Characteristics of cognitive health in older adults do not include

Characteristics of cognitive health in older adults, It does not include no memory loss at all, cognitive level that is completely consistent with that of young adults, no negative mood swings, and no need for external support. , these four are currently the most common misunderstandings about cognitive health in the elderly.

I have been a volunteer for geriatric cognitive screening in the community for three years. I have seen too many family members who grab the hand of the elderly and say, "Doctor, please check if he has Alzheimer's disease. He keeps forgetting things recently." Not long ago, I met Aunt Wang, who lives in Building 3. She is 71 years old. On the road that day, she met an old colleague she hadn’t seen for many years. She was so engrossed in chatting that she forgot to pick up her grandson from school. Her son casually said, “Are you out of your mind?” She was so scared that she didn’t dare to go out for half a month. She always felt that she had Alzheimer’s disease. After a full set of cognitive screening tests, all indicators were much better than the average for the same age group.

To be honest, everyone’s misunderstanding of “old age forgetfulness” is really too deep. Interestingly, scholars in different fields have different opinions on this issue: Most neuroscientists believe that as age increases, neurons in the hippocampus of the brain naturally undergo apoptosis, and mild instantaneous memory decline is a normal physiological manifestation. As long as it does not affect instrumental daily living abilities - that is, being able to buy groceries, cook, take medicine regularly, and take care of personal finances, it does not fall into the category of cognitive abnormalities at all. ； Researchers in the sociology of gerontology are more inclined to believe that the "forgetfulness" of many elderly people is essentially a problem of attention allocation. Compared with young people, the attention of the elderly is more likely to be occupied by things they care about. For example, they have been thinking about what soup to make for their wife who has just been discharged from the hospital, turning around and forgetting to buy salt. This is essentially a matter of priority choice, not a degradation of cognitive ability. When we conduct screenings, we usually make a compromise, first checking for external causes, and never labeling the elderly as "cognitive deterioration" at the first step.

There is also a very common misunderstanding, that is, cognitively healthy elderly people must react quickly, learn things quickly, and be as good as young people in their twenties and thirties. I met a 73-year-old retired accountant before. His children pulled him over and said, "My dad is too slow to respond. I couldn't answer a question for him for a long time. There must be a cognitive problem." As a result, when doing a delayed memory test, the old man could name the five things he was shown 10 minutes ago. He even remembered the color of each thing clearly. On the contrary, the son who accompanied him got stuck on the third answer. After asking later, I found out that the uncle has been doing accounting all his life, and he is used to thinking clearly before speaking. He is slow but very sure. He has never made a wrong account in his life. To use an inappropriate analogy, it’s like comparing the speed of taking pictures with a new smartphone and a professional SLR that has been used for more than ten years. The SLR is slow to boot, but the raw format photos taken can surpass the details of the mobile phone. The "running speed" of the brains of the elderly may indeed have slowed down, but the stored experience, logical ability, and in-depth thinking ability are often incomparable to young people.

Many people also think that cognitively healthy elderly people should be cheerful and amiable every day. If they lose their temper or get emotional one day, they are "confused". In fact, this is also wrong. Uncle Li in our community had to pull out all the roses he had planted for nearly ten years because the property management wanted to convert the small garden downstairs into a parking lot. He was so angry that he sat in the property management office and argued all afternoon. Then he checked the civil code and asked more than a dozen neighbors to sign and write a letter of complaint. He also recorded a video and sent it to the owner group. The logic was very clear. In the end, the property management not only restored the small garden, but also compensated him with new rose seedlings. You said he was emotionally disturbed that day and was cognitively unhealthy? On the contrary, being able to clearly express one's dissatisfaction and knowing how to protect one's rights through legal means is a sign of intact cognitive function. On the contrary, the situation where you used to love talking and laughing, but suddenly become uninterested in anything, and have no reaction when a relative at home has an accident, are the early signs of cognitive impairment that you should be alert to.

Finally, a common misunderstanding is that cognitively healthy elderly people must be completely independent and can do everything by themselves. If they need help from others to get their cell phones or remind them to take medicine, it means they have cognitive deterioration. This is really too harsh on the elderly. Smart devices are updated so quickly nowadays. Many young people have to think about it for a long time before playing a new APP. Why should the elderly be expected to learn it instantly? I once taught a 72-year-old grandma to cut short videos. She even asked her granddaughter to teach her how to post on WeChat Moments. After only 3 days of learning, she was able to cut clips for her fellow Yue opera fans and add subtitles and background music better than me. It was just that no one was willing to teach her patiently before. And even for elderly people who are completely cognitively healthy, as their physical functions decline, such as blurry eyes and numb hands, it is normal for them to need help from others, and it has nothing to do with cognitive health.

By the way, there is actually a lot of controversy over the definition of cognitive health in the elderly in the academic community. Some scholars believe that as long as the cognitive level is lower than the average cognitive level of the same age group, it is considered mild cognitive impairment, and early intervention is needed.； Some scholars also believe that casually labeling the elderly as "cognitive deterioration" will cause psychological implications for the elderly. They are fine in the first place, but in the end they really feel that their brains are failing. As front-line service providers, we are actually more inclined to the latter. The mental state of the elderly has a great impact on their cognitive level. They are told "you are old and confused" all day long, and even healthy people are prone to problems.

In fact, at the end of the day, many people's misunderstanding about cognitive health in the elderly is that they essentially regard "aging" as an "abnormality" that needs to be corrected. They always think that the elderly must meet the standards of young people to be healthy. But think about it, as people get older, their hair will turn gray, their skin will wrinkle, and the brain will of course show normal signs of aging. As long as you can live your life in a clear way and enjoy the things you like, even if you occasionally forget your keys, lose your temper, or occasionally need a helping hand from your juniors, that is still a good form of cognitive health. There is really no need to be overly anxious.