Cognitive Ability in the Elderly: The Role of Self-Transcendence, Self-Compassion and Positive Affect

Document Type : Original Article

Authors

1 Associate Professor, Department of Counseling, Shahid Bahonar University of Kerman, Kerman, Iran

2 Department of psychology, Faculty of literature and humanities, Shahid Bahonar University of Kerman, Kerman, Iran

3 , Department of Psychology, Shahid Bahonar University, Kerman, Iran

Abstract

Aging is associated with unavoidable changes in cognitive abilities. Therefore, considering the aging of the population and the importance of cognitive functions at this sensitive age, identifying the factors affecting cognitive ability among elderly to strengthen their cognitive functions deserves attention. The present study aimed to investigate the role of self-transcendence, self-compassion and positive affect in predicting cognitive ability in elderly. It was a descriptive-correlational study. The statistical population of this study included all elderly (60 to 70 year) in Kerman from 2019 to 2020. 208 elderly participants were selected using convenience sampling from Kerman Province Retirement Association. The research instruments were Nejati Cognitive Ability Questionnaire, Neff Compassion Scale, and Levinson Self-Transcendence Questionnaire. Data were analyzed using Pearson correlation coefficient and multiple regression. The results of Pearson correlation coefficient showed the significant positive relationship between self-transcendence and cognitive ability in the elderly. Besides, a significant positive relationship was reported between self-compassion and cognitive ability in the elderly. Furthermore, these results also suggested a significant positive relationship between positive affect and cognitive ability in elderly. The results of regression analysis also showed that self-transcendence and positive affect can positively predict cognitive ability in elderly. However, self-compassion was not a predictor of cognitive ability in elderly. Therefore, using therapeutic techniques based on self-transcendence theory and providing therapeutic interventions based on increasing positive affect, it is possible to promote cognitive ability and prevent cognitive failures in elderly.

