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Contents lists available at ScienceDirect

Archives of Gerontology and Geriatrics

journal homepage: www.elsevier.com/locate/archger

Differences in cognitive performance, level of dependency and quality of life

(QoL), related to age and cognitive status in a sample of Spanish
old adults under and over 80 years of age
Dolores Calero *, Elena Navarro
Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Granada, 18071 Granada, Spain

A R T I C L E I N F O

A B S T R A C T

Article history:
Received 22 July 2010
Received in revised form 25 November 2010
Accepted 26 November 2010

The main objective of this study was to analyze the similarities and differences in cognitive performance,
level of dependency, cognitive plasticity and QoL in a sample of youngold adults and oldold adults,
bearing in mind both the age-group (under or over 80 years) and the cognitive status of the participants.
The study population consisted of 220 people living in sheltered accommodation for elderly people in the
South of Spain, with an average age of 80.75 years. Participants were evaluated by means of cognitive
performance tests, a QoL questionnaire, a depression scale and a dependency assessment scale. The
results indicate that the main differences in the variables analyzed are due to the cognitive status of the
sample and not to the fact that the participants are under or over 80 years of age. The ndings show that
major inter-individual differences in this stage of life depend not only on age but also on cognitive status,
which is thus an important factor to take into account when working with this sector of the population.
2010 Published by Elsevier Ireland Ltd.

Keywords:
Youngold adults
Oldold adults
Cognitive performance
Healthy old adults
Quality of life

1. Introduction
Research into aging currently occupies a central place in sociosanitary studies, owing principally to the phenomenon of
longevity. People between 75 and 85 years of age now represent
the most rapidly growing sector of the population (Twamley et al.,
2006), while in countries such as the USA and the UK, the
probability of living 100 years or more has increased notably in
recent decades (Engber et al., 2009). This situation means that the
stage of life corresponding to old age may last for up to 30 years,
forcing gerontologists and psychologists to consider it not as a
single phase of development as has been the tendency in more
traditional approaches but as a period of life marked by
important inter-individual age-related differences, which should
therefore be subdivided into different stages. In this regard, it is
signicant that a distinction has been established in the literature
between youngold adults and oldold adults. The boundary
between the two groups varies, with some authors xing the limit
at 70 years (e.g., Colcombe and Kramer, 2003), others at 75 years
(e.g., Halpert and Zimmerman, 1986), others at 80 years (e.g.,
Dodge et al., 2008), and still others at 85 years of age (e.g., Parker
et al., 1992). Nevertheless, the most commonly accepted boundary
is 80 years, since according to the Baltes group (Baltes and Smith,

* Corresponding author. Tel.: +34 58 243 754; fax: +34 58 243 749.
E-mail address: mcalero@ugr.es (D. Calero).

2003) this is the age by which 50% of each generational cohort

would have died. Those who attain 80 years and over are thus a
special group who, as Menec and Chippereld (1997) point out,
have exceeded normal life expectancy and may be considered as a
biological elite.
The division between the group of youngold adults and old
old adults would seem to be justied by important differences
detected between the two populations, referring in general to the
maintenance of a good level of cognitive and physical performance
in the group of youngold adults (Carnes and Olshansky, 2007) in
contrast to a situation of generalized loss and decline in the group
of oldold adults. In this respect, various authors have carried out
cross-sectional studies which indicate signicant differences in
favor of the youngold adults with regard to the following
dimensions: episodic memory (Backman et al., 2000); linguistic
comprehension coherent with the fact that the onset of a decline
in verbal processing skills occurs from 75 years (McGinnis, 2009);
verbal uency (Snitz et al., 2009); digit retention tasks; digit and
symbol tests and general cognitive ability tasks (Read et al., 2006).
Similarly, some studies (Persad et al., 2002) have reported an agerelated decline in working memory (WM) tasks, at times
associated with interference from distractors or with a central
executive component. This seems to suggest an association
between WM decits and problems of sustained and divided
attention and in fact a number of studies establish a relation
between poor WM and attention (Humes and Floyd, 2005). In
addition, a signicant decline in perceptual speed has been

