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Pages 1-16

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From page 1...
... As human life expectancy increases, maintaining one's cognitive abilities is key to assuring the quality of those added years. Cognitive aging is a public health concern from many perspectives.
From page 2...
... At this point in time, when the older population is rapidly growing in the United States and across the globe, it is important to carefully examine what is known about cognitive aging, to identify the positive steps that can be taken to maintain and improve cognitive health, and then to take action to implement those changes by informing and activating the public, the health sector, nonprofit and professional associations, the private sector, and government agencies. In the past several decades rapid gains have been made in understanding the non-disease changes in cognitive function that may occur with aging and in elucidating the range of cognitive changes, from those that are normal with aging to those that are the result of disease; much remains to be learned yet the science is readily advancing.
From page 3...
... . • Risk and Protective Factors:  ealth and environmental factors over the life span influence cognitive H aging.
From page 4...
... (The stability in the number of neurons -- that is, the lack of neuron death in areas supporting cognition -- seen with aging is in contrast to the extensive neuron loss that occurs in Alzheimer's disease.) Recommendation 1: Increase Research and Tools for Assessing Cogni tive Aging and Cognitive Trajectories The National Institutes of Health, the Centers for Disease Control and Prevention, research foundations, academic research institutions, and private-sector companies should expand research on the trajectories of cognitive aging and improve the tools used to assess cognitive changes and their effects on daily function.
From page 5...
... UNDERSTANDING THE POPULATION IMPACT While a great deal of research has examined the occurrence, causes, natural history, pathogenesis, and clinical management of dementia, including Alzheimer's disease, less attention has been paid to cognitive aging per se, particularly from a public health perspective. Population-based information about the nature and extent of cognitive aging provides a basis for building public awareness and understanding and can be used to engage individuals and their families in maintaining cognitive health; to inform health care professionals, financial professionals, and others as they educate and advise their older patients and clients; and to guide program development and implementation.
From page 6...
... Given the importance to the public's health of preventing individuals' cognitive impairment and promoting their cognitive health, it is important to develop an in-depth understanding of these various beneficial and deleterious factors to guide prevention and remediation efforts. However, much remains to be learned about the relationship between lifestyle and risk factors and the maintenance of cognitive health throughout the adult life span.
From page 7...
... • Take additional actions that may promote cognitive health, including Be socially and intellectually engaged, and engage in lifelong learning; Get adequate sleep and receive treatment for sleep dis orders if needed; Take steps to avoid the risk of cognitive changes due to delirium if hospitalized; and Carefully evaluate products advertised to consumers to improve cognitive health, such as medications, nutri tionals, and cognitive training. Recommendation 4: Increase Research on Risk and Protective Factors and Interventions to Promote Cognitive Health and Prevent or Reduce Cognitive Decline The National Institutes of Health, the Centers for Disease Control and Prevention, other relevant government agencies, nonprofit organiza tions, and research foundations should expand research on risk and protective factors for cognitive aging and on interventions aimed at pre venting or reducing cognitive decline and maintaining cognitive health.
From page 8...
... Recommendation 5: Ensure Appropriate Review, Policies, and Guide lines for Products That Affect Cognitive Function or Assert Claims Regarding Cognitive Health The Food and Drug Administration and the Federal Trade Commis sion, in conjunction with other relevant federal agencies and consumer organizations, should determine the appropriate regulatory review, policies, and guidelines for • over-the-counter medications (such as antihistamines, seda tives, and other medications that have strong anticholinergic activity) that may affect cognitive function, and • interventions (such as cognitive training, nutriceuticals, sup plements, or medications)
From page 9...
... Specifically, health care professionals should use patient visits to: • identify risk factors for cognitive decline and recommend measures to minimize risk; and review patient medications, paying attention to medications known to have an impact on cognition; • provide patients and families with information on cogni tive aging (as distinct from dementia) and actions that they can take to maintain cognitive health and prevent cognitive decline; and • encourage individuals and family members to discuss their concerns and questions regarding cognitive health.
From page 10...
... Efforts are under way in many areas, but challenges remain in knowing how best to help older adults identify and address the potential impacts of cognitive aging. Recommendation 8: Develop Consumer Product Evaluation Criteria and an Independent Information Gateway The Centers for Disease Control and Prevention, National Institutes of Health, and the Administration for Community Living, in conjunc tion with other health and consumer protection agencies, nonprofit organizations, and professional associations, should develop, test, and implement cognitive aging information resources and tools that can
From page 11...
... . Recommendation 9: Expand Services to Better Meet the Needs of Older Adults and Their Families with Respect to Cognitive Health Relevant federal and state agencies (including the Administration for Community Living [ACL]
From page 12...
... , and other consumer health information relevant to cognitive ag ing meet health literacy standards.
From page 13...
... Major challenges for public information campaigns about cognitive aging are to differentiate the messages from those about Alzheimer's disease and other dementias and to promote actions to enhance or maintain cognitive health and to prevent or reduce cognitive decline. Recommendation 10: Expand Public Communications Efforts and Promote Key Messages and Actions The Centers for Disease Control and Prevention, the Administration for Community Living, the National Institutes of Health, other relevant federal agencies, state and local government agencies, relevant nonprofit and advocacy organizations and foundations, professional societies, and private-sector companies should develop, evaluate, and communi cate key evidence-based messages about cognitive aging through social marketing and media campaigns; work to ensure accurate news and storylines about cognitive aging through media relations; and promote effective services related to cognitive health in order to increase public understanding about cognitive aging and support actions that people can do to maintain their cognitive health.
From page 14...
... Individuals and families: •  e physically active and intellectually and socially engaged, monitor medi B cations, and engage in healthy lifestyles and behavior; •  alk with health care professionals about cognitive aging concerns; T •  e aware of the potential for financial fraud and abuse, impaired driving B skills, and poor consumer decision making; •  ake health, finance, and consumer decisions based on reliable evidence M from trusted sources. Communities, community organizations, senior centers, residential facilities, housing and transportation planners, local governments: •  rovide opportunities for physical activity, social and intellectual engage P ment, lifelong learning, and education on cognitive aging; expand relevant programs and facilities; • mprove walkability and public transportation options in neighborhoods, I communities, and cities.
From page 15...
... . Public health agencies at the federal, state, and local levels; aging organizations; media; professional associations; and consumer groups: •  trengthen efforts to collect and disseminate population-based data on S cognitive aging as separate from dementia and other neurodegenerative diseases; •  evelop and widely disseminate independent authoritative information re D sources on cognitive aging and criteria for consumer evaluation of products and medications that claim to enhance cognition; •  evelop, test, and disseminate key messages regarding cognitive aging D through social marketing campaigns, media awareness efforts, and other approaches to increase public understanding about cognitive aging; and promote activities that help maintain cognitive health.
From page 16...
... " Although changes in cognitive function vary widely among individuals, there are a number of actions that would make a difference and promote cognitive health; these are summarized in Box S-2 and detailed throughout the discussion and recommendations in this report. Cognitive aging is not just an individual or family or health care system challenge -- it is an issue that affects the fabric of society and requires actions by many and varied stakeholders.


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