Use It or Lose It: Preventing Cognitive Decline
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Use It or Lose It: Preventing Cognitive Decline

Cognitive Aging

Changes in cognitive function, such as slow speed of information processing, are common in normal aging. However, there is considerable variation among individuals, and cognitive decline is not inevitable.

man running on beach In fact, many older adults appear to avoid cognitive decline into their ninth decade of life, and some even beyond. The best news of all is that some risk factors for cognitive decline are potentially manageable, according to researchers.

Cognition is a combination of skills including:

  • Attention
  • Learning
  • Memory
  • Language and speech
  • Fine motor skills
  • Visuospatial orientation
  • Executive functions, such as
    • Goal-setting
    • Planning
    • Judgment

Slow speed of information processing, which may cause other deficits in cognitive functioning, is a hallmark of normal aging. Structural changes in the brain are associated with cognitive decline in apparently normal aging; however, the cause of these changes remains unknown. Three types of cognitive decline with aging have been recognized:

  • Age-associated memory impairment (AAMI)—mild memory impairment that can occur with normal aging, but cannot be detected with objective psychometric testing for the person’s age group
  • Mild cognitive impairment (MCI)—mild memory loss that can be detected with objective psychometric testing for the person’s age group
  • Dementia (includes Alzheimer’s disease)–chronic, progressive, irreversible, global cognitive impairment and memory loss that are severe enough to affect daily functioning

Risk Factors for Cognitive Decline

A number of research studies have identified common, potentially modifiable risk factors for cognitive decline. These risk factors include:

If you have a medical condition that may be causing your cognitive decline, talk to your doctor.

Vital Activities for a Vital Mind

According to the Mayo Foundation for Medical Education and Research, as you age, your brain remains capable of adapting to stimuli. Although declines occur in certain cognitive functions, other cognitive functions increase with age and can compensate for functions that may decline. Researchers found that people who age with greater stores of knowledge may show increased adaptation. Vocabulary also tends to improve with age. Certain activities can assist older adults in increasing their capacity to learn and adapt as they age.

The Institute for the Study of Aging and the International Longevity Center-USA recommend the following strategies:

Stay Socially Active

A study in the Annals of Internal Medicine found that having no social ties was an independent risk factor for cognitive decline in older persons. Therefore, maintaining many social connections and participating in social activities are recommended. Researchers suggest that social activities help prevent cognitive decline by stimulating the mind and challenging people to communicate.

Working at a paid or volunteer job may also help. Complex intellectual work has been found to increase the cognitive function of older workers. Work also provides an opportunity for social interactions and a sense of personal mastery, both of which may be important in maintaining the vitality of the brain.

Keep Learning

Some studies suggest that having a low level of formal education and poor linguistic skills is a risk factor for cognitive decline in later life. However, other studies have not found this association. Nonetheless, many studies on humans and animals suggest that lifelong learning is beneficial in preserving cognitive vitality in later life.

One such study, published in the Journal of the American Medical Association, found that frequent participation in mentally stimulating activities is associated with a reduced risk of Alzheimer’s disease. Mental stimulation is not limited to formal education and can include everyday activities such as:

  • Reading books, newspapers, or magazines
  • Playing games such as:
    • Cards
    • Checkers
    • Crosswords, or other puzzles
  • Going to museums

A number of studies have also shown that older adults with mild cognitive decline can improve cognitive functioning (including reasoning, memory, visual perception, attention, and skill coordination) through special training. However, training is often specific to the skills trained and learned.


Some studies show improved cognitive functioning in older adults who exercise. It’s possible that exercise may contribute to cognitive vitality by improving mood and reducing stress and other risk factors that contribute to cognitive decline. Although more research is needed, the latest data suggest that engaging in physical exercise, including enjoyable leisure activities, may help prevent cognitive decline.

Ask Your Doctor About Herbs and Supplements

Malnutrition and vitamin deficiencies can lead to cognitive disorders (including dementia) in older people. Some studies suggest that antioxidants, such as vitamin E, may slow the progression of Alzheimer's disease. The herb Ginkgo biloba, which is also used to treat Alzheimer's disease, is also used to improve age-related mental decline. Talk to you doctor, though, before taking any herbs or supplements. There may be safety issues related to other conditions that you have and medications that you are taking.

Eat a Low-Fat Diet

A nutritious, low-fat diet may protect against cognitive decline by providing necessary nutrients and reducing the risk of diseases that contribute to cognitive decline, such as high blood pressure, type 2 diabetes, high cholesterol, and atherosclerosis.

Practice Stress Management

Acute stress, particularly long-term stress, is associated with cognitive impairment, especially in older adults. Stress management or counseling may be helpful in learning better responses to stress. This, in turn, can promote cognitive vitality.

Get Help for Sleep Disorders

Sleep disorders and sleep disruption are common in older people. These may adversely affect cognitive function, particularly memory and learning. In addition, older adults with sleep disorders may experience adverse cognitive effects associated with the use of sedatives and hypnotics, which are often prescribed for insomnia. Older adults may benefit from good sleep strategies, such as going to bed and waking up at the same time each day.

Seek Help for Other Conditions

Cognitive decline in older adults is often associated with underlying medical conditions, such as high blood pressure. Furthermore, many have more than one of these conditions, which may increase their risk for cognitive impairment. Cognitive vitality may be restored when these conditions are treated.

Talk to Your Doctor

If you’re concerned about memory loss or other cognitive impairment, do not try to diagnose or treat yourself. Your doctor can provide assessment, counseling, and treatment.

Cognitive decline is not an inevitable part of aging. Research suggests that staying mentally, socially, and physically active and healthy can increase cognitive vitality and play an important role in quality of life and survival. In addition, there is a growing interest in the development of drug treatments that may enhance cognitive vitality in older people who are experiencing normal aging.


National Council on Aging

National Institute on Aging


Mental Health Canada

Seniors Canada On-line


Bassuk SS, Glass TA, and Berkman LF. Social disengagement and incident cognitive decline in community-dwelling elderly persons. Ann Intern Med . 1999;131: 165-173.

Enhancing memory and mental function. EBSCO Natural and Alternative Treatments website. Available at: Updated July 2008. Accessed July 29, 2008.

Fillit HM, Butler RN, O’Connell AW, et al. Achieving and maintaining cognitive vitality with aging. Mayo Clin Proc . 2002; 77: 681-696.

The Institute for the Study of Aging and the International Longevity Center-USA website. Available at: . Accessed July 29, 2008.

Wilson RS, Mendes de Leon CF, et al. Participation in cognitively stimulating activities and risk of incident Alzheimer's disease. J Am Med Assoc . 2002; 287:742-748.

Yaffe K, Blackwell T, Gore R, et al. Depressive symptoms and cognitive decline in nondemented elderly women. Arch Gen Psychiatry . 1999;56: 425-430.

Last reviewed June 2008 by Rimas Lukas, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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