The risk factors for cognitive impairment are distributed in three periods, and these four cornerstones can be effectively prevented!

Author: Wang Huali, Professor of Peking University Sixth Hospital

Reviewer: Hu Wenli, Chief Physician, Beijing Chaoyang Hospital, Capital Medical University

The risk of cognitive decline is age-related, with the incidence of cognitive impairment generally being low before age 65. However, once you are over 65, the incidence roughly doubles with every 5 years of age.

1. What are the risk factors for cognitive impairment in the elderly?

Internationally recognized risk factors for cognitive impairment are generally distributed in three stages of life: childhood, middle age and late age.

In childhood, education level is considered a significant factor, and lower education levels are associated with a higher risk of cognitive impairment. However, this relationship is not absolute. Even if education is limited in childhood, subsequent social activities, lifelong learning, and other forms of knowledge acquisition can theoretically have a protective effect on the brain. Therefore, it is crucial to recognize low education level as an important risk factor for cognitive impairment and take active measures to improve it.

As people enter middle age, several risk factors closely related to cognitive impairment begin to emerge. These include chronic diseases such as high blood pressure, diabetes, and elevated low-density lipoprotein cholesterol levels, especially when blood pressure and blood sugar are poorly controlled; chronic traumatic brain injury, such as brain damage caused by long-term participation in high-risk sports such as boxing; hearing loss; and significant obesity problems, all of which increase the risk of cognitive impairment.

In later life, unhealthy lifestyle becomes one of the main risk factors, such as unreasonable eating habits, smoking and excessive drinking. In addition, poorly controlled diabetes and hypertension, impaired vision, lack of social activities, poor mental state (such as long-term depression), irregular physical exercise, lack of participation in social interaction, and environmental exposure, especially environmental pollution, may increase the risk of cognitive impairment.

As our understanding of the impact of cognitive impairment deepens, people are paying more and more attention to the cognitive health of the elderly and realizing the importance of preventive measures.

2. What are the four cornerstones for preventing cognitive impairment?

So far, although no fundamental method for preventing cognitive impairment has been found, studies have shown that the risk of cognitive impairment can be reduced by up to 40% by preventing risk factors. Preventive measures mainly include the following four aspects:

First, we should advocate lifelong learning. Lifelong learning helps maintain the plasticity of the brain and keep it active. Extensive learning during childhood can enhance brain reserves. The higher the cognitive reserve, the lower the risk of cognitive impairment. Recent studies have shown that continuous reading can reduce the risk of cognitive impairment. Therefore, young people should cultivate the habit of reading to enhance brain vitality.

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Secondly, maintain good living habits. A balanced diet is an important guarantee for cognitive health and brain health. An unbalanced diet not only damages the brain, but also increases the risk of diseases such as heart disease, high blood pressure, diabetes and obesity, which in turn increase the burden on the brain and lead to cognitive decline.

The World Health Organization points out that smoking and even passive smoking may increase the risk of cognitive impairment, so the Global Tobacco Control Initiative advocates quitting smoking to reduce this risk. Appropriate physical exercise can promote the production of brain-derived neurotrophic factor, which helps nerve cells grow or maintain functional connections between them. Lack of exercise reduces this protective effect.

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Third, strengthen chronic disease management and correct visual and auditory impairment. Many chronic diseases, such as hypertension, diabetes, hyperlipidemia, obesity and other non-communicable diseases, need to be effectively managed and treated. Heart health is the guarantee of brain health, and controlling the risk factors of cardiovascular disease is of great significance to the prevention of cognitive impairment.

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Finally, maintain mental health. For the elderly, if they are pessimistic, depressed, or lose interest in the outside world, they should be actively encouraged to participate in social activities and puzzle games. These activities help reshape brain function, improve plasticity, and have a positive effect on preventing cognitive impairment. At the same time, maintaining a positive attitude, pursuing new things, and maintaining curiosity and freshness are also important strategies for maintaining mental health and promoting brain cognitive health.

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To sum up, lifelong learning, good living habits, chronic disease management and mental health maintenance constitute the four cornerstones for preventing cognitive impairment.