 References
 
Alea, N., Ali, S., & Arneaud, M. J. (2017). What I value and why I remember: Values and the functions of memory in a Trinidadian lifespan sample. The International Journal of Reminiscence and Life Review, 4(2), 67-78.
Allen, A. B., Goldwasser, E. R., & Leary, M. R. (2012). Self-compassion and well-being among older adults. Self and Identity, 11(4), 428-453.
Baharvandi, B., KazemianMoghadam, K., Haroon Rashidi, H. (2020). The Effectiveness of Compassion-Focused Therapy on Ambiguity Tolerance and Death Anxiety in the Elderly. Aging Psychology, 6(1), 13-26. [Persian]
Brown, L., Huffman, J. C., & Bryant, C. (2019). Self-compassionate aging: A systematic review. The Gerontologist, 59(4), 311-324.
Castro-Schilo, L., Fredrickson, B. L., & Mungas, D. (2019). Association of positive affect with cognitive health and decline for elder Mexican Americans. Journal of Happiness Studies, 20(8), 2385-2400.
Chiesa, A., Calati, R., & Serretti, A. (2011). Does mindfulness training improve cognitive abilities? A systematic review of neuropsychological findings. Clinical Psychology Review, 31(3), 449-464.
Chu, S. T. W., Fung, H. H., & Chu, L. (2019). Is Positive affects related to meaning in life differently in younger and older adults? A time sampling study. The Journals of Gerontology: Series B, gbz086, 1-9. https://doi.org/10.1093/geronb/gbz086
Cleare, S., Gumley, A., & O'Connor, R. C. (2019). Self‐compassion, self‐forgiveness, suicidal ideation, and self‐harm: A systematic review. Clinical Psychology & Psychotherapy, 26(5), 511-530. https://doi:10.1002/cpp.2372
Cox, S. R., MacPherson, S. E., Ferguson, K. J., Nissan, J., Royle, N. A., MacLullich, A. M. J., Wardlaw, J. M., & Deary, I. J. (2014). Correlational structure of ‘frontal’ tests and intelligence tests indicates two components with asymmetrical neurostructural correlates in old age. Intelligence, 46, 94-106.
DeYoung, C. G., Quilty, L. C., Peterson, J. B., & Gray, J. R. (2014). Openness to experience, intellect, and cognitive ability. Journal of Personality Assessment, 96(1), 46-52.
Fang, Z., Ray, L. B., Owen, A. M., & Fogel, S. (2017). Neural Correlates of human cognitive abilities during sleep. BioRxiv, Article 130500. https://doi.org/10.1101/130500
Farhadi, M., Alizadeh G., & Kordnoghabi, R. (2017). The investigation Factor analysis of the Adult Self-Transcendence Inventory in  
Bu Ali Sina University students. Quarterly of Educational Measurement, 7(28), 241-255. [Persian]
Foong, H. F., Hamid, T. A., Ibrahim, R., Haron, S. A., & Shahar, S. (2018). Predicting cognitive function of the Malaysian elderly: A Structural equation modelling approach. Aging & Mental Health, 22(1), 109-120.
Garland, E. L., Geschwind, N., Peeters, F., & Wichers, M. (2015). Mindfulness training promotes upward spirals of positive affect and cognition: multilevel and autoregressive latent trajectory modeling analyses. Frontiers in Psychology, 6, 15.
Hahn, M., Joechner, A. K., Roell, J., Schabus, M., Heib, D. P., Gruber, G., Peigneux, Ph. & Hoedlmoser, K. (2019). Developmental changes of sleep spindles and their impact on sleep‐dependent memory consolidation and general cognitive abilities: A longitudinal approach. Developmental Science, 22(1), Article e12706.
Hashemi, Z., Eyni, S. (2020). Perceived Stress in the Elderly: The Role of Spiritual Intelligence, Self-Compassion, and Psychological Hardiness. Aging Psychology, 5(4), 289-299. [Persian]
Herriot, H., Wrosch, C., & Gouin, J. P. (2018). Self-compassion, chronic age-related stressors, and diurnal cortisol secretion in older adulthood. Journal of Behavioral Medicine, 41(6), 850-862.
Hsu, Y. C., & Wright, C. L. (2019). The effects of a Socially Supportive Activities Program (SSAP) on mood in long term care: A pilot study. Geriatric Nursing, 40(6), 572-578.
Kang, Y., Cooper, N., Pandey, P., Scholz, C., O’Donnell, M. B., Lieberman, M. D., Taylor, S. E., Strecher, V. J., Dal Cin, S., Konrath, S., Polk, T. A., Resnicow, K., An, L., & Falk, E. B. (2018). Effects of self-transcendence on neural responses to persuasive messages and health behavior change. Proceedings of the National Academy of Sciences of the United States of America, 115(40), 9974–9979.
Khosravi, S., Sadeghi, M., Yabandeh, M.R. (2013). Psychometric Properties of Self-Compassion Scale (SCS). Journal of Psychological Models and Methods, 4(13), 47-59. [Persian]
Kim, C., & Ko, H. (2018). The impact of self-compassion on mental health, sleep, quality of life and life satisfaction among older adults. Geriatric Nursing, 39(6), 623-628.
Klimecki, O. M., Leiberg, S., Ricard, M., & Singer, T. (2014). Differential pattern of functional brain plasticity after compassion and empathy training. Social Cognitive and Affective Neuroscience, 9(6), 873-879.
Le, T. N. (2011). Life satisfaction, openness value, self-transcendence, and wisdom. Journal of Happiness Studies, 12(2), 171-182.
Lee, P. L. (2016). A joyful heart is good medicine: Positive affect predicts memory complaints. The American Journal of Geriatric Psychiatry, 24(8), 662-670.
Lee, S. (2015). An exploration of antecedents of positive affect among the elderly: a cross-sectional study. The European Journal of Public Health, 26(1), 187-191.
