Through The Eyes of Alzheimer’s
Through The Eyes of Alzheimer’s
Ali R. Rahimi,MD,FACP,AGSFProfessor of Medicine
Mercer University School of Medicine
Ali R. Rahimi,MD,FACP,AGSFProfessor of Medicine
Mercer University School of Medicine
ObjectivesObjectives• Review the following in context to artistic
ability:– Typical Aging Process– Effects of aging in selected artists
• Monet• Rembrandt
– Process of Alzheimer’s Disease (AD)– Effects of Alzheimer’s Disease in selected artists
• Carolus Horn• William Utermohlen
– Review and Conclusions
• Review the following in context to artistic ability:– Typical Aging Process– Effects of aging in selected artists
• Monet• Rembrandt
– Process of Alzheimer’s Disease (AD)– Effects of Alzheimer’s Disease in selected artists
• Carolus Horn• William Utermohlen
– Review and Conclusions
Aging of The BrainAging of The Brain
• Steady decline of organ function and regulatory functions
• Atrophy of the brain • Reduced blood flow to the brain• Decreased number of nerve cells• Reaction time to stimuli slows
• Steady decline of organ function and regulatory functions
• Atrophy of the brain • Reduced blood flow to the brain• Decreased number of nerve cells• Reaction time to stimuli slows
Aging of The BrainAging of The Brain
• Above mentioned changes have effect on intelligence and cognition
• Declines in intelligence began at about age 60
• Difficulty with recall and accumulating new information also appear
• Above mentioned changes have effect on intelligence and cognition
• Declines in intelligence began at about age 60
• Difficulty with recall and accumulating new information also appear
Aging of The BodyAging of The Body
• Atrophy of all muscle systems• Decreased muscle strength and
endurance• Disease processes, such as arthritis,
impair mobility and limit fine movements– Arthritis in about 50% of patients
• Decreased physical activity
• Atrophy of all muscle systems• Decreased muscle strength and
endurance• Disease processes, such as arthritis,
impair mobility and limit fine movements– Arthritis in about 50% of patients
• Decreased physical activity
Aging of The BodyAging of The Body
• Visual changes affect ability to see clearly and produce detailed work
• Depression • Decreased self-confidence due to
increasing limitations and decreasing amounts of freedom
• Visual changes affect ability to see clearly and produce detailed work
• Depression • Decreased self-confidence due to
increasing limitations and decreasing amounts of freedom
Results of AgingResults of Aging
• Decreased ability to achieve same level of work as previously possible– Thinking processes and coordination
decreased– Physical ability to draw and paint
decreased– Motivation and energy to work is
decreased
• Decreased ability to achieve same level of work as previously possible– Thinking processes and coordination
decreased– Physical ability to draw and paint
decreased– Motivation and energy to work is
decreased
Aging’s Effect on ArtAging’s Effect on Art
• Decline of output during aging• Peak productivity in 30’s and 40’s• Productivity declines after 40’s• Definite exceptions to this rule
– Grandma Moses started painting at age 78 and completed works at age 101
– Rembrandt painting until death in 1669
• Decline of output during aging• Peak productivity in 30’s and 40’s• Productivity declines after 40’s• Definite exceptions to this rule
– Grandma Moses started painting at age 78 and completed works at age 101
– Rembrandt painting until death in 1669
Aging Related Impairments to
Creating Art
Aging Related Impairments to
Creating Art•Visual impairments
–ex. the aging eye• Physical impairments
– ex. rheumatoid arthritis• Changes in energy/drive• General aging
•Visual impairments–ex. the aging eye
• Physical impairments– ex. rheumatoid arthritis
• Changes in energy/drive• General aging
Effects Seen From an Aging Eye
Effects Seen From an Aging Eye
• Increased glare• Decreased color
discrimination• Decreased
contrast sensitivity
• Decreased acuity
• Increased glare• Decreased color
discrimination• Decreased
contrast sensitivity
• Decreased acuity
• Decreased perception of motion
• Decreased field of view
• Decreased perception of motion
• Decreased field of view
Aging Related Disease Processes of
The Eye
Aging Related Disease Processes of
The Eye• Cataracts• Presbyopia• Macular Degeneration• Glaucoma• Diabetic Retinopathy• All have effect on an artist’s
perception
• Cataracts• Presbyopia• Macular Degeneration• Glaucoma• Diabetic Retinopathy• All have effect on an artist’s
