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Higher awareness of positive age-related changes (AARC gains) is related to better mental health, whereas higher awareness of negative age-related changes (AARC losses) is related to poorer mental and physical health. So far perceived gains and losses have been explored separately, but people report gains and losses concurrently in varying degrees, and different profiles of gains and losses may be differentially associated with health. We identified profiles of gains and losses and explored whether different profiles differed in physical, mental, and cognitive health. We used cross-sectional data from the PROTECT study (N = 6192; mean (SD) age = 66.1 (7.0)). Using latent profile analysis, a four-class solution showed the best model fit. We found that 45% of people perceived many gains and few losses (Class 1); 24% perceived moderate gains and few losses (Class 2); 24% perceived many gains and moderate losses (Class 3); 7% perceived many gains and many losses (Class 4). Analysis of variance and Chi-squared tests showed that Class 1 had relatively better physical, mental, and cognitive health, followed by Classes 2, 3, and 4. Experiencing one’s ageing to a high degree as gain may be related to better health only when individuals interpret ageing as involving low levels of loss across several life domains. Risk in terms of poorer health emerged in those who perceived high losses. Considering gains and losses in parallel, rather than separately, may lead to a more fine-tuned understanding of relations with health.

Research exploring whether health predicts self-perceptions of aging (SPA) has mostly focused on single predictors and has been hampered by short observational intervals. We examined whether 20-year changes in cognitive functioning, physical and mental health predict SPA. We used data of 103 German participants who remained of a sample of 500 participants born in 1930-1932 enrolled in the Interdisciplinary Longitudinal Study of Adult Development (ILSE) in 1993/1996 (mean age at fourth measurement wave = 82.5 years). Health indicators included six cognitive tests, objective and subjective physical health, and self-reported depression. We used a new and multidimensional (awareness of age-related gains and losses) and a well-established (attitudes toward own aging) measure of SPA. Linear regression analyses showed that, among the cognitive tests, decline in information processing speed (Digit Symbol) predicted less awareness of age-related gains and more awareness of age-related losses but not attitudes toward own aging. Decline in subjective but not objective physical health, predicted more awareness of age-related losses and negative attitudes toward own aging, but not awareness of age-related gains. Increase in depressive symptoms predicted more awareness of age-related losses and negative attitudes toward own aging, but not awareness of age-related gains. The size of associations suggests that objective cognitive decline has limited influence on older adults' SPA and, if so, only when the decline is related to mental slowing. Similarly, perceived physical and mental health, but not objective health, have a small-to-moderate influence on awareness of age-related losses and attitudes toward own aging. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Longitudinal effects of subjective age on adult health and survival are well-documented (Westerhof et al., 2014). This systematic review provides an updated and expanded evaluation of the state of the field. A systematic search in PsycInfo, Web of Science, Scopus, and PubMed resulted in 103 articles: 19 articles from the 2014 meta-analysis and 84 newer articles. Sixty-five articles focused on physical health (e.g., subjective health, objective health, and health behaviors), 41 studied mental health outcomes (e.g., mental health disorders, well-being, and quality of life), and 18 articles used mortality as the outcome. Important developments during the past years include new instruments, particularly multidimensional assessment of subjective aging, and a more fine-grained representation of health outcomes, including bio indicators. A major outcome is that most studies confirmed the longitudinal effects of subjective aging on health as reported previously, but on a much broader study portfolio.

Higher awareness of positive age-related changes (AARC gains) is related to better mental health, whereas higher awareness of negative age-related changes (AARC losses) is related to poorer mental and physical health. So far perceived gains and losses have been explored separately, but people report gains and losses concurrently in varying degrees, and different profiles of gains and losses may be differentially associated with health. We identified profiles of gains and losses and explored whether different profiles differed in physical, mental, and cognitive health. We used cross-sectional data from the PROTECT study (N= 6,192; mean(SD) age= 66.1(7.0)). Using latent profile analysis, a four-class solution showed the best model fit. We found that 45% of people perceived many gains and few losses (Class 1); 24% perceived moderate gains and few losses (Class 2); 24% perceived many gains and moderate losses (Class 3); 7% perceived many gains and many losses (Class 4). Analysis of variance and Chi-square tests showed that Class 1 had relatively better physical, mental, and cognitive health, followed by Classes 2, 3, and 4. Experiencing one’s ageing to a high degree as gain may be related to better health only when individuals interpret ageing as involving low levels of loss across several life domains. Risk in terms of poorer health emerged in those who perceived high losses. Considering gains and losses in parallel, rather than separately, may lead to a more fine-tuned understanding of relations with health.

