Cognitive Fitness, Assessment, and Cognitive Rehabilitation of Older Population: From MMSE to Computerized and VR Based Tools

Revisiting the Model of Successful Aging

Whether aging is necessarily related to a general decline of function is a matter of controversy. One of the most studied models of successful aging, the model by Rowe and Kahn (1997), described successful aging with the following ingredients:

• 1.

  Absence of disease, absence of disability or risk factors;

• 2.

  Maintenance of physical and cognitive functioning; and

• 3.

  Active involvement with life (described as connections with people including close friends or relatives.

In more operative terms, Vaillant and Mukamal (2001) point out that successful aging at the ages of 70 to 80 years old can be predicted by variables measured and controlled by the person prior to being 50 years old: not smoking more than 30 daily cigarettes, absence of alcohol abuse, stable marriage, a mass body index between 21 and 29, regular exercise and high education level. The only factor that could appear after the fifties and considered to affect successful aging is depression. Finally, Moraesand Souza (2005), according to their results, describe the successful ager as a person with an optimistic view of the future, ability to accept changes, high self-esteem, positive self-image, sense of autonomy, well-developed mechanisms to choose meaningful goals, as well as to optimize resources and compensate loss (to develop strategies that compensate errors), and a reserve of capacity and resistance (also known as resilience), that allows them to recover, adjust and readapt to novel situations emerging in their daily lives.

However, this successful aging profile looks ideal and most of the criticism derives from the fact that this definition would apply to a very scarce segment of the general population. In other words, it is very difficult for any older person to fulfill all the requirements indicated in the model of successful aging by Rowe and Kahn, and in their subsequent reviews. Hence, there is a need to rethink the approach to successful aging and consider a flexibilization of this ideal profile proposed by Rowe and Kahn at the end of the last century.