Leung, P., Orgeta, V., Musa, A., & Orrell, M. (2019). Emotional distress mediates the relationship between cognitive failures, dysfunctional coping, and life satisfaction in older people living in sheltered housing: A structural equation modelling approach. International Journal of Geriatric Psychiatry, 34(1), 179-185.
Levenson, M. R., Jennings, P. A., Aldwin, C. M., & Shiraishi, R. W. (2005). Self-transcendence: Conceptualization and measurement. The International Journal of Aging and Human Development, 60(2), 127-143.
Lim, K. H. L., Pysklywec, A., Plante, M., & Demers, L. (2019). The effectiveness of Tai Chi for short-term cognitive function improvement in the early stages of dementia in the elderly: a systematic literature review. Clinical Interventions in Aging, 14, 827.
Martela, F., Ryan, R. M., & Steger, M. F. (2018). Meaningfulness as satisfaction of autonomy, competence, relatedness, and beneficence: Comparing the four satisfactions and positive affect as predictors of meaning in life. Journal of Happiness Studies, 19(5), 1261-1282.
Meyer, L. P., & Leppma, M. (2019). The Role of Mindfulness, Self‐Compassion, and Emotion Regulation in Eating Disorder Symptoms among College Students. Journal of College Counseling, 22(3), 211-224.
Mousavi, F., Rozsa, S., Nilsson, T., Archer, T., Anckarsäter, H., & Garcia, D. (2015). Personality and intelligence: persistence, not self-directedness, cooperativeness or self-transcendence is related to twins’ cognitive abilities. Journal of Peer-Reviewed, 3, Article e1195.
Neff, K. (2003). The development and validation of a scale to measure self-compassion. Self and Identity, 2, 223–250.
Nejati V. (2013). Cognitive Abilities Questionnaire: Development and Evaluation of Psychometric Properties. Advances in Cognitive Sciences, 15(2), 11-19. [Persian].
Ngernsukphaiboon, T., Chantranuwathana, S., Noomwongs, N., Sripakagorn, A., & Hemrungrojn, S. (2016). A Study on Car Following and Cognitive Ability of Elderly Drivers by Using Driving Simulator (No. 2016-01-1737). SAE Technical Paper.
Park, H., Chey, J., & Lee, J. (2017). Vocabulary knowledge is not a predictor of general cognitive functioning in elderly people with very low educational attainment. Dementia and Neurocognitive Disorders, 16(1), 20-25.
Phenice, L. A., & Griffore, R. J. (2013). The importance of object memories for older adults. Educational Gerontology, 39(10), 741-749.
Ramanoël, S., Hoyau, E., Kauffmann, L., Renard, F., Pichat, C., Boudiaf, N., Krainik, A., Jaillard, A., & Baciu, M. (2018). Grey matter volume and cognitive performance during normal aging. A Voxel-Based Morphometry study. Frontiers in Aging Neuroscience, 10, Article 235.
Rammstedt, B., Danner, D., & Martin, S. (2016). The association between personality and cognitive ability: Going beyond simple effects. Journal of Research in Personality, 62, 39-44.
Reed, P. G. (2013). Theory of self-transcendence. In M. J. Smith & P. J. Liehr (Eds.), Middle Range Theory for Nursing (3rd ed.,) (pp. 109-140). Springer.
Reed, A. E., & Carstensen, L. L. (2012). The theory behind the age-related positivity effect. Frontiers in Psychology, 3, Article 339. https://doi.org/10.3389/fpsyg.2012.00339
Rikoon, S. H., Brenneman, M., Kim, L. E., Khorramdel, L., MacCann, C., Burrus, J., & Roberts, R. D. (2016). Facets of conscientiousness and their differential relationships with cognitive ability factors. Journal of Research in Personality, 61, 22-34.
Schubert, A. L., Nunez, M. D., Hagemann, D., & Vandekerckhove, J. (2019). Individual differences in cortical processing speed predict cognitive abilities: a model-based cognitive neuroscience account. Computational Brain & Behavior, 2(2), 64-84.
Shin, H. S., Black, D. S., Shonkoff, E. T., Riggs, N. R., & Pentz, M. A. (2016). Associations among dispositional mindfulness, self-compassion, and executive function proficiency in early adolescents. Mindfulness, 7(6), 1377-1384.
Sommers-Spijkerman, M., Trompetter, H., Schreurs, K., & Bohlmeijer, E. (2018). Pathways to improving mental health in compassion-focused therapy: Self-reassurance, self-criticism and affect as mediators of change. Frontiers in Psychology, 5(9), Article 2442.
Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th Ed.). Boston: Allyn & Bocon.
Varaee, P., Momeni, K., Moradi, A. (2017). The Prediction of psychological well-being based on religiosity and self-compassion in the elderly. Aging Psychology, 3(1), 45-54. [Persian]
Vitale, S. A., Shaffer, C. M., & Acosta Fenton, H. R. (2014). Self-transcendence in Alzheimer’s disease: The application of theory to practice. Journal of Holistic Nursing, 32(4), 347-355.
Walsh, S. M., Lamet, A. R., Lindgren, C. L., Rillstone, P., Little, D. J., Steffey, C. M., Rafalko, SY., Sonshine, R. (2011). Art in Alzheimer's Care: Promoting Well‐Being in People with Late‐Stage Alzheimer's disease. Rehabilitation Nursing, 36(2), 66-72.
Watson D, Clark LA, Tellegen A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063-1070.
Wild, C. J., Nichols, E. S., Battista, M. E., Stojanoski, B., & Owen, A. M. (2018). Dissociable effects of self-reported daily sleep duration on high-level cognitive abilities. Sleep, 41(12), Article zsy182. https://doi.org/10.1093/sleep/zsy182
 