Objectives:Evidence linking subjective concerns about cognition with poorer objective cognitive performance is limited by reliance on unidimensional measures of self-perceptions of aging (SPA). We used the awareness of age-related change (AARC) construct to assess self-perception of both positive and negative age-related changes (AARC gains and losses). We tested whether AARC has greater utility in linking self-perceptions to objective cognition compared to well-established measures of self-perceptions of cognition and aging. We examined the associations of AARC with objective cognition, several psychological variables, and engagement in cognitive training.Design:Cross-sectional observational study.Participants:The sample comprised 6056 cognitively healthy participants (mean [SD] age = 66.0 [7.0] years); divided into subgroups representing middle, early old, and advanced old age.Measurements:We used an online cognitive battery and measures of global AARC, AARC specific to the cognitive domain, subjective cognitive change, attitudes toward own aging (ATOA), subjective age (SA), depression, anxiety, self-rated health (SRH).Results:Scores on the AARC measures showed stronger associations with objective cognition compared to other measures of self-perceptions of cognition and aging. Higher AARC gains were associated with poorer cognition in middle and early old age. Higher AARC losses and poorer cognition were associated across all subgroups. Higher AARC losses were associated with greater depression and anxiety, more negative SPA, poorer SRH, but not with engagement in cognitive training.Conclusions:Assessing both positive and negative self-perceptions of cognition and aging is important when linking self-perceptions to cognitive functioning. Objective cognition is one of the many variables – alongside psychological variables – related to perceived cognitive losses.

Objectives Although the evidence linking views on aging (VoA) with aging outcomes is robust, little is known about how different types of VoA may interact to influence such outcomes. Therefore, this study examined two types of VoA, age stereotypes (AS), representing general VoA, and self-perceptions of aging (SPA), representing personal VoA. We operationalized SPA in terms of awareness of age-related change (AARC), distinguishing between gain- and loss-related SPA (e.g., awareness of positive and negative age-related changes, respectively). Based on theoretical reasoning, we hypothesized that AS would be an antecedent of SPA, and that the effect of AS on physical and mental health would be mediated by SPA. Method A total of 819 German and U.S. adults aged 40–98 completed a survey on VoA, physical health, and mental health at baseline and 2.5 years later. Structural equation modeling with latent variables was used to examine the effects of Time 1 AS (predictor) and Time 2 gain- and loss-related SPA (mediators) on physical and mental health outcomes. Results As hypothesized, AS predicted later SPA. Loss-related SPA mediated the effect of AS on physical health; both gain- and loss-related SPA mediated the effect of AS on mental health. Discussion Congruent with theoretical assumptions, our findings provide empirical support for a directional pathway by which AS shape later SPA. We conclude that AS and SPA may affect physical health outcomes more strongly than mental health outcomes. Studies that assess both types of VoA are needed to illuminate the pathways by which VoA influence aging outcomes.