0167-4943/$ see front matter 2010 Published by Elsevier Ireland Ltd.

doi:10.1016/j.archger.2010.11.030

Please cite this article in press as: Calero, D., Navarro, E., Differences in cognitive performance, level of dependency and quality of life
(QoL), related to age and cognitive status in a sample of Spanish old adults under and over 80 years of age. Arch. Gerontol. Geriatr.
(2010), doi:10.1016/j.archger.2010.11.030

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D. Calero, E. Navarro / Archives of Gerontology and Geriatrics xxx (2010) xxxxxx

established, and two key effects of age on perceptual speed

identied: slowing-down and an increase in performance variability (Lovden et al., 2005).
Not all studies nd such differences in cognitive performance
between the group of youngold adults and oldold adults,
reporting good levels of performance in both cases (Colcombe and
Kramer, 2003; Sims et al., 2009). However, this is probably because
these studies usually x the boundary between youngold adults
and oldold adults at 70 (Sims et al., 2009), i.e., at too young an age
for such differences to be revealed.
One nding which appears systematically throughout the
literature is the fact that as age advances, a corresponding increase
arises both in levels of dependency and in the probability of
developing dementia. The passage of time is thus one of the factors
most closely associated with the need for care and support from
others, and the extent of discapacity and/or dependency and of
physical decline is greater for the group of oldold adults
(Townsend, 1981). In the case of dementia, a recent meta-analysis
by Twamley et al. (2006) analyzed 91 studies evaluating cognitive
performance and the functional and structural neuroimaging of
subjects in the pre-clinical phase of dementia. The conclusions
reached were rst of all, that the greatest risk factor for dementia is
age, with an exponential increase in the prevalence of dementia in
old adults between 65 and 85. Secondly, the study suggest the
existence of a pattern of decline in cognitive performance which
appears to be relatively mild and stable approximately six years
before the onset of dementia, but which becomes accelerated and
non-linear in the period preceding onset (Amieva et al., 2005). This
fact may be associated with compensatory mechanisms, such as
those proposed in the theory of cognitive reserve which provide
the individual with a series of quantitative and qualitative
mechanisms that make him/her more resistant to pathological
cerebral processes (Stern, 2002). In this context, the term cognitive
plasticity has acquired great importance as a construct referring to
a persons capacity for cognitive modiablity. As early as the late
1980s, the Baltes group (Kliegl et al., 1989) proposed a method for
assessing cognitive plasticity in old age known as testing the limits,
which aims to determine the potential performance of a subject
under optimal assessment conditions. This involves introducing a
training phase in the assessment, enabling the differences in pretest/post-test scores to be viewed as an estimation (or operationalization) of the old adults cognitive plasticity (FernandezBallesteros et al., 2007).
Research has succeeded in establishing the presence of
cognitive plasticity in healthy old adults, the absence of plasticity
in old adults with cognitive impairment, and the implications of
plasticity with respect to the early diagnosis of dementia (Baltes
et al., 1986; Baltes and Raykov, 1996). Other studies have
highlighted the predictive capacity of plasticity with respect to
the cognitive evolution of old adults (Calero and Navarro, 2004),
and have identied age-related differences in plasticity (Yang and
Krampe, 2009). In this last respect, several authors (Singer et al.,
2001; Yang et al., 2006; Yang and Krampe, 2009) have found that
although plasticity may be maintained in the group of oldold
adults, it is present to a lesser extent than in the group of young
old adults.
Further differences between the two groups in this case in
favor of the oldold adults have been found in variables related to
emotional aspects. Many studies report high rates of concurrence
of depression in old adults with mild cognitive impairment (e.g.,
the meta-analysis of Panza et al., 2010), but the data indicate that
the depression is associated with age-related cognitive impairment or with other variables such as ethnicity or socioeconomic status (Steffens et al., 2009) and modulated by others such
as educational level (Avila et al., 2009). Thus for example Blazer
et al. (1991) established a negative correlation between age and

