Healthy Aging (2024)

Some changes in the ability to think are considered a normal part of the aging process. We develop many thinking abilities that appear to peak around age 30 and, on average, very subtly decline with age. These age-related declines most commonly include overall slowness in thinking and difficulties sustaining attention, multitasking, holding information in mind and word-finding. Research indicates that age-related changes in brain structures such as decreased hippocampal, frontal and temporal lobe volumes are a common aspect of aging that contributes to some of the thinking changes.

However, not all thinking abilities decline with age. In fact, vocabulary, reading and verbal reasoning remain unchanged or even improve during the aging process.

Normal Aging vs. Dementia

While some mild changes in cognition are considered a normal part of the aging process, dementia is not. Normal age-related declines are subtle and mostly affect thinkingspeed and attention. In abnormal aging, declines in cognition are more severe and may include other thinking abilities, such as rapid forgetting or difficulties navigating, solving common problems, expressing oneself in conversation or behaving outside of social rules. Abnormal aging can also include the motor system resulting in excessive tripping, falls or tremor. Often it is difficult to determine exactly when a person should be concerned with cognitive changes they may be experiencing. Symptoms vary from person to person – what is normal for one person may not be normal for another. This contributes to the challenges clinicians face when determining whether what someone is experiencing is a significant decline for them or within normal expectations.

Abnormal Aging: Mild Cognitive Impairment vs. Dementia

Mild cognitive impairment (MCI) and dementia are broad terms that indicate that there is a decline in cognition greater than would be expected for that person’s age, education or development. MCI means that the cognitive declines do not affect the person’s ability to carry out everyday tasks (e.g., shopping, cooking, driving), while dementia indicates those cognitive difficulties are impacting the person’s ability to complete everyday tasks. The terms MCI and dementia only tell us the severity of the problem but not the cause; some of the most common causes of MCI and dementia are Alzheimer’s disease, vascular disease, frontotemporal degeneration and Lewy body disease.

Symptoms to Watch For

The progression of cognitive deficits observed in conditions such as Alzheimer’s disease may be accelerated in the few years immediately preceding the diagnosis. Accelerated cognitive decline may not occur until events, like a life stressor or other illness (e.g., pneumonia), reach a threshold where the brain can no longer compensate for damage. Thus, it is important to get regular medical check-ups to monitor the extent and severity to which someone may be experiencing cognitive decline. Independent living should not be compromised during normal aging, unlike the transition to a neurodegenerative condition.

Risk Factors for Cognitive Decline

There are several risk factors for Alzheimer’s disease and other causes of dementia. Research suggests approximately 50% of Alzheimer’s disease cases may be related to these modifiable risk factors:

1. Type 2 diabetes
2. High blood pressure
3. Midlife obesity
4. Smoking
5. Depression
6. Little or no mental activity
7. Little or no physical exercise

Maintaining Your Brain

Research suggests that the combination of good nutrition, physical activityand mental and social engagement may provide benefit in promoting brain health.

• Stay away from smoking.
• Exercise at a moderately high level of physical activity. Exercise facilitates oxygen and growth factors in the brain and helps modulate the brain’s immune responses.
• Get routine medical care. Illnesses in your body affect your brain’s ability to optimally function.
• Maintain excellent cardiovascular health (e.g., blood pressure, cholesterol levels). What’s good for the heart is good for the brain!
• Build social support networksto reduce stress, challenge your brain and share the aging process with other people who are experiencing the same changes and joys of entering into the latter years of life.
• Keep doing the activities that challenge you and you enjoy for as long as possible. Trying new activities may be a great way to challenge your brain to make new brain connections. Gardening, playing bridge, walking, reading or other activities that are complicated enough to involve your mind but don’t add stress to your life are great examples.
• Maintain a healthy diet. Plan your meals around your vegetables and then fill in with other foods. Otherwise, as a general plan, eat a variety of foods as close to their natural state as possible.

While it is important to remain vigilant about maintaining good health, it is equally important to acknowledge that there are individual differences during the aging process. You should discuss any concerns you may have with a healthcare professional.

Resources

• A Patient’s Guide to Healthy Aging (PDF)
• A Healthcare Provider’s Guide to Healthy Aging (PDF)
• Active Minds, Healthy Brains infographic (PDF)
• What is Brain Health? from the National Institute on Aging
• Cognitive Health and Older Adultsfrom the National Institute on Aging
• How the Aging Brain Affects Thinking from the National Institute on Aging
• Healthy Aging Program and The Healthy Brain Initiative from the Centers for Disease Control and Prevention
• Know Your Blood Pressure (PDF)
• Learn about exercise and physical activity
• Learn about the Mediterranean diet pyramid and the MIND diet
• Learn about sleep and sleep hygiene
• Learn about mindfulness-based stress reduction (MBSR)
• Volunteer for research on healthy aging