Background and objectives This two-study article describes the development and evaluation of a multidimensional questionnaire based on the subjective aging construct Awareness of Age-Related Change (AARC). AARC captures the inherent multidimensionality and complexity of aging attitudes, which are strongly linked to indicators of successful aging, including health and well-being. Research design and methods In Study 1, we generated a large item pool related to subjective aging experiences and then evaluated the psychometric properties of a 189-item version of the AARC questionnaire in a sample of 396 adults aged 40-95 years. Based on findings from Study 1, we retained the best-performing items and arrived at a more parsimonious 50-item version (AARC-50). In Study 2, the psychometric properties of the 50-item version were examined in an expanded sample of 424 adults ages 40-98. Results Factor analyses in Study 1 indicated a two-factor structure of the questionnaire, representing the awareness of positive (AARC-Gains) and negative (AARC-Losses) age-related changes across five behavioral domains. Confirmatory factor analysis in Study 2 further supported this two-factor structure. In both studies, the AARC questionnaire demonstrated strong psychometric properties, including scale and item reliability, convergent and divergent validity, and predictive validity. Discussion and implications The availability of a reliable and valid assessment tool for measuring AARC-Gains and AARC-Losses allows researchers to capture detailed information about adults' positive and negative self-perceptions of aging across multiple behavioral domains, which are instrumental for promoting successful aging.

Background and objectives Existing measures of subjective aging have been useful in predicting developmental outcomes. Unlike other constructs of subjective aging, Awareness of Age-Related Change (AARC) focuses on how adults' self-perceptions of aging result in an awareness of age-related gains and losses. We developed a 10-item short form (SF) of the existing 50-item AARC questionnaire as a reliable, valid, and parsimonious solution for use primarily in large-scale surveys but also in applied contexts. Research design and methods AARC was assessed in a German and North American sample of 819 individuals. Item selection for the suggested AARC-10 SF was based on multidimensional item response theory (MIRT). Multi-group confirmatory factor analysis (CFA) was used to test for measurement invariance (MI) across groups of participants in middle age (40-69 years), early old age (70-79 years), and advanced age (80+ years). Concurrent and discriminant validity in old age was assessed with regard to established measures of subjective aging, well-being, and health. Results The AARC-10 SF showed adequate fit to the data and reliability for the perceived gains and losses composites. Valid comparison of latent means was confirmed for early old and advanced age respondents and with some reservation also for middle-aged individuals due to partial MI. Concurrent and discriminant validity were confirmed. Discussion and implications The proposed AARC-10 SF offers an economic device to measure AARC and use the construct as an antecedent or outcome in the context of substantive model testing in large-scale survey data.

To support older adults’ preferences to age in place, home and community-based aging-related resources are available, but are often under-utilized. Many barriers prevent individuals from accessing aging-related resources, especially in rural and geographically isolated locations. Therefore, we set out to better understand the perspectives of community members who plan to age in place in rural areas. We administered a survey as part of a broader university-community partnership called Senior Access Points (SAP), which addresses aging-related resource access. Participants were N = 210 individuals living in rural regions across Northern Colorado, ranging from 37 to 94 years old (mean age = 68.91, SD = 8.85). We assessed hopes and worries about growing older at home, and awareness of available resources. Two independent coders applied a pre-determined coding scheme, then achieved consensus ratings. An overwhelming majority of participants affirmed the importance of being able to remain in their current home (94.8%) or community (95.3%) as they age. Top hopes for aging in place centered around health/medical; housing/home services; and independent rural lifestyle. The top worries were related to health/medical; housing/home services, and transportation. Resource awareness was low: 43.3% of all participants were not aware of any available resources. Overwhelmingly, rural residents hope to grow older at home, but may not know how to connect to resources that support this goal. The resource needs we identified are being used to inform community-driven approaches to improve both awareness and availability of community resources in these rural communities.

This study evaluated the feasibility and efficacy of the AgingPlus intervention program. AgingPlus is an 8-week multi-component motivational program which promotes increased physical activity by targeting adults’ negative views on aging (NVOA) and perceptions of control, two known psychological barriers to physical exercise. A total of 62 adults, ages 50–82 years, participated in this feasibility study. We assessed NVOA, perceptions of control, and physical activity level at baseline (Week 0), immediate posttest (Week 4), and delayed posttest (Week 12). High attendance rates, low attrition, and positive participant feedback indicated that the program had high acceptability. Repeated measures multivariate analyses of variance (RM-MANOVA) showed statistically significant and substantively meaningful improvements in NVOA, control beliefs, and physical activity from pretest to immediate and delayed posttest. The program effects did not differ between those younger or older than age 65. These findings provide ...