depression, once factors of functional discapacity and cognitive

impairment had been controlled.
With regard to QoL, a study by Fernandez-Ballesteros and
Zamarron (2007) investigated various aspects of this concept in old
adults of different ages, and found signicant differences in favor of
the group under 80 years in relation to education level, level of
income, social integration and levels of activity and leisure. In
contrast, Hamarat et al. (2002) found no signicant differences
between old adults under and over 75 years with respect to
satisfaction with life or coping resources.
Bearing in mind these ndings, the general objective of the
present study was to analyze the similarities and differences in
cognitive performance, level of dependency, cognitive plasticity
and QoL in a group of youngold adults (under 80 years) and old
old adults (over 80 years) living in nursing home for elderly people
in the south of Spain. However in the analysis of this overall
objective will take into account the participants cognitive status
because we believe that the differences due to age can be
modulated by this other factor.
2. Subjects and methods
2.1. Participants
The study participants were 220, of whom 88 (40%) were men
and 132 (60%) were women. Average age was 80.75  7.18 years
(S.D.), age range 6596 years. Participants were selected from
sheltered accommodation for elderly people in the province of
Granada, in the South of Spain. The subjects were divided into groups
on the basis of age range and the presence/absence of cognitive
impairment, as described in the Procedures section.
2.2. Measures
Socio-sanitary questionnaire: Designed for the present study,
the objective of this instrument was to obtain various sociodemographic and health-related data. These data were selfreported by the participants.
Mini-examen-cognoscitivo (MEC) (Lobo et al., 1979): This is
the Spanish translation and adaptation of the mini-mental state
examination (MMSE) (Folstein et al., 1975) with a nal score of 35
points. Widely used for the detection of cognitive impairment, the
MEC explores a series of cognitive functions rapidly and
systematically: temporospatial orientation, immediate and longterm memory, attention, calculation, language, abstract reasoning
and praxis. The nal score obtained from the test is normally used
as a global index and as a follow-up method for measuring the
evolution of cognitive functions in processes such as cognitive
impairment and dementia.
Tarea de atencion sostenida (TAS) (sustained attention task)
(Calero and Salguero, unpublished): This computer program is a
Spanish version of Conners Continuous performance test (Conners, 2000) and was created for the present study. The program
presents a simple vigilance task designed to evaluate capacity for
sustained attention. The stimuli are numbers presented on the
computer screen with a presentation interval of 500 ms. Subjects
are required to touch the keyboard every time a particular
numerical sequence (36) appears. The sequence represents 15% of
the total numerical display. The program explores various
parameters but in this study the total number of correct responses
was taken into account as a measure of the subjects attention
capacity, with scores ranging from 0 to 60 (total correct TAS
scores).
Semantic category uency task: This simple task involves
specifying as many words as possible belonging to a given category
such as animals, during a period of 1 min. The dependent variable

Please cite this article in press as: Calero, D., Navarro, E., Differences in cognitive performance, level of dependency and quality of life
(QoL), related to age and cognitive status in a sample of Spanish old adults under and over 80 years of age. Arch. Gerontol. Geriatr.
(2010), doi:10.1016/j.archger.2010.11.030

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is the number of relevant non-repeated words uttered by the

