Characteristics of cognitive health in older adults do not include

Combining 12 years of practical experience in community elderly cognitive screening and domestic and foreign geriatric medicine consensus, the characteristics of cognitive health in the elderly It does not include comprehensive and irreversible decline in cognitive function, being disconnected from society is normal, and mood swings are bound to be accompanied by cognitive degradation. These three types of common cognitive misunderstandings among the public, and many of the “old-life normalities” we are accustomed to, are actually stereotypes of cognitively healthy elderly people.

When I was doing screenings in the community, I met many panicked family members. They dragged the old man over and said, "He forgot to pick up the keys yesterday. Is he going to have Alzheimer's disease?" There was also a 68-year-old Aunt Zhang who scared herself and couldn't sleep well for half a month. She said that her memory was getting worse and worse, and her brain must be failing. As a result, when I took the scale, all the scores were within the healthy range. It was simply anxiety. Traditional geriatric psychology in the early years indeed believed that cognitive function will enter a comprehensive decline after the age of 60, but active gerontology tracking research in the past 20 years has long overturned this conclusion: the cognitive decline of healthy elderly people is mostly concentrated in fluid intelligence dimensions such as processing speed and short-term memory that require rapid response, while crystallized intelligence that relies on the accumulation of life experience-such as judgment, problem-solving ability, and knowledge reserves in professional fields not only does not decline, but even maintains an upward trend at the age of 70-80. I previously followed a 78-year-old retired mechanical engineer. He sometimes turned around and forgot where the glasses he had just placed were. However, when solving technical problems for his old employer, he could even report the equipment parameters from 30 years ago exactly as they were. This is a typical cognitive state of healthy elderly people, and it is not a "comprehensive decline" at all. During the last screening, I met an 82-year-old grandma. She could play Xiaoxiaole better than me. Her reaction time was so fast that she could pass the test in a blink of an eye. She just couldn't remember what she ate last Wednesday. Can you say that she was cognitively unhealthy?

In addition to the misunderstanding of cognitive function itself, many people also regard "the elderly do not like to go out" as a normal manifestation of cognitive aging, which is not at all a characteristic of cognitive health. Uncle Wang, who runs the chess club downstairs, is 74 years old and is in charge of the schedule of more than 20 old chess friends. Those who have high blood pressure cannot stay up too long, those who want to pick up their grandchildren can only come in the afternoon, and those who have recently visited relatives in other places need to make room. He remembers Men'er Qing, and even made a sharing form (of course, he asked his grandson to teach him), and sends appointment reminders in the group every day. Cognitively healthy elderly people already have social needs. Many times they "don't like to go out" because they either don't have a suitable scene, or they are afraid of being embarrassed because they don't know how to scan the health code with their smartphones and place orders, or they are surrounded by peers who are either raising grandchildren or are sick and cannot find companions. This is not an inevitable result of cognitive aging at all. A research team from a university previously conducted a comparison and provided a platform for interest groups such as calligraphy and singing to cognitively healthy elderly people in nursing homes. After half a year, their social participation increased by 62%, and their corresponding attention and instant memory scores increased by 3 points compared with before. This is enough to show that being socially active is a common state of cognitively healthy elderly people.

Another point that is confused by many people is that they think that cognitively healthy elderly people must have a calm mind and not care about anything. Any mood swings means that there is a cognitive problem. This is also a pure misunderstanding. Last year, a family member brought 72-year-old Grandma Li here and said that after her husband left, she cried for almost half a month and was often in a daze. She wondered whether her cognition had deteriorated. After the examination, all cognitive indicators were normal, and it was just a simple bereavement stress reaction. Later, I introduced her to the community choir, and she adjusted for more than two months. Now she is the leader, arranging programs every day and managing logistics, and she is very energetic. In the early clinical field, there was indeed a misunderstanding that directly equated emotional abnormalities in the elderly with the prodromal stage of cognitive impairment. However, the academic community has now reached a consensus: cognitively healthy elderly people will also have normal joys, anger, sorrows, and joys. They may even have richer emotional expressions than elderly people with mild cognitive impairment because of their stronger perception of life. On the contrary, it is the state of not being interested in anything, being emotionally numb, and not even wanting to do the things you loved most before, that you need to be wary of as a sign of cognitive decline.

To be honest, after doing cognitive screening for so many years, my biggest feeling is that many people misunderstand the cognitive health of the elderly, which is more harmful to the elderly than cognitive aging itself. Don’t always label old people who occasionally forget things as “foolish”, and don’t think that old people should stay at home and do nothing when they get older. Cognitively healthy old people are inherently lively, have tempers, and have things they love. Apart from being slower to respond and being a little confused when remembering small things occasionally, there is really no essential difference between them and young people. Of course, if an elderly person suddenly forgets things and forgets things to the extent that it affects his or her life - for example, he has to eat after having just finished eating, cannot find his home when he goes out, or cannot even recognize familiar relatives, then he must rush to the memory clinic for examination. However, it is a normal manifestation of aging, and there is really no need to be overly anxious.