Cognitive health in old age is characterized by

The core feature of cognitive health in the elderly has never been "as good as young people's memory", but the ability to maintain cognitive functions that match their age and life scenes, independently control the rhythm of daily life, and actively adapt to the normal cognitive changes brought about by age, without affecting social participation and life happiness due to cognitive fluctuations.

I worked at a community geriatric cognitive screening site for more than half the past two years, and I met too many people who used "forgetting things" as an excuse to label themselves or the elderly in their families as "dementia". In fact, it is completely unnecessary.

Last time, a 72-year-old Uncle Li dragged his wife for a screening. When he walked in, he sighed and said that his "brain was broken." He couldn't even remember the account number for paying the electricity bill last week, and he couldn't find his keys for three days. After completing the entire scale, the cognitive score was completely within the normal range for his peers. I asked a few more questions and found out that he picked up his grandson at the gate of the primary school at 7:30 every day. He remembered that his child did not eat coriander and had to add more vinegar. He also remembered that the manhole cover at the west entrance of the community was loose and had to take a detour. The community chess competition every Wednesday afternoon was always a success. Last month, he won the second prize and brought back a barrel of cooking oil that the whole family ate for less than half a month. This kind of "forgetfulness" simply means that the brain actively makes room for unimportant information, and is not considered cognitive impairment at all.

Oh, by the way, the academic community has been arguing about the definition of cognitive health for a while. The traditional school of neurology takes "no organic pathological changes" as a hard bar, that is, there are no clear lesions of Alzheimer's disease or vascular dementia, there is no abnormal atrophy in brain images, and the cognitive scale score is not lower than the norm threshold. However, in recent years, more and more researchers in the fields of geriatrics and sociology have favored the standard of "functional adaptation" - even if there are slight age-related brain structural changes, such as slight temporal lobe atrophy, as long as one can cope with one's daily needs and can participate in one's favorite social activities, one is considered cognitively healthy.

I have encountered such an example. The 68-year-old Aunt Wang had a brain MRI for a physical examination. The report said "slight temporal lobe atrophy, follow-up recommended." She was so scared that she couldn't sleep well for half a month, and she always felt that she was about to suffer from Alzheimer's disease. As a result, when she came to our place for screening, she took out her mobile phone and saved the performance schedules of several square dance teams. She also remembered the taboos of each team member. Last month, she organized everyone to go to Tianmu Mountain. Her guides were more detailed than those of young people. She knew which B&Bs had delicious food, which photo spots were less crowded, and how much discount seniors could get on tickets. She also played short videos on a regular basis, and the videos she had cut of square dance performances had over 10,000 views. Do you think her cognition is unhealthy? Anyway, I think it is much better than many young social beasts who stay at home every day and watch short videos and even remember their own meals.

It’s interesting to say that when I first got screened, I always loved the score on the scale. If it was two points lower than the norm, I would get nervous and would recommend people to go to the hospital for further examination. Later, after meeting more people, I discovered that the scale is really just a reference. Look at Grandpa Chen, who lives in Building 3 of our community. He is 80 this year, and his instant memory test score is two points lower than the 70-year-old norm. But last month he chased me to ask how to activate digital renminbi. He said that he was afraid of losing it when he bought groceries. He said that he would be able to use it after learning it twice. He was also studying how to use taxi-hailing software recently. He said that in the future, when my wife goes to the hospital for a review, he does not have to wait for his children to send him. He can take a taxi himself. The curiosity about new things in his eyes is really incomparable to many 60-year-olds who stay at home every day and don't even know that the supermarket downstairs has a new owner.

Nowadays, many children get nervous when they see their parents forgetting something. They insist on buying a bunch of cognitive training books, forcing the elderly to memorize words and do arithmetic problems every day. This makes the elderly extremely stressed and makes them more prone to cognitive anxiety. There are also different views in the academic community regarding methods of cognitive maintenance. The classic cognitive training school does advocate regular standardized mental exercises, such as memory training and attention training, but the humanistic school of elderly care believes that it is much more useful to let the elderly do things they are interested in than to force them to do training they do not like. If you ask an old man who loves to play chess to go to the chess club to play chess with others every day, his mind will spin faster than how many arithmetic problems he has to solve. ； If you ask your aunt who loves to visit you to chat with your old sisters and dance square dances, the cognitive stimulation brought by social interaction will be much better than playing cognitive games on a tablet.

In fact, there is no 100% uniform standard for cognitive health in the elderly. To put it bluntly, the elderly feel comfortable living their lives and can arrange their lives clearly. Even if they occasionally forget something insignificant, they can find it when they turn around. They don't have to worry about others every day, and they can also find some new fun that interests them from time to time. This is enough.