Promoting Successful Cognitive Aging: A Ten-Year Update

Abstract

A decade has passed since we published a comprehensive review in this journal addressing the topic of promoting successful cognitive aging, making this a good time to take stock of the field. Because there have been limited large-scale, randomized controlled trials, especially following individuals from middle age to late life, some experts have questioned whether recommendations can be legitimately offered about reducing the risk of cognitive decline and dementia. Despite uncertainties, clinicians often need to at least make provisional recommendations to patients based on the highest quality data available. Converging lines of evidence from epidemiological/cohort studies, animal/basic science studies, human proof-of-concept studies, and human intervention studies can provide guidance, highlighting strategies for enhancing cognitive reserve and preventing loss of cognitive capacity. Many of the suggestions made in 2010 have been supported by additional research. Importantly, there is a growing consensus among major health organizations about recommendations to mitigate cognitive decline and promote healthy cognitive aging. Regular physical activity and treatment of cardiovascular risk factors have been supported by all of these organizations. Most organizations have also embraced cognitively stimulating activities, a heart-healthy diet, smoking cessation, and countering metabolic syndrome. Other behaviors like regular social engagement, limiting alcohol use, stress management, getting adequate sleep, avoiding anticholinergic medications, addressing sensory deficits, and protecting the brain against physical and toxic damage also have been endorsed, although less consistently. In this update, we review the evidence for each of these recommendations and offer practical advice about behavior-change techniques to help patients adopt brain-healthy behaviors.

Are Sleep Problems Related to Psychological Distress in Healthy Aging during the COVID-19 Pandemic? A Review

“…Aging is also characterized by a reduced proportion of Rapid Eye Movement (REM) sleep, a substantial reduction in non-REM (NREM) stage three sleep, and fragmented sleep with frequent interruptions, leading to a shorter total sleep time and greater amount of wake after sleep onset [45]. This leads older people to a reduction in daily functioning [46], increasing the risk of developing cognitive decline [47] and highlighting a potential causal association between sleep disorders and the pathogenesis of neurocognitive diseases, as typical aspects of neurodegenerative disorders [8].…”

“…The majority of the studies did not perform a cognitive assessment to verify whether the subjects were in normal cognitive aging; this aspect could have led to biased results. Considering the close relationship between sleep disorders and cognitive decline in the older population [47], it would be useful to investigate this aspect during the pandemic period through a more in-depth neuropsychological assessment. In addition, other factors that may affect cognitive decline should be considered, such as depression and anxiety [106,107], which have been previously related to sleep disorders.…”

Novel Nutraceutical Compounds in Alzheimer Prevention

“…Flavonoids are some of the major categories of antioxidants that can be found in apples, being quercetin one of the most important ones within this classification [ 7 ]. Quercetin can be extracted from the whole fruit, but apple peel contains greater amounts of this substance rather than the flesh of this fruit [ 7 ]. It was estimated that apples contain 2.1 to 7.2 mg/100 g of quercetin, which is mostly found in its glycoside form that is soluble in water [ 20 ].…”

“…In this context, and considering the explosive increase in AD incidence, the path to AD prevention appears as a most promising avenue to control the spread of this disease [ 6 ]. Healthy lifestyles, along with several nonpharmacological actions, were demonstrated through clinical studies to prevent manifestations of the disease and even mitigate the symptoms of diagnosed AD patients [ 7 ]. These actions include cognitive and sensory stimulation, mindfulness, practice of Chinese medicine, the Ayurveda, and especially nutrition.…”

Stem Cells: Innovative Therapeutic Options for Neurodegenerative Diseases?

“…AD is first and foremost a condition of neuronal and synaptic loss throughout the brain, primarily affecting hippocampus and the basal forebrain networks, thereafter, progressing to brain cortex. Atrophy of these brain regions, leading to a significant reduction in brain volume, closely correlate to cognitive decline and memory deficits in these patients [58]. The acknowledged neuropathological hallmarks of AD are represented by extracellular senile plaques, composed of amyloid-β (Aβ) peptide, followed by intracellular deposition of neurofibrillary tangles (NFTs) generated by hyperphosphorylated protein tau [59].…”