Aging is accompanied by a range of well-documented changes to physical and cognitive functioning. Due to the interaction of genetic and environmental influences across time, the human body becomes more susceptible to a variety of physical disease states (Ferrucci et al., Reference Ferrucci, Gonzalez-Freire, Fabbri, Simonsick, Tanaka, Moore and de Cabo2020). Cognitively, alterations to neural structure and function are related to commonly observed declines in abilities such as processing speed, episodic memory, and executive functioning (Lichtenberger and Kaufman, Reference Lichtenberger and Kaufman2013). As such, researchers have traditionally focused study aims on probing the mechanisms underlying pathological age-related changes, on identifying groups at higher risk for decline, and on developing interventions to remediate deficits. However, there is a growing literature identifying exceptions to the typical trajectory of aging, and researchers are beginning to discover mechanisms of resiliency and resistance to age-related pathology.

One umbrella concept describing a wide variety of approaches to investigating age-related maintenance and growth is Successful Aging (Depp and Jeste, Reference Depp and Jeste2006). A related term is SuperAgers, operationally defined as older adults (80+ years) whose memory performances are indistinguishable from scores obtained by people 20–30 years their junior, and who are free from measurable norm-referenced impairments in other cognitive domains as well (Rogalski et al., Reference Rogalski2013). Although this research is still in its early phase, evidence suggests that these individuals have higher quality social relationships, as well as high levels of psychological well-being in general (Cook Maher et al., Reference Cook Maher2017), suggesting a close connection between cognitive and emotional health. Psychological well-being is important for all older adults, regardless of their memory abilities, with mounting evidence suggesting that positive beliefs and self-perceptions about aging improve mental health (Levy et al., Reference Levy, Pilver and Pietrzak2014), protect against dementia (Levy et al., Reference Levy, Slade, Pietrzak and Ferrucci2018), and reduce inflammation (Levy and Bavishi, Reference Levy and Bavishi2018). Overall, these advances are beginning to shed light on an underappreciated aspect of aging, which is the potential for maintenance and even growth in particular abilities across the adult lifespan.

The study by Sabatini et al. (Reference Sabatini2021) expands this body of research by measuring perceived age-related gains and losses in a large sample of older adults from the UK. Specifically, they assessed awareness of age-related change (AARC), which reflects a person’s perception of whether increased age has altered their life experiences, performance, or behavior (Diehl and Wahl, Reference Diehl and Wahl2010). In the Sabatini et al. (Reference Sabatini2021) study, AARC was examined globally and in relation to physical health, cognitive health, interpersonal functioning, socioemotional skills, and lifestyle factors. The authors then measured associations between positively and negatively valanced AARC and perceived cognitive decline, objective cognitive performance, and depression and anxiety. They reported three primary results: (1) AARC losses correlated with greater symptoms of depression and anxiety, (2) global AARC gains and losses shared more variance with objective cognitive scores than did measures of perceived cognitive decline, and (3) gains in social cognitive skills were associated with lower scores on cognitive tests. We will now discuss these three findings in turn.

First, many geriatric clinicians assess cognitive functioning, in part, by asking for their patients’ perceptions of their own cognitive abilities. It seems intuitive that decrements in skills such as concentration, communication, memory recall, and problem-solving would become obvious in a person’s daily life and that the person could then accurately describe such changes to a healthcare provider. However, humans are prone to biases and memory failures, and the ability to introspect and then accurately report on one’s own cognitive functioning is often imprecise. In fact, a large literature has developed suggesting that subjective cognitive complaints are only weakly related to objective cognitive performance (˜1% variance shared) and that subjective cognition overlaps to a much greater degree with psychiatric symptoms and personality characteristics than with cognitive test scores (Burmester et al., Reference Burmester, Leathem and Merrick2016; Crumley et al., Reference Crumley, Stetler and Horhota2014). Sabatini et al. (Reference Sabatini2021) added to this literature by reporting relationships between AARC losses (including in cognition) and depression and anxiety, as well as nonsignificant relationships between perceived cognitive decline and cognitive performance. Taken together, this literature suggests that, for many older adults, their subjective experience of daily problems with thinking and memory is a valid indicator of their underlying psychological and emotional health, but that it does not correspond to current performances on structured, lab-based tests. Such knowledge is highly valuable to both researchers and clinicians in the field of aging.

