Cognitive health in old age is characterized by

The core characteristics of cognitive health in the elderly are never "memory as good as young people" or "quick reaction speed", nor is it completely free of minor omissions, but Able to independently control daily life functions, maintain a relatively stable emotional state, and maintain a continuous willingness to participate in the world around them ——This is the most practical summary after I have been doing cognitive intervention work for the elderly in the community for 6 years and encountered nearly a thousand cases.

Last week, a family member dragged his 76-year-old mother to the screening. As soon as she entered the door, she was extremely anxious: "Doctor, please check quickly. My mother forgot to bring her keys twice this week. Does she have Alzheimer's disease?" ”I turned around and asked my aunt what she usually does at home. She said she gets up every morning to make breakfast for my wife, goes to the park to play Tai Chi for two hours in the afternoon, and teams up with my old sisters to play scripted killer in the evening. Last time I played Murderer Ben, I fooled everyone. I gave her a commonly used MMSE cognitive screening test, and she scored 28 points (a full score of 30, and a score above 27 is considered a normal range). I turned around and told her family that you were just worried.

To be honest, the academic community’s standards for determining cognitive health in the elderly are not yet completely unified. There are two schools of thought that have been arguing for many years. One group is the "function-oriented group", which believes that as long as the elderly can independently complete daily tasks such as eating, dressing, traveling, and managing finances, even if they occasionally forget things and react slowly, these are normal signs of aging, and there is no need to over-intervene, which will instead make the elderly anxious. The other group is the "early screening radicals" who believe that as long as there is cognitive decline that does not match the age, even if it does not affect life at all, it is necessary to intervene as early as possible, conduct cognitive training, and adjust lifestyles to nip the risk of Alzheimer's disease in the bud. When I work on my own projects, I actually don’t stick to the standards of a certain school. I met 62-year-old Uncle Li before. His ability to remember people’s names is indeed much worse than that of his peers. He forgot the social worker he just met when he turned around, but he felt that it would not affect his life at all. He usually loves to play chess. , we did not force him to have boring memory exercises, so we arranged for him to participate in community chess interest classes and organize weekly competitions. After half a year, he was tested again. His memory score increased by 3 points. He also said that he had met several chess friends recently and he could remember their names.

Oh, by the way, many people have a misunderstanding that if an elderly person can settle accounts and not be cheated, that means they are cognitively healthy. This is not true. Last year I met an 80-year-old man who could cut off a few cents from a vendor when buying vegetables. He could pay with his mobile phone more easily than young people. However, his family members said that he had been unable to find his home when he went out in the past six months. He always suspected that his wife was stealing his money, and would bang the table and curse at every little thing. I screened him and was finally diagnosed with early-stage frontotemporal lobe dementia - the earliest damage caused by this disease is not memory or calculation ability, but emotional regulation and spatial orientation. If you only look at whether you can settle accounts, it is easy to miss the diagnosis.

I often tell the family members who come for consultation that the cognitive health of the elderly is actually like an old house that has been lived in for decades. It is normal for two pieces of wall to fall off and the switch to light up only after pressing it twice. As long as the foundation is stable, the beams and columns are not crooked, and people can live in it normally, there is no need to carry out extensive construction, demolition and reinstallation. Don't be so nervous when you see an old man forgetting something. You have to sign up for a "memory improvement class" that costs tens of thousands of dollars and force the old man to memorize numbers and do exercises every day. Previously, a family member insisted on enrolling his 72-year-old father in such a class. The old man used to have a good time walking around and playing chess every day. After practicing for half a month, he was so anxious that he couldn't sleep every day. His forgetfulness became even worse. This is completely putting the cart before the horse.

I met the 82-year-old Grandpa Wang a while ago. He has a deaf ear, sometimes speaks garbled words, and his cognitive screening score is just below the passing mark of 27 points. However, he can't help but go to the community library every day to sort out newspapers. He also actively signs up to tell revolutionary stories to left-behind children in primary schools in his jurisdiction. Before each visit, he checks information and writes outlines several days in advance, and looks up notes when he forgets. The children especially like him. If you say that according to the scale score, his cognitive level is not high, but I always feel that his cognitive state is much healthier than those old people who stay at home every day, have no interest in anything, and whose scale score is two or three meters higher than him.

In the final analysis, there has never been a standardized answer to the cognitive health of the elderly. It is not just a scale that measures a certain score or more and it is good. The core is that the elderly live comfortably, can understand their own little life, and are willing to deal with the outside world, which is better than anything else.