Existing evidence suggests that individuals’ subjective experience of cognitive decline may be a risk state for dementia. However, whether self-awareness of positive changes confer cognitive protection is unknown. We examined the extent to which awareness of positive (AARC gains) and negative (AARC losses) age-related changes explains variability in objective cognitive performance in a sample of 6,231 UK residents (Mean age= 66.1 years, 75.9% women) without cognitive impairment. We tested a structural equation model with AARC gains and losses as predictors of cognitive performance and depressive symptoms as a mediator of the association of AARC losses with cognitive performance. The model fit the data well. The correlation between AARC gains and losses was negligible, yet higher levels of both AARC gains and losses predicted poorer cognitive scores. Hence, higher AARC gains did not confer cognitive protection. This unexpected pattern of results underscores the complexity of mapping individuals’ awareness onto objective outcomes.

Background: A questionnaire assessing awareness of positive and negative age-related changes (AARC gains and losses) was developed in the US and Germany. We validated the short form of the measure (AARC-10 SF) and the cognitive functioning subscale from the 50-item version of the AARC (AARC-50) questionnaire in the UK population aged 50 and over. Methods: Data from 14,797 participants in the PROTECT cohort were used to explore and confirm the psychometric properties of the AARC measures including: validity of the factor structure; reliability; measurement invariance across males and females and across individuals with and without a university degree; and convergent validity with measures of self-perception of aging and mental, physical, and cognitive health. We also explored the relationship between demographic variables and AARC. Results: We confirmed the two-factor structure (gains and losses) of the AARC-10 SF and the AARC-50 cognitive functioning subscale. Both scales showed good reliability and convergent validity. The meaning of AARC gains and losses was the same across males and females and across individuals with and without a university degree. Items composing AARC scales had the same meaning across individuals with and without a university degree. Items composing the AARC-50 cognitive functioning subscale had the same meaning across males and females. Two items in the AARC-10 SF had different meaning across males and females. Demographic variables significantly predicted AARC gains and losses. Conclusions: The AARC-10 SF and AARC-50 cognitive functioning subscale can help to identify UK individuals who perceive age-related changes in their mental, physical, and cognitive health.

Learning opportunities beyond the classroom create lasting and positive effects on students’ academic and professional growth. When faculty members participate in engaged scholarship in their local communities, out-of-classroom learning opportunities for students likewise expand. In the context of aging, the array of opportunities for students to engage with community partners is vast, from interactive course assignments to research opportunities, clinical experience, local policy efforts, and more. This paper builds on previous theoretical and empirical work from scholars (including AGHE and GSA Fellows) in the science of engagement, and integrates case examples of campus-community relationships from our collective years in the academy. Examples will showcase how engaged teaching, engaged research, and engaged service collectively informs and enriches our students’ experiences. In the spirit of the 2020 conference theme, we will discuss opportunities for university-community engagement as a way to strengthen and inspire current and future gerontological pedagogy.

A robust body of evidence points to the importance of views on aging (VoA) in influencing developmental outcomes in later life. Now that this connection has been well-established, research has turned to examine mechanisms, processes, and pathways by which VoA and health are interconnected throughout adult development. The presentations in this symposium use longitudinal datasets to address the pressing question of how VoA and health are associated over time. Timescales range from 6-months post-hospital stay, to 9 year longitudinal follow-up. Presentations will provide evidence concerning both physical and mental health conditions and symptoms (e.g., Brothers et al; Schönstein et al.). Furthermore, the studies focus on various aging outcomes, ranging from functional ability (Brothers et al.) to recovery from hospital stays (Blawert et al.), to sensory loss (Wettstein et al.), to specific medical conditions including depression, back pain, rheumatism (Schönstein et al.). Three of the talks provide evidence for the effects of VoA on health, and one presents evidence of specific health conditions as longitudinal predictors of later VoA. Thus, an important question that this cohesive set of talks will raise is the issue of bi-directionality, by which VoA affect health, and vice versa. Concluding the symposium, the discussant will share insights about how these presentations contribute to the current understanding of mechanisms of the associations between VoA and health, and the role of VoA for ageism. She will additionally provide an overview of new areas for future research that can help to advance the understanding of these complex interactions.

