What are the characteristics of cognitive health in the elderly?

For those of us who spend many years doing cognitive screening in the community, the core feature of cognitive health in the elderly is not "good memory and quick response" at all, but that cognitive ability is fully adapted to our own life needs and does not delay normal life. Last week I met 76-year-old Aunt Li. I just told her about the free clinic next week and forgot about it. But every day she has to prepare meals for her diabetic wife, remember the dosage of four anti-diabetic drugs, and even know which vegetable shop downstairs sells vegetables for 20 cents cheaper. The scale measured that her instant memory score was almost 10 points lower than the norm, but we all felt that her cognitive state was particularly healthy.

In fact, the academic community now has different opinions on this standard. Scholars doing research in the laboratory are more inclined to use a unified cognitive score to draw a line. If it is below a certain threshold, it is classified as cognitive abnormality. However, we who are on the front line always feel that this standard is too "rigid" - many old people who have never been to school in their lives cannot even recognize the numbers and patterns on the scale. We can't judge people as having cognitive problems just because of this, right?

In addition to this core "just enough", most cognitively healthy elderly people also have a common feature, that is, their ability to regulate emotions is not bad. It’s easy to understand. Emotional regulation itself requires the cognitive function support of the prefrontal cortex. If there is a cognitive problem, the first thing that may appear is a drastic change in personality. For example, a formerly gentle person suddenly becomes suspicious and irritable, or is always trapped in negative emotions and cannot get out. I have met the 81-year-old Grandpa Wang before. He was miserable for half a year after his wife passed away two years ago. He quickly adjusted and signed up for a calligraphy class in the community. Now he goes hiking in the suburbs with his travel companions every week. When talking about his wife, he always says, "If she were here, she would definitely like me to go out for more walks." This ability to escape from negative emotions is the best proof of intact cognitive function.

To be honest, the cognitive system of the elderly is just like the senior smartphones they are used to. They do not need to install dozens of apps and run large-scale games like the smartphones of young people. As long as they can make calls, scan health codes, play opera storytelling, and meet their daily needs, it is a good machine. It is unfair to always ask the elderly for the memory and reaction speed of young people.

Of course, this does not mean that all forgetfulness is normal. If an elderly person who was able to calculate his accounts clearly suddenly cannot even calculate 10 yuan for groceries, or if he suddenly cannot find his way home after walking for more than ten years, even if it only happens once in a while, it is not normal cognitive aging, and it is best to go to the hospital for screening as soon as possible. We usually go to the community to do science popularization, and we always tell the elderly not to worry that they will develop Alzheimer's disease just because they forgot something. As long as they don't delay their daily eating, drinking, socializing, and doing whatever they want to do, they can be comfortable every day, which is the best state of cognitive health.