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Cognitive Health

Cognitive Health and Older Adults

Indian and Asian women laughingCognitive health—the ability to clearly think, learn, and remember—is an important component of brain health. Others include:

  • Motor function—how well you make and control movements
  • Emotional function—how well you interpret and respond to emotions
  • Sensory function—how well you feel and respond to sensations of touch, including pressure, pain, and temperature

This guide focuses on cognitive health and what you can do to help maintain it. The following steps can help you function every day and stay independent—and they have been linked to cognitive health, too.

Take Care of Your Physical Health

Taking care of your physical health may help your cognitive health. You can:

Eat Healthy Foods

A healthy diet can help reduce the risk of many chronic diseases, such as heart disease or diabetes. It may also help keep your brain healthy.

In general, a healthy diet consists of fruits and vegetables; whole grains; lean meats, fish, and poultry; and low-fat or non-fat dairy products. You should also limit solid fats, sugar, and salt. Be sure to control portion sizes and drink enough water and other fluids.

Researchers are looking at whether a healthy diet can help preserve cognitive function or reduce the risk of Alzheimer's. For example, there is some evidence that people who eat a "Mediterranean diet" have a lower risk of developing mild cognitive impairment.

Researchers have developed and are testing another diet, called MIND, a combination of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. One study suggests that MIND may affect the risk of Alzheimer's disease.

Get more information about healthy eating for older adults.

Be Physically Active

Being physically active—through regular exercise, household chores, or other activities—has many benefits. It can help you:

  • Keep and improve your strength
  • Have more energy
  • Improve your balance
  • Prevent or delay heart disease, diabetes, and other diseases
  • Perk up your mood and reduce depression

Studies link ongoing physical activity with benefits for the brain, too. In one study, exercise stimulated the human brain's ability to maintain old network connections and make new ones that are vital to cognitive health. Other studies have shown that exercise increased the size of a brain structure important to memory and learning, improving spatial memory.

Aerobic exercise, such as brisk walking, is thought to be more beneficial to cognitive health than non-aerobic stretching and toning exercise. Studies are ongoing.

Federal guidelines recommend that all adults get at least 150 minutes of physical activity each week. Aim to move about 30 minutes on most days. Walking is a good start. You can also join programs that teach you to move safely and prevent falls, which can lead to brain and other injuries. Check with your healthcare provider if you haven't been active and want to start a vigorous exercise program.

For more information, see Go4Life®, NIA's exercise and physical activity campaign for older adults.

Keep Your Mind Active

Being intellectually engaged may benefit the brain. People who engage in meaningful activities, like volunteering or hobbies, say they feel happier and healthier. Learning new skills may improve your thinking ability, too. For example, one study found that older adults who learned quilting or digital photography had more memory improvement than those who only socialized or did less cognitively demanding activities.

Lots of activities can keep your mind active. For example, read books and magazines. Play games. Take or teach a class. Learn a new skill or hobby. Work or volunteer. These types of mentally stimulating activities have not been proven to prevent serious cognitive impairment or Alzheimer's disease, but they can be fun!

Scientists think that such activities may protect the brain by establishing "cognitive reserve." They may help the brain become more adaptable in some mental functions, so it can compensate for age–related brain changes and health conditions that affect the brain.

Formal cognitive training also seems to have benefits. In the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial, healthy adults 65 and older participated in 10 sessions of memory training, reasoning training, or processing–speed training. The sessions improved participants' mental skills in the area in which they were trained. Most of these improvements persisted 10 years after the training was completed.

Be wary of claims that playing certain computer and online games can improve your memory and other types of thinking. Evidence to back up such claims is evolving. NIA and others are supporting research to determine if different types of cognitive training have lasting effects.

For more information, see Participating in Activities You Enjoy.

Stay Connected with Social Activities

Connecting with other people through social activities and community programs can keep your brain active and help you feel less isolated and more engaged with the world around you. Participating in social activities may lower the risk for some health problems and improve well-being.

So, visit with family and friends. Join programs through your Area Agency on Aging, senior center, or other community organizations.

We don't know for sure yet if any of these actions can prevent or delay Alzheimer's disease and age–related cognitive decline. But some of them have been associated with reduced risk of cognitive impairment and dementia.

Reduce Risks to Cognitive Health

Genetic, environmental, and lifestyle factors are all thought to influence cognitive health. Some of these factors may contribute to a decline in thinking skills and the ability to perform everyday tasks such as driving, paying bills, taking medicine, and cooking.

