loss of peers

loss of loved ones

must access resilience/depression

Aging is a multifactorial process. However it is charaterized by a main pattern of decline of the adaptation abilities to life conditions. Life conditions induce external and internal "stressors" at organic (systems, organs, cells, genes, DNA, tRNA etc...) and psycho-cognitive levels. The body of the elder has to continue to adapt to the stressors. A lot of confounding stressors can exist : ex. environmental (UV-radiations, cosmic waves, climate changes,...),  psychological (loss of work, loved people, ...), etc... Also the responses to stressors can vary from individual to individual in function of the acquired internal organization at different levels due to life history, varying kinetics of reaction to stressors, new adaptive solutions (efficient DNA mutations, ...), interactions between levels. Study design should be based on statistically significant samples for the influence of confounding parameters to fall into a 2-sigma zone (not easy !).              

In terms of cognitive-communication variables would want to consider: sensory loss (both hearing & vision); any pseudodementias (confused responses due to another condition such as delirium or depression); medications that can induce a cognitive or communication loss; undiagnosed mental health issues (e.g., depression, anxiety, bipolar, etc.), and second language considerations.  Regarding impact on 'study design' these would impact any cognitive-communication assessment including screenings (e.g., Montreal Cognitive Assessment) or full-battery psychological assessments as well as follow-through on given directions for tasks given.