Cognitive health education content for the elderly

Cognitive health education for the elderly does not have unified standardized content. The core is centered around the three dimensions of "layered and adapted cognitive maintenance training, controllable risk factor avoidance, and family social support" and is accurately adjusted according to the elderly's cognitive level, interest preferences, and basic physical conditions. The core goal is to slow down the rate of cognitive decline and reduce the risk of dementia, rather than "reversing aging" or "curing cognitive impairment."

Last year, I met 62-year-old Aunt Zhang when I was doing a cognitive screening at a neighborhood elderly care service center. My son said that she couldn't even calculate the winnings and losses in mahjong recently. He suspected that she had Alzheimer's disease, so he took her for a check-up. The result was that her cognitive test score was completely within the normal range. ——To put it bluntly, I just retired and suddenly became free. I stayed up until one or two o'clock every day to watch short videos. My blood sugar also exceeded the standard for half a month. I adjusted my work and rest, controlled my blood sugar, and followed the community handicraft class for half a month to make beads. The problem of "confusion" in accounting disappeared.

The core influencing factors of cognitive health that are now recognized by academic circles are from the 2020 Lancet Dementia Prevention Report: 12 controllable risk factors throughout the life cycle, including insufficient education in youth, high blood pressure, obesity, hearing loss in middle age, diabetes, smoking, depression, social isolation, lack of exercise, etc. in old age. Controlling these factors can delay the occurrence of dementia by up to 40%. This is also the underlying logic of all current cognitive health education content. No matter which genre of content, the content cannot avoid the popularization of these basic common sense.

When it comes to specific implementation content, the differences between different genres are actually quite large. The European and American evidence-based systems recommend standardized cognitive training, such as 15 minutes of working memory training and attention switching training every day, which are completed with a special APP or paper manual. For the elderly who have been diagnosed with mild cognitive impairment (MCI), after 6 months of standardized intervention, the cognitive function score can be improved by an average of 2-3 points. However, through practice in our domestic communities, compliance with this standardized training is extremely low. Less than 20% of the elderly can persist for more than three months. Many elderly people feel like they are "taking a test at school" and are naturally resistant.

Therefore, people who provide front-line services for the elderly in China are more willing to hide cognitive training in daily life scenes: teaching the elderly to use mobile phones to retouch pictures, shoot short videos to post on Moments, memorize dance steps and dance in squares, and even organize "old story sharing sessions" for the elderly to tell their experiences in their youth. The effect of this kind of nostalgic therapy is actually no worse than standardized training, and the compliance performance is over 80%. Previously, we tracked 20 healthy elderly people who participated in old story sharing sessions. Six months later, the recall score of the cognitive assessment increased by an average of 1.8 points, which was not much different from the improvement of MCI elderly people who received APP training during the same period.

Oh, by the way, "Doing more arithmetic problems and memorizing more ancient poems can prevent dementia" is widely circulated on the Internet. In fact, there is quite a controversy in the academic circles. One school of research believes that active brain use can improve cognitive reserve and indeed slow down the rate of decline. ； The other group found that if the elderly are very resistant to tasks such as doing arithmetic and memorizing words, it will induce anxiety and increase cortisol levels in the body, which will in turn accelerate cognitive decline. We met the 78-year-old Uncle Li before. His children bought him a bunch of cognitive training question books. He made a sad face every day, and within a month he complained that his "brain was getting stupider." Later we persuaded him to stop doing it and join the community chess team - he originally loved playing chess and played for 2 hours a day. When tested three months later, his cognitive score increased by 2 points.

What many people tend to overlook is that half of the content of cognitive health education for the elderly is actually for family members. We have seen too many elderly people who originally had normal age-related forgetfulness, but were asked by their family members every day, "Why do you forget things again?" So now when we do science popularization, we will repeatedly emphasize to family members: Don’t deliberately strengthen the negative label of the elderly as “forgetful”, encourage them to do things they are interested in, even if it is just calling old colleagues for 10 minutes every day to chat about the past, the effect is much better than forcing them to do training.

To be honest, after four years of working in community cognitive health education, my biggest feeling is that there is no universal content template. Some elderly people like to be quiet. It is good for them to write calligraphy at home, raise flowers, and read the newspaper every day to take note of the news. ； Some elderly people love to be active. They go out to square dance every day, go to the vegetable market with friends, and help pick up their grandchildren from school. This can fully achieve the effect of maintaining cognition. After all, the academic community has not fully understood the mechanism of cognitive aging. It can help the elderly maintain a happy mood, a regular life, and the habit of actively using their brains, which is more effective than any fancy training program.