Divergent thinking in healthy and pathological aging

In recent decades, constructs such as cognitive reserve (CR) and divergent thinking (DT) have received increasing attention in the study of healthy and pathological aging because of their potential in terms of targets for cognitive stimulation programs and/or early diagnosis. However, the results of studies on DT skills in the healthy elderly population have often been inconsistent. Therefore, a systematic review was performed to systematize these results. This first study showed that this inconsistency may be due to some theoretical and methodological issues. Nevertheless, it was pointed out that more recent studies have shown that older subjects seem to have the ability to think as divergently as younger subjects, when specific intervening variables such as processing speed and working memory skills are considered. Furthermore, a second study showed how this controversial effect may be influenced by the negative impact of psychological symptoms such as apathy and depression (very frequent in the elderly population) on DT performance of elderly subjects and the possible moderating effects of CR. Finally, a third study showed that verbal DT appears to be spared even in the prodromal stages of neurodegenerative diseases (i.e., in patients with Mild Cognitive Impairment, MCI). In contrast, figural DT is already impaired in these patients and could be considered by future studies as an early marker of disease. Although these preliminary results need to be confirmed by further studies, some implications can be drawn. It can be argued that, especially verbal DT, with its proven relationship to the CR construct, could be considered a useful target for cognitive enhancement in healthy elderly and for early cognitive stimulation interventions in MCI patients. Finally, as a clinical implication, particular attention should be paid to the detection and possible treatment of psychological symptoms such as apathy and depression in this specific population.