perception
Aging Related Impairments to
Creating Art
Aging Related Impairments to
Creating Art• Visual impairments
– ex. the aging eye
•Physical impairments–ex. rheumatoid arthritis
• Changes in energy/drive• General aging
• Visual impairments– ex. the aging eye
•Physical impairments–ex. rheumatoid arthritis
• Changes in energy/drive• General aging
Pierre-Auguste Renoir (1841-1919)
Pierre-Auguste Renoir (1841-1919)
• • •Afflicted with rheumatoid arthritis in 1894
•Produced almost 400 paintings after diagnosis
•Adept skill even with arthritis
•Afflicted with rheumatoid arthritis in 1894
•Produced almost 400 paintings after diagnosis
•Adept skill even with arthritis
Aging Related Impairments to
Creating Art
Aging Related Impairments to
Creating Art• Visual impairments
– ex. the aging eye• Physical impairments
– ex. rheumatoid arthritis
•Changes in energy/drive•General aging
• Visual impairments– ex. the aging eye
• Physical impairments– ex. rheumatoid arthritis
•Changes in energy/drive•General aging
Aging of an ArtistAging of an Artist
• •
•Rembrandt (1606-1669)
•Famous for detailed portraits and visual acuity
•Chronicled his aging with over 100 self-portraits
•Rembrandt (1606-1669)
•Famous for detailed portraits and visual acuity
•Chronicled his aging with over 100 self-portraits
Aging of Rembrandt (1669)
Aging of Rembrandt (1669)
• •
•Presbyopia caused decreased detail and clarity
•Final works linked by broader brush strokes, less detail and yellowish hue
•Presbyopia caused decreased detail and clarity
•Final works linked by broader brush strokes, less detail and yellowish hue
The Aging ArtistThe Aging Artist
• Visual aging can decrease precision and cause color usage changes
• Decreased dexterity and mobility leads to broader strokes and less detail
• Decreased energy causes decreased production
• Overall, though, aging artist still able to produce works comparable to works they created when they were younger
• Visual aging can decrease precision and cause color usage changes
• Decreased dexterity and mobility leads to broader strokes and less detail
• Decreased energy causes decreased production
• Overall, though, aging artist still able to produce works comparable to works they created when they were younger
Process of Alzheimer’sProcess of Alzheimer’s
• Typical aging process + disease process
• Most common neurodegenerative disease of the elderly
• Subtle, progressive changes• Loss of synaptic connections
• Typical aging process + disease process
• Most common neurodegenerative disease of the elderly
• Subtle, progressive changes• Loss of synaptic connections
Alzheimer’s and The Brain
Alzheimer’s and The Brain
• General brain atrophy• 4 classic changes:
– Cortical atrophy– Degeneration of cholinergic neurons– Neurofibrillary tangles– Accumulation of amyloid plaques
• General brain atrophy• 4 classic changes:
– Cortical atrophy– Degeneration of cholinergic neurons– Neurofibrillary tangles– Accumulation of amyloid plaques
Consequences of Alzheimer’s
Consequences of Alzheimer’s
• Brain related changes lead to many cognitive impairments:– Memory impairment– Visuospatial disorientation– Language impairment– Constructional apraxia
• Brain related changes lead to many cognitive impairments:– Memory impairment– Visuospatial disorientation– Language impairment– Constructional apraxia
Consequences of Alzheimer’s (Cont’d)
Consequences of Alzheimer’s (Cont’d)
• Alzheimer’s patients do not benefit from “clues” or “reminders”
• Difficulty in finding words, drawing simple objects, and locating objects
• Decreased abstract thinking• Have little insight into own disease
• Alzheimer’s patients do not benefit from “clues” or “reminders”
• Difficulty in finding words, drawing simple objects, and locating objects
• Decreased abstract thinking• Have little insight into own disease
Brain’s Influence in Art
Brain’s Influence in Art
• Anterior left hemisphere– Coordinates limb and eye movements
• Occipital/Temporal cortical areas– Perceive form and depth
• Parietal areas– Influence perception of space– Control movement in space and time
• Anterior left hemisphere– Coordinates limb and eye movements
• Occipital/Temporal cortical areas– Perceive form and depth
• Parietal areas– Influence perception of space– Control movement in space and time
Effects of Brain Damage in ArtEffects of Brain Damage in Art
• Right hemisphere damage– Hemi spatial neglect– Spatial relationships of parts of image
