Abstract
Examining high functioning cohorts of older people can help identify changes in daily function typical of normal aging. “High functioning” includes people who do not meet criteria for cognitive impairment and ADL disability. Even among high functioning cohorts, older adults at greater ages and with subtle cognitive impairment show greater deficits in daily function. However, these deficits are not uniform. In many domains, function is preserved. This pattern of selective decline with preserved function overall reflects compensatory processes, which in turn suggest an adaptive brain. Brain aging is characterized by continual functional reorganization and repair as the brain responds to one particular set of neural insults, that is, aging. Efforts to blunt the effects of brain aging on daily function (through volunteering, physical activity, cognitive training, and improved sleep health) have so far shown only small to moderate effects. The safest conclusion at this point is a need to support cognition across the lifespan through investment of resources for better early and mid-life educational, occupational, and neighborhood environments, as well as opportunities for continued cognitive engagement in late life.
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