COMMENTARY

Cognitive Health for an Aging Population

Laura A. Stokowski, RN, MS

Disclosures

November 16, 2009

In This Article

What Can Be Accomplished Now?

I asked Lynda Anderson, PhD, of the CDC's Healthy Aging Program, why government agencies aren't recommending specific strategies for maintaining cognitive health. Using the example of physical activity and cognition, Anderson explained, "Science points to an association between physical activity and cognition, so we could say that physical activity is good for your brain. However, research hasn't yet identified the type, frequency, duration, or intensity of physical activity needed to improve cognition or prevent cognitive decline. So we can't identify a specific physical activity intervention, program, or regime that has been shown to improve cognition or prevent cognitive decline."

Ongoing research is trying to clarify the relationships among physical inactivity, vascular risk factors, and cognitive health status. Devising specific brain health strategies that are firmly grounded in science is a complex and time-consuming effort, and we may not have the answers we want for years to come.

In the meantime, our rapidly aging generation of baby boomers compels us to take action now, by using the best available evidence regarding health behaviors that hold the greatest promise for preventing cognitive decline.[18] The causes of cognitive decline are multifactorial, so it makes sense to pursue easily accomplished strategies like correcting vitamin D deficiency, which has been shown to affect cognitive performance,[38] in the elderly and counseling patients regarding other interventions that have a high benefit-to-risk ratio in achieving cognitive health and halting cognitive decline, such as the following:

  • Reducing vascular risk factors by treating hypertension and high cholesterol, and stopping smoking;

  • Keeping body weight and blood sugar under control;

  • Exercising and avoiding physical inactivity. Engaging in activities such as walking, bicycling, gardening, tai chi, yoga, and other activities for about 30 minutes daily;

  • Avoiding head injuries;

  • Following a heart-healthy, brain-healthy, low-fat diet, rich in antioxidants, with a moderate alcohol intake; considering vitamin supplements;

  • Treating emotional health issues, such as depression and stress;

  • Staying mentally active by staying curious and involved, committing to lifelong learning, reading, writing, working on puzzles, attending plays or lectures, playing games, gardening, or pursuing memory exercises; and

  • Remaining socially active by engaging in social and leisure activities through volunteering, traveling, or joining social clubs.

Most of these interventions are already in the public health realm of health promotion and disease prevention; but individual compliance may profit from the added emphasis on brain health, particularly given the public's rising fears related to AD. In many cases, the benefits will be cumulative. For example, not only is increased physical activity strongly associated with improved cognitive function, but also the secondary benefits of reducing cardiovascular disease and other medical conditions associated with cognitive decline could be considerable.[26] Even moderate exercise such as walking has been associated with better cognitive function.[39]

The critical nature of brain health must be on par with cardiovascular health, reducing obesity, and preventing type 2 diabetes and cancer, not only at the community-prevention level but also on a one-on-one level in primary prevention. Healthcare providers can't continue to compartmentalize health, talking only about "neck-down" healthy living. The assessment of cognitive health must be fully integrated into all healthcare encounters, and cognitive health issues must be incorporated into the counseling of clients on how to live a longer, healthier life.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....