Relatedly, mild cognitive impairment (MCI) is a term used to describe the intermediate stage between normal cognitive aging and dementia. The most common cause of dementia, Alzheimer’s disease (AD), is associated with the abnormal accumulation of the proteins amyloid-β (Aβ) and tau in the brain. ĭementia is a general term that describes a set of symptoms, including difficulties with thinking and memory, which interfere with the ability to perform activities of daily living. In fact, studies have suggested that more than half of adults over the age of 65 have concerns about their memory. The prospect of losing memory and independence is among the most feared aspects of aging. Members of this age group have been particularly concerned about maximizing longevity and quality of life. In the next decade, that number is projected to grow to 74 million. Currently, 53 million people over the age of 65 live in the U.S. In the United States (U.S.), the older population is also growing rapidly, as 75 million Baby Boomers (the cohort born between 19) turn 65. Already in Europe, more than a quarter of the population (190 million) is older than age 60. This number is expected to grow to 2.1 billion by 2050, and to 3.1 billion by 2100. As of 2019, there were an estimated one billion people over the age of 60 globally. By 2050, the global life expectancy is predicted to reach 77.1 years. In 2019, the global life expectancy at birth reached 72.6 years, an increase of more than eight years since 1990. Average life expectancy has dramatically increased in the last several decades and is predicted to continue increasing on a similar trajectory. In this update, we will summarize the findings of past and recent research, present them in an accessible format, and offer practical advice about helping patients to adopt brain-healthy behaviors.Īccording to a 2019 United Nations report, the population over the age of 60 is growing faster than other age groups. Several major health organizations have published brain health recommendations based on research studies investigating how various behaviors and lifestyle factors affect the risk of developing cognitive decline and dementia. Many of the suggestions made in 2010 have been supported by additional research and have been increasingly embraced clinically. A Pubmed search of papers linked to relevant key words, including “brain health,” “healthy brain aging,” “promoting cognitive health,” “preventing cognitive decline,” “dementia risk reduction,” “dementia prevention,” and “Alzheimer prevention,” went from 917 published in 2001-2010 to 6,243 published in 2011-2020. The number of articles on cognitive/brain health and dementia risk reduction has grown substantially. A decade has passed, making this a good time to take stock of the field, which has garnered increasing interest. In 2010, we published an article in this journal entitled, “Promoting successful cognitive aging: a comprehensive review”. In this update, we review the evidence for each of these recommendations and offer practical advice about behavior-change techniques to help patients adopt brain-healthy behaviors. Other behaviors like regular social engagement, limiting alcohol use, stress management, getting adequate sleep, avoiding anticholinergic medications, addressing sensory deficits, and protecting the brain against physical and toxic damage also have been endorsed, although less consistently. Most organizations have also embraced cognitively stimulating activities, a heart-healthy diet, smoking cessation, and countering metabolic syndrome. Regular physical activity and treatment of cardiovascular risk factors have been supported by all of these organizations. Importantly, there is a growing consensus among major health organizations about recommendations to mitigate cognitive decline and promote healthy cognitive aging. Many of the suggestions made in 2010 have been supported by additional research. Converging lines of evidence from epidemiological/cohort studies, animal/basic science studies, human proof-of-concept studies, and human intervention studies can provide guidance, highlighting strategies for enhancing cognitive reserve and preventing loss of cognitive capacity. Despite uncertainties, clinicians often need to at least make provisional recommendations to patients based on the highest quality data available. Because there have been limited large-scale, randomized controlled trials, especially following individuals from middle age to late life, some experts have questioned whether recommendations can be legitimately offered about reducing the risk of cognitive decline and dementia. A decade has passed since we published a comprehensive review in this journal addressing the topic of promoting successful cognitive aging, making this a good time to take stock of the field.
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