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Making Sense of Alzheimer’s is a creative space for people to understand the past, present and future of Alzheimer’s disease. It is an evolving forum, a gallery of ideas, a museum without walls.

IOM Report on Cognitive Aging

The Institute of Medicine’s recent report, Cognitive Aging: Progress in Understanding and Opportunities for Action, is timely. The U.S. population is rapidly aging and individuals are becoming more concerned about their cognitive health. Older adults view “staying sharp” as perhaps one of their most important health care goals.

Prepared by the Committee on the Public Health Dimensions of Cognitive Aging, the report examines the concept of cognitive aging, its impact on public health, and the research and  education needed to better understand and maintain the cognitive health of older adults.

Cognitive aging is a process of gradual, ongoing, yet highly variable, changes in cognitive functions that occur as people get older. Age-related changes in cognition can affect not only memory but also decision-making, judgment, processing speed, and learning.

“Among our key findings was that both human and animal models show how in cognitive aging, neurons are not working as well, but they’re not dying,” says Making Sense of Alzheimer’s Jason Karlawish, MD, a member of the report committee. He noted that this is important because “Synapses may be sick, but there’s a chance they can get well again.”

The report’s findings and recommendations address steps individuals, health care professionals, communities and society can take to promote cognitive health:

ο    Increasing research and tools to improve the measurement of cognitive aging.

ο    Promoting physically activity; reducing and managing cardiovascular disease risk factors,
including high blood pressure, diabetes, and smoking; and regularly discussing and
reviewing with a health care professional the medications that might influence cognitive
health.

ο    Expanding public communications efforts around cognitive aging with clear messages that
the brain ages, just like other parts of the body; cognitive aging is not a disease; cognitive
aging is different for every individual (there is wide variability across persons of similar age);
some cognitive functions improve with age, and neurons are not dying as in Alzheimer’s
disease (hence, realistic hope is inherent in cognitive aging); and finally, there are steps that
patients can take to protect their cognitive health.

ο    Developing and improving financial programs and services used by older adults to help
them avoid financial exploitation, optimize independence, and make sound financial
decisions.

ο    Health care systems and health care professionals should implement interventions to insure
optimal cognitive health across the life cycle including programs to avoid delirium
associated with medications or hospitalizations.

ο    Determining the appropriate regulatory review, policies and guidelines for products advertised to consumers to improve cognitive health, particularly medications, nutritional supplements, and cognitive training.

The Journal of the American Medical Association commented in a “Viewpoint” article that “Cognitive aging is not a disease, but it is a major public health issue. … Patients are already concerned. The time has come for physicians, other health care professionals, and researchers to enter the conversation with them.”

The report, a slide set,  and a four-page key point summary, are free and available for download at www.iom.edu/cognitiveaging.

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