Elderly cognitive health education content

The core of cognitive health education for the elderly is by no means a "collection of anti-dementia tips" sold on the market, but a full-chain knowledge system that is adapted to elderly groups with different cognitive status and covers three dimensions: physiological intervention, psychological adjustment, and social support. It includes not only cognitive decline risk prevention and control content for healthy elderly people, but also non-drug intervention guidance for people with mild cognitive impairment, not to mention the popularization of care and support for patients with cognitive impairment and their families.

I have been doing cognitive health science popularization in the community for three years, and I have seen too many misunderstandings about this matter among the elderly and even their family members. When many people hear the word "cognitive health", their first reaction is "I don't have dementia, why should I learn this?" In fact, there has been no unified conclusion in the academic circles and popular science circles about the priority groups covered by cognitive health education: one group advocates that resources should first be allocated to high-risk groups over 65 years old, those with hypertension, diabetes, and family history of dementia, and priority should be given to screening and targeted science popularization. After all, the risk of cognitive decline for these people is 3-5 times that of ordinary elderly people. ； The other group believes that universal science education should be conducted for the entire elderly population first. After all, many elderly people have no idea about the early signs of cognitive decline. Among the 120 community elderly people we surveyed last month, 70% regarded "frequently forgetting to bring keys and forgetting to turn off the fire when cooking" as "normal phenomena of aging." By the time it is discovered that it is mild cognitive impairment, the best intervention period has been missed.

Don't tell me, last month I met a 68-year-old Aunt Zhang. She used to say that her poor memory was due to her being "confused." It wasn't until she listened to our 15-minute popular science talk at a community market that she realized that she forgot to turn off the gas stove two or three times a week. This was already a warning sign of cognitive decline. Going to the hospital for screening turned out to be mild cognitive impairment. Later, she adjusted her diet, went square dancing for an hour every day with her old sisters, and joined a community craft group. Her cognitive score increased instead of falling during the six-month review. She said, "If I had known this knowledge earlier, I wouldn't have been so worried for half a year, and almost caused a fire."

Many people think that cognitive health education is about teaching the elderly to do arithmetic problems and memorize ancient poems. In fact, this is not the case at all. Take dietary guidance as an example. When we were doing science popularization in the past, some old people would ask if it would be effective if we had to eat Western food and drink olive oil every day. In fact, there is no unified standard answer here in the academic community: The Mediterranean diet has been highly praised internationally, saying that more olive oil, deep-sea fish, and nuts are good for cognition. However, last year, a study by the Nutrition Department of Peking University Third Hospital showed that as long as you eat enough dark green leafy vegetables 5 times a week, 1-2 deep-sea fish, and one or two grains a day, our traditional Chinese dietary pattern has almost no difference in cognitive protection effect from the Mediterranean diet. There is no need to blindly follow the trend and eat things you are not used to. The last time I did a science popularization, I didn’t use PPT at all. I carried a basket of vegetables and told everyone about lettuce, seabass, and corn. It was much more effective than talking about amyloid beta and oxidative stress. The old man remembered it very well, and he would deliberately pick two more green leafy vegetables when he went to the market later.

What many people tend to overlook is that the audience for cognitive health education is not only the elderly, but also family members and caregivers. I met a 70-year-old Uncle Li before. After he was diagnosed with mild cognitive impairment, the child spent thousands on a so-called "professional cognitive training course". He was forced to memorize 10 English words and do 20 arithmetic problems every day. As a result, Uncle Li became more and more frustrated and felt that he had "really become a useless old fool." Later, he directly resisted all training and was unwilling to leave the house. After we learned about it, we quickly communicated with his children and changed the training content to what Uncle Li likes: watering several pots of flowers at home every day, remembering to pick up his grandson from school at 4 p.m., and playing chess with his old friend twice a week. After only three months of persistence, Uncle Li's condition has improved a lot, and he has now actively signed up for calligraphy classes in the community.

Speaking of which, I have to mention whether the paid cognitive training that everyone is most concerned about is worth buying? To be honest, according to the guidelines for the prevention and control of cognitive impairment released by the Chinese Geriatrics Society in 2023, structured professional cognitive training does have the effect of delaying the decline of elderly people with mild cognitive impairment. However, many courses on the market that cost several thousand yuan are essentially packaging building blocks, puzzles, and memory games into "exclusive patented courses."

If the elderly person in your family has been diagnosed with Alzheimer's disease, the focus of health education is not on training cognition, but more on teaching caregivers how to understand the elderly person's abnormal behavior: for example, if the elderly person suddenly throws things around, it is not because he is deliberately losing his temper. It is most likely that he is not feeling well or has needs that he does not know how to express.； For example, don’t change the placement of furniture at home casually, otherwise the elderly will easily get lost and fall. ； The caregiver's own psychological adjustment is also very important. I had an aunt who took care of her husband with Alzheimer's disease for 5 years, and she suffered from moderate depression. Later, after joining our caregiver support group, I realized that I don't have to do everything myself. Occasionally asking a caregiver to cover for half a day, I can go out to dance square dances or go shopping with my old sisters. This is not irresponsible, but can provide better care for the elderly.

After all, cognitive health education for the elderly has never been a high-level academic content, and there is no standard answer that is universally applicable. Just as everyone's physique is different, the suitable exercise methods are also different. Cognitive health management must also fit the living habits and preferences of each elderly person. It does not need to be so fancy and can be implemented in every day, only then it is truly useful.