How can health professionals enhance cognitive health in older adults?

An expert panel convened by the Institute of Medicine clarified the cognitive aging process by making a distinction from Alzheimer disease and related dementias, and provided recommendations to enhance cognitive health in older adults. Now a new article published in Annals of Internal Medicine highlights key points of that report and serves as a guide for health care professionals seeking to improve the quality of life of older adults by maintaining brain health.

Practitioners define "cognition" as mental functions encompassing attention, thinking, understanding, learning, remembering, problem solving, and decision making. As a person ages there is a gradual, but marked change in these cognitive functions, which is referred to as "cognitive aging."

"Cognitive aging is not a disease or a level of impairment—it is a lifelong process that affects everyone," explains lead author Dr. Sharon K. Inouye, Director of the Aging Brain Center at the Institute for Aging Research, Hebrew SeniorLife in Boston, Massachusetts and Professor of Medicine, Harvard Medical School. "Given the sizable number of adults approaching older age, understanding the impact of cognitive aging has become a significant health concern."

Older adults seem to share the same concern about their health as a 2014 survey by the AARP found that 93% of respondents said maintaining brain health was a top priority. In response, the Institute of Medicine committee created recommendations that focus on prevention and intervention opportunities, seek to educate health care practitioners, and help raise public awareness of cognitive health. Action areas for practitioners include:

• Conduct a formal cognitive assessment to detect cognitive impairment
• Screen for risk factors such as alcohol use, smoking history, and diet
• Promote benefit of physical exercise, lifelong learning, social engagement and adequate sleep
• Highlight importance of reducing cardiovascular risks such as hypertension and diabetes
• Identify persons at high risk for delirium before or at hospital admission and institute preventive strategies
• Minimize prescription of inappropriate medications

The article also covers cognitive health as it relates to driving safety, financial decision-making, use of nutraceuticals and effectiveness of brain games among older adults. "There is still more to learn about the biological process involved with cognitive aging, but there are interventions that can be made now," says Dr. Inouye. "Health care professionals play a vital role in working with older patients and their caregivers to maintain optimal brain health."