Skip to main content
. 2023 Sep 13;17:1240630. doi: 10.3389/fnhum.2023.1240630

Table 1.

List of HCA definitions within the neuroscience, psychology, and gerontology fields.

Reference Proposed definition Focus Term defined
1.1 Neuroscience
Hendrie et al. (2006) “Healthy cognitive aging is not just the absence of cognitive impairment, but the development and preservation of the multi-dimensional cognitive structures that allow the older adult to maintain social connectedness, and ongoing sense of purpose, and the abilities to function independently, to permit functional recovery from illness and injury, and to cope with residual cognitive deficits.”
  • Link to behavioral preservation

  • Distinction from pathology

  • Integration of multiple dimensions

  • Healthy Cognitive Aging

Daffner (2010) “An alternative definition of normal cognitive aging suggests that it represents “non-pathological” aging, that is, older individuals without identifiable diseases or conditions (e.g., Alzheimer’s disease (AD), cerebral vascular disease) that negatively impact the central nervous system. However, many would argue that there is a continuum between normal and pathological cognitive aging.”
  • Distinction from binary view highlighting the possibility of a continuum

  • Link to behavioral consideration

  • Non-pathological aging

  • Normal Cognitive Aging

Greenwood et al. (2011) “Successful cognitive aging (refers to) maintaining intact cognitive functioning while living to late old age”
  • Distinction between cognitive age and chronological age

  • Maintenance of cognitive capacities

  • Successful Cognitive Aging

Malaspina et al. (2011) “Successful cognitive aging broadly refers to the multi-determined process of preserving cognitive abilities or exhibiting less-than-expected decline in neural structure and function typically associated with aging and its comorbidities.”
  • Integration of multiple dimensions

  • Includes functional and structural changes

  • Maintenance of cognitive capacities

  • Successful Cognitive Aging

Depp et al. (2012) “An additional approach to operationalization would be to define success in reference to preservation of past performance—i.e., maintaining levels of cognitive performance attained at mid-life.”
  • Consideration of individual changes

  • Maintenance of cognitive capacities

  • Successful Cognitive Aging

Dumas (2015, 2017) “Normal aging has been defined as aging changes that occur in individuals free of overt diseases of the nervous system. The goal of successful aging is to maintain intact cognitive functioning all the way until death. Normal cognitive aging is not dementia and does not result in the loss of neurons, rather, there are changes in brain functioning”
  • Maintenance of cognitive capacities

  • Non-pathological aging

  • Includes functional changes

  • Normal Cognitive Aging

Wallace et al. (2017) “Successful cognitive aging was defined as the absence of neurocognitive impairment (as defined by deficits in tasks of episodic learning, information processing speed, executive function, and motor skills) depression, and functional impairment (instrumental activities of daily living).
  • Integration of multiple dimensions

  • Includes cognitive and behavioral changes

  • Non-pathological aging

  • Successful Cognitive Aging

Moore et al. (2018) “Successful cognitive aging criteria (defined as the absence of objective neurocognitive deficits and subjective cognitive symptoms)”
  • Includes cognitive and behavioral changes

  • Non-pathological aging

  • Successful Cognitive Aging

Stern et al. (2022) “The use of a common vocabulary and operational definitions“(“… such as reserve and resilience…”) “will facilitate even greater progress in understanding the factors that are associated with successful aging”
  • Consideration of individual changes

  • Maintenance of cognitive capacities

  • Non-pathological aging

  • Includes behavioral changes

  • Successful Cognitive Aging

1.2 Psychology
Harrison et al. (2012) “SuperAgers were defined as individuals over age 80 with episodic memory performance at least as good as normative values for 50- to 65-year-olds.”
  • Suggests a comparison to Normative scores

  • Focus on a specific cognitive function

  • Emphasizes importance of chronological age

  • Successful Cognitive Aging

Smith (2016) “Aging with normal cognitive changes is defined by the subtle loss of cognitive and functional performance that occurs in normal aging, even when known brain diseases are absent”
  • Non-pathological aging

  • Focus on cognitive and functional performance

  • Normal Cognitive Aging

Silverman and Schmeidler (2018) “Successful cognitive aging is intact cognition in the oldest-old; we define resistant successful cognitive aging as successful cognitive aging despite high risk.”
  • Focus on intact cognition

  • Suggests comparison of cognitive age to chronological age

  • Successful Cognitive Aging

Cabeza et al. (2018) “Optimal aging defined as the situation in which cognitive abilities are preserved throughout aging.
Healthy aging humans (defined here as aging in individuals who are apparently free of brain disease)”
  • Maintenance of cognitive functioning

  • Non-pathological aging

  • Normal Cognitive Aging

Leal and Yassa (2019) “Normal is “conforming to a standard; usual, typical, or expected.” Note that characterizations of normal versus abnormal in terms of pathology or illness are not the purpose of this chapter. In fact, the chapter does not attempt to characterize normal as a condition that is free of pathology (it is not) but merely as the typical or majority condition.”
  • Suggests a comparison to normative scores

  • Highlights that NCA may not be the opposite of pathological aging

  • Normal Cognitive Aging

Oschwald et al. (2020) “we refer to (healthy cognitive aging as the) processes that occurs in the absence of pathological cognitive impairments, as previous literature has not yet reached a consensus on the definition of healthy cognitive aging.”
  • Non-pathological aging

  • Healthy Cognitive Aging

1.3 Gerontology
Massaldjieva (2018) “Normal Cognitive Aging: Cognitive aging allowing for active and independent living
Successful Cognitive Aging: Maintenance of intact cognitive functioning all the way until death”
  • SCA is linked to social preservation

  • NCA is linked to maintenance of cognitive functions

  • Normal Cognitive Aging

  • Successful Cognitive Aging

Mendoza-Ruvalcaba et al. (2018) “The concept of cognitive functioning in normal aging has been defined as the functioning of the cognitive system, either in adaptation or alteration, which can generate a regression or successful management of the functions of daily life in older adults”
  • Focus on functional and social performance

  • Maintenance of cognitive capacities

  • Normal Cognitive Aging

Cadar (2018) “There is no clear consensus in defining healthy or successful cognitive aging, but it can be described as the maintenance of most cognitive abilities as until older age and a minimum variation in the spectrum of normal cognitive decline with aging.”
  • Maintenance of cognitive capacities

  • Focus on cognitive performance

  • Suggests a comparison to normative scores

  • Healthy Cognitive Aging

  • Successful Cognitive Aging

Rowe and Kahn (1987) “In many data sets that show substantial average decline with age, one can find older persons with minimal physiologic loss, or none at all, when compared to the average of their younger counterparts. These people might be viewed as having aged successfully with regard to the particular variable under study (…). They, in combination with people who show the typical nonpathological age-linked losses that we propose to designate usual, constitute the heterogeneous category of the normal (that is, nondiseased) in any age group.”
  • SCA linked to minimal physiologic loss

  • NCA linked to non-pathological aging

  • Successful Cognitive Aging

  • Normal Cognitive Aging

Clouston et al. (2020) “Normal Cognitive aging is generally characterized by a slow but steady decay in fluid cognition (Salthouse, 2019) resulting from a seemingly unavoidable biological process (Richards and Deary, 2014).”
  • Focus on fluid cognition

  • Steady decline of cognitive capacities

  • Normal Cognitive Aging