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

First, we need to clarify a few exclusions that are most likely to be confused by the public: cognitively healthy elderly people do not have no memory loss at all, nor do they need to have cognitive levels that are completely the same as those of young adults, nor do they need to have no mood swings at all.

I have been working as a grassroots service at a cognitive intervention center on the street for almost six years. I have met too many elderly people who clutched their hands and said they must have dementia as soon as they sat down. The reason was simply that they forgot to pick up their grandson from school last week, or they miscalculated a few dollars when buying groceries. As a result, after taking a full set of cognitive assessments, their scores were all within the health threshold. Take the 72-year-old Uncle Wang who came here last month. He attended a gathering of old colleagues a while ago. He stared at the old colleague he had known for more than 40 years and was stunned for half a minute without calling out his name. When he got home, he was so anxious that he couldn't sleep well for two or three days. He was worried that it was a precursor to Alzheimer's disease. I asked him Didn't he remember it later? He said that he remembered it as soon as he left the hotel. A similar situation never happened again. He could still make his own strategies and take his wife on self-driving tours in the surrounding areas. This was not a cognitive abnormality, it was completely a normal manifestation of brain aging.

Many people have a misunderstanding about cognitive health in the elderly, thinking that health means having no problems at all. In fact, the brain, like the joints and organs in the body, will naturally show signs of aging after sixty or seventy years of use. For example, it is like an old car that has been driven for more than ten years. The speed may be half a beat slower than that of a new car. Occasionally, you need to turn the key more to start the ignition. But as long as it does not break down halfway and can run long distances normally, it is in good performance. The same goes for the brains of old people. They remember things slower than when they were young, they have to ask their children twice more to learn new smartphone functions, and their reaction speed is slightly slower. As long as it does not affect their independent life, it is considered healthy. There is no need to criticize yourself for your cognitive status in your twenties and thirties.

There is also a common misunderstanding that cognitively healthy elderly people must always have a calm mind and not have negative emotions. This is not a characteristic of cognitive health. We usually refer to the latest research progress when providing grassroots services. At present, the academic community has different views on the situation of "occasional forgetting of the names of acquaintances". A few cutting-edge studies believe that if this situation occurs more than three times a month, even if you can remember it after being prompted, more in-depth follow-up is recommended. However, in the current common clinical diagnostic standards, this situation that does not affect social interaction and daily life is still classified as normal aging, and everyone should not be too nervous. As for mood swings, it's more normal. As long as the mood swings have clear triggers and can be adjusted back on their own within a week or two, such as being sad for a week because the cat they have owned for several years has gone missing, or being angry for two days after being defrauded of hundreds of dollars by a scammer, and then returning to a normal pace of life, it is not an abnormal situation at all. Only those who have been depressed and irritable for more than half a month without any inducement, or whose personality has suddenly changed, and people who were originally cheerful suddenly become withdrawn and indifferent, need to be alert to whether there is a cognitive problem.

I usually tell the elderly people who come for screening, don’t just read some symptoms of dementia on the Internet and apply them to yourself. If you are really unsure, go to a cognitive screening point in the community for a free assessment. It is much more useful than being anxious at home.