“Successful” Cognitive Aging – Normal Changes and Preventative Measures

In my work as a neuropsychologist, I have seen many older adults for cognitive evaluations. One of the questions I am asked most frequently relates to whether an individual’s “forgetfulness” is normal for their age or if it should be reason for concern. With much research focused on dementia over the past several years, Alzheimer’s disease being one of the most common types of dementia, many older adults present for evaluation due to concerns that these subtle changes that they notice may be the beginning of something like a dementia process. However, as we get older, there are changes that naturally occur to our bodies, and some mild changes in our brain are no exception. Research has shown that it is normal to experience some minor cognitive changes with age. For example, it may take more repetitions to learn new information, you may miss paying a bill for one month that was particularly chaotic, you may absent-mindedly misplace your glasses, or at times forget an acquaintance’s name. This is because some cognitive abilities are typically resilient to change over time or may even improve (e.g., vocabulary) while other abilities (e.g., conceptual reasoning, memory, processing speed) may show some gradual decline over time. These are all normal parts of the aging process, although for some people this creates a significant amount of worry.

Even so, should these difficulties develop into more consistent patterns of behavior and occur frequently, it can interfere with a person’s ability to function (e.g., attend appointments, manage medications, feel more effortful to solve problems). This may not definitively mean that something is wrong, but it may be helpful to see a professional (e.g., family physician, neuropsychologist) to evaluate what may be contributing to these concerns. Of note, there are several modifiable factors that can impact cognitive functioning that are not permanent but can cause someone to feel like it is harder to focus or remember information. Some of these factors include poor sleep, medical issues, pain, stress, depression/anxiety, coping with grief, and medication side effects. If addressed or resolved, there may be an improvement in cognitive functioning.

At the end of the day, one of the most important steps is making a commitment to live a healthy lifestyle and prevent any unnecessary changes in brain health. Research indicates that there is benefit to certain healthy lifestyle behaviors that can have a positive impact on overall brain health. Although many of these things ideally should begin early in life to prevent changes over time, it is never too late to begin healthy behaviors that can have a positive impact on both cognitive efficiency and reduction of brain changes. The following are ways to support brain health:

  • Follow up with a medical provider. This can be helpful to rule out any medical reason that may be contributing to cognitive concerns (e.g., pain management); partner with your family doctor to manage any chronic or ongoing medical concerns.
  • Eat healthy. Current research indicates that it may be most beneficial for brain health to eat a Mediterranean diet, consuming healthy fats (e.g., Omega 3s) and plenty of fruits, vegetables, lean meat, and whole grains.
  • Exercise. As approved by a physician, even light walking every day can help. The main goal is to incorporate more movement into your day, which can include activities such as gardening, cleaning, or fixing up the house. Especially as we get older, stretching, yoga or tai chi exercises are low impact and can help build balance and strength.
  • Get good sleep. Sleep hygiene strategies are important; one of the most helpful ways to condition your brain to attain good sleep is to go to bed and get up at same time every day. The research is clear that sleep has a very significant effect on how well we can think and function.
  • Manage sensory changes. Changes to both vision and hearing can make it difficult to engage in conversations and activities in the same way, and some individuals may think they are experiencing a cognitive problem when it is a change in sensory functioning. Ensure to use glasses and hearing aids as needed; attend regular checkups for vision and hearing.
  • Stay cognitively and socially active. Although there is no one “brain game” or puzzle that has been shown to be helpful in maintaining cognitive skills, the key is to engage in cognitively stimulating activities that you enjoy – no need to frustrate yourself or force yourself to do activities that are not enjoyable to you. Some people may enjoy puzzles, while others would rather read or play an instrument. Social activities can include discussion groups, meeting friends for coffee, or spending time with family and friends.
  • Manage mood and anxiety. Both of these can impact thinking skills (e.g., memory, attention) if not managed well.

Even though there may not be a cure for certain cognitive changes that occur over time, the above modifiable factors combined with a healthy lifestyle are within our control and can go a long way to decrease cognitive changes over time.

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