incorrect• Left hemisphere damage
– Less impaired spatial arrangement– Oversimplification– Tremulous quality to work
• Right hemisphere damage– Hemi spatial neglect– Spatial relationships of parts of image
incorrect• Left hemisphere damage
– Less impaired spatial arrangement– Oversimplification– Tremulous quality to work
Alzheimer’s Scope of Damage
Alzheimer’s Scope of Damage
• Alzheimer’s generally causes global deterioration– Will see combination of right and
left sided impairments due to global effect
– Position of plaques and lesions plays a role in changes seen
– Usually do not see hemi spatial neglect or tremulous quality
• Alzheimer’s generally causes global deterioration– Will see combination of right and
left sided impairments due to global effect
– Position of plaques and lesions plays a role in changes seen
– Usually do not see hemi spatial neglect or tremulous quality
Cornerstones of Alzheimer’s ArtCornerstones of Alzheimer’s Art
• Fewer angles• Impaired perception• Impaired spatial relationships• Increased simplification• Overall production impaired• Severity of these changes
correlates with severity of disease
• Fewer angles• Impaired perception• Impaired spatial relationships• Increased simplification• Overall production impaired• Severity of these changes
correlates with severity of disease
Contextual Criteria in Alzheimer’s ArtContextual Criteria in Alzheimer’s Art
• Impaired ability to draw squares and houses
• Subject matter more abstract– Magical subjects increasingly popular
• Ornamentation more prevalent• Increased scribbling• More geometric, linear shapes used
• Impaired ability to draw squares and houses
• Subject matter more abstract– Magical subjects increasingly popular
• Ornamentation more prevalent• Increased scribbling• More geometric, linear shapes used
Formal Criteria in Alzheimer’s Art
Formal Criteria in Alzheimer’s Art
• Regression– Lack of perspective– Primitive, child-like qualities
• Distortion– Increasing comic or grotesque quality– Cartoon-like quality to work
• Condensation– Overfilling/overflowing of space
• Regression– Lack of perspective– Primitive, child-like qualities
• Distortion– Increasing comic or grotesque quality– Cartoon-like quality to work
• Condensation– Overfilling/overflowing of space
Formal Criteria in Alzheimer’s Art
Formal Criteria in Alzheimer’s Art
• Transformation– Anatomic features placed
inappropriately– Physiognomy (applying strange facial
features to humans and animals)
• Stereotype– Repetition of a subject or object
• Transformation– Anatomic features placed
inappropriately– Physiognomy (applying strange facial
features to humans and animals)
• Stereotype– Repetition of a subject or object
Formal Criteria in Alzheimer’s Art
Formal Criteria in Alzheimer’s Art
• Woodenness– Enclosing pictures within frames– Decreased depth (less shading)– Increased rigidity (decreased
movement/fluidity)– More rigid geometric shapes
• Woodenness– Enclosing pictures within frames– Decreased depth (less shading)– Increased rigidity (decreased
movement/fluidity)– More rigid geometric shapes
Formal Criteria in Alzheimer’s Art
Formal Criteria in Alzheimer’s Art
• Disintegration– Neglect of spatial relationships– Loosening of physiognomy
•Animal and human qualities become even more abstract
• Disintegration– Neglect of spatial relationships– Loosening of physiognomy
•Animal and human qualities become even more abstract
Carolus Horn (1921-1992)
Carolus Horn (1921-1992)
• Designer for advertising company (clients included Coca-Cola®)
• Completed “leisure paintings” in his free time– Enjoyed drawing animals– Enjoyed capturing the Rialto Bridge in
Venice, Italy
• Designer for advertising company (clients included Coca-Cola®)
• Completed “leisure paintings” in his free time– Enjoyed drawing animals– Enjoyed capturing the Rialto Bridge in
Venice, Italy
Carolus HornCarolus Horn
• Diagnosed with Alzheimer’s in 1984
• Diagnosed at age 63• Disease presented with memory
impairment, difficulty recognizing people, impaired reading and speaking abilities
• Diagnosed with Alzheimer’s in 1984
• Diagnosed at age 63• Disease presented with memory
impairment, difficulty recognizing people, impaired reading and speaking abilities
Carolus HornCarolus Horn
• Progression of disease can be seen through paintings
• Painted Rialto Bridge at least five times from 1978 to 1988
• Allows visualization of the artistic changes that Alzheimer’s caused in Horn
• Progression of disease can be seen through paintings
