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Use It or Lose It: Preventing Cognitive Decline
Cognitive Aging

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Changes in cognitive function, such as slow speed of information processing, are common in normal aging. However, each person is different 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 may be manageable.

Three types of cognitive decline with aging have been recognized:

  • Age-related changes in memory—mild memory impairment that can occur with normal aging. These people can do as well as younger patients on memory tests if they are given enough time.
  • Amnestic mild cognitive impairment (MCI)—mild memory loss; signs include misplacing things, forgetting important events or appointments, and having difficulty coming up with the right words
  • 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 risk factors for cognitive decline. Some of these risk factors include:

  • Increased age
  • Having a specific gene (APOE-e4) linked to Alzheimer's disease
  • Lack of mental activity
  • Substance use and abuse, including:
  • Lack of physical exercise
  • Malnutrition
  • Chronic stress
  • Certain medical conditions, such as:
  • Lack of involvement in social activities

If you have a medical condition that may be causing your cognitive decline, talk to your doctor.

Vital Activities for a Vital Mind

As you age, changes occur throughout your body, including in your brain. But while it may take older adults longer than younger people to do certain cognitive activities, like complex memory tests, some areas of mental ability may even improve, such as vocabulary. Certain activities can assist older adults in increasing their capacity to learn and adapt as they age.

Stay Socially Active

One study has found that having a limited social network is a risk factor for dementia in older persons. Risk factors include living alone or not having any close social ties. Therefore, maintaining many social connections and participating in social activities are advised. Researchers suggest that social activities help prevent cognitive decline by stimulating the mind and challenging people to communicate.

Keep Learning

Participating in leisure activities like reading, playing board games, and playing musical instruments are associated with decreased risk of dementia.

One study, published in the Journal of the American Medical Association, found that frequent participation in mentally stimulating activities are 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 such as cards, checkers, and crossword puzzles
  • Going to museums

However, while these things certainly won't hurt, a systematic review of 36 trials found that improvements in memory couldn't be attributed specifically to mentally stimulating activities.

Exercise

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

Vitamins and other herbal supplements get lots of attention as possible cures or ways to prevent cognitive decline. But are supplements really helpful in people who are not deficient in certain vitamins? Researchers have studied whether antioxidants, like vitamin E, are able to slow the progression of Alzheimer's disease. The results have not clearly shown that they are of any benefit. 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 there has been no proven benefit for Gingko in studies. Nor has there been any benefit on cognitive performance found in people taking fish oil supplements.

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 medications 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.

Get Help for Sleep Disorders

Sleep disorders and sleep disruption are common in older people. These may affect cognitive function, particularly memory and learning. Daytime sleepiness, which may be a symptom of a sleep disorder, has been associated with an increased risk for dementia. 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.

RESOURCES:

National Council on Aging
http://www.ncoa.org

National Institute on Aging
http://www.nia.nih.gov

CANADIAN RESOURCES:

Mental Health Canada
http://www.mentalhealthcanada.com

Seniors Canada On-line
http://www.seniors.gc.ca

References:

Alzheimer disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated March 31, 2014. Accessed July 9, 2014.

Alzheimer's disease and non-Alzheimer’s dementia. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/biomedical-libraries/natural-alternative-treatments. Updated July 2012. Accessed July 9, 2014.

Enhancing memory and mental function. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/biomedical-libraries/natural-alternative-treatments. Updated July 2012. Accessed July 9, 2014.

Foley D, Monjan A, Masaki K, Ross W, Havlik R, White L, Launer L. Daytime sleepiness is associated with 3-year incident dementia and cognitive decline in older Japanese-American men. J Am Geriatr. Soc 2001 Dec;49(12):1628.

Forgetfulness: knowing when to ask for help. National Institutes of Health National Institute on Aging website. Available at: http://www.nia.nih.gov/health/publication/forgetfulness-knowing-when-ask-help. Updated April 17, 2014. Accessed July 9, 2014.

Fratiglioni L, Wang HX, Ericsson K, Maytan M, Winblad B. Influence of social network on occurrence of dementia: a community-based longitudinal study. Lancet. 2000 Apr 15;355(9212):1315.

Mild cognitive impairment (MCI). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 1, 2014. Accessed July 9, 2014.

Verghese J, Lipton RB, Katz MJ, Hall CP, Derby CA, Kuslansky G, Ambrose AF, et al. Leisure activities and the risk of dementia in the elderly. N Engl J Med. 2003 Jun 19;348(25):2508.

Wilson RS, Mendes De Leon CF, Barnes LL, Schneider JA, Bienias JL, Evans DA, Bennett DA. Participation in cognitively stimulating activities and risk of incident Alzheimer disease. JAMA. 2002 Feb 13;287(6):742-8.



Last reviewed July 2014 by Michael Woods, 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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