Cognitive Aging: Progress in Understanding and Opportunities for Action (2015)
Chapter: 8 Opportunities for Action
Aging is inevitable, but individuals, families, communities, and society can take actions that may help prevent or ameliorate the impact of aging on cognition, create greater understanding about its impact, and help older adults live fuller and more independent lives. One of the major concerns of older adults is “Will I stay sharp?” Although changes in cognitive function vary widely among individuals, actions that would make a difference and promote cognitive health are summarized in Box 8-1 and detailed throughout the discussion and recommendations in this report. Cognitive aging is not just an individual or family or health care system challenge—it is an issue that affects the fabric of society and requires actions by many and varied stakeholders. How society responds to these challenges will reflect the value it places on older adults and how it views their continued involvement and contribution to their families, social networks, and communities.
The committee heard throughout its work on this study that cognitive aging is a concern to many people across all cultural groups and income levels. In recent years a vigorous public health, research, and community response has focused on Alzheimer’s disease and other neurodegenerative dementias. These efforts should continue to be strengthened. At the same time, similar efforts should be made in the field of cognitive aging. Attention needs to be paid to the cognitive vulnerabilities of the vast majority of older adults who may experience cognitive decline that is not caused by a neurodegenerative disease. They, too, want to maintain their cognitive health to the fullest extent possible. The committee hopes that a commitment to addressing cognitive aging by many sectors of society will bring about further effective interventions, greater understanding of risk and protective factors, and a society that values and sustains cognitive health.
BOX 8-1
Opportunities for Action
Many of the following actions require multiple efforts involving a number of agencies, organizations, and sectors, as well as individuals and families. These efforts will be greatly strengthened by joint and collaborative efforts.
Individuals and families:
- Be physically active and intellectually and socially engaged, monitor medications, and engage in healthy lifestyles and behavior;
- Talk with health care professionals about cognitive aging concerns;
- Be aware of the potential for financial fraud and abuse, impaired driving skills, and poor consumer decision making;
- Make health, finance, and consumer decisions based on reliable evidence from trusted sources.
Communities, community organizations, senior centers, residential facilities, housing and transportation planners, local governments:
- Provide opportunities for physical activity, social and intellectual engagement, lifelong learning, and education on cognitive aging; expand relevant programs and facilities;
- Improve walkability and public transportation options in neighborhoods, communities, and cities.
Health care professionals and professional associations and health care systems:
- Learn about cognitive aging and engage patients and families in discussions;
- Pay attention to cognition during wellness visits, prescribing and reviews of medications, and during hospital stays and post-surgery;
- Identify useful and evidence-based community and patient resources and make sure patients and families know about them;
- Develop core professional competencies in cognitive aging as distinct from dementia and other neurodegenerative diseases in treatment and in counseling patients and families;
- Address factors that lead to delirium in hospitalized patients.
Public health agencies at the federal, state, and local levels; aging organizations; media; professional associations; and consumer groups:
- Strengthen efforts to collect and disseminate population-based data on cognitive aging as separate from dementia and other neurodegenerative diseases;
- Develop and widely disseminate independent authoritative information resources on cognitive aging and criteria for consumer evaluation of products and medications that make claims to enhance cognition;
- Develop, test, and disseminate key messages regarding cognitive aging through social marketing campaigns, media awareness efforts, and other approaches to increase public understanding about cognitive aging; and promote activities that help maintain cognitive health.
Research funders and researchers:
- Explore cognitive aging as separate from dementia and other neurodegenerative diseases in basic, applied, and clinical research;
- Expand research on the trajectories of cognitive aging and improve assessments of cognitive changes and impacts on daily function;
- Focus research on risk and protective factors for cognitive aging and on developing and improving implementation of interventions aimed at preventing or reducing cognitive decline and maintaining cognitive health.
Policy makers, regulators, and consumer advocacy and support organizations:
- Support the resources needed to understand and address cognitive aging;
- Determine (or provide input into the appropriate regulatory review) policies and guidelines for products, medications, and other interventions that claim to enhance cognitive function or that have a negative impact on cognition;
- Develop, validate, and disseminate policies, products, services, and informational materials focused on cognitive aging and addressing potential financial, health, and safety impacts, harms, and vulnerabilities.
Private-sector businesses, including the financial, transportation, and technology industries:
- Develop, validate, and disseminate policies, products, services, and informational materials focused on cognitive aging and addressing potential financial, health, and safety impacts, harms, and vulnerabilities.
