Cognitive Aging Progress in Understanding and Opportunities for Action (2015) / Chapter Skim
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1 Introduction
1 Introduction
Pages 17-30
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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.
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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.
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This will include relevant research on human behavior change and the evidence based approaches needed to ensure the retention of healthy practices to maintain cognitive health and remediate cognitive decline. • E ducation of health professionals -- This study will explore the education of health professionals related to cognitive health and decline and will identify examples of best practices for educating health professions to ensure high quality care and education for older adults and their families about cognitive aging and its possible consequences.
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The committee provides a conceptual definition of cognitive aging as a process of gradual, ongoing, yet highly variable changes in cognitive functions that occur as people get older. Cognitive aging is a lifelong process.
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odifiable and non-modifiable factors include genetics, culture, education, M medical comorbidities, acute illness, physical activity, and other health behaviors. ognitive aging can be influenced by development beginning in utero, C infancy, and childhood.
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These many brain functions and the neural structures and networks that support them change at different rates and in different ways over time, with the particular changes based on a large number of interacting factors, including genetic makeup, education, environment, lifestyle, and trauma. A clear body of evidence indicates that as individuals age a decline occurs in specific brain functions that cannot be attributed to disease processes in the brain, such as neurodegeneration from Alzheimer's disease or stroke.
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. Changes in cognition also have the potential to affect health directly by impairing a patient's ability to take the proper medication dose on the correct schedule or to understand risks and benefits when choosing a treatment option or health insurance plan (IOM, 2014)
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. Even though the public health implications of cognitive aging may be unique for each country due to their distinct social, cultural, and economic conditions, the challenges and opportunities that these countries face are all related.
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. This increasing diversity of the population calls for a focus on improving cognitive measurement techniques and the development of appropriate metrics and interventions for diverse ethnic, cultural, and racial groups as part of the broad effort to improve cognitive health in the aging population.
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This report focuses on the public health dimensions of cognitive aging and touches only briefly on the numerous basic science questions and neuropsychological assessment challenges related to cognitive aging. In addressing the public health challenges of cognitive aging, the committee identified several cross-cutting themes and key messages (see Chapter 7)
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Due to the complexity of the human brain, numerous risk and protective factors may affect cognitive abilities (including genetics, physical activity, traumatic brain injury, sleep quality, comorbidities, acute illness, delirium, and medications) (see Chapters 4A, 4B, 4C)
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Chapter 5 focuses on health care's response to cognitive aging, with discussions on increasing the abilities of health professionals to assess cognitive aging and to use wellness visits to discuss these issues with their patients. The community's response to cognitive aging is discussed in Chapter 6, which describes the wide variety of resources that are currently available and that need to be developed for older adults and their families facing decisions on personal finances, driving, technology, and cognitive-related products.
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U.S. Census Bureau American Community Survey Reports.
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