Cognitive Aging & Dementia
For well over ten years, I was involved in clinical work and subsequently research related to the topic of geriatric neuropsychology. Eight of those years was spent conducting research on subjective cognitive decline, or SCD. This term refers to a syndrome of older adulthood whereby people report significant concern about changes in their thinking abilities, more than just normal aging, yet who score within normal limits on standardized clinical-neuropsychological tests. Not all, but a significant proportion of these older adults will in fact decline to mild cognitive impairment and Alzheimer’s dementia (AD).
We were interested to identify cognitive processes that separate those with SCD from healthy controls before the emergence of clinical impairment. Findings from our research demonstrated the role of attention capacity (Smart et al., 2014a), updating/working memory (Smart & Krawitz, 2015), and reaction time intra-individual variability (Mulligan et al., 2016) in discriminating persons with SCD from healthy controls. A prime reason to study SCD is to investigate early interventions that could slow or even prevent non-normal cognitive decline. To that end, we completed a randomized controlled trial of tailored mindfulness training for older adults with SCD, finding improvements in both neural, behavioral, and self-report measures (Smart et al., 2016; Smart & Segalowitz, 2017). This is currently being developed into a clinician manual by Oxford University Press’ Treatments That Work Series, with an anticipated publication date of mid-to-late 2020. Finally, we also completed a systematic review and meta-analysis of non-pharmacologic interventions for SCD (Smart et al., 2017), demonstrating that cognitive interventions have a small but clinically significant effect on cognitive function in persons with SCD.
The pinnacle of my aging work was co-authoring a book on geriatric neuropsychology, entitled the Neuropsychology of Cognitive Decline: An Applied Developmental Approach (Tuokko & Smart, 2018; Guilford Press). After much success in the field of aging, for personal and professional reasons, I have decided to wind down this stream of research to focus on my other work on self-regulation. I am grateful for my experiences and knowledge gained in this field, but I know that there are many skilled and passionate researchers at UVic who will be ‘carrying the torch’ of geriatric psychology and gerontology after my departure.