• Painted Rialto Bridge at least five times from 1978 to 1988
• Allows visualization of the artistic changes that Alzheimer’s caused in Horn
Rialto Bridge (1978)Rialto Bridge (1978)
• Typical “leisure painting”
• Detail and shading are very precise
• Lots of movement and fluidity
• Typical “leisure painting”
• Detail and shading are very precise
• Lots of movement and fluidity
Rialto Bridge (Mid 1980’s)
Rialto Bridge (Mid 1980’s)
• • • Painted at
beginning of disease
• Ability to form smooth arches and round shapes still present
• Less movement and shading
• Painted at beginning of disease
• Ability to form smooth arches and round shapes still present
• Less movement and shading
Rialto Bridge (1986)Rialto Bridge (1986)
• •
• 2 Years after diagnosis
• Mild to moderate stage of AD
• Condensation-increased use of yellow
• Figures more cartoonish
• Ability to round shapes decreasing
• 2 Years after diagnosis
• Mild to moderate stage of AD
• Condensation-increased use of yellow
• Figures more cartoonish
• Ability to round shapes decreasing
Rialto Bridge (1988)Rialto Bridge (1988)
• •
• 4 years after diagnosis
• Moderate to severe stage of AD
• Unable to form smooth arch
• Predominance of yellow increased
• Less detailed clouds and cartoonish figures
• 4 years after diagnosis
• Moderate to severe stage of AD
• Unable to form smooth arch
• Predominance of yellow increased
• Less detailed clouds and cartoonish figures
Painting From 1988Painting From 1988
• •
• Woodenness-enclosed within a frame
• Stereotype-repetition of symbols/shapes
• Magical themed subject matter
• Increased ornamentation
• Woodenness-enclosed within a frame
• Stereotype-repetition of symbols/shapes
• Magical themed subject matter
• Increased ornamentation
Painting From Late 1980’s
Painting From Late 1980’s
• •
• Increasing simplicity and lack of details
• Ability to square windows impaired
• Altered physiognomy-animals with human features
• Increasing simplicity and lack of details
• Ability to square windows impaired
• Altered physiognomy-animals with human features
Art From End Stage Ad
Art From End Stage Ad
• • • Condensation-red
only color used• Total
disintegration-loss of ability to form realistic image
• Unable to form squares
• Regression to child-like quality
• Condensation-red only color used
• Total disintegration-loss of ability to form realistic image
• Unable to form squares
• Regression to child-like quality
Last Attempts at ArtLast Attempts at Art
• • • Drive to create
art still present days before death
• Unable to create a realistic image
• Loss of artistic talent at this point
• Drive to create art still present days before death
• Unable to create a realistic image
• Loss of artistic talent at this point
William Utermohlen (1936-Present)
William Utermohlen (1936-Present)
• Artist from Philadelphia who moved to England in 1957
• Known for detailed figurative work, portraits, and murals
• Self-motivated to produce self portraits that showed effect of Alzheimer’s on his artistic ability
• Artist from Philadelphia who moved to England in 1957
• Known for detailed figurative work, portraits, and murals
• Self-motivated to produce self portraits that showed effect of Alzheimer’s on his artistic ability
William UtermohlenWilliam Utermohlen
• No family history of Alzheimer’s• Car accident at age 55 left him
unconscious for 30 minutes• Diagnosis of Alzheimer’s made at age
61– MMSE: 22/30, depressed, lapses in
memory, spatial impairment in all aspects of life
• No family history of Alzheimer’s• Car accident at age 55 left him
unconscious for 30 minutes• Diagnosis of Alzheimer’s made at age
61– MMSE: 22/30, depressed, lapses in
memory, spatial impairment in all aspects of life
William UtermohlenWilliam Utermohlen
• Increasing difficulty reproducing his image as disease progressed
• Was aware of problems present in his work, but was unable to fix them
• Verbal impairment declined quickly, found that painting helped him to express things more easily
• Increasing difficulty reproducing his image as disease progressed
• Was aware of problems present in his work, but was unable to fix them
• Verbal impairment declined quickly, found that painting helped him to express things more easily
Utermohlen at Age 60Utermohlen at Age 60
• Painted before diagnosis
• Figure gripping table overpowered by room and skylight
• Meant to show fear and isolation of surroundings
• Painted before diagnosis
• Figure gripping table overpowered by room and skylight