subject. Various authors (Hodges et al., 1996) consider this to be
one of the most reliable tasks for discriminating between the initial
phases of cognitive impairment.
WM evaluation task (Yuill et al., 1989): This task measures the
extent of WM through the presentation of cards consisting of three
numbers. The subject is required to read the numbers of each card
aloud and to remember the last number, which he/she is required
to repeat once all the cards have been presented. The maximum
number of cards and numbers to recall is 5, yielding a WM score
between 0 and 5.
Auditory verbal learning test-learning potential (AVLT-LP)
(Spanish adaptation by Calero et al., 2000): Deriving from the
classic verbal memory test by Rey (1964), this learning potential
test consists of the presentation of 15 common words, which the
participant is required to repeat immediately after hearing. The list
of words is presented six times. The rst two presentations (pretest) follow standard procedure, while the next two constitute the
training and include feedback on performance, support and
repetition of forgotten words. The two nal presentations
represent the post-test and again follow standard procedure.
Scores used in the present study were as follows: (1) AVLT-LP pre:
the score obtained from the average number of correct recalls in
the rst two presentations; (2) AVLT-LP gain score: the difference
between the AVLT-LP pre and the AVLT-LP post (average number of
words correctly recalled in the last two presentations); (3) AVLT-LP
sustained recall: the number of words recalled by the subject once
the six presentations had concluded and after carrying out the WM
task as interference. Previous studies show that the training given
in the intermediate presentations signicantly improves subjects
performance. The test has become established as a measure of
cognitive plasticity in different populations such as people with
schizophrenia or dementia (Wiedl et al., 2001).
CUBRECAVI (Cuestionario breve de calidad de vida) (Short
QoL questionnaire) (Fernandez-Ballesteros and Zamarron, 2007).
The CUBRECAVI questionnaire aims to provide a multi-dimensional evaluation of the QoL in old adults. The questionnaire
consists of 21 sub-scales grouped in the following dimensions: (1)
health (subjective, objective and psychic); (2) social integration;
(3) functional abilities; (4) activity and leisure time; (5) quality of
environment; (6) satisfaction with life; (7) education; (8) income;
(9) health and social services. The questionnaire has been shown to
be reliable, with moderate indices of internal consistency
(between 0.70 and 0.92), and has been validated and assessed
for the Spanish population and various South American countries
(Fernandez-Ballesteros and Zamarron, 2007).
Geriatric depression scale (GDS) (Yesavage, 1988): This is a selfreport in which the subject is required to answer a total of 23 yes/
no questions relating to his/her state of mind. Scores range from 0
to 23 with a cut-off point at 11, with scores up to 10 representing a
normal state of mind and scores of 11 and over indicating
depressive symptomatology. The scale has been shown to be
reliable (internal consistency 0.94; two halves: 0.94, testretest
0.85). Validity with the Zung scale (r = 0.85) and Hamilton scale
(r = 0.83) has also been demonstrated. A validated Spanish
adaptation is available.
Baremo de Valoracion de la Situacion de la Dependencia
(BVD) (dependency assessment scale) (developed by Spanish
Ministry of Social Affairs, 2007): This instrument provides a
classication of different levels of personal autonomy and the need
for supervision and/or support in various types of activity, with a
view to determining the extent and level of dependency of each
person. Subjects may score up to 100 points, divided into the
following levels of dependency: Grade 1: 2549 points; Grade II:
5074 points; Grade III: 75100 points. Assessment of functional
deterioration is distributed in nine areas: (1) eating and drinking;

(2) urination and defecation control; (3) personal hygiene; (4)

other types of bodily care; (5) dressing; (6) health maintenance; (7)
body mobility; (8) mobility in the home; (9) mobility outside the
home. Additional sections are included to provide complementary
social information as follows: (10) shopping; (11) meal preparation; (12) housework and clothes-washing. The scale has been
validated by Reed (2002).
2.3. Procedures
The research was presented to various nursing homes for
elderly people in order to request their collaboration. Center
personnel were asked to make a pre-selection of participants with
the following characteristics: age 65 years or over; absence of
serious illness and dementia; absence of motor and or/sensorial
decits. Once selected, each participant was informed individually
of the objectives of the study and of the assessment to be carried
out, so he/she could give informed consent. Assessment was
conducted by experienced psychologists in two sessions with a
maximum duration of 1 h each.
Bearing in mind the study objectives, the sample was classied
according to two factors: age range and presence/absence of
cognitive impairment. Two groups were established on the basis of
age, the rst consisting of subjects of 80 years and under (n = 96,
age range = 6580, average age = 74.09  4.04), and the second
consisting of subjects of 81 years and over (n = 124, age range = 81
96, average age = 85.91  4.21). For cognitive status classication, the
MEC score was taken as reference, with a cut-off point of 25 out of a
maximum score of 35 to differentiate between participants with and
without cognitive impairment. This is in accordance with limit the
established in other studies carried out on the Spanish population to
determine the presence/absence of cognitive impairment (Calero
et al., 2000).
As a consequence of using two factors, four groups were
established with the following characteristics: (a) healthy young
old adults (n = 72, average age = 73.7  4.06); (b) healthy oldold
adults (n = 69, average age = 85.78  4.17); (c) youngold adults with
cognitive impairment (n = 24, average age = 75.25  3.84); (d) old
old adults with cognitive impairment (n = 55, average age =
86.07  4.28).
2.4. Statistical analysis
The SPSS vers. 15.0 statistical program was used to create a
general linear univariant model. The two factors (age range and
cognitive status) were applied to the model for all the variables
assessed (cognitive, life satisfaction and dependency), considered
as dependent variables.
3. Results
First of all, if we analyze the sample on the basis of age only, we
nd two groups with a signicantly different typological
distribution, as shown in Table 1. The group of youngold adults
can be seen to contain a higher number of healthy and independent
subjects, while the group of oldold adults presents a higher
number of women, subjects with cognitive impairment and
dependent subjects (Table 1).
As stated previously, the studys main objective was to
determine the inuence of the two factors, age and cognitive
status (taken together or separately) on each variable of cognitive
performance, QoL and dependency. In relation to the cognitive
variables (Table 2) (sustained recall, verbal memory, WM, verbal
uency, attention capacity and cognitive plasticity), signicant
age-related differences appear only in the variable of sustained
recall (AVLT-LP sustained recall F = 7.850, p < 0.01). In all the

