Cognitive Health in Older Adults

OlderAdultCare.com Team Written by OlderAdultCare.com teamDr. Burak Gezen, M.D.Medically reviewed by Dr. Burak E. Gezen M.D.
Cognitive Health

Cognitive health is how well you think, learn, and remember. It includes functions like emotional responses, motor skills, and sensory responses. It’s a major component of quality of life and independence for older adults. Once cognitive health starts to decline, a person may begin to lose their ability to care for themselves. They might start to forget where they live, how to get dressed, or how to eat. It usually occurs as a gradual process and might start with trouble remembering words or names, trouble concentrating, or learning at a slower pace.

It describes how you think, feel, and behave. Stress, anxiety, and depression can affect our mental health. When it does, it can cause physical symptoms and psychological symptoms too.

1. What is Cognitive Impairment in Seniors? 

What is Cognitive Health in Older Adults

As we age, it’s natural to have some cognitive decline. Age-related decline includes learning things at a slower pace, some attention issues, trouble with multitasking, and trouble finding words. You might even forget a person’s name you met only a few times.

However, it should never get to the point where it affects your everyday life. You shouldn’t get lost on your way home or forget a loved one’s name or birthdate. When you begin to forget important events like this or start to have major personality changes for seemingly no reason, then it becomes a concern.

Cognitive impairment comes in the form of symptoms. For example, people might have trouble remembering important events, learning new material, lacks concentration, or they might not be able to make decisions. The last point doesn’t mean indecisiveness. It means they truly can’t function to decide on everyday life occurrences. People that have cognitive impairments experience a daily disturbance to their lives.

Impairment in older adults is caused by a variety of reasons. Most common disorder is called mild cognitive impairment. For some, their medication might have a side effect, metabolic or endocrine derangements, delirium due to illnesses like a UTI or infection, depression, certain health conditions, and dementia.

Cognitive disorders can include dementia, amnesia, or delirium. These disorders affect everyday life. Time and space become disoriented. Some forms are temporary like delirium, and others are progressive like dementia. Cognitive disorders range on their causes and many don’t have a cause but can be treated. These treatments are designed to minimize symptoms to restore as much cognitive function as possible.

2. What are the Types of Cognitive Impairments? 

What are the Types of Cognitive Impairments

The most common forms of cognitive impairments don’t have cures but do have treatments. You can slow the progression down as well. There are some impairments that are caused by conditions or medications that resolve themselves once treated. For this article, we will focus on the most common types of cognitive impairments.

What is Dementia?

Dementia is a group of symptoms associated with a decline in memory, reasoning skills, and thinking skills. There are many types of dementia and conditions that can cause dementia. Alzheimer’s is the most common cause of dementia and results in about 80% of causes. It’s important to note that dementia isn’t a normal part of the aging process.

2.1 Mild Cognitive Impairment

Mild Cognitive Impairment is typically anormal occurrence in older adults. It is often noticed a subjective decline in language, mental function and thinking. MCI is more of a nuisance rather than a barrier to independent living. If the cognitive impairment is severe enough to affect independent living then more severe cognitive impairment might be present.

2.2 Delirium or Encephalopathy

Delirium and Encephalopathy is an acute deterioration of cognitive function. Common causes include infection such as UTI, medication side effects, or any other medical illnesses. Any rapid in cognitive function should be evaluated by your doctor.

Some over counter medications such as some antihistamines, allergy medicines or sleep aides can cause delirium. (diphenhydramine)

2.3 Alzheimer’s Disease

Alzheimer’s disease is one of the most common form of dementia. It has both genetics and environmental factors.

Alzheimer’s disease is still a mystery. For example, we do know some causes for it like mutations of genes. Alzheimer’s patients have plaques or protein clumps called beta-amyloid in the brain. These proteins are thought to damage healthy neurons and brain connections.  Alzheimer’s is a progressive form of dementia. Most of the treatment for Alzheimer’s is supportive, not curative. There are some medications that have some modest benefits for some patients.

Learn about Alzheimer’s Care

2.4 Vascular Dementia

Vascular dementia is caused by damage to the blood vessels that supply your brain with blood. Issues with blood vessels can potentially cause strokes. It can also damage the fibers in the white matter of the brain. The most common signs of this dementia include problems with thinking, problem-solving, focus, and organization.

In contrast to other types of dementia, symptoms can occur abruptly.

One of the most important components to treating vascular dementia is to preventing more damage caused by lack of blood flow. Medications such as aspirin and management of high blood pressure, diabetes and high cholesterol may be particularly important. If medications, diet and exercise prevent recurring strokes, then this form of dementia can sometimes be halted.