Genetic factors are passed down (inherited) from a parent to child and cannot be controlled. But environmental and lifestyle factors can be changed, particularly those you can control yourself. These factors include: 

  • Health problems, such as heart disease, diabetes, stroke, and depression
  • Brain injuries
  • Some medicines, or improper use of them
  • Lack of physical activity
  • Poor diet
  • Smoking
  • Drinking too much alcohol
  • Sleep problems
  • Little social activity and being alone most of the time

Health Problems

Many health conditions affect the brain and pose risks to cognitive function. These conditions include:

  • Heart disease and high blood pressure—can lead to stroke and changes in blood vessels related to dementia
  • Diabetes—damages blood vessels throughout the body, including the brain; increases risk for stroke and heart attack; associated with increased risk for Alzheimer's
  • Alzheimer's disease—causes a buildup of harmful proteins and other changes in the brain that leads to memory loss and other thinking problems
  • Stroke—can damage blood vessels in the brain and increase risk for vascular dementia
  • Depression—can lead to confusion or attention problems; has also been linked to dementia
  • Delirium—shows up as an acute state of confusion, often during a hospital stay, and is associated with subsequent cognitive decline

It's important to prevent or seek treatment for these health problems. They affect your brain as well as your body!

Brain Injuries

Older adults are at higher risk of falls, car accidents, and other accidents that can cause brain injury. Alcohol and certain medicines can affect a person's ability to drive safely and increase the risk for accidents and brain injury. Learn about and deal with risks for falls, and participate in fall prevention programs. Wear helmets and seat belts to help prevent head injuries as well.

Medicines

Some medicines, and combinations of medicines, can affect a person's thinking and the way the brain works. For example, certain drugs can cause confusion, memory loss, hallucinations, and delusions in older adults.

Medicines can also interact with food, dietary supplements, alcohol, and other substances. Some of these interactions can affect how your brain functions. Drugs that can harm older adults' cognition include:

  • Antihistamines for allergy relief
  • Medicines for anxiety and depression
  • Sleep aids
  • Antipsychotics
  • Muscle relaxants
  • Some drugs to treat urinary incontinence
  • Medications for relief of cramps in the stomach, intestines, and bladder

Lack of Physical Activity

Lack of exercise and other physical activity may increase your risk of diabetes, heart disease, depression, and stroke—all of which can harm the brain. In some studies, physical activity has been linked to improved cognitive performance and reduced risk for Alzheimer's disease. More research in this area is needed, however.

Poor Diet

A number of studies link eating certain foods with keeping the brain healthy—and suggest that other foods can increase health risk. For example, high-fat, high-sodium foods can lead to health problems, like heart disease and diabetes, that harm the brain.

Smoking

Smoking is harmful to your body and your brain. It raises the risk of heart attack, stroke, and lung disease. Quitting smoking at any age can improve your health.

Alcohol

Drinking too much alcohol affects the brain by slowing or impairing communication among brain cells. This can lead to slurred speech, fuzzy memory, drowsiness, and dizziness. Long-term effects may include changes in balance, memory, emotions, coordination, and body temperature. Staying away from alcohol can reverse some of these changes.

As people age, they may become more sensitive to alcohol's effects. The same amount of alcohol can have a greater effect on an older person than on someone who is younger. Also, some medicines can be dangerous when mixed with alcohol. Ask your doctor or pharmacist for more information.

Sleep Problems

At any age, getting a good night's sleep supports brain health. Sleep problems—not getting enough sleep, sleeping poorly, and sleep disorders—can lead to trouble with memory, concentration, and other cognitive functions.

Sleep apnea is a sleep disorder that causes short pauses in breathing when a person is sleeping. It can lead to high blood pressure, stroke, or memory loss. Treatment for sleep apnea begins with lifestyle changes, such as avoiding alcohol, losing weight, and quitting smoking. Use of a special device ordered by a doctor may also help.

Social Isolation and Loneliness

Social isolation and feeling lonely may be bad for brain health. Loneliness has been linked to higher risk for dementia, and less social activity to poorer cognitive function.

For More Information About Cognitive Health

NIA Alzheimer’s and related Dementias Education and Referral (ADEAR) Center
1-800-438-4380 (toll-free)
adear@nia.nih.gov
www.nia.nih.gov/alzheimers
The National Institute on Aging’s ADEAR Center offers information and free print publications about Alzheimer’s disease and related dementias for families, caregivers, and health professionals. ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources.

Alzheimer's Association
1-800-272-3900 (toll-free)
1-866-403-3073 (TTY/toll-free)
info@alz.org
www.alz.org