Age Related Cognitive Decline
Cognitive function appears to peak around age 20 and diminish steadily over the remaining years of life.1,2 With life expectancies increasing dramatically in the last century, cognitive decline and dementia have become major contributors to disability and mortality.3,4
Aging is associated with gradual changes in the brain that slow and reduce its function. As a result of these changes, it is common for elderly people, even those without neurological disease, to find it takes longer to perform mental tasks and to experience diminished memory, attention, and abilities to learn, reason, and solve problems.2 Although some cognitive decline occurs during normal aging, its rate of progression is affected by lifestyle, environmental, and genetic factors,5 some of which may be modifiable.1,6
Aging is a complex process, and age-related conditions like cognitive decline are multifactorial. Some factors that likely contribute to age-related cognitive decline are:
- stem cell senescence,
- brain oxidative stress and mitochondrial dysfunction,
- neuroinflammation (inflammation in the brain),
- circadian rhythm and metabolic disturbances,
- vascular dysfunction,
- abnormal protein accumulation,
- disordered homocysteine metabolism,
- changing hormone levels, and
- epigenetic factors—changes in the way genes are expressed.
These same mechanisms also appear to contribute to dementia and neurodegenerative diseases like Alzheimer disease and Parkinson disease.1
Currently, much is known about lifestyle factors that work together to promote healthy brain aging, such as eating a nutrient-dense diet (eg, Mediterranean-style diet), being physically active, reducing stress, getting adequate sleep, and regularly engaging in mentally and socially stimulating activities.1,4,6 In addition, a number of integrative interventions have been identified as having protective effects on brain function.7,8
This protocol will review many underlying factors that contribute to cognitive decline, and describe several novel medical strategies, lifestyle and dietary habits, and integrative interventions that can support healthy cognitive function and brain health throughout life.