomers — putting payouts for millions of pensioners at risk."
The dispute resulted in a strike and, as is typical in a town where one company can mean so much, people taking both sides of the dispute. Matters deteriorated and now there is a lawsuit from the company against the union, asking for compensation and claiming the strike was unlawful. The suit will have far-reaching ramifications since multi-employer pension plans exist beyond this one:
In total, 10 million current and retired workers participate in multi-employer pensions, according to the Pension Benefit Guaranty Corporation. These pensions allow employees to move from one job to another within the same pension and carry their retirement benefits with them.... Many of these multi-employer pensions are on track to run out of money. If the pension runs out of money, retired workers might only get a small percent of the money they thought they had earned through decades of work.
There's a bit of a domino effect in these kind of pension plans, since, as the article notes, "[i]f one of the companies paying into the multi-employer plan falters, the other firms are left on the hook to pay even more to stabilize the fund."
Not sure how this will all come out in the end, but for now, go enjoy your peeps!
April 1, 2018 in Consumer Information, Current Affairs, Food and Drink, Other | Permalink
Wednesday, March 21, 2018
With World Elder Abuse Awareness Day just a few months away, it's time to think about any events your organization might offer. According to the USC Center on Elder Mistreatment NCEA email, a microsite has been created that offers suggestions, helpful hints, events and more. Want to take some kind of action? Check the information here for 13 ideas in a number of categories. Planning an event? List it there. It's never too early to start planning! And let others know using #WEAAD.
March 21, 2018 in Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Health Care/Long Term Care, International, Other, Programs/CLEs | Permalink
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Thursday, March 15, 2018
Margaritaville, at least the Jimmy Buffett version, is no longer a state of mind. The Washington Post ran a story about Jimmy Buffett's foray into senior housing. Adopting a laid-back attitude at Latitude Margaritaville explains that the "Key West-inspired houses are being built along streets linked to lyrics of Buffett’s 1977 hit 'Margaritaville.'" Continuing the them, the pet spa is "Barkaritaville" and the fitness center is "Fins up!" Guess what's on the menu at the local restaurant? If you guessed "Cheeseburger in Paradise" you'd be right! And as the article makes clear, Buffett is a significant business entrepreneur.
How's this for fun in a 55+ community. "[O]ne element of Latitude Margaritaville that makes it unusual for an active-adult community: Live music shows will be scheduled five to seven nights a week." But why a 55+ community for Jimmy Buffett? "he decision to expand the Margaritaville brand into active-adult communities seems like a natural fit, particularly because Buffett’s fans tend to be aging baby boomers who have followed his career for decades." And fans have come-with over 100,000 requesting information about the planned community. The homes are selling like hot cakes (or maybe sponge cake would be better to say) with over 225 selling within two months. However, there's a ways to go to full occupancy once the 2 developments of 7,000 are finished over the next decade. The community is around 10 miles away from Daytona Beach and close to hospitals and other services. Many other amenities are planned, and of course, there is always the chance that Jimmy Buffett might perform!
Who would want to pass up the chance to live on Spongecake Court? Come on-admit it, that song is going through your head now....
March 15, 2018 in Consumer Information, Current Affairs, Health Care/Long Term Care, Housing, Other, Retirement | Permalink
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Wednesday, March 14, 2018
Somehow I never thought I'd right that phrase. Yet, Palo Alto is taking steps to become a dementia-friendly city! Palo Alto looks to become a 'dementia-friendly city' explains that
Palo Alto is among a growing number of communities around the world that have begun to look at how government, businesses and residents can work together to provide better resources — like training for first responders, community support networks and policies that better aid employees who are also caregivers — for the expanding population of aging adults who are being diagnosed with dementia.
Palo Alton has a little more than 30,000 residents now who have dementia (including Alzheimer's) and it is estimated that that number will exceed 50,000 by 2030. "As part of its broader push for an "age-friendly Silicon Valley," Santa Clara County last year joined Dementia Friends, a global movement begun by the Alzheimer's Society in the United Kingdom to change the way people think about dementia."
