What are the characteristics of cognitive health in old age?

After running community cognitive screening and intervention services for five years, we now generally believe that the core characteristics of cognitively healthy elderly people are actually the ability to interact with the real world independently and smoothly. It is not "not forgetful at all" that is considered healthy as everyone thinks.

Last week, I met 78-year-old Aunt Zhang while doing a screening at a neighborhood elderly care service station. When I sat down, the first sentence she complained about was, "I've been having a hard time recently. I couldn't find the reading glasses I just put on when I turned around." As a result, I found out during the conversation that she can not only manage her pension passbook, but also remember the birthdays of every old sister. She sings Henan opera in the office, and goes around two streets every day to pick up her granddaughter from school. She even remembers her granddaughter’s favorite lemon tea with 30% sugar and less ice. All the indicators on the screening scale are within the healthy range. Those trivial things that are forgotten after turning around are just normal aging memory loss and do not affect normal life at all.

Of course, there are now different judgment tendencies in academic circles and practical fields. One group of scholars believes that "emotional stability" should be included as a core feature. They say that the early stages of cognitive degradation are often accompanied by personality mutations. For example, if a previously gentle person suddenly becomes suspicious and irritable, you should be vigilant.； However, there are also many front-line colleagues who do not agree with this standard. After all, the temper of an old man is related to his temperament. Some old people have a short temper all their lives. You cannot say that he has cognitive problems just because he loves to play chess with his old friends and get red-faced.

In the past, many family members felt that their "brain has deteriorated" when they saw that the elderly could not use smartphones. In fact, this was also a misjudgment. Last month, a family member took 72-year-old Uncle Li for a check-up and said that he couldn't even scan the health code. He must have a cognitive problem. After careful investigation, he found out that his wife had done all these things before. He had only been out of town to help his daughter with the children for half a month. It was the first time he had encountered these things. Later, he followed our mobile phone class for the elderly and learned it three times. Now he can not only scan the health code and pay utility bills online, but also take pictures of the rose flowers and hair family groups he planted. He is better at playing than many of his peers. In fact, cognitively healthy elderly people, even if they are slow to accept new things, can slowly master them as long as they are willing to learn. If they cannot remember no matter how they are taught, or even forget to add salt to the specialty dishes they have cooked for decades, that is a sign that they need to be vigilant.

You can compare the cognitive system of the elderly to the water and power grid of an old house that has been lived in for decades. The normal aging state is that the circuit breaker occasionally trips and the network speed is slower. Just turn on the switch and restart the router. It does not affect daily life at all.； If there is a complete water and power outage, and even basic lighting cannot be provided, then there is a fundamental failure. There are also studies showing that the cognitive status of the elderly who are willing to actively socialize and go out is generally better, but this is only an influencing factor, not a criterion. Some elderly people like to draw and write at home and do not like to go out to join in the fun. As long as they can arrange their own lives and communicate smoothly with family and friends, they are also in good cognitive health.

When we do science popularization for family members, we always say that there is no need to worry about the old man’s minor problems of forgetting things occasionally, and we should pay more attention to his daily state. As long as he can live his life clearly, that is the best cognitive state.