• Meant to show fear and isolation of surroundings
Utermohlen at Age 60Utermohlen at Age 60
• Typical self-portrait
• Serves as reference point for style and artistic ability
• Anatomically correct
• Appropriate perspective
• Typical self-portrait
• Serves as reference point for style and artistic ability
• Anatomically correct
• Appropriate perspective
Utermohlen at Age 62Utermohlen at Age 62
• •
• Earliest signs of decreasing ability to form realistic self-image
• Conveys increasing sense of anxiety
• Decreasing ability to define features
• Earliest signs of decreasing ability to form realistic self-image
• Conveys increasing sense of anxiety
• Decreasing ability to define features
Utermohlen at Age 63Utermohlen at Age 63
• •
• Changes becoming more pronounced
• Sense of proportion altered
• No background present
• Changes becoming more pronounced
• Sense of proportion altered
• No background present
Utermohlen at Age 64Utermohlen at Age 64
• •
• Facial features blurred and disjointed
• Took 2 months to complete
• Would regularly rub out work when unhappy and try to redo
• Unrealistic self-image
• Facial features blurred and disjointed
• Took 2 months to complete
• Would regularly rub out work when unhappy and try to redo
• Unrealistic self-image
Utermohlen at Age 65Utermohlen at Age 65
• •
• •
• More abstract style of self-portrait
• Primitive, child-like style of work
• Loss of realism
• More abstract style of self-portrait
• Primitive, child-like style of work
• Loss of realism
• •
•
•
Utermohlen at Age 66Utermohlen at Age 66
• •
• Attempt at more realistic style
• No close resemblance to human form
• Perspective and anatomic placement incorrect
• Attempt at more realistic style
• No close resemblance to human form
• Perspective and anatomic placement incorrect
The Artist with Alzheimer’s
The Artist with Alzheimer’s
• Horn and Utermohlen serve as first artists to document the effect of Alzheimer’s on artistic ability
• Their paintings clearly show decline in ability in relationship to progression of the disease
• Both artists show the classic signs of impairment of Alzheimer’s as previously mentioned
• Horn and Utermohlen serve as first artists to document the effect of Alzheimer’s on artistic ability
• Their paintings clearly show decline in ability in relationship to progression of the disease
• Both artists show the classic signs of impairment of Alzheimer’s as previously mentioned
Art and Alzheimer’sArt and Alzheimer’s
• Producing art may also benefit Alzheimer’s patients because it serves as an outlet and expression for their feelings when other ways of expression may be impaired
• It also allows the patient control over a creative process when the disease has taken control away from them
• Producing art may also benefit Alzheimer’s patients because it serves as an outlet and expression for their feelings when other ways of expression may be impaired
• It also allows the patient control over a creative process when the disease has taken control away from them
Final ConclusionFinal Conclusion
• Aging artists and those afflicted with Alzheimer’s Disease prove that no matter the obstacles life places in front of you the drive and determination to create refuses to be destroyed.
• Aging artists and those afflicted with Alzheimer’s Disease prove that no matter the obstacles life places in front of you the drive and determination to create refuses to be destroyed.
ReferencesReferences
• “A portrait of Alzheimer’s.” BBC News Online: Health. 22 Apr 2003 http://news.bbc.co.uk/2/hi/health/1412428.stm.
• Crutch S, Isaacs K, Rossor M. Some workmen can blame their tools: artistic change in an individual with Alzheimer’s disease. Lancet 2001;357:2129-33.
• Cummings J and Zarit J. Probable Alzheimer’s Disease in an Artist. JAMA 1987;258(19):2731-34.
• Derbyshire D. “Artist Charts His Slide into Dementia.” Telegraph Online. 29 June 2001. 22 Apr 2003<http://www.telegraph.co.uk/news/main.jhtml.
• “A portrait of Alzheimer’s.” BBC News Online: Health. 22 Apr 2003 http://news.bbc.co.uk/2/hi/health/1412428.stm.
• Crutch S, Isaacs K, Rossor M. Some workmen can blame their tools: artistic change in an individual with Alzheimer’s disease. Lancet 2001;357:2129-33.
• Cummings J and Zarit J. Probable Alzheimer’s Disease in an Artist. JAMA 1987;258(19):2731-34.
• Derbyshire D. “Artist Charts His Slide into Dementia.” Telegraph Online. 29 June 2001. 22 Apr 2003<http://www.telegraph.co.uk/news/main.jhtml.