A public hearing on this is scheduled for late March. Thanks to my colleague and dear friend Mark Bauer for alerting me to this article.
March 14, 2018 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Other | Permalink
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Tuesday, March 13, 2018
There are amazing technologies out there, and I'm sure more are being invented as I write this. Kaiser Health News ran a story about technology designed to allow elders to age in place and to satay connected. New Technologies Help Seniors Age In Place — And Not Feel Alone opens by relating a story of one elder who agreed to the use of a long-distance monitoring system so her son across the country could keep track of her well-being. "For many, the technology offers not just the tools they need to continue to live at home, but newfound confidence and connectedness with faraway family and friends." One expert quoted in the article has named this trend as "'monitored independence,' and it is changing how older generations age in America. 'People want to be autonomous, irrespective of age,'" said this expert. The article notes that voice-assisted technologies are goign to play a large role in helping elders age in place as these devices can do a lot more than just play music. Pair those with apps designed to help elders and will become proactive in interactions rather than reactive. The article offers a forthcoming app as an example where it will ask the elder if the elder has remembered to take her medication. There are currently apps that remind the user to take medication and allows the user to designate a second party to get an alert if the user misses a dose of medication.
More fall detection devices are coming our way as well, some very soon and others before too long.
It's interesting to see tech moving into this market and hopefully more will be done to help us live independently longer. Is anyone thinking about the privacy aspects of using all this tech?
March 13, 2018 in Consumer Information, Current Affairs, Health Care/Long Term Care, Other, Web/Tech | Permalink
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Tuesday, January 30, 2018
The New York Times ran an article about recent research regarding the correlation between early retirement and longevity. The Connection Between Retiring Early and Living Longer looks at a number of studies here and abroad.
That retirement promotes health and prolongs life isn’t obvious. After all, work provides income and, for some, health insurance — both helpful for maintenance of well-being. It also can provide purpose and camaraderie. Evidence is mounting that loneliness and social isolation are linked to illness, cognitive decline and death. One study of American retirees found them less likely to be lonely or depressed.
For some, retirement doesn't have a healthy impact. Developing, or continuing, good eating habits and exercise are critical. "Retirees are more likely to exercise, and those who do are better off for it. One study found retirees get more sleep and spend more time doing household work and gardening — both of which are more active than a desk job. Another study found that better health in retirement may be because of the reduced likelihood of smoking." Those are all good things, but for many, retirement is outside of their financial ability. "[A]ccording to a recent national survey by the Board of Governors of the Federal Reserve System, many Americans don’t have the resources to retire. About 20 percent of Americans over 44 years old have no retirement savings. Half of Americans are at risk of being unable to maintain their standard of living in retirement. If you want to retire, whether for health benefits or otherwise, you’ll have to start preparing when you’re still young."
January 30, 2018 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Other, Retirement | Permalink
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Monday, January 22, 2018
The National Center on Law & Elder Rights has announced their next webinar, this one on elders and bankruptcy. Legal Basics: Debt Collection Protections for Older Consumers is set for February 13, 2018 at 2 p.m. est. According to the email announcement, here is the description:
An increasing number of older consumers are struggling with unmanageable debt as Americans carry more credit card, student loan, and other debts into retirement than in past decades. Debt collectors often aggressively pursue older adults to repay debt from fixed incomes.
This free webinar, Legal Basics: Debt Collection Protections for Older Consumers, outlines the issues facing older consumers and offers strategies to help address the challenges. This session will highlight federal protections for older consumers from abusive debt collection practices.
The webinar is free. Click here to register.
January 22, 2018 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Other, Programs/CLEs, Webinars | Permalink
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Friday, January 19, 2018
We have previously blogged about the concept of shared housing. It can take many forms and can be a great option for certain elders. The New York Times ran an article about it in NY. Getting a Roommate in Your Golden Years explains that
The concept of pairing older people with younger ones, particularly those who are not family members, is not a new one: It was popularized by Maggie Khun, an elder-rights activist who opened up her Philadelphia home to others for more than 20 years before she died in 1995. Today’s home sharing, however, is as likely to be between those of the same age as it is to be intergenerational. The crucial thing is that it involves two or more people sharing an apartment or a house to their mutual benefit. And finances often play a big role.