 

Keywords

References

                                                                     References
 
Alea, N., Ali, S., & Arneaud, M. J. (2017). What I value and why I remember: Values and the functions of memory in a Trinidadian lifespan sample. The International Journal of Reminiscence and Life Review, 4(2), 67-78.
Allen, A. B., Goldwasser, E. R., & Leary, M. R. (2012). Self-compassion and well-being among older adults. Self and Identity, 11(4), 428-453.
Baharvandi, B., KazemianMoghadam, K., Haroon Rashidi, H. (2020). The Effectiveness of Compassion-Focused Therapy on Ambiguity Tolerance and Death Anxiety in the Elderly. Aging Psychology, 6(1), 13-26. [Persian]
Brown, L., Huffman, J. C., & Bryant, C. (2019). Self-compassionate aging: A systematic review. The Gerontologist, 59(4), 311-324.
Castro-Schilo, L., Fredrickson, B. L., & Mungas, D. (2019). Association of positive affect with cognitive health and decline for elder Mexican Americans. Journal of Happiness Studies, 20(8), 2385-2400.
Chiesa, A., Calati, R., & Serretti, A. (2011). Does mindfulness training improve cognitive abilities? A systematic review of neuropsychological findings. Clinical Psychology Review, 31(3), 449-464.
Chu, S. T. W., Fung, H. H., & Chu, L. (2019). Is Positive affects related to meaning in life differently in younger and older adults? A time sampling study. The Journals of Gerontology: Series B, gbz086, 1-9. https://doi.org/10.1093/geronb/gbz086
Cleare, S., Gumley, A., & O'Connor, R. C. (2019). Self‐compassion, self‐forgiveness, suicidal ideation, and self‐harm: A systematic review. Clinical Psychology & Psychotherapy, 26(5), 511-530. https://doi:10.1002/cpp.2372
Cox, S. R., MacPherson, S. E., Ferguson, K. J., Nissan, J., Royle, N. A., MacLullich, A. M. J., Wardlaw, J. M., & Deary, I. J. (2014). Correlational structure of ‘frontal’ tests and intelligence tests indicates two components with asymmetrical neurostructural correlates in old age. Intelligence, 46, 94-106.
DeYoung, C. G., Quilty, L. C., Peterson, J. B., & Gray, J. R. (2014). Openness to experience, intellect, and cognitive ability. Journal of Personality Assessment, 96(1), 46-52.
Fang, Z., Ray, L. B., Owen, A. M., & Fogel, S. (2017). Neural Correlates of human cognitive abilities during sleep. BioRxiv, Article 130500. https://doi.org/10.1101/130500
Farhadi, M., Alizadeh G., & Kordnoghabi, R. (2017). The investigation Factor analysis of the Adult Self-Transcendence Inventory in  
Bu Ali Sina University students. Quarterly of Educational Measurement, 7(28), 241-255. [Persian]
Foong, H. F., Hamid, T. A., Ibrahim, R., Haron, S. A., & Shahar, S. (2018). Predicting cognitive function of the Malaysian elderly: A Structural equation modelling approach. Aging & Mental Health, 22(1), 109-120.
Garland, E. L., Geschwind, N., Peeters, F., & Wichers, M. (2015). Mindfulness training promotes upward spirals of positive affect and cognition: multilevel and autoregressive latent trajectory modeling analyses. Frontiers in Psychology, 6, 15.
Hahn, M., Joechner, A. K., Roell, J., Schabus, M., Heib, D. P., Gruber, G., Peigneux, Ph. & Hoedlmoser, K. (2019). Developmental changes of sleep spindles and their impact on sleep‐dependent memory consolidation and general cognitive abilities: A longitudinal approach. Developmental Science, 22(1), Article e12706.
Hashemi, Z., Eyni, S. (2020). Perceived Stress in the Elderly: The Role of Spiritual Intelligence, Self-Compassion, and Psychological Hardiness. Aging Psychology, 5(4), 289-299. [Persian]
