Healthy Aging

Some changes in thinking are considered a normal part of the aging process. We develop many cognitive abilities that appear to peak around age 30 and, on average, decline very subtly with age. These age-related declines most commonly include overall slowness in thinking and difficulties sustaining attention, multitasking, holding information in mind, and word-finding. Research indicates that age-related changes in brain structures, such as decreased hippocampal, frontal, and temporal lobe volumes, are common aspects of aging that contribute to some cognitive changes.

However, not all thinking abilities decline with age. In fact, vocabulary, reading, and verbal reasoning remain unchanged or even improve with age.

Normal Aging vs. Dementia

While mild cognitive changes are considered a normal part of the aging process, dementia is not. Normal age-related declines are subtle and mostly affect thinking speed and attention. In abnormal aging, declines in cognition are more severe and may include other thinking abilities, such as rapid forgetting or difficulties navigating, solving common problems, expressing oneself in conversation, or behaving outside social rules. Abnormal aging can also affect the motor system, leading to excessive tripping, falls, or tremor. Often, it is difficult to determine exactly when a person should be concerned with cognitive changes they may be experiencing. Symptoms vary from person to person – what is normal for one person may not be normal for another. This contributes to the challenges clinicians face when determining whether what someone is experiencing is a significant decline for them or within normal expectations.

Abnormal Aging: Mild Cognitive Impairment vs. Dementia

Mild cognitive impairment (MCI) and dementia are broad terms that indicate that there is a decline in cognition greater than would be expected for that person’s age, education, or development. MCI means that cognitive decline does not affect the person’s ability to carry out everyday tasks (e.g., shopping, cooking, driving), whereas dementia indicates that those cognitive difficulties are affecting the person’s ability to complete everyday tasks. The terms MCI and dementia only tell us the severity of the problem but not the cause; some of the most common causes of MCI and dementia are Alzheimer’s disease, vascular disease, frontotemporal degeneration, and Lewy body disease.

Symptoms to Watch For

  • Getting lost in familiar places
  • Repetitive questioning
  • Odd or inappropriate behaviors
  • Forgetfulness of recent events
  • Repeated falls or loss of balance
  • Personality changes
  • Decline in planning and organization
  • Changes in diet/eating habits
  • Changes in hygiene
  • Increased apathy
  • Changes in language abilities, including comprehension

The progression of cognitive deficits observed in conditions such as Alzheimer’s disease may be accelerated in the few years immediately preceding the diagnosis. Accelerated cognitive decline may not occur until events, such as a life stressor or another illness (e.g., pneumonia), reach a threshold at which the brain can no longer compensate for damage. Thus, it is important to get regular medical check-ups to monitor the extent and severity of cognitive decline. Independent living should not be compromised during normal aging, unlike the transition to a neurodegenerative condition.

Risk Factors for Cognitive Decline

There are several risk factors for Alzheimer’s disease and other causes of dementia. Research suggests approximately 50% of Alzheimer’s disease cases may be related to these modifiable risk factors:

  1. Type 2 diabetes
  2. High blood pressure
  3. Midlife obesity
  4. Smoking
  5. Depression
  6. Little or no mental activity
  7. Little or no physical exercise
What is Brain Health?

Maintaining Your Brain

Research suggests that a combination of good nutrition, physical activity, and mental and social engagement may promote brain health.

  • Stay away from smoking.
  • Exercise at a moderately high level of physical activity. Exercise facilitates the delivery of oxygen and growth factors to the brain and helps modulate the brain’s immune responses.
  • Get routine medical care. Illnesses in your body affect your brain’s ability to function optimally.
  • Maintain excellent cardiovascular health (e.g., blood pressure, cholesterol levels). What’s good for the heart is good for the brain!
  • Build social support networks to reduce stress, challenge your brain, and share the aging process with others who are experiencing the same changes and joys of entering the latter years of life.
  • Keep doing the activities that challenge you and that you enjoy for as long as possible. Trying new activities may be a great way to challenge your brain to make new brain connections. Gardening, playing bridge, walking, reading, or other activities that are complicated enough to involve your mind but don’t add stress to your life are great examples.
  • Maintain a healthy diet. Plan your meals around your vegetables and then fill in with other foods. Otherwise, as a general plan, eat a variety of foods as close to their natural state as possible.

While it is important to remain vigilant about maintaining good health, it is equally important to acknowledge that there are individual differences during the aging process. You should discuss any concerns you may have with a healthcare professional.

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