Please cite this article in press as: Calero, D., Navarro, E., Differences in cognitive performance, level of dependency and quality of life
(QoL), related to age and cognitive status in a sample of Spanish old adults under and over 80 years of age. Arch. Gerontol. Geriatr.
(2010), doi:10.1016/j.archger.2010.11.030

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Table 1
Distribution of the study sample in terms of cognitive status, gender and level of
dependency.

x2

Youngolds

Oldolds

Healthy
Cognitively impaired

72
24

69
55

8.807

Women
Men

42
54

90
34

18.740

<0.0001

Independent
Dependent

45
52

30
93

12.524

<0.002

p
<0.002

remaining variables, including MEC score and cognitive plasticity,

no signicant differences are found related to the factor of age.
A second result related to cognitive status is that, as expected, in
all the cognitive variables analyzed, a signicant effect was found
in favor of the participants without cognitive impairment,
independently of the age group to which they belong. These

Table 2
The mean scores obtained as a function of age group and cognitive status in
cognition, plasticity and dependency, mean  S.D.
Variables

Age groups

Healthy adults

Impaired adults

AVLT-LP Sus. recall

Y
O
Y
O
Y
O
Y
O
Y
O
Y
O
Y
O
Y
O

7.14  3.41
6.05  3.48
4.90  2.42
5.01  2.56
2.13  1.14
1.95  1.03
12.57  3.71
11.76  3.89
39.67  15.51
40.00  14.55
4.26  2.22
4.58  2.91
28.75  2.96
28.78  3.72
13.23  20.84
13.07  12.10

3.74  2.94
1.70  2.07
3.63  1.81
3.91  2.61
0.67  1.09
0.79  0.97
8.38  4.09
7.94  3.89
23.39  19.51
27.97  14.10
2.67  2.19
3.56  3.11
19.50  3.72
18.62  4.21
23.72  16.20
29.70  18.87

AVLT-LP pre
WM
Verbal uency
Total corrected
TAS score
AVLT-LP gain score
MEC score
Dependency

Sources
AVLT-LP Sus. recall

Age range
(AR)
Cognitive
status (CS)
Age * CS

Sum of square

F(1,219)