ReferencesReferences
• Dipiro J, et al. Pharmacotherapy: A pathiophysiologic approach. New York:McGraw-Hill, 1999.
• Espinel C. de Kooning’s late colours and forms: dementia, creativity, and the healing power of art. Lancet 1996;347:1096-98.
• Galasko D, ed. Clinics in Geriatric Medicine: Alzheimer’s Disease and Dementia. Vol.17 No. 2. Philadelphia: W.B. Saunders Co., 2001.
• “Grasping Creativity.” 22 Apr 2003 <http://arttech.about.com/library/weekly/aa02/401a.htm.
• Dipiro J, et al. Pharmacotherapy: A pathiophysiologic approach. New York:McGraw-Hill, 1999.
• Espinel C. de Kooning’s late colours and forms: dementia, creativity, and the healing power of art. Lancet 1996;347:1096-98.
• Galasko D, ed. Clinics in Geriatric Medicine: Alzheimer’s Disease and Dementia. Vol.17 No. 2. Philadelphia: W.B. Saunders Co., 2001.
• “Grasping Creativity.” 22 Apr 2003 <http://arttech.about.com/library/weekly/aa02/401a.htm.
ReferencesReferences
• Kane R, Ouslander J, Abrass I. Essentials of Clinical Geriatrics. 3rd ed. New York:McGraw-Hill, 1994.
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• Kirk A and Kerteza A. On Drawing Impairment in Alzheimer’s Disease. Arch Neurol 1991;48:73-77.
• Maurer K and Frölich L. “Paintings of an artist with progressive Alzheimer’s Disease.” Alzheimer’s Insights Online. 22 Apr 2003http://www.alzheimer-insights.com/insights/vol6no2/vol6no2a.htm.
• Meulenberg F. de Koonings dementia. Lancet 1996;347:1838.
ReferencesReferences
• Miller B. “Alzheimer’s and Artistic Abilities.” Alzheimer’s Association of Northern California and Northern Nevada Newsletter. Winter 2003:pg 1 and 6.
• Morley J. “Aging through the Eye of the Artist.” Aging Successfully. Fall 1999; Vol. IX, No. 3:1-3, 22.
• “Rembrandt.” Webmuseum, Paris. 22 Apr 2003<http://www.ibiblio.org/wm/paint/auth/rembrandt/.>
• Scharlach A and Robinson B. Cirriculum Module on The Aging Process. 22 Apr 2003<http://1st-socrates.berkeley.edu/~aging/ModuleProcess.html.>
• Miller B. “Alzheimer’s and Artistic Abilities.” Alzheimer’s Association of Northern California and Northern Nevada Newsletter. Winter 2003:pg 1 and 6.
• Morley J. “Aging through the Eye of the Artist.” Aging Successfully. Fall 1999; Vol. IX, No. 3:1-3, 22.
• “Rembrandt.” Webmuseum, Paris. 22 Apr 2003<http://www.ibiblio.org/wm/paint/auth/rembrandt/.>
• Scharlach A and Robinson B. Cirriculum Module on The Aging Process. 22 Apr 2003<http://1st-socrates.berkeley.edu/~aging/ModuleProcess.html.>
ReferencesReferences
• “The Self-Portrait as Self-Study.” 22 Apr 2003 http://www.research.umbc.edu/~ivy/selfportrait/study.html.
• “Van Rijn, Rembrandt Harmensz (1606-1669).” 22 Apr 2003<http://www.psych.ucalgary.ca/pace/va-lab/AVDE_Website/rembrandt.html.
• “Visual Aging.” 22 Apr 2003 http://www.psych.ucalgary.ca/pace/va-lab/AVDE-Website/visualaging.html.
• Williams M. Complete Guide to Aging and Health. New York:Harmony Books, 1995.
• “The Self-Portrait as Self-Study.” 22 Apr 2003 http://www.research.umbc.edu/~ivy/selfportrait/study.html.
• “Van Rijn, Rembrandt Harmensz (1606-1669).” 22 Apr 2003<http://www.psych.ucalgary.ca/pace/va-lab/AVDE_Website/rembrandt.html.
• “Visual Aging.” 22 Apr 2003 http://www.psych.ucalgary.ca/pace/va-lab/AVDE-Website/visualaging.html.
• Williams M. Complete Guide to Aging and Health. New York:Harmony Books, 1995.
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