CDC Brain Health Initiative Focuses on Cognitive Research
Aldrich, Nancy, Aging Today
Anyone who has not yet heeded the public health message to get off the couch needs to know that there is another good reason to listen to the experts. Reducing cardiovascular risk factors and staying physically active may help preserve people's minds as well as their bodies. Furthermore, there may be other things they can do to preserve their cognitive health.
For years, people believed that a decline in mental abilities was an inevitable part of aging. That view is now proving to be incorrect. A reexamination of available research is focusing public health attention on lifestyle changes to help maintain cognitive performance. Although much more research is needed in this area, the good news is that such brainhealthy behaviors as controlling weight and blood pressure, staying physically active and being involved in the community are lifestyle changes that many people are already adopting for their physical and emotional health. "All the things that we know are bad for your heart turn out to be bad for your brain," said Marilyn S. Albert, director of the Division of Cognitive Neuroscience at Johns Hopkins University School of Medicine.
Because there is no uniform definition of cognitive health, researchers are still struggling to describe all of its aspects. A recent literature review by the Cognitive and Emotional Health Project (CEHP), an initiative involving researchers from the National Institutes of Health (NIH) and several universities, used a positive approach to denning cognitive health. "We said cognitive health shouldn't just be the absence of disease, but rather the development and preservation of a multidimensional cognitive structure," said Hugh C. Hendrie, who chairs the CEHP Critical Analysis Committee.
"That structure allows elderly people to maintain social connectedness, an ongoing sense of purpose, and the ability to function independently and to permit functional recovery," explained Hendrie, a psychiatry professor at the Indiana University Center for Aging Research. The CEHP team published its review in Alzheimer's and Dementia: The Journal of the Alzheimer's Association (January 2006).
Cognitive impairment involves problems with memory, understanding or using words, and identifying objects. Cognitive decline can range from the normal changes associated with the aging brain, to mild cognitive impairment, to dementia. These are different conditions, not necessarily a progression of one disease. Many people retain their cognitive capabilities into very old age. Some age-related cognitive decline-slower information processing and mild memory impairment, for example-does occur.
Interestingly, autopsy examinations of older people who were not demented sometimes show brain pathology similar to Alzheimer's or other dementias. Why the same microscopic brain changes affect some people less than others is not yet understood. Some researchers believe that there is a cognitive reserve related to higher education, literacy, or involvement in social and leisure activities. For example, N. Scarmeas reported in the September 2004 issue of Current Neurology and Neuroscience Reports that this reserve appears to protect people against cognitive decline despite pathological changes associated with dementia. However, Albert noted it is also possible that education levels are tied to the fact that mental stimulation is likely to be higher among people with more education. Therefore, staying mentally active throughout life may be a more important factor than being well educated.
Research by the National Institute on Aging indicated that more than 10 reversible conditions can cause or mimic cognitive impairment. These conditions are related to emotional distress, physical illness, medications, nutrition deficiencies, social and cultural restraints, or alcohol abuse. Some of these conditions can be treated.
MAINTAINING COGNITIVE HEALTH
"There is growing evidence that high blood pressure and diabetes are important factors that appear to increase the risk of later developing dementing disease. …