It remains unknown how distinct types of views on aging (VoA) are related to one another, and to aging outcomes. We used a latent-variable structural equation model to test the hypothesis that generalized views on aging (assessed as Age Stereotypes (AS)) would influence personal views on aging (assessed as Self-Perceptions of Aging (SPA)), which in-turn would influence later physical and mental health. Data came from a longitudinal survey on VoA (N= 537, MageT1 = 64.13, age rangeT1 = 40-98). As expected, SPA mediated the effect of AS on physical (loss-SPA: β = .23, p< .001; gain-SPA: β = .06, p< .001; R2 = .62) and mental health (loss-SPA: β = .13, p< .001; gain-SPA: β = .03, p< .01, ; R2 = .31). Congruent with theoretical assumptions, our findings provide empirical support for a directional pathway by which generalized views on aging affect health outcomes via personal views of aging.

Dynamic integration theory (DIT) describes emotion development across the lifespan, from childhood to old age. In doing so, DIT draws on a number of perspectives, such as equilibrium theories, theories of cognitive development, and theories of behavioral adaptation, and takes a strong cognitive-developmental view on emotion experience and emotion regulation. Two propositions are at the core of DIT. First, the development of emotion experience and emotion regulation proceeds from simple and automatic reactions to increasingly complex and integrated cognitive-affective structures (i.e., schemas). These cognitive-affective structures can be ordered in terms of increasing levels of cognitive complexity and integration, with integration referring to a person’s ability to acknowledge both positive and negative affect states and to tolerate and reconcile the contradictions and tensions that these states generate. Second, DIT also postulates that the efficiency with which cognitive-affective systems work is a result of the dynamic interplay between contextual variables and person-specific characteristics. Three key factors contribute to this dynamic interplay between person and context: (1) the strength of the affective arousal, (2) the person’s cognitive resources for dealing with different affect states, and (3) pre-existing trait-like dispositions and reaction tendencies that may either hinder or facilitate emotion regulation. Thus, a person’s emotion experience and emotion regulation in a given situation are the product of the dynamic interaction of these factors. Considerable empirical evidence supports the theoretical propositions of DIT, including findings speaking to changes in emotion experience and emotion regulation in later life when declines in cognitive functioning tend to become normative.

To determine whether an advance care planning (ACP) decision-aid could improve communication about end-of-life treatment wishes between patients with amyotrophic lateral sclerosis (ALS) and their clinicians.Forty-four patients with ALS (21, English-speaking, without dementia) engaged in ACP using an interactive computer based decision-aid. Before participants completed the intervention, and again three months later, their clinicians reviewed three clinical vignettes, and made treatment decisions (n = 18) for patients. After patients indicated their agreement with the team's decisions, concordance was calculated.The mean concordance between patient wishes and the clinical team decisions was significantly higher post-intervention (post = 91.9%, 95% CI = 87.8, 96.1, vs. pre = 52.4%, 95% CI = 41.9, 62.9; p 0.001). Clinical team members reported greater confidence that their decisions accurately represented each patient's wishes post-intervention (mean = 6.5) compared to pre-intervention (mean = 3.3, 1 = low, 10 = high, p0.001). Patients reported high satisfaction (mean = 26.4, SD = 3.2; 6 = low, 30 = high) and low decisional conflict (mean = 28.8, SD = 8.2; 20 = low, 80 = high) with decisions about end-of-life care, and high satisfaction with the decision-aid (mean = 52.7, SD = 5.7, 20 = low, 60 = high). Patient knowledge regarding ACP increased post-intervention (pre = 47.8% correct responses vs. post = 66.3%; p 0.001) without adversely affecting patient anxiety or self-determination.A computer based ACP decision-aid can significantly improve clinicians' understanding of ALS patients' wishes with regard to end-of-life medical care.