Herriot, H., Wrosch, C., & Gouin, J. P. (2018). Self-compassion, chronic age-related stressors, and diurnal cortisol secretion in older adulthood. Journal of Behavioral Medicine, 41(6), 850-862.
Hsu, Y. C., & Wright, C. L. (2019). The effects of a Socially Supportive Activities Program (SSAP) on mood in long term care: A pilot study. Geriatric Nursing, 40(6), 572-578.
Kang, Y., Cooper, N., Pandey, P., Scholz, C., O’Donnell, M. B., Lieberman, M. D., Taylor, S. E., Strecher, V. J., Dal Cin, S., Konrath, S., Polk, T. A., Resnicow, K., An, L., & Falk, E. B. (2018). Effects of self-transcendence on neural responses to persuasive messages and health behavior change. Proceedings of the National Academy of Sciences of the United States of America, 115(40), 9974–9979.
Khosravi, S., Sadeghi, M., Yabandeh, M.R. (2013). Psychometric Properties of Self-Compassion Scale (SCS). Journal of Psychological Models and Methods, 4(13), 47-59. [Persian]
Kim, C., & Ko, H. (2018). The impact of self-compassion on mental health, sleep, quality of life and life satisfaction among older adults. Geriatric Nursing, 39(6), 623-628.
Klimecki, O. M., Leiberg, S., Ricard, M., & Singer, T. (2014). Differential pattern of functional brain plasticity after compassion and empathy training. Social Cognitive and Affective Neuroscience, 9(6), 873-879.
Le, T. N. (2011). Life satisfaction, openness value, self-transcendence, and wisdom. Journal of Happiness Studies, 12(2), 171-182.
Lee, P. L. (2016). A joyful heart is good medicine: Positive affect predicts memory complaints. The American Journal of Geriatric Psychiatry, 24(8), 662-670.
Lee, S. (2015). An exploration of antecedents of positive affect among the elderly: a cross-sectional study. The European Journal of Public Health, 26(1), 187-191.
Leung, P., Orgeta, V., Musa, A., & Orrell, M. (2019). Emotional distress mediates the relationship between cognitive failures, dysfunctional coping, and life satisfaction in older people living in sheltered housing: A structural equation modelling approach. International Journal of Geriatric Psychiatry, 34(1), 179-185.
Levenson, M. R., Jennings, P. A., Aldwin, C. M., & Shiraishi, R. W. (2005). Self-transcendence: Conceptualization and measurement. The International Journal of Aging and Human Development, 60(2), 127-143.
Lim, K. H. L., Pysklywec, A., Plante, M., & Demers, L. (2019). The effectiveness of Tai Chi for short-term cognitive function improvement in the early stages of dementia in the elderly: a systematic literature review. Clinical Interventions in Aging, 14, 827.
Martela, F., Ryan, R. M., & Steger, M. F. (2018). Meaningfulness as satisfaction of autonomy, competence, relatedness, and beneficence: Comparing the four satisfactions and positive affect as predictors of meaning in life. Journal of Happiness Studies, 19(5), 1261-1282.
Meyer, L. P., & Leppma, M. (2019). The Role of Mindfulness, Self‐Compassion, and Emotion Regulation in Eating Disorder Symptoms among College Students. Journal of College Counseling, 22(3), 211-224.
Mousavi, F., Rozsa, S., Nilsson, T., Archer, T., Anckarsäter, H., & Garcia, D. (2015). Personality and intelligence: persistence, not self-directedness, cooperativeness or self-transcendence is related to twins’ cognitive abilities. Journal of Peer-Reviewed, 3, Article e1195.
Neff, K. (2003). The development and validation of a scale to measure self-compassion. Self and Identity, 2, 223–250.
Nejati V. (2013). Cognitive Abilities Questionnaire: Development and Evaluation of Psychometric Properties. Advances in Cognitive Sciences, 15(2), 11-19. [Persian].
