What are the characteristics of cognitive health in older adults?

I have been doing cognitive screening for the elderly in communities for almost five years and have met nearly a thousand elderly people. The current general consensus in the industry is that the core of cognitively healthy elderly people is that they can maintain normal cognitive functions that match their age, can independently handle various needs in daily life and social interaction, and have no pathological cognitive decline.

Many family members asked at first, "Is my mother forgetting to turn off the fire recently because she has dementia?" In fact, it is not that exaggerated. Just like the 78-year-old Aunt Zhang who lives in our community, she occasionally forgets where she put the chrysanthemum tea she just brewed.

Of course, the definition of cognitive health in the academic community is not yet completely unified. One group of studies believes that as long as the elderly can fully take care of themselves, even if their memory is significantly lower than when they were young, it is considered healthy. Another group believes that it is necessary to refer to the cognitive norm data of the same age group. A score that is two standard deviations below the norm is considered abnormal. We usually take these two standards into consideration when doing community screening, and will not label the elderly as "cognitive abnormalities" based on scale scores alone.

Many people’s impression of cognitive health is limited to “good memory.” In fact, another very important point is emotional regulation and decision-making ability. Previously, we screened a 72-year-old retired teacher, Uncle Li. After retirement, he learned photography, cut short videos, and discussed shooting techniques with young netizens on Douyin. The last time he accidentally broke the lens he just bought when he was shooting an outdoor scene. Another old man might feel distressed and unable to eat for several days, so he turned around and joked to his wife, "It's time to find something new to play with." This state of being able to quickly adjust emotions without being too aggressive when encountering problems is actually a manifestation of the intact executive function of the prefrontal lobe. After all, cognition does not only include memory, but logical judgment, emotional perception, and decision-making abilities are all important components.

Last time, a family member brought his 68-year-old father for screening and said that the old man could not learn to use a smart phone and must have cognitive problems. Later, we talked and found out that the old man is usually not interested in digital products and would rather read newspapers and play chess. He really needs to learn to make video calls. You can learn it after being taught two or three times. This kind of subjective "not wanting to learn" is completely different from the "unable to learn" caused by cognitive impairment. Don't just make mistakes. If you are really unsure, go to the community to do a free cognitive screening, which is much more reliable than trying to figure it out at home.