SUMMARY Aim: This study aims to characterize gender-specific behavioral profiles in nondemented amyotrophic lateral sclerosis subjects with behavioral changes (ALSbi). Methods: Caregivers of 106 subjects (53 male) completed an amyotrophic lateral sclerosis standardized clinical interview framed around the Frontal Behavioral Inventory (FBI) structured questionnaire to rate patients on behaviors associated with declines in frontal and temporal self-regulatory capacities. Subjects evaluated evidenced two or more nonoverlapping behavioral symptoms. Inventory items were grouped into disinhibited, apathetic and stereotypic subclasses for between-gender evaluation by independent t-tests and within-gender evaluation by Mann–Whitney U and Spearman rho. Results: Males showed greater disinhibition (p = 0.000), and loss of insight (p = 0.011), jocularity (p = 0.009) and impulsivity (p = 0.005). Females showed significant relationships between personal neglect and indifference (p = 0.000), impulsivity (p = 0.0.013) and jocularity (p = 0.013). Conclusion: Gender differences are evident in ALSbi, characterized by gender-specific loss of social sophistication, and their characterization may allow for better detection of female ALSbi patients, as well as contribute to treatment planning and quality of life for ALSbi patients and their caregivers.

Research in the previous decade has found a link between amyotrophic lateral sclerosis (ALS) and frontotemporal degeneration (FTD). It is estimated that as many as 50% of all people with ALS will have some degree of cognitive impairment and that approximately 10%-25% of patients will meet the Neary criteria for FTD. For the caregivers of persons with both ALS and FTD, the burden of care can be quite high. Nurses are in a position to help the caregivers cope.

This study evaluated the feasibility and efficacy of the Aging(Plus) intervention program. Aging(Plus) is an 8-week multi-component motivational program which promotes increased physical activity by targeting adults’ negative views on aging (NVOA) and perceptions of control, two known psychological barriers to physical exercise. A total of 62 adults, ages 50–82 years, participated in this feasibility study. We assessed NVOA, perceptions of control, and physical activity level at baseline (Week 0), immediate posttest (Week 4), and delayed posttest (Week 12). High attendance rates, low attrition, and positive participant feedback indicated that the program had high acceptability. Repeated measures multivariate analyses of variance (RM-MANOVA) showed statistically significant and substantively meaningful improvements in NVOA, control beliefs, and physical activity from pretest to immediate and delayed posttest. The program effects did not differ between those younger or older than age 65. These findings provide promising support for the feasibility and efficacy of the Aging(Plus) program.

This study examined how 2 distinct facets of perceived personal lifetime-future time perspective (FTP) and awareness of age-related change (AARC)-are associated with another, and how they may interact to predict psychological well-being. To better understand associations among subjective perceptions of lifetime, aging, and well-being, we tested a series of models to investigate questions of directionality, indirect effects, and conditional processes among FTP, AARC-Gains, AARC-Losses, and psychological well-being. In all models, we tested for differences between middle-aged and older adults, and between adults from the United States and Germany. Analyses were conducted within a structural equation modeling framework on a cross-national, 2.5-year longitudinal sample of 537 community-residing adults (age 40-98 years). Awareness of age-related losses (AARC-Losses) at Time 1 predicted FTP at Time 2, but FTP did not predict AARC-Gains or AARC-Losses. Furthermore, future time perspective mediated the association between AARC-Losses and well-being. Moderation analyses revealed a buffering effect of awareness of age-related gains (AARC-Gains) in which perceptions of more age-related gains diminished the negative effect of a limited future time perspective on well-being. Effects were robust across age groups and countries. Taken together, these findings suggest that perceived age-related loss experiences may sensitize individuals to perceive a more limited future lifetime which may then lead to lower psychological well-being. In contrast, perceived age-related gains may function as a resource to preserve psychological well-being, in particular when time is perceived as running out. (PsycINFO Database Record