78.476

7.850

<0.006

480.453

48.058

<0.001

subjects achieve higher scores in all the cognitive variables

assessed: sustained attention (AVLT-LP sustained attention:
F = 48.058, p < 0.01); verbal memory (AVLT-LP pre: F = 10.343,
p < 0.01); WM (F = 65.505, p < 0.01); verbal uency (F = 47.605,
p < 0.01), attention capacity (total correct TAS scores: F = 33.468,
p < 0.01) and cognitive plasticity (F = 9.809, p < 0.01). In all these
variables, the oldold adults with cognitive impairment achieve
lower scores, regardless of their age group.
Nevertheless, in relation to the cognitive plasticity variable, it
should be pointed out that the improvements registered after the
AVLT-LP training phase are clinically signicant for all the groups,
with the size of effect of pre/post improvements ranging from 1.10
for the group of healthy oldold adults to 1.48 for the group of
healthy youngold adults.
Turning to the level of dependency, the results again show that
signicant differences arise only in relation to the factor of
cognitive status, in such a way that the healthy adults, regardless of
their age group, obtain scores indicating a greater degree of
independence (F = 1.349, p < 0.01). In addition, it should be noted
that no signicant age/cognitive status interaction effect was
established in any of the variables assessed (Table 2).
The results in relation to the QoL variables, assessed by means
of the CUBRECAVI questionnaire and the GDS, are shown in Table 3.
Table 3
Mean scores obtained by the subjects as a function of age group and CS in the
CUBRECAVI QoL scales and in the GDS, mean  S.D.
Variables

Age groups

Healthy adults

Health

Y
O

3.28  0.39
3.25  0.42

Impaired adults
3.38  0.55
3.17  0.49

Education level

Y
O

1.14  1.07
1.06  0.90

0.84  1.27
0.72  0.64

Functional abilities

Y
O

3.08  0.95
2.94  0.84

2.86  0.68
2.39  1.02

Activity and leisure

Y
O

2.16  0.56
2.06  0.47

1.95  0.42
1.92  0.50

Satisfaction with life

Y
O

2.65  0.96
2.94  0.90

2.42  0.77
2.66  0.94

Social services

Y
O

3.02  0.57
3.05  0.58

2.58  0.76
3.05  0.49

Depression

Y
O

9.67  5.98
8.67  5.73

10.2  16.15
10.84  6.66

7.071

0.707

<0.402

AVLTLP pre

AR
CS
Age * CS

1.755
62.006
0.288

0.293
10.343
0.048

<0.589
<0.002
<0.827

Health recall

AR
Cognitive status (CS)
Age * CS

0.634
0.006
0.365

3.364
0.033
1.935

<0.068
<0.856
<0.166

WM

AR
CS
Age * CS

0.030
72.568
0.955

0.778
65.505
0.862

<0.379
<0.001
<0.354

Education level

AR
CS
Age * CS

0.417
4.226
0.013

0.457
4.636
0.014

<0.500
<0.032
<0.904

Verbal uency

AR
CS
Age * CS

17.063
707.349
411.354

1.148
47.605
1.349

<0.285
<0.001
<0.747

Functional abilities

AR
CS
Age * CS

3.858
6.359
1.172

5.590
6.997
1.907

<0.019
<0.009
<0.169

Total correct TAS score

AR
CS
Age * CS

241.695
8009.029
180.5910

1.010
33.468
0.755

<0.316
<0.001
<0.386

Activity and leisure

AR
CS
Age * CS

0.175
1.316
0.048

0.685
5.164
0.189

<0.409
<0.024
<0.664

AVLT-LP gain score

AR
CS
Age * CS

16.134
74.876
3.629

2.114
9.809
0.475

<0.148
<0.002
<0.491

Satisfaction with life

AR
CS
Age * CS

3.116
2.858
0.027

3.707
3.390
0.320

<0.086
<0.067
<0.859

MEC

AR
CS
Age * CS

8.174
4272.010
9.477

6.80
355.148
7.88

<0.411
<0.0001
<0.376

Social services

AR
CS
Age * CS

2.772
2.039
2.077

8.231
6.054
6.167

<0.005
<0.015
<0.014

Dependency

AR
CS
Age * CS

368.310
7989.819
411.354

1.208
0.197
1.349

<0.273
<0.0001
<0.247

Depression

AR
CS
Age * CS

1.539
81.214
29.608

0.042
2.191
0.799

<0.839
<0.140
<0.372

Sources

Sum of square F(1,212) p

Please cite this article in press as: Calero, D., Navarro, E., Differences in cognitive performance, level of dependency and quality of life
(QoL), related to age and cognitive status in a sample of Spanish old adults under and over 80 years of age. Arch. Gerontol. Geriatr.
(2010), doi:10.1016/j.archger.2010.11.030