The article focuses on the win-win, cost savings on both sides among others. The article features one New Yorker who is running low on funds and turned to a service in Manhattan that matches folks. "The New York Foundation for Senior Citizens connected her with a licensed social worker who asked a host of questions, including details about her sleeping habits, personality, interests and daily schedule. She also had to provide three personal recommendations and her rental agreement, to prove she was on the lease. And she was asked to describe what she considered the ideal roommate. Her response: someone who wasn’t home much."
Another expert quoted in the story notes that shared housing can be a way to fight homelessness amongst elders. Don't think homelessness is an issue for elders? Think again. "Statistics show that the number of older Americans who are homeless is growing. In 2007, homeless people 62 and older who sought shelter accounted for 2.9 percent of the country’s homeless population. By 2016, the percentage had risen to 4.7, according to estimates from the National Alliance to End Homelessness, a Washington, D.C., advocacy group."
Does an elder need to go through an organization to find a roommate? No, but there are certainly advantages to doing so! For example, one elder interviewed for the story detailed her travails in finding the right match. Another expert in the article highlighted the benefits of using an agency.
She advises those interested in home sharing not to go about it on their own: Go through a nonprofit service, she said, or ask a trusted eldercare professional, friends or family to help properly vet the prospective roommates. And before you sign a lease with a boarder, make sure to do a background check... “You need a huge amount of trust and to be very clear with your expectations,” she said. . . “But if you have the help you need to stay in your home — and the tenant gains affordable housing in exchange — I think there’s much to gain socially and spiritually when young and old live together.”
January 19, 2018 in Consumer Information, Current Affairs, Housing, Other | Permalink
Wednesday, January 17, 2018
Tuesday, January 16, 2018
Those Boomers (or should I say, more accurately, we boomers). We invented lots of things (if you ask us) including rock 'n roll and now we are experiencing hearing loss. It was only a matter of time.... after years of playing all that rock music so loudly (of course our parents warned us), we are reaping the after effects-hearing loss (this is a tongue in cheek statement, BTW). Baby boomers destroyed their hearing. Biotech is trying to fix it
opens with these paragraphs
Baby boomers grew up with music blasting from dorm room turntables, car stereos, and arenas where the sound of a band at full throttle could rival the roar of a jet engine. Volume became an act of generational defiance. As rocker Ted Nugent put it: “If it’s too loud, you’re too old.” ... Turns out, it was too loud. Millions of boomers are now grappling with hearing loss — some of it caused by turning the volume to 11 — prompting companies to develop treatments that improve upon the expensive and often limited-value hearing aids and surgical implants that have been around for decades.
Intrigued. Find yourself amongst those who maybe played your music at "11"? Want to read more? The Boston Globe also an the article. The article looks at the frequency (no pun intended, honestly) of hearing loss and it's a lot, the treatments being researched, and more. And before you go off to tell your children to turn down the volume on their music, the article notes noise isn't the only reason for hearing loss. Some of it is genetic and another is age related. Technology plays a role as well, with one expert noting the impact of leaf blowers and ear buds. Different devices and developing drugs are being studied as an option for those with hearing loss.
January 16, 2018 in Consumer Information, Current Affairs, Health Care/Long Term Care, Other, Science | Permalink
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Friday, December 29, 2017
2017 has been a bit of a wild ride, and I thought it would be good to end the year on a happy news item. So, check out this article in the New York Times.
Want to Be Happy? Think Like an Old Person. is an update on a series that follows six New York elders who at the time of the first article were " over the age of 85, one of the fastest-growing age groups in America. The series of articles began the way most stories about older people do, with the fears and hardships of ...." In this article, the author is examining happiness. "Older people report higher levels of contentment or well-being than teenagers and young adults. The six elders put faces on this statistic. If they were not always gleeful, they were resilient and not paralyzed by the challenges that came their way. All had known loss and survived. None went to a job he did not like, coveted stuff she could not afford, brooded over a slight on the subway or lost sleep over events in the distant future. They set realistic goals. Only one said he was afraid to die."
