How Can Health Professionals Enhance Cognitive Health in Older Adults?

BOSTON — An expert panel convened by the Institute of Medicine clarified the cognitive aging process by making a distinction from Alzheimer disease and related dementias, and provided recommendations to enhance cognitive health in older adults. Now a new article published in Annals of Internal Medicine highlights key points of that report and serves as a guide for health care professionals seeking to improve the quality of life of older adults by maintaining brain health.

Practitioners define “cognition” as mental functions encompassing attention, thinking, understanding, learning, remembering, problem solving, and decision making. As a person ages there is a gradual, but marked change in these cognitive functions, which is referred to as “cognitive aging.”

“Cognitive aging is not a disease or a level of impairment—it is a lifelong process that affects everyone,” explains lead author Dr. Sharon K. Inouye, Director of the Aging Brain Center at the Institute for Aging Research, Hebrew SeniorLife in Boston, Massachusetts and Professor of Medicine, Harvard Medical School. “Given the sizable number of adults approaching older age, understanding the impact of cognitive aging has become a significant health concern.”

Older adults seem to share the same concern about their health as a 2014 survey by the AARP found that 93% of respondents said maintaining brain health was a top priority. In response, the Institute of Medicine committee created recommendations that focus on prevention and intervention opportunities, seek to educate health care practitioners, and help raise public awareness of cognitive health. Action areas for practitioners include:

- Conduct a formal cognitive assessment to detect cognitive impairment
- Screen for risk factors such as alcohol use, smoking history, and diet
- Promote benefit of physical exercise, lifelong learning, social engagement and adequate sleep
- Highlight importance of reducing cardiovascular risks such as hypertension and diabetes
- Identify persons at high risk for delirium before or at hospital admission and institute preventive strategies
- Minimize prescription of inappropriate medications

The article also covers cognitive health as it relates to driving safety, financial decision-making, use of nutraceuticals and effectiveness of brain games among older adults.
“There is still more to learn about the biological process involved with cognitive aging, but there are interventions that can be made now,” says Dr. Inouye. “Health care professionals play a vital role in working with older patients and their caregivers to maintain optimal brain health.”

The article was funded in part by the National Institute on Aging (grants P01AG031720, K07AG041835, and R01AG044518). Dr. Inouye holds the Milton and Shirley F. Levy Family Chair.


About Annals of Internal Medicine
Established in 1927 by the American College of Physicians (ACP), Annals of Internal Medicine is the premier internal medicine journal. Annals of Internal Medicine’s mission is to promote excellence in medicine, enable physicians and other health care professionals to be well informed members of the medical community and society, advance standards in the conduct and reporting of medical research, and contribute to improving the health of people worldwide. To achieve this mission, the journal publishes a wide variety of original research, review articles, practice guidelines, and commentary relevant to clinical practice, health care delivery, public health, health care policy, medical education, ethics, and research methodology. In addition, the journal publishes personal narratives that convey the feeling and the art of medicine.

About the Institute of Medicine
Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public. The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies. For more information, visit http://national-academies.org or http://iom.edu.

About the Institute for Aging Research
Scientists at the Institute for Aging Research seek to transform the human experience of aging by conducting research that will ensure a life of health, dignity and productivity into advanced age. The Institute carries out rigorous studies that discover the mechanisms of age-related disease and disability; lead to the prevention, treatment and cure of disease; advance the standard of care for older people; and inform public decision-making. The Aging Brain Center within IFAR studies cognitive aging and conditions affecting brain health.

About Hebrew SeniorLife
Hebrew SeniorLife, an affiliate of Harvard Medical School, is a national senior services leader uniquely dedicated to rethinking, researching and redefining the possibilities of aging. Based in Boston, the non-profit, non-sectarian organization has provided communities and health care for seniors, research into aging, and education for geriatric care providers since 1903. For more information about Hebrew SeniorLife, visit https://www.hebrewseniorlife.org, follow us on Twitter @H_SeniorLife, like us on Facebook, or read our blog.