Use It or Lose It: Preventing Cognitive Decline
Changes in cognitive function, such as slow speed of information processing, are common in normal aging. However, there is considerable variation among individuals, and cognitive decline is not inevitable.
In fact, many older adults appear to avoid cognitive decline into their ninth decade of life, and some even beyond. The best news of all is that some risk factors for cognitive decline are potentially manageable, according to researchers.
Cognition is a combination of skills including:
- Language and speech
- Fine motor skills
- Visuospatial orientation
Executive functions, such as
Three types of cognitive decline with aging have been recognized:
- Age-associated memory impairment (AAMI)—mild memory impairment that can occur with normal aging, but cannot be detected with objective psychometric testing for the person’s age group
- ]]>Mild cognitive impairment]]> (MCI)—mild memory loss that can be detected with objective psychometric testing for the person’s age group
- ]]>Dementia]]> (includes ]]>Alzheimer’s disease]]>)–chronic, progressive, irreversible, global cognitive impairment and memory loss that are severe enough to affect daily functioning
Risk Factors for Cognitive Decline
A number of research studies have identified common, potentially modifiable risk factors for cognitive decline. Some of these risk factors include:
- Lack of mental activity
- Substance use and abuse, including:
- Lack of physical exercise
- Chronic stress
- Certain medical conditions, such as:
- Lack of involvement in social activities
- Taking many kinds of medicines
If you have a medical condition that may be causing your cognitive decline, talk to your doctor.
Vital Activities for a Vital Mind
According to the Mayo Foundation for Medical Education and Research, as you age, your brain remains capable of adapting to stimuli. Although declines occur in certain cognitive functions, other cognitive functions increase with age and can compensate for functions that may decline. Researchers found that people who age with greater amounts of knowledge may be better able to adapt. Vocabulary also tends to improve with age. Certain activities can assist older adults in increasing their capacity to learn and adapt as they age.
The Institute for the Study of Aging and the International Longevity Center recommends the following strategies:
Stay Socially Active
A study in the Annals of Internal Medicine found that having no social ties was an independent risk factor for cognitive decline in older persons. Therefore, maintaining many social connections and participating in social activities are recommended. Researchers suggest that social activities help prevent cognitive decline by stimulating the mind and challenging people to communicate.
Working at a paid or volunteer job may also help. Complex intellectual work has been found to increase the cognitive function of older workers. Work also provides an opportunity for social interactions and a sense of personal mastery, both of which may be important in maintaining the vitality of the brain.
Some studies suggest that having a low level of formal education and poor language skills are risk factors for cognitive decline in later life. However, other studies have not found this association. Nonetheless, many studies on humans and animals suggest that lifelong learning is beneficial in preserving cognitive vitality in later life.
One such study, published in the Journal of the American Medical Association , found that frequent participation in mentally stimulating activities is associated with a reduced risk of Alzheimer’s disease. Mental stimulation is not limited to formal education and can include everyday activities such as:
- Reading books, newspapers, or magazines
- Playing games (eg, cards, checkers, crossword puzzles)
- Going to museums
A number of studies have also shown that older adults with mild cognitive decline can improve cognitive functioning (including reasoning, memory, visual perception, attention, and skill coordination) through special training. However, training is often specific to the skills trained and learned.
Some studies show improved cognitive functioning in older adults who exercise. It is possible that exercise may contribute to cognitive vitality by improving mood and reducing stress and other risk factors that contribute to cognitive decline. Although more research is needed, data suggest that engaging in physical exercise, including enjoyable leisure activities, may help prevent cognitive decline.
Ask Your Doctor About Herbs and Supplements
Malnutrition and vitamin deficiencies can lead to cognitive disorders (including dementia) in older people. For example, ]]>vitamin B12 deficiency]]> can cause confusion. But, what if you do not have a deficiency? Are supplements still helpful? Researchers have studied whether antioxidants, like ]]>vitamin E]]>, are able to slow the progression of Alzheimer's disease. But, the results have been mixed. ]]>Ginkgo biloba]]> has also gotten a lot of attention as researchers try to find out if this herb has any effect on age-related mental decline. As with vitamin E, the results have been conflicting.
If you are considering herbs and supplements, talk to your doctor first. There may be safety issues related to other conditions that you have and other medicines that you are taking.
Eat a Low-Fat Diet
A nutritious, ]]>low-fat diet]]> may protect against cognitive decline by providing necessary nutrients and reducing the risk of diseases that contribute to cognitive decline, such as high blood pressure, ]]>type 2 diabetes,]]> high cholesterol, and atherosclerosis.
Practice Stress Management
Stress, particularly long-term stress, is associated with cognitive impairment, especially in older adults. ]]>Stress management]]> or ]]>counseling]]> may be helpful in learning better responses to stress. This, in turn, can promote cognitive vitality.
Get Help for Sleep Disorders
]]>Sleep disorders]]> and sleep disruption are common in older people. These may adversely affect cognitive function, particularly memory and learning. In addition, older adults with sleep disorders may experience adverse cognitive effects associated with the use of sedatives, which are often prescribed for ]]>insomnia]]> . Older adults may benefit from good sleep strategies, such as going to bed and waking up at the same time each day.
Seek Help for Other Conditions
Cognitive decline in older adults is often associated with underlying medical conditions, such as high blood pressure. Furthermore, many have more than one of these conditions, which may increase their risk for cognitive impairment. Cognitive decline may be slowed when these conditions are treated.
Talk to Your Doctor
If you are concerned about memory loss or other cognitive impairment, do not try to diagnose or treat yourself. Your doctor can provide assessment, counseling, and treatment.
National Council on Aging
National Institute on Aging
Mental Health Canada
Seniors Canada On-line
Alzheimer's disease and non-Alzheimer’s dementia. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=114. Updated September 2009. Accessed January 8, 2010.
Bassuk SS, Glass TA, Berkman LF. Social disengagement and incident cognitive decline in community-dwelling elderly persons. Ann Intern Med. 1999;131:165-173.
Enhancing memory and mental function. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=114 . Updated July 2008. Accessed July 29, 2008.
Fillit HM, Butler RN, O’Connell AW, et al. Achieving and maintaining cognitive vitality with aging. Mayo Clin Proc . 2002; 77: 681-696.
The Institute for the Study of Aging and the International Longevity Center-USA website. Available at: http://www.aging-institute.org . Accessed July 29, 2008.
Wilson RS, Mendes de Leon CF, et al. Participation in cognitively stimulating activities and risk of incident Alzheimer's disease. J Am Med Assoc . 2002; 287:742-748.
Yaffe K, Blackwell T, Gore R, et al. Depressive symptoms and cognitive decline in nondemented elderly women. Arch Gen Psychiatry . 1999;56: 425-430.
1/8/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Snitz BE, O'Meara ES, Carlson MC, et al. Ginkgo biloba for preventing cognitive decline in older adults: a randomized trial. JAMA. 2009;302:2663-2670.
Last reviewed June 2010 by ]]>Brian Randall, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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