This attitude, the article explains, has a name: "the paradox of old age: that as people’s minds and bodies decline, instead of feeling worse about their lives, they feel better. In memory tests, they recall positive images better than negative; under functional magnetic resonance imaging, their brains respond more mildly to stressful images than the brains of younger people."
Two of the six have died, and the updates on the remaining four show some ups, downs, adjustments, and changes.
So ends another year for four members of New York’s oldest old: not with a whimper, but with small joys to ease their aches. Each lost a little and moved a year closer to death, as we all did. But each welcomed another morning, the start of another year to come. All had beaten the odds just to get this far.
Resilience and perseverance matters.
Happy New Year
December 29, 2017 in Consumer Information, Current Affairs, Health Care/Long Term Care, Other | Permalink
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Monday, December 18, 2017
Thursday, December 14, 2017
There's been a lot of attention of late regarding the very serious opiod crisis. But I think it's important to keep in mind the issue of polypharmacy and elders. The Washington Post ran this article, The other big drug problem: Older people taking too many pills, which opens with this "[c]onsider it America’s other prescription drug epidemic." The article offers sobering statistics
Researchers estimate that 25 percent of people ages 65 to 69 take at least five prescription drugs to treat chronic conditions, a figure that jumps to nearly 46 percent for those between 70 and 79. Doctors say it is not uncommon to encounter patients taking more than 20 drugs to treat acid reflux, heart disease, depression or insomnia or other disorders.
In fact, some elders have health issues from polypharmacy, some which are preventable, according to the article. The polypharmacy problems can create a vicious cycle for some folks for whom "the side effects of drugs are frequently misinterpreted as a new problem, triggering more prescriptions, a process known as a prescribing cascade." Often, a hospitalization and new meds on top of the existing ones contribute to the problem. Evidently the problem of polypharmacy, although not new, is increasing. The article explains that some doctors are engaging in what is referred to as "deprescribing" which is explained as "systematically discontinuing medicines that are inappropriate, duplicative or unnecessary." The article explains a number of hurdles to this goal, including lack of research, time constraints, advertising and just changing the status quo.
This is a really interesting article and worth the read!
December 14, 2017 in Cognitive Impairment, Consumer Information, Current Affairs, Health Care/Long Term Care, Other | Permalink
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I recall a children's song I learned about the importance of keeping your old friends while making new friends. So the Kaiser Health News story about friends caught my eye. Good Friends Might Be Your Best Brain Booster As You Age reports on a new study from Northwestern regarding the connection between "brain health and positive relationships." The Northwestern Study, Psychological well-being in elderly adults with extraordinary episodic memory is an open source article available as well as a pdf. Here is the abstract from the study
The Northwestern University SuperAging Program studies a rare cohort of individuals over age 80 with episodic memory ability at least as good as middle-age adults to determine what factors contribute to their elite memory performance. As psychological well-being is positively correlated with cognitive performance in older adults, the present study examined whether aspects of psychological well-being distinguish cognitive SuperAgers from their cognitively average-for-age, same-age peers.
Want to live longer and happier, then be nice to your good friends (maybe call them up now and tell them hi!). The article's concluding summary offers this
SuperAgers endorse higher levels of Positive Relations with Others compared to their cognitively healthy but average-for-age same-age peers suggesting that this aspect of psychological well-being may be an important factor for exceptional cognitive aging. Investigation of the longitudinal effects of psychological well-being on subsequent cognitive performance and investigation of the conceivable relationship between psychological well-being and von Economo neurons in SuperAgers represent intriguing future directions.
December 14, 2017 in Cognitive Impairment, Consumer Information, Current Affairs, Health Care/Long Term Care, Other | Permalink
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