Ngernsukphaiboon, T., Chantranuwathana, S., Noomwongs, N., Sripakagorn, A., & Hemrungrojn, S. (2016). A Study on Car Following and Cognitive Ability of Elderly Drivers by Using Driving Simulator (No. 2016-01-1737). SAE Technical Paper.
Park, H., Chey, J., & Lee, J. (2017). Vocabulary knowledge is not a predictor of general cognitive functioning in elderly people with very low educational attainment. Dementia and Neurocognitive Disorders, 16(1), 20-25.
Phenice, L. A., & Griffore, R. J. (2013). The importance of object memories for older adults. Educational Gerontology, 39(10), 741-749.
Ramanoël, S., Hoyau, E., Kauffmann, L., Renard, F., Pichat, C., Boudiaf, N., Krainik, A., Jaillard, A., & Baciu, M. (2018). Grey matter volume and cognitive performance during normal aging. A Voxel-Based Morphometry study. Frontiers in Aging Neuroscience, 10, Article 235.
Rammstedt, B., Danner, D., & Martin, S. (2016). The association between personality and cognitive ability: Going beyond simple effects. Journal of Research in Personality, 62, 39-44.
Reed, P. G. (2013). Theory of self-transcendence. In M. J. Smith & P. J. Liehr (Eds.), Middle Range Theory for Nursing (3rd ed.,) (pp. 109-140). Springer.
Reed, A. E., & Carstensen, L. L. (2012). The theory behind the age-related positivity effect. Frontiers in Psychology, 3, Article 339. https://doi.org/10.3389/fpsyg.2012.00339
Rikoon, S. H., Brenneman, M., Kim, L. E., Khorramdel, L., MacCann, C., Burrus, J., & Roberts, R. D. (2016). Facets of conscientiousness and their differential relationships with cognitive ability factors. Journal of Research in Personality, 61, 22-34.
Schubert, A. L., Nunez, M. D., Hagemann, D., & Vandekerckhove, J. (2019). Individual differences in cortical processing speed predict cognitive abilities: a model-based cognitive neuroscience account. Computational Brain & Behavior, 2(2), 64-84.
Shin, H. S., Black, D. S., Shonkoff, E. T., Riggs, N. R., & Pentz, M. A. (2016). Associations among dispositional mindfulness, self-compassion, and executive function proficiency in early adolescents. Mindfulness, 7(6), 1377-1384.
Sommers-Spijkerman, M., Trompetter, H., Schreurs, K., & Bohlmeijer, E. (2018). Pathways to improving mental health in compassion-focused therapy: Self-reassurance, self-criticism and affect as mediators of change. Frontiers in Psychology, 5(9), Article 2442.
Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th Ed.). Boston: Allyn & Bocon.
Varaee, P., Momeni, K., Moradi, A. (2017). The Prediction of psychological well-being based on religiosity and self-compassion in the elderly. Aging Psychology, 3(1), 45-54. [Persian]
Vitale, S. A., Shaffer, C. M., & Acosta Fenton, H. R. (2014). Self-transcendence in Alzheimer’s disease: The application of theory to practice. Journal of Holistic Nursing, 32(4), 347-355.
Walsh, S. M., Lamet, A. R., Lindgren, C. L., Rillstone, P., Little, D. J., Steffey, C. M., Rafalko, SY., Sonshine, R. (2011). Art in Alzheimer's Care: Promoting Well‐Being in People with Late‐Stage Alzheimer's disease. Rehabilitation Nursing, 36(2), 66-72.
Watson D, Clark LA, Tellegen A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063-1070.
Wild, C. J., Nichols, E. S., Battista, M. E., Stojanoski, B., & Owen, A. M. (2018). Dissociable effects of self-reported daily sleep duration on high-level cognitive abilities. Sleep, 41(12), Article zsy182. https://doi.org/10.1093/sleep/zsy182
 
 

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  • Receive Date: 07 July 2020
  • Revise Date: 05 August 2020
  • Accept Date: 09 August 2020

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