Characteristics of cognitive health in older adults do not include

There is no memory decline at all, the speed of thinking and reaction is the same as in youth, there are no negative mood swings throughout the process, and the living habits and interests are stable for a long time.

I have been a volunteer at a community elderly cognitive screening site for almost three years. The most common scene I encountered was when family members dragged the elderly in and said angrily, "Look, my mother forgot to give her change after buying groceries yesterday. Does she have Alzheimer's?" ”I turned around and asked the old man where he got in the croquet match he participated in last month. The old man could clearly tell the score of each game. He even remembered the goal score of the old man from the opponent team who liked to play side kicks.

In fact, there are currently two mainstream directions for judging the cognitive health of the elderly in China. The research team of Peking University Sixth Hospital prefers the comparison of physiological indicators. They believe that as long as there is no pathological atrophy of the temporal lobe and hippocampus, and the decline rate does not exceed 15% compared with the cognitive baseline three years ago, even if the person is in a healthy state, occasional transient memory omissions are completely normal physiological manifestations.； The team at Shanghai Jingwei Geriatrics focuses more on the integrity of social functions. They believe that even if you forget some trivial matters in life, as long as you can take care of yourself, participate in social activities normally, and handle your daily affairs, it belongs to the category of cognitive health. There is no need to rely on absolute memory standards.

I once met Mr. Chen, who was a senior engineer before he retired. He is 78 years old. Now, when he calculates the water, electricity and gas bills at home, he sometimes has to take out a calculator and click twice. His family members always say, "You didn't even need to make drafts to calculate the engineering drawings. Why are you so slow now?" They even secretly took him to have a brain CT, and there were no problems. In fact, the conduction speed of brain synapses will naturally slow down with age. Just like an old person cannot run as well as a young person, it is normal for the brain to react slowly. As long as the logic is correct and things can be done clearly, it is not a sign of cognitive unhealthy. This is also the consensus of the two schools.

Another common misunderstanding is that cognitively healthy elderly people should be happy every day and should not have negative emotions. Emo or daze means cognitive problems. Last year, there was an Aunt Wang in our area. She was in a trance for more than two months after her husband left. Sometimes she forgot to turn off the fire while cooking porridge. Neighbors asked her daughter whether it was a precursor to Alzheimer's disease. As a result, her daughter took her for an evaluation. Except for a slightly lower instant memory score, all other indicators were normal. Three months later, Aunt Wang signed up for a cheongsam catwalk class. Now she is also the team leader, coordinating performance times and counting clothing sizes. She is quicker than many young people. Decreased attention and memory deviations caused by transient mood swings have nothing to do with cognitive impairment. There is no need to blame the disease as soon as it occurs.

What’s more interesting is that many people think that the elderly should live step by step. If they suddenly want to learn new things or change the habits that have been used for decades, they are “muddleheaded.” On the contrary, they think that it is healthy to keep the same life trajectory for decades. I have collected data from a small sample over the past few years when doing screening. Among those who are still willing to try new things after the age of 70, such as learning smartphones, calligraphy, and live streaming, the proportion of subsequent mild cognitive impairment is nearly 30% lower than that of the elderly whose living habits have not changed at all for more than ten years. In fact, being willing to accept new information and adjust living habits shows that the brain's plasticity is still well maintained. If it is fixed in a completely unchanged comfort zone for a long time, the brain will not get enough stimulation, and it will be more prone to problems.

Oh, by the way, if you are really unsure about the cognitive status of the elderly at home, don’t blindly compare those self-assessments from unknown sources on the Internet. Many communities now have free cognitive screening services. Spending more than ten minutes to do a professional assessment is much more reliable than guessing at home. You don’t need to be scared when you see the elderly forgetting something. Most of the time, it is a sign of normal aging, so just relax.