Characteristics of cognitive health in older adults include

Daily decision-making ability is stable, social functions remain intact, and emotional regulation is within a reasonable range. This is currently a consensus reached in the fields of geriatric psychiatry and community elderly care services in China.

Many people’s first reaction is that “good memory means good cognition”, but this is not true. I have been doing cognitive intervention services for the elderly in the community for 5 years. I have seen too many elderly people in their 80s who cannot remember what their grandsons ate last week, but they can calculate their monthly income and expenses at home and go to the market to buy vegetables. They can also take out their mobile phones to check the batch number when they come to sell "health care beds", and then call our community to report fraud - this is a typical manifestation of stable decision-making ability. At present, the academic community does have different judgment standards on this point: researchers in the field of neurocognition pay more attention to memory indicators and believe that if episodic memory (that is, the ability to recall specific events and scenes) declines beyond the normal threshold for the same age group, we need to be vigilant. However, front-line service providers are more "functionally oriented" - as long as the elderly can make common sense judgments on matters related to their own interests that do not harm their own rights and interests, even if they are more forgetful, they still belong to the category of cognitive health.

Being able to handle things on your own is the foundation. Whether you can maintain your accustomed social and life rhythm is also an important basis for our judgment.

Uncle Li, 78, was an engineer at a machinery factory before retiring. He had a quiet temperament and did not like to have dinner parties when he was working. After retirement, he spent most of his time at home playing with model airplanes and only went hiking once a week with two old colleagues. Last time his daughter came to me and asked if her father's cognitive decline was due to not going out all day. I chatted with her for half an hour to find out that Uncle Li could not only assemble the model airplane at home, but also give tutorials to novices online. He planned the route, brought water and medicine, and talked about the parameters of the model airplane with netizens clearly during the weekly mountain climbing trip. How could this be cognitive decline? This social function is very good. Some clinical assessment scales regard "number of social interactions per week" as an important scoring item, and believe that low social frequency is a sign of cognitive decline. However, humanistic geriatric psychology researchers generally believe that as long as the elderly's social participation status is consistent with his usual behavior pattern and there is no sudden social withdrawal, even if he likes to be alone, it is completely healthy. There is no need to force the elderly to square dance or participate in group activities.

There is another feature hidden in the details that many family members often don’t notice until it is very serious, which is the stability of emotional control.

When Aunt Wang's wife passed away, she was unwilling to go out for three months. She sat on the balcony and touched her husband's photos every day. Her son was so anxious that he took her to the hospital for a checkup. As a result, all cognitive scores were within the normal range. The doctor said it was a normal response to mourning. Later, we came to chat with her every week. After more than half a year, she gradually recovered. Now she also participates in community handicraft classes, and occasionally makes small dolls and sends them to us. Indeed, many studies regard "persistent emotional abnormalities" as prodromal symptoms of cognitive impairment, such as unwarranted suspicion, sudden rage, and long-term depression, which require vigilance, but the premise is that there are "no inducements" - if you encounter specific life events such as the death of your wife, moving, or falling, short-term mood swings are completely normal and cannot be directly equated with cognitive deterioration.

Oh, by the way, there is another misunderstanding that needs to be mentioned. Many people think that "the elderly can read and use smartphones as cognitive health", which is not correct. I have seen many elderly people who are good at watching short videos and grabbing red envelopes, but then they were defrauded out of tens of thousands by the "magic medicine" in the live broadcast room. People with this kind of decision-making ability must be alert to the possibility of cognitive decline even if they play with mobile phones.

After working in this industry for a long time, I feel that there has never been an absolute unified standard for "cognitive health". Just like some of our young people have good memories and some have bad memories, the same is true for the elderly. Don't use online test questions to casually label the elderly as "dementia". As long as he lives comfortably, can take care of his own life, and does not cause unnecessary trouble to himself and those around him, then he is healthy. Of course, if there is a sudden change that is completely different from before, for example, a person who has been frugal all his life suddenly spends tens of thousands of yuan on useless health products, or a person who used to be particularly mild-tempered suddenly suddenly accuses his family of stealing his money, then it is not too late to go to the hospital for examination in time.