Second, in addition to AARC losses, Sabatini and colleagues (Reference Sabatini2021) reported that AARC gains predicted cognitive test scores better than the person’s subjective cognitive change, attitude toward their own aging, or subjective age, although these effect sizes were small. As noted above, the global AARC measure included several overarching factors that are important to general health and quality of life. Factors such as social engagement, renewing one’s sense of purpose/meaning, and embracing a positive lifestyle are each associated with longevity (Pizzo, Reference Pizzo2020). Also, being more attentive to one’s physical health can have numerous benefits if it leads to increased exercise and/or reduced fall risk (Bherer et al., Reference Bherer, Erickson and Liu-Ambrose2013). By including multiple constructs known to be related to healthy aging, the AARC screening measure may provide a more complete picture of the individual’s perception of their functioning, which could explain why it provided a better window into cognitive test performance than merely assessing self-reported cognitive abilities. However, as mentioned above, these effect sizes were small, and so the clinical meaningfulness of this finding could be questioned and future researchers should attempt to replicate the Sabatini et al. (Reference Sabatini2021) results.

Third, the conceptualization and measurement of cognitive functioning is often targeted to the specific domains of attention, processing speed, language, visuospatial abilities, learning/memory, and aspects of executive functioning. While these skills are highly relevant to health and well-being, a hyperfocus on “cold” cognitive skills can present a somewhat narrow window into thinking and behavior. A broader view would include affectively laden social or “hot” cognitive processes such as theory of mind, emotional regulation, and empathy, among others. Importantly, aging is related to maintenance and improvement in some of these skills and this is reflected in research on lower levels of mental illness in older compared to younger adults (Westerhof and Keyes, Reference Westerhof and Keyes2010), as well as in work on wisdom (Jeste et al., Reference Jeste2020; Leeman et al., Reference Leeman, Knight, Fein, Winterbotham and Webster2021), resilience (López et al., Reference López2020; Treichler et al., Reference Treichler2020), and emotion regulation (Fernández-Fernández et al., Reference Fernández-Fernández, Losada-Baltar, Márquez-González, Paniagua-Granados, Vara-García and Luque-Reca2020; Urry and Gross, Reference Urry and Gross2010). Sabatini et al. (Reference Sabatini2021) measured social cognitive gains in older adults by inquiring about increases in experience, knowledge, foresight, information, wisdom, and thoughtfulness. Surprisingly, their results showed negative correlations between these items measuring social cognition and objective cognitive test performance. There are a number of possible explanations for this finding. It could simply be due to the authors’ brief assessment of social cognition (e.g. wisdom was measured with the statement “I have become wiser”) in comparison to prior work (Thomas et al., Reference Thomas2019), and/or by limitations in the authors’ objective cognitive battery (four tests administered online). Alternatively, it could be that a third variable (e.g. age-related alterations to the brain) is driving both increases in “hot” social cognitive abilities and declines in “cold” lab-based cognitive skills. Finally, it is also possible that declining cognition in some older adults is associated with poor insight into and awareness of their overall functioning (anosognosia), leading them to incorrectly report higher levels of social cognitive abilities. Of course, these alternatives are not mutually exclusive.

Regardless of the ultimate explanation for the Sabatini et al. (Reference Sabatini2021) cognitive results, the literature as a whole suggests that social cognition and emotional health can improve across age. As mentioned above, rates of many mental illnesses decline as people move into older adulthood, and corresponding increases in average happiness and positive affect have been noted (Cacioppo et al., Reference Cacioppo, Hawkley, Kalil, Hughes, Waite, Thisted, Eid and Larsen2008; Stawiski et al., Reference Stawski, Almeida, Sliwinski and Smyth2008). Multiple explanations have been offered for this trend, including the so-called “positivity effect,” which represents the tendency for older adults to experience a higher ratio of positive to negative emotions relative to younger adults (Mather and Carstensen, Reference Mather and Carstensen2005). It is posited that a reduction in the tendency of aging adults to experience unpleasant emotions, along with equivalent experience of pleasant emotions, drives this effect. Importantly, the positivity effect is manifested in cognitive processes such as attention, where many older adults utilize top-down processes to selectively and preferentially attend to positive rather than negative stimuli, and memory, where they display a bias towards the recall of positive experiences. These cognitive strategies are utilized by many aging adults to elevate their mood, in spite of (or possibly because of) declining cognitive resources.

In conclusion, aging is accompanied by physical and performance-based cognitive declines, but there is growing recognition of the potential for social and emotional growth across the adult lifespan. The work by Sabatini and colleagues (Reference Sabatini2021) adds support for the construct of AARC, as well as for the use of the AARC measures as tools for screening degrees of both positive and negative perceptions. It is hoped that by assessing AARC gains and losses, researchers and clinicians will be better able to identify both sides of the coin with respect to aging. This could lead to a more comprehensive understanding of all aspects of the aging process and could inform efforts to maximize wellness and quality of life in older adults.