2.5 Lewy Body Dementia

Lewy body dementia is one of the more common types of progressive dementia. It appears like abnormal balloon-like clumps of protein in the brain. Common symptoms include visual hallucinations, personality changes, acting out dreams in sleep, uncoordinated movements, tremors, and low focus and attention.

Lew Body Dementia is treated similar to Alzheimer’s.

2.6 Frontotemporal Dementia

This type experiences a breakdown of nerve cells and connections in the frontal and temporal lobes of the brain. Typically, behavioral changes, personality, thinking, language, judgment, and movement become affected.

3. How to Maintain Cognitive Health in Old Age? 

How to Maintain Cognitive Health in Old Age

Cognitive decline in your later years might scare you and you want to lessen your risk or slow the aging process. While you can’t completely stop the process, you can delay it. How?

3.1 Take Care of Your Physical Health

First, you must take care of your physical health. Get regular health screenings and manage any health conditions you may have like diabetes, hypertension, or high cholesterol. If you take any medications, learn about them and what they can do to your health. Some medications have side effects that affect your sleep and memory. Don’t smoke or drink alcohol. Ensure you get at least eight hours of sleep per night.

Eat a Mediterranean diet with proper portion control and plenty of water. Researchers have found this diet to lower the risk for dementia and Alzheimer’s. Scientists believe this healthy diet of fresh fruits, vegetables, fish, and little red meat or refined carbs and sugars could prevent chronic health disorders. Many health conditions are linked to a Western diet like cardiovascular disease. These types of conditions age your brain faster.

Some researchers have experimented with a new diet called the MIND diet. It combines the Mediterranean diet with the DASH diet (diet developed to reduce hypertension). Studies have shown promising results in reducing Alzheimer’s and cognitive decline.

3.2 Exercise Regularly

Physical activity has dozens of benefits to your overall health and mental well-being. Exercise can prevent diseases and improve existing conditions, improve your mood, increase your energy, and help with your balance. When you improve your balance, you reduce your risk for falls and potential head injuries that can cause cognitive decline.

Studies on Alzheimer’s and exercise show it may reduce the risk to develop it. Studies show that exercise increase brain structure sizes, which improves memory and learning. Other studies show that aerobic exercises like walking is more beneficial than stretching and toning exercises.

3.3 Train Your Brain

Studies show that engagement in meaningful activities like music, theatre, dance, creative writing, and volunteering improve quality of life and form better memory and self-esteem. It has also shown a reduction in stress too.

If the above activities aren’t your favorites, it’s okay! There are many others you can partake in that do have improvement on your cognitive function. Learning new activities, reading, brain games like chess or checkers have been shown to reduce dementia and Alzheimer’s cognitive impairment.

3.4 Socialize

Studies have shown that maintaining social activities boosts your mood, increases longevity, and gives you a sense of purpose. These can help your self-esteem and improve cognitive function. Volunteer, participate in hobbies or organizations, or frequently meet up with your friends and family. These social interactions help with reducing your risk of cognitive impairment and dementia.

Learn about Companion Care

3.5 Keep Stress to a Minimum

Stress happens to all of us. Sometimes stress can help us to change our thoughts and inspire us to do better. However, if you experience too much stress and too often, it can change your brain, affect memory, and increase your risk for cognitive issues like Alzheimer’s and dementia.

To release stress, you can exercise or write your thoughts. Some other techniques include practicing meditation or mindfulness. Breathing exercises help relax your body and lessen muscle tension. It also helps to lower blood pressure too.

3.6 Get Medical Evaluation

Basic workup might be wanted for anyone having cognitive issues.

Consider discussing with your provider if you need brain imaging such as CT scan or MRI, to evaluate for reversible causes of dementia. A CT scan may show old strokes which would suggest vascular dementia. CT scan could also reveal cause of rare dementia called Normal Pressure Hydrocephalus which can sometimes be cured with the placement of special drain.

Consider discussing with your provider, basic labs such as B12 level and thyroid. B12 and thyroid deficiencies can cause forms of dementia that can sometimes be cured.

4. Final Thoughts 

When you or a loved one begins to experience cognitive decline, it becomes scary. You might worry all hope is lost. However, there are ways you can minimize risk factors and slow current progression. If you suspect a loved one or yourself is experiencing a decline, speak with a doctor for help. They can conduct a health screening to see the underlying causes and create a treatment plan. In the meantime, you can perform the activities above to help reduce risk or slow decline.