For most Americans, staying "mentally sharp" as they age is a very high priority. Declines in memory and decision-making abilities may trigger fears of Alzheimer's disease or other neurodegenerative diseases. However, cognitive aging is a natural process that can have both positive and negative effects on cognitive function in older adults - effects that vary widely among individuals. At this point in time, when the older population is rapidly growing in the United States and across the globe, it is important to examine what is known about cognitive aging and to identify and promote actions that individuals, organizations, communities, and society can take to help older adults maintain and improve their cognitive health. Cognitive Aging assesses the public health dimensions of cognitive aging with an emphasis on definitions and terminology, epidemiology and surveillance, prevention and intervention, education of health professionals, and public awareness and education. This report makes specific recommendations for individuals to reduce the risks of cognitive decline with aging. Aging is inevitable, but there are actions that can be taken by individuals, families, communities, and society that may help to prevent or ameliorate the impact of aging on the brain, understand more about its impact, and help older adults live more fully and independent lives. Cognitive aging is not just an individual or a family or a health care system challenge. It is an issue that affects the fabric of society and requires actions by many and varied stakeholders. Cognitive Aging offers clear steps that individuals, families, communities, health care providers and systems, financial organizations, community groups, public health agencies, and others can take to promote cognitive health and to help older adults live fuller and more independent lives. Ultimately, this report calls for a societal commitment to cognitive aging as a public health issue that requires prompt action across many sectors.

Possible new breakthroughs in understanding the aging mind that can be used to benefit older people are now emerging from research. This volume identifies the key scientific advances and the opportunities they bring. For example, science has learned that among older adults who do not suffer from Alzheimer's disease or other dementias, cognitive decline may depend less on loss of brain cells than on changes in the health of neurons and neural networks. Research on the processes that maintain neural health shows promise of revealing new ways to promote cognitive functioning in older people. Research is also showing how cognitive functioning depends on the conjunction of biology and culture. The ways older people adapt to changes in their nervous systems, and perhaps the changes themselves, are shaped by past life experiences, present living situations, changing motives, cultural expectations, and emerging technology, as well as by their physical health status and sensory-motor capabilities. Improved understanding of how physical and contextual factors interact can help explain why some cognitive functions are impaired in aging while others are spared and why cognitive capability is impaired in some older adults and spared in others. On the basis of these exciting findings, the report makes specific recommends that the U.S. government support three major new initiatives as the next steps for research.

By 2030 there will be about 70 million people in the United States who are older than 64. Approximately 26 percent of these will be racial and ethnic minorities. Overall, the older population will be more diverse and better educated than their earlier cohorts. The range of late-life outcomes is very dramatic with old age being a significantly different experience for financially secure and well-educated people than for poor and uneducated people. The early mission of behavioral science research focused on identifying problems of older adults, such as isolation, caregiving, and dementia. Today, the field of gerontology is more interdisciplinary. When I'm 64 examines how individual and social behavior play a role in understanding diverse outcomes in old age. It also explores the implications of an aging workforce on the economy. The book recommends that the National Institute on Aging focus its research support in social, personality, and life-span psychology in four areas: motivation and behavioral change; socioemotional influences on decision-making; the influence of social engagement on cognition; and the effects of stereotypes on self and others. When I'm 64 is a useful resource for policymakers, researchers and medical professionals.

The United States is among the wealthiest nations in the world, but it is far from the healthiest. Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other, "peer" countries. In light of the new and growing evidence about the U.S. health disadvantage, the National Institutes of Health asked the National Research Council (NRC) and the Institute of Medicine (IOM) to convene a panel of experts to study the issue. The Panel on Understanding Cross-National Health Differences Among High-Income Countries examined whether the U.S. health disadvantage exists across the life span, considered potential explanations, and assessed the larger implications of the findings. U.S. Health in International Perspective presents detailed evidence on the issue, explores the possible explanations for the shorter and less healthy lives of Americans than those of people in comparable countries, and recommends actions by both government and nongovernment agencies and organizations to address the U.S. health disadvantage.

This bk explres hw th envir influ th devlpmnt & maintnnce of cogn abltes. It offers bth a respnse to thse who focus primarily on genes as detrmners of develpl outcmes & an elabortn of jst wht it is abt "contxts" tht mkes for their effcts on thse outcomes

The theme of the present volume concerns people' s response to the natural environment, considered at scales varying from that of a house hold plant to that of vast wilderness areas. Our decision to focus on this particular segment of the physical environment was prompted in part by the intrinsic interest in this subject on the part of a diverse group of sodal scientists and professionals-and of laypersons, for that matter and in part by the relative neglect of this topic in standard treatments of the environment-behavior field. It also serves to bring out once again the interdisdplinary nature of that field, and we are pleased to have been able to inc1ude representatives from geography, sodology, soda! ecology, and natural recreation among our contributors. We believe that this volume will serve a useful purpose in helping to integrate the find ings and concepts in this presently somewhat fragmented field, scat tered as they are over a very diverse array of publications representing a similarly varied group of spedalties. It is hoped that the result will be to stimulate future development of this area and to add a measure of in creased coherence to it. Volume 7 of our series will be devoted to the theme of elderly people and the environment, with M. Powell Lawton joining us as guest co-editor. The titles of the papers comprising Volume 7 are shown on page v. Irwin Altman J oachim F. Wohlwill ix Contents Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .