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COGNITIVE DECLINE IS REAL - and here is how you can stop it

Author: Jeevitha Ramesh


Maria was a middle-aged woman. One day, she got a call while cooking, which distracted her attention. After getting a fiery odour from her kitchen, she realized that she did not turn the stove off! Initially, she thought that such incidents were minor, but later they started to worry her. These things included losing keys, forgetting the names of her friends, difficulty in following a conversation or story in a movie. Maria then took an appointment with a doctor, and after the initial sessions, Maria was diagnosed with cognitive decline.


Studies show that 10.9% of adults aged 65 years and above suffer from cognitive decline in India. Among adults aged between 35-60 years, 8.8 % have issues with various cognitive functions. Advancing age is associated with an increased risk of declining cognitive ability or simply cognitive decline. Unfortunately, the number of people suffering from cognitive decline and other brain-related issues is expected to triple by 2040. This will become a major challenge to healthcare systems in the near future.


Cognitive decline means a decrease in the various mental abilities like problem-solving, understanding facts, retaining knowledge (memory), planning, and organizing (executive functions), etc. Such a decline limits an individual's ability to complete basic tasks of independent living (like cooking, home management, and safety) and can also affect mood and emotions. To put it simply, cognitive decline means that the brain doesn't work as well as it used to in the younger years.


Cognitive decline isn't the same as cognitive impairment. Cognitive impairment happens due to damage or disease, whereas cognitive decline occurs due to the natural ageing process.


What are the specific causes of cognitive decline?

The exact cause of cognitive decline is not known. But, various factors like poor diet, negligible physical and mental activity, unhealthy lifestyle, and even biological issues can accelerate the decline. Anything that is not good for normal brain health can lead to cognitive decline like,

  • Unhealthy diet: When the body does not get proper nutrition, it can't perform at its best.

  • Recent studies show that malnutrition weakens the brain’s ability to make decisions, process thoughts effectively, learn, and recall information. This decline can become permanent if healthy diet is not consumed.

  • Biological issues: High blood pressure, cholesterol, thyroid abnormalities, and diabetes can lead to pathological disruption of brain cells.

  • When brain cells are affected, the function gets deteriorated and can lead to cognitive compromise.

  • Aging and hormones: Age-related cognitive decline, as experienced by Maria, can result from many individual factors.

  • With age, estrogen levels in women (this also affects men) will begin to go down. Though it has little effect initially, over time, it can cause a lack of energy and a decline in brain functions such as learning, memory, and fine motor control (like writing, picking up things using fingers).

  • Free radicals: Human body builds up something called free radicals.

  • Free radicals are molecules or atoms with an unpaired electron, which means they are highly reactive and can cause damage to the cellular structure.

  • A lifetime buildup of free radicals from poor food choices and environmental toxins can cause a cellular breakdown in the brain. These free radicals also harden the arteries and restrict blood flow to the brain.

Other things such as genetics, brain damage, and mental health issues like depression can also accelerate cognitive decline.


As one ages, it’s common to find oneself forgetting. For example, where one has kept the car/house keys or not remembering the names of people known for years. Forgetfulness can be a natural part of aging, but one should not ignore it as it may cause severe impacts or signs of major medical conditions like dementia or Alzheimer’s.


The symptoms of cognitive decline may be hard to spot when they don’t significantly impact regular social functioning, family life, or work performance. But one can consider the following issues as signs of cognitive decline.



Signs of cognitive decline

Symptoms of cognitive decline can stay fixed or stable for many years or even improve over time, with varied influences on an individual's daily life.


Let us now look into some of the evidence-based activities that keep the brain healthy and slow down or prevent cognitive decline. As there is no effective treatment that can completely cure cognitive decline, it is always better to take preventive measures or follow practices that can keep us from cognitive decline.


  • Exercise: Exercise offers a wide array of health benefits.

  • Studies have shown that regular exercise improves cognitive function in people who already have memory problems as there is an increased supply of oxygen to brain cells.

  • Diet: A diet with fruits, vegetables, whole grains, beans, nuts and seeds, and olive oil. This pattern of food protects against cognitive decline.

  • Healthy food can lower the risk of developing cognitive impairment and slows the development of dementia in individuals who already have the condition.

  • Alcohol: Recent research has established that frequent alcohol-consuming individuals had a 22% higher risk of getting Alzheimer's (issue of major cognitive decline and memory loss) than nondrinkers

  • Sleep: Good sleep is known to improve overall health and may prevent cognitive decline.

  • Studies have proven that individuals who sleep less than seven to eight hours regularly scored less on tests that measured mental function. This may be because learning and memories are not consolidated during irregular and improper sleep.

  • Social contacts: Social interaction can have profound effects on brain health and longevity.

  • Research evidence shows that strong social connections are as meaningful as physical activity and a healthy diet. It is also proven that people with strong social ties are less likely to experience cognitive decline than those who are alone.

  • Social activities require engaging in critical mental processes, including attention and memory, which can support cognition.

  • Frequent engagement helps strengthen neural networks, slowing normal age-related declines. It may also help strengthen cognitive reserve, which can delay the onset of dementia.

A recent study showed that brain training reduces the risk of cognitive decline and dementia. At Cambridge, the brain sciences department conducted a study where it examined the link between cognitive activities and cognition. Results showed that cognitive activities like playing chess, solving puzzles, and sudoku helped in cognitive improvement, and this practice can also decrease the onset of cognitive decline.


It is important to adopt effective measures that increase the brain capacity and cognitive reserve to overcome cognitive decline. There are a variety of lifestyle improving and cognitive reserve-building programs. These programs can help rebuild cognitive reserve and retrain cognitive processes so that any impairment or cognitive decline slows down.


In this line, the Brighter minds ReStart program uses a practical approach to cope with cognitive decline through brain-training exercises. The program will also help individuals understand and modify lifestyle aspects to protect brain health and enhance cognitive capacity.


References:

  1. Taylor CA, Bouldin ED, McGuire LC (2018). Subjective Cognitive Decline Among Adults Aged ≥45 Years — United States, 2015–2016. MMWR Morb Mortal Wkly Rep, 67(27): 753–757.

  2. Gibson AK, Richardson VE. Living Alone With Cognitive Impairment. Am J Alzheimers Dis Other Demen. 2017 Feb;32(1):56-62

  3. Portacolone E, Johnson JK, et.al. The Effects and Meanings of Receiving a Diagnosis of Mild Cognitive Impairment or Alzheimer’s Disease When One Lives Alone. J Alzheimer’s Disease 61 (2018) 1517–1529.

  4. Waldorff FB, et.al. If you don’t ask (about memory), they probably won’t tell. J Fam Pract. 2008 Jan;57(1):41-4.

  5. Haring, et.ad. Cardiovascular Disease and Cognitive Decline in Postmenopausal Women: Results From the Women’s Health Initiative Memory Study. J Am Heart Assoc. 2013 Dec; 2(6):

  6. Chen LY et.al. Association of Atrial Fibrillation With Cognitive Decline and Dementia Over 20 Years: The ARIC-NCS (Atherosclerosis Risk in Communities Neurocognitive Study) J Am Heart Assoc. 2018;7

  7. Baird C, Lovell J, et.al. The impact of cognitive impairment on self-management in chronic obstructive pulmonary disease: A systematic review, Respir Med. 2017 Aug;129:130-139.

  8. Anderson L, et.al. Demographic and Health Status Differences Among People Aged 45 or Older With and Without Functional Difficulties Related to Increased Confusion or Memory Loss, 2011 Behavioral Risk Factor Surveillance. Prev Chronic Dis 2015;12:140


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