What are the characteristics of cognitive health in older adults that are not included?

The answer is actually very clear. The characteristics of cognitive health in old age do not include cognitive abilities that are exactly the same as those in young adults, nor do they require the absence of any occasional symptoms of forgetfulness, nor do they require a "lifetime guarantee" that they will not suffer from cognitive impairment.

I have been volunteering in the community for elderly cognitive health intervention for almost three years. I have encountered too many elderly people who have misunderstandings about this matter. They panic when they forget something, for fear that they may have Alzheimer's disease. Uncle Zhang, who used to live in Building 3, is 73 years old. He can beat most of the old men in the neighborhood when playing chess. He can even make a few cents when shopping for groceries and doing accounts. Last week, he forgot to bring his mobile phone when he went out to buy breakfast. When he came back, he complained to his children for several days, saying that his brain was not working anymore, so he forced himself to undergo a screening. All cognitive scores were within the healthy range. I explained to him that an old man’s brain is like a laptop that has been used for more than ten years. It is normal for it to start slowly and to have too many softwares running at the same time. As long as there is no problem with the core functions and it does not delay normal use, it is not considered a malfunction.

Of course, there are now different voices in the academic community. Some cutting-edge neuroscience research believes that there is no so-called "normal aging forgetfulness" at all. All cognitive decline that can be detected has potential pathological causes, but current detection methods cannot detect it. But from the perspective of front-line practice, we still prefer to use "whether it affects daily social functions" as the criterion for classification. We can't require a 70-year-old man to memorize words as fast as a 20-year-old college student, right? If we really go by that absolute standard, I'm afraid not many elderly people can be considered "cognitively healthy", which will only increase everyone's anxiety.

There are also many people who believe that as long as they are cognitively healthy now, they will definitely not get dementia in the future. This is also a big misunderstanding. Cognitive health is only an assessment of the current state. If you have long-term high blood pressure, do not smoke or drink alcohol, and stay at home every day without going out or interacting with others, your future risk of disease will still be much higher than that of an elderly person who loves to be active and social. Therefore, we always talk to the elderly in the community to do cognitive screening once a year. It is much more useful to go out more often to dance in the square, play mahjong, learn to grow flowers and make videos, etc., rather than worrying about forgetting your keys.

When it comes to the signs that you need to be vigilant about, they are the abnormal symptoms that have affected your normal life: such as forgetting what you just said, repeatedly adding salt when cooking, not being able to find your way home when you go out, your originally gentle temper suddenly becoming irritable and suspicious, and even familiar old neighbors can’t recognize you. Don’t ignore these situations, and go to the neurology department or memory clinic of the hospital for a checkup. Early intervention is much more effective.