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D. Calero, E. Navarro / Archives of Gerontology and Geriatrics xxx (2010) xxxxxx

As may be seen, if the age factor alone is taken into account,

signicant differences in favor of the youngold adults appear in
only two variables: functional abilities (F = 5.59, p < 0.05) and
social services (F = 8.231, p < 0.01). Secondly, regarding the
cognitive status factor, signicant differences in favor of the
healthy subjects appear in the following variables: education level
(F = 4.636, p < 0.05), functional abilities (F = 6.997, p < 0.01),
activities and leisure (F = 5.164, p < 0.05), and social services
(F = 6.054, p < 0.05). Thirdly, it should be noted that a signicant
age-range/cognitive status interaction appears for the social
services variable, in favor of the healthy youngold adults
(F = 6.167, p < 0.05).
It is worth highlighting that for the variable depression, no
signicant differences appeared between the groups, whether
according to age range (F = 0.042, p > 0.1) or cognitive status
(F = 2.191, p > 0.1), and no interaction between the two factors was
apparent (Table 3).
4. Discussion
This study arose from the need to extend research in a highly
relevant area in current gerontology studies, related to the fact that
the over-80s are the fastest-growing sector of the population in the
developed world, while at the same time 80 years seems to be the
boundary marking important differences between the so-called
youngold adults and oldold adults.
Accordingly, the general objective of our research was to
analyze the similarities and differences in diverse variables
(cognitive functioning, level of dependency, cognitive plasticity
and QoL) between a sample of youngold and oldold adults living
in sheltered accommodation in the South of Spain. In addition, we
sought to determine if such differences depend only on the agegroup to which the subjects belong, or if they are also related to the
cognitive status of the sample, an area which has not been covered
in previous research.
In relation to cognitive performance, no differences between
subjects under and over 80 were established in any of tasks except
sustained recall, enabling us to afrm that performance was not
related to age per se. By contrast, with the exception of long-term
memory, differences in cognitive performance were related to the
cognitive status of the sample, with the healthy subjects
presenting a superior level of performance regardless of their
age. Specically, the following variables did not present agerelated differences, although in each case differences depending on
cognitive status were observed in favor of the healthy adults:
verbal memory, WM, verbal uency, attention capacity and
cognitive plasticity.
With regard to attention capacity, the absence of signicant
age-related differences between the groups is probably due to the
variability of performance in this task, as indicated by the S.D. This
would be in accordance with other studies establishing that
attention is relatively well-preserved in advanced ages, although
there is an increase in performance variability and in the time
required to carry out attention tasks (Anstey et al., 2003).
To sum up, in general terms these data do not lend support to
other research which indicates the existence of signicant
differences between youngold adults and oldold adults related
exclusively to the variable of age in the following areas: episodic
memory (Backman et al., 2000), linguistic aspects (McGinnis,
2009), digit retention tasks and general cognitive ability tasks
(Read et al., 2006).
Turning to the variable of cognitive plasticity, data found in our
study again reveal no signicant age-related differences in the
AVLT-LP gain score, indicating that youngold adults and oldold
adults have a similar capacity to benet from the training given in
the intermediate phase of the AVLT-LP task, thus displaying

