The Institute of Medicine has released Cognitive Aging: Progress in Understanding and Opportunities for Action, a report on the public health dimensions of cognitive aging. The report, released on April 14, 2015, is timely. The U.S. population is rapidly aging and individuals are becoming more concerned about their cognitive health. Older adults view “staying sharp” as perhaps one of their most important health care goals.
Prepared by the Committee on the Public Health Dimensions of Cognitive Aging, the report assesses examined definitions and terminology, epidemiology and surveillance, prevention and intervention, education of health professionals, and public awareness and education.
Jason Karlawish, MD, associate director of the Penn Memory Center and director of the Penn Prevention Research Center’s Healthy Brain Research Center — a member of the CDC supported Healthy Brain Network dedicated to surveillance, education, awareness and empowerment that promotes brain health — was a member of the report committee.
“This report is a beginning,” Dr. Karlawish explained. “ Over the last 30 years we have made substantial progress in understanding the causes of neurodegeneration. Alzheimer’s disease has gone from a hidden disorder, to a front and center national concern. Now, we need to pay the same attention to cognitive aging.”
Cognitive aging is a process of gradual, ongoing, yet highly variable, changes in cognitive functions that occur as people get older. Age-related changes in cognition can affect not only memory but also decision-making, judgment, processing speed, and learning. “Among our key findings was that both human and animal models show how in cognitive aging, neurons are not working as well, but they’re not dying.” Dr. Karlawish noted that this is important because “Synapses may be sick, but there’s a chance they can get well again.”
The report’s findings and recommendations address steps individuals, health care professionals, communities and society can take to promote cognitive health:
- Increasing research and tools to improve the measurement of cognitive aging.
- Promoting physically activity; reducing and managing cardiovascular disease risk factors, including high blood pressure, diabetes, and smoking; and regularly discussing and reviewing with a health care professional the medications that might influence cognitive health.
- Expanding public communications efforts around cognitive aging with clear messages that the brain ages, just like other parts of the body; cognitive aging is not a disease; cognitive aging is different for every individual (there is wide variability across persons of similar age); some cognitive functions improve with age, and neurons are not dying as in Alzheimer’s disease (hence, realistic hope is inherent in cognitive aging); and finally, there are steps that patients can take to protect their cognitive health.
- Developing and improving financial programs and services used by older adults to help them avoid financial exploitation, optimize independence, and make sound financial decisions.
- Health care systems and health care professionals should implement interventions to insure optimal cognitive health across the life cycle including programs to avoid delirium associated with medications or hospitalizations.
- Determining the appropriate regulatory review, policies and guidelines for products advertised to consumers to improve cognitive health, particularly medications, nutritional supplements, and cognitive training.
The report, a slide set, and a four-page key point summary, are free and available for download at www.iom.edu/cognitiveaging.