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February 20th 2008 21:32
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Memory Loss And Other Cognitive Impairment Becoming Less Common In Older Americans
ScienceDaily A new nationally representative study shows a downward trend in the rate of "cognitive impairment" -- the umbrella term for everything from significant memory loss to dementia and Alzheimer's disease -- among people aged 70 and older.
The prevalence of cognitive impairment in this age group went down by 3.5 percentage points between 1993 and 2002 -- from 12.2 percent to 8.7 percent, representing a difference of hundreds of thousands of people.
Today's older people are much likelier to have had more formal education, higher economic status, and better care for risk factors such as high blood pressure, high cholesterol and smoking that can jeopardize their brains.
In fact, among the 11,000 people in the study, those with more formal education and personal wealth were less likely to have cognitive problems.
"We know mental stimulation has an impact on the way a person's brain is 'wired,' and that education early in life likely helps build up a person's cognitive reserve. We also know cardiovascular health has a close link with brain health," he continues.
At the same time, the use of cholesterol-lowering drugs, blood pressure medications and other preventive cardiovascular medications and strategies increased dramatically in the 1990s. These factors may have helped protect seniors' brain function by decreasing the incidence of vascular dementia -- cognitive problems brought on by mini-strokes, strokes and decreased blood flow to and within the brain due to "hardened" or clogged arteries.
A good cognitive reserve can protect brains from minor insults, keeping them intact longer for thinking and memory by finding a way around a damaged area.
The study divides individuals into four categories -- no cognitive impairment, and mild, moderate and severe CI -- based on their performance on a standardized cognitive test.
But the authors caution that they could not tell which patients had true dementia, which requires additional clinical information, or Alzheimer's disease, which can be positively identified only on autopsy. However, the cutoff points for the different categories of CI were based on prior studies and on data from a new sub-study of the HRS designed to identify dementia specifically.
While the new study shows a decline in CI prevalence over time, the researchers note that the gains made in the 1990s and early 2000s might be offset by the damage that could result if the current epidemic of type 2 diabetes keeps growing among the elderly and if current middle-aged and younger people stick with unhealthy eating and exercise habits that lead to unhealthy weights and blood pressures.
Even if the proportion of older adults with CI keeps declining, the total number of older adults with CI and dementia will likely increase significantly due to the huge increase in the size of the over-65 population as the Baby Boom generation enters older age in the coming decades.
Meanwhile, they say, today's older Americans should not rest on their laurels -- but instead should be pursuing activities that can keep their minds sharp and their cardiovascular risk low. From crossword puzzles and volunteer activities to blood pressure medications, today's seniors can work to boost their brain health now and prevent decline later.
"More and more studies suggest that walking and other types of physical activity are important for preventing cognitive and memory decline," says co-author Eric Larson, M.D., M.P.H., executive director of the Group Health Center for Health Studies in Seattle, where he has led many studies of the relationship between physical activity and brain health.
"The evidence seems to be showing that staying mentally engaged with the world in any fashion -- reading, talking with friends, going to church, going to movies -- is also likely to help reduce your risk down the road," says Langa.
Adapted from materials provided by University of Michigan Health System.
So get wealthy and educated as well as all the other factors. Easy? Don't believe it.
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