|Year : 2016 | Volume
| Issue : 1 | Page : 3-5
Relevance of cognition and cognitive decline in elderly in the new millennium
Indira Sharma1, Ashutosh Kumar2
1 Department of