cognitive modiability or plasticity. By contrast, differences in

plasticity do arise in relation to cognitive status, with the subjects
with cognitive deterioration displaying a smaller degree of
plasticity, as expected from the beginning. This nding is in
accordance with previous studies (Baltes and Raykov, 1996),
although even for this group, clinically signicant improvements
take place as a result of the training phase. In general, our results
for cognitive plasticity support the ndings of authors such as
Singer et al. (2001) or the Yang-group (Yang and Krampe, 2009) to
the effect that cognitive plasticity is preserved in the oldold adults
group, albeit to a lower extent.
With regard to the variable of dependency, results show that
there are no signicant inter-group differences in relation to the
total score of the Ministry scale, although this is probably due to
the high variability (demonstrated by the large see S.D.s). Similarly,
only the group of old adults with cognitive deterioration present a
mean score corresponding to dependency, at the level of Grade 1
(moderate). However, inter-group differences do appear on
analyzing the number of subjects classied as dependent and
independent in the two age groups, with 64% of the total number of
dependent subjects belonging to the over-80 group. These data are
in line with previous studies which show that the age is one of the
factors most closely associated with dependency (Townsend,
1981).
Turning to the QoL variable, measured through the CUBRECAVI
questionnaire, our data reveal no signicant differences between
the age-groups in any of the scales, except functional abilities in
which the younger group presents better results and use of social
services in which the oldold show higher scores, that is, report
higher use of services. This nding is coherent with the higher level
of independence of the younger group. The two scales also reveal
signicant differences depending on cognitive status, so that the
group of healthy youngold adults seems to present the highest
levels of quality of life in relation to these two aspects. Similarly,
signicant differences related to cognitive status (but not to age)
arise in other variables measured by the CUBRECAVI questionnaire,
with the healthy subjects presenting a higher level both of
education and of activity and leisure. Previous research has found a
similar link between education level and absence of impairment
(Leach et al., 2008). Additionally, this nding may be related to the
theory of cognitive reserve, which proposes that an active lifestyle
and higher education level act as factors which protect against
cognitive decline (Stern, 2002).
In the case of depression, previous research on the subject
seems to indicate lower levels of depression in the oldest groups
(Leach et al., 2008). While the present study does not reveal such
differences in favor of the oldold group, it is noticeable that the
mean scores in the GDS are without exception lower than the cutoff point indicating depression. It therefore seems that the sample
as a whole presents a normal state of mind, with neither the
younger nor the older group presenting a depressive symptomatology.
To sum up, the novelty of the present study lies in the analysis of
the relation between variables recognized as relevant in the
specialized gerontology literature, and two factors (age and
cognitive status) which are considered both separately and taking
into account their interaction. Up to now, these two factors have
been analyzed separately (for age groups, see for example Carnes
and Olshansky, 2007; McGinnis, 2009; for cognitive status, see
Amieva et al., 2005; Twamley et al., 2006). The most interesting
result was the nding that there are few differences due to age,
while there are many differences related to cognitive status both in
cognitive variables (verbal memory, WM, verbal uency, attention
capacity and cognitive plasticity) and in four QoL variables
(functional abilities, activity and leisure, education level and use
of social services) and to the level of dependency. That is why,

Please cite this article in press as: Calero, D., Navarro, E., Differences in cognitive performance, level of dependency and quality of life
(QoL), related to age and cognitive status in a sample of Spanish old adults under and over 80 years of age. Arch. Gerontol. Geriatr.
(2010), doi:10.1016/j.archger.2010.11.030

G Model

AGG-2405; No. of Pages 6

D. Calero, E. Navarro / Archives of Gerontology and Geriatrics xxx (2010) xxxxxx

given the relationship between two variables (older age, more

people with cognitive impairment), it seems necessary to analyze
them together when trying to establish performance models at
different stages of aging.
This means that for these old adults living in nursing homes in
the south of Spain, more differences are due to cognitive
performance than to age. This leads us to reect yet further on
the variability observed in this stage of life, since our data do not
lend support to the idea of a differentiation based solely on the fact
of reaching 80 years, but rather highlight the importance of
cognitive status as a factor to be taken into account.
Nevertheless, given the number of subjects in the sample and
the characteristics of the study population (youngold adults and
oldold adults) living in sheltered accommodation, further studies
are required to corroborate these results and to extend this line of
research. Also we take into account variables that also relate to the
age of the elderly such as gender and level of dependency.
Conict of interest statement
None.
Acknowledgements
This work was supported by the Research Project PSI-200800850: psychological predictors of cognitive decline and dependency in adults over 75 years, nanced by the Spanish Ministry of
Education and Science (I + D). This article was translated from
Spanish by Julian Bourne of the Faculty of Translation and
Interpreting, University of Granada.
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Please cite this article in press as: Calero, D., Navarro, E., Differences in cognitive performance, level of dependency and quality of life
(QoL), related to age and cognitive status in a sample of Spanish old adults under and over 80 years of age. Arch. Gerontol. Geriatr.
(2010), doi:10.1016/j.archger.2010.11.030