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Book Forum: Geriatric Psychiatry   |    
Psychology and the Aging Revolution: How We Adapt to Longer Life
NORMUND WONG, M.D.
Am J Psychiatry 2003;160:195-a-196. doi:10.1176/appi.ajp.160.1.195-a
View Author and Article Information
Silver Spring, Md.

Edited by Sara Honn Qualls, Ph.D., and Norman Abeles, Ph.D. Washington, D.C., American Psychological Association, 2000, 313 pp., $39.95.

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What is an aging revolution? Consider a few of these facts. At the beginning of the 20th century the average life expectancy was only about 47 years. By 2050 it is estimated that more than 800,000 people will be 100 years old or older. With the customary retirement age in the mid-60s, individuals can expect another 20–30 years of meaningful activities. Aware of the aging revolution and its impact on the associated psychological and social functioning of mature individuals, the American Psychological Association has encouraged all the psychology subdisciplines to explore how aging affects basic human processes and has devoted increasing attention to the clinical practice of geropsychology.

The editors of this book assembled presentations at the 1997 annual meeting of the American Psychological Association that examined how aging affects cognition, memory, social relationships, emotion, physical and mental health, and responses to psychotherapy. In addition to two introductory chapters, there are seven sections to the book. To provide a comprehensive sweep, all of the papers by necessity are succinct and well referenced. Section 1, Neuropsychology and Aging, provides an enticing entry. In the first paper, Albert postulates that changes in the brain in early Alzheimer’s disease serve as a likely explanation for memory problems in older adults. She highlights the progress made in understanding the basic components of the memory system and their neurobiological substrates and cognitive aging, especially in regard to age-related memory changes and age-related disease. In the second chapter of this section, Kaszniak and Newman discuss two popular neuropsychological models of cognitive aging—the right-hemisphere hypothesis and the frontal-system hypothesis—and point out that earlier cognitive aging studies may have overestimated the degree of cognitive decline associated with healthy aging.

In section 2, Memory and Aging, the chapter by Light documents that, except in the case of automatic memory, older adults show memory loss as they age. She discusses three theories of memory and concludes that age-related memory declines are probably linked to those of broader cognitive processes. The chapter by Charness addresses the frequently debated issue of whether the knowledge accumulated as a person ages might offset some of the age-related cognitive declines in memory and other domains of cognitive functioning. As in the previous section, all conclusions are well-documented. Section 3, Emotion and Aging, is a single chapter by Levenson. He presents data from his laboratory and others to suggest that emotion is one of the few psychological domains in which functioning is not only well preserved but improves with age.

Section 4, Social Relationships in Later Life, consists of two chapters, one by Ryan and La Guardia and one by Rook. Ryan and La Guardia claim that a small set of basic psychological needs must be fulfilled in an ongoing manner throughout the life spans of individuals in order for them to experience well-being, integrity, and continued growth. The frustration or neglect of these needs results in both functional losses and decreased true well-being. Rook examines the evolution of social relationships in later adulthood and finds that social relationships and patterns of social interaction evolve in later adulthood in ways that reflect the dual themes of selectivity (or selective optimization) and compensation. She describes three strategies that older adults use to compensate for the loss or disruption of their social networks.

Section 5, Health Psychology and Aging, contains two brief chapters. In the first, Matthews stresses that behavioral medicine and aging research are complementary and are indistinguishable in some areas. In the next chapter, Siegler writes optimistically about the progress being made in the field of psychology and aging and health and predicts that future progress is likely to come from behavioral medicine approaches to evaluate specific pathophysiological mechanisms responsible for aging.

In section 6, Depression and Aging, Joiner provides an overview on current developments and controversies in depression and discusses psychological risk factors and implications for assessment and therapy. Gatz writes on variations in depression of later life, exploring whether older people are more depressed. She addresses the differences between early- and late-life depression as well as the risk factors, some correlates, and etiologic mechanisms in old age and examines hypotheses to explain late-life depression.

The final section of the book, Psychotherapy and Aging, has only one chapter by Norcross and Knight, which is probably the most controversial of the book. The authors offer their perspectives on current trends in psychotherapy research, policy, and practice, especially as it affects older adults. They stress that under managed care this population will encounter more, rather than fewer, barriers to receiving appropriate psychological services and advocate the adoption of an integrated, life-course perspective on psychotherapy, especially for senior citizens.

The editors of this book provide thoughtful and clarifying transitions between all seven of the sections. The chapters are uniformly of high quality and succinct, and their conclusions are well documented and researched. Because the presentations are brief and packed with data, professionals in the mental health and behavioral health fields desiring ready access to supporting sources will find this book highly useful. The references in most of the chapters are excellent. However, this book calls for focused attention and repeated readings of some chapters to fully appreciate their findings and conclusions.

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