ABSTRACT

The ongoing demographic changes, namely the increasing longevity of people, have brought new societal challenges. In particular, the longer life expectancy in very old age is associated with a significant higher risk of becoming dependent. One of the main reasons of losing functional autonomy in general is dementia, and in particular, is Alzheimer’s disease (AD). Dementia is one of the most disabling health conditions in old age. A central characteristic of dementia is a chronic deterioration of intellectual functions and other cognitive skills severe enough to interfere with the ability to perform activities of daily living [1]. For most people in

Western societies, a possible loss of autonomy is considered very distressing, nowadays more than ever before. In fact, forgetfulness and absentmindedness are among the least desirable and controllable losses anticipated for later life [2]. Complaints of memory loss are among the most frequently reported symptoms of aging by elderly people [3,4]. These complaints are associated with a marked fear of losing control [5]. Surveys indicate that dementia is the condition most feared by older adults in the United States [6]. The reason for this phenomenon is twofold: (a) Establishing and maintaining autonomy is a socially highly valued goal and therefore a central developmental task throughout the life span-thus a loss of autonomy is seen as a painful and sorrowful individual experience. (b) In modern individualistic society, social networks and family ties are not as solid as they were in the past-loss of autonomy means mainly institutionalization [2]. Therefore, functional autonomy and good cognitive functioning are closely related and core conditions of successful aging.