SUMMARY Aims: To investigate regional and gender differences in prevalence rates and the pattern of cognitive and behavioral impairment in amyotrophic lateral sclerosis. Materials & methods: One hundred and ten subjects (55 male) from 14 amyotrophic lateral sclerosis clinics were cross-sectionally evaluated with the Penn State Brief Exam of frontal and temporal dysfunction syndromes. Results: Prevalence rates of cognitive impairment and behavioral impairment were statistically equivalent among rural, suburban and urban subgroups. Females evidenced significant strengths in fluency and limitations in configurational processing. Patterns of regional findings suggested greater frontal cortical involvement in the rural sample. Females demonstrated more bihemispheric involvement in comparison to more left hemispheric involvement for males. Conclusions: Regional prevalence differences in frontotemporal disease prodrome appear insignificant and multifactorial, while being consistent with the toxicity model implicating pesticides in frontal lobe change. Female gender potentially masks the frontotemporal disease prodrome due to a bilateral distribution of language processing, which requires an assessment of right hemisphere-mediated capacities to detect.

Background: Amyotrophic lateral sclerosis (ALS) is a multi-system disorder in which frontotemporal dysfunction without overt dementia is relatively common. Accordingly, there is need for a valid, brief, motor-free cognitive examination conducive to the ALS Clinic. Objective: To validate a brief examination against a comprehensive neuropsychological battery to determine its sensitivity in identifying deficits in judgment and problem solving. We enrolled 13 individuals with intact brief examinations, 25 individuals with 1 or more impaired brief examination measures, and 18 healthy volunteers. Cognitive brief examination measures were classified into factors based on Guilford's Structure of Intellect theory. Cognitive anosognosia ratios were calculated to examine the degree of "unawareness of cognitive deficit." Results: Statistically significant correlations were evidenced for each brief examination and comprehensive examination measure categorized by the same Guilford factor. In comparison to healthy controls, insight to level of cognitive abilities was significantly compromised for cognitively impaired ALS patients, with respect to their ratings of their responses to comprehension tasks assessing convergent and divergent production. Conclusions: Brief examination measures of verbal fluency and problem solving may serve as sensitive indicators of emerging difficulties in ALS patients with frontotemporal dysfunction. The prevalence of cognitive anosognosia warrants further attention because of its impact on treatment compliance, safety and quality of life for ALS patients with frontotemporal dysfunction.

Objectives This study examined (a) the empirical associations among three subjective aging (SA) constructs: felt age, attitudes toward own aging (ATOA), and awareness of age-related change (AARC); (b) the moderating role of chronological age in these associations; and (c) the predictive relevance of the SA constructs with regard to two developmental correlates: functional health and satisfaction with life. Method Participants were 819 adults aged 40-98 years from the United States and Germany. Parallel multiple mediation, moderated mediation, and hierarchical regression analyses were used. Results As hypothesized, AARC mediated the association between the global measures of SA (felt age and ATOA) and the developmental correlates. Specifically, more negative global subjective aging predicted more AARC losses, which predicted poorer health and well-being. Furthermore, this mediation pathway was moderated by chronological age, such that, with increasing age, greater AARC was more strongly related to poorer functional health (but not well-being). The multidimensional measure, AARC, accounted for a significant amount of the variance in the developmental correlates over and above the unidimensional SA constructs. A consistent pattern emerged supporting the role of domain specificity and valence. Discussion These findings support the need for conceptualizing SA across different behavioral domains and for distinguishing between positive and negative SA.

We improved standard treatment approaches by systematically addressing cognitive and behavioral change in association with frontal and temporal dysfunction in ALS. We evaluated the profile of inchange 198 ALS patients with a 20-minute screen exam. Significant deficiencies in letter fluency and reading comprehension (N=59) were found in 22.7% and 12.8% of limb onset and 36.4% and 20% of bulbar-onset patients. Deficiencies in abstract reasoning and judgment were found in 17%, and 29.5% of limb onset and 19.2%, and 46.7% of bulbar-onset patients. Significant behavioral change (N=89) was also reported in 2.4% of limb onset and 4.3% of bulbar-onset patients. Accommodations were provided from the time of initial detection of acquired deficiencies, with the goal of optimizing the patient's role in decision making throughout the process of treatment planning and implementation. This screen is of practical clinical value for assessment and intervention of deficiencies that affect treatment and quality of life.