By Leslie Kernisan
Want to stay mentally sharp for as long as possible?
Myth: Maintaining cognitive health means preserving your memory.
Fact: Cognitive health is far more than having a good memory. It also involves decision-making, attention and problem-solving.
Myth: Cognitive function always declines with age.
Fact: Aging can have positive and negative effects on cognition.
Myth: Brain neurons die as you age, so there is no way to prevent cognitive decline.
Fact: In the absence of disease, neuron death is minimal.
Myth: There is nothing you can do to improve your cognitive health.
Fact: There are actions individuals and families can take to help support their cognitive health and adapt to age-related cognitive changes.
6 Ways to Protect Your Brain as You Age:
In its full report, the IOM devotes 120 pages to reviewing the factors that affect cognitive aging, along with interventions that might improve brain health. It summarizes the most important suggestions for the public in its handy action guide, and I’ve paraphrased them below (the first three are the most important):
- Be physically active.
- Reduce your cardiovascular risk factors (including hypertension, diabetes and smoking).
- Manage your medications by reviewing them with a clinician and learning about their effects on cognitive health.
- Be socially and intellectually active.
- Get adequate sleep.
- Learn to prevent delirium, a decrease in cognitive function that can be triggered by hospitalization, medications or certain illnesses.
Risky Medications and Delirium Prevention
All six of these recommendations are important and useful. But two particularly caught my eye, because they are actions that we especially focus on in geriatrics: medication management and delirium prevention.
Now I hate to say this, but I think you should know the truth: We geriatricians focus on them in part because they are often overlooked by our doctor colleagues. Most clinicians are very busy and usually have not had special training in modifying healthcare to be a better fit for older adults.
The IOM’s “Action Guide for Health Care Providers” spells out what doctors should be doing in those areas. For instance, it mentions that the use of over-the-counter anticholinergics should be assessed. (This is a topic I covered recently in a Next Avenue blog post.)
We hope that many health providers read this IOM action guide and modify their work accordingly.
But here’s an insider tip from me to you: When you find out that expert organizations feel the need to remind doctors to do something, that’s a sign that doctors aren’t doing it reliably. Which means it is smart to be proactive and remind your doctors to help you.
Why Seniors Get Delirium
Delirium is an incredibly common and important health complication that affects seniors.
It’s basically a state of worse-than-usual mental function that can be brought on by some illness or stress on the body or mind. It is the reason older adults are often confused after surgery, but can also be the only outward sign of a potentially serious infection in someone living at home. Delirium is associated with all kinds of bad health outcomes, including longer hospital stays, health complications and even acceleration of cognitive decline. But you can help prevent it, or at least make sure it gets noticed and managed promptly.
The IOM reports that cognitive aging can affect an older adult’s ability to manage complex tasks such as driving and finances. It notes that victims of financial elder abuse lose billions every year. (My guess is that many of those victims are suffering from more than cognitive aging, but yes, this is a serious problem.)
Nutrition and Other Approaches for Brain Health
In preparing this report, the IOM conducted a comprehensive review of different approaches that have been studied in relation to cognitive health. So if you are wondering about a particular approach that’s not mentioned above, chances are it is covered in the full report.
The summary on the effect of various diets, including the Mediterranean diet, is here and the summary regarding vitamins, including antioxidants, starts here.
Basically, for now the IOM has concluded that some of the dietary approaches have promise but we need more research to confirm their effectiveness. The report also concludes that the medical literature doesn’t convincingly support vitamin supplementation to prevent cognitive decline.
If You or a Relative Has Alzheimer’s
Part of the purpose of the IOM report is to draw attention to cognitive aging as a health issue that is distinct from dementia and deserves its own attention from the public, practicing clinicians and researchers.
This is a reasonable position. That said, if you’re concerned about brain health for someone with a dementia diagnosis, you should know this: The cognitive aging recommendations listed above do improve the brain health of people with Alzheimer’s or another form of dementia.
Why? Because the recommendations are basically about how you can optimize brain health and brain function; they apply whether a person has experienced brain aging or extra damage from a disease.
If we can all do better in helping people optimize their brain health and in compensating for any cognitive aging, our society will be a better place for aging Americans.
Biology of Aging: Research Today for a Healthier Tomorrow is a 2-hour online continuing education (CE/CEU) course that introduces some key areas of research and looks ahead to the future, as today’s research provides the strongest hints of things to come.
Alzheimer’s Disease Progress Report: Intensifying the Research Effort is a 3-hour online continuing education (CE/CEU) course that reviews basic mechanisms and risk factors of AD and details recent research findings.
Aging: The Unraveling Self is a 3-hour online continuing education (CE/CEU) course that examines the biological, social, and psychological aspects of aging.
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