Hemispheric organization of the brain and its prevailing impact on the neuropsychology of aging.

Age differences in brain hemispheric asymmetry have figured prominently in the neuropsychology of aging. Here, a broad overview of these empirical and theoretical approaches is provided that dates back to the 1970s and continues to the present day. Methodological advances often brought new evidence to bear on older ideas and promoted the development of new ones. The deficit-focused hypothesis of accelerated right-hemisphere aging is reviewed first, followed by subsequent accounts pertaining to compensation, reserve, and their potential hemispheric underpinnings. Structural and functional neuroimaging reveal important and consistent age-related patterns, including indications of reduced brain asymmetry in older relative to younger adults. While not mutually exclusive, different neuropsychologic theories of aging offer divergent interpretations of such patterns, including age-related reductions in neural specificity (dedifferentiation) and age-related compensatory bilateral recruitment [e.g., Hemispheric Asymmetry Reduction in Older Adults (HAROLD); Compensation-Related Utilization of Neural Circuits Hypothesis (CRUNCH)]. Further, recent neurobehavioral evidence suggests that the right hemisphere plays a unique role in resisting the neurocognitive effects of aging via brain reserve. Future advances in human cognitive neuroscience, including neurostimulation methods for targeted interventions, along with analytic techniques informed by machine learning promise new insights into the neuropsychology of aging and the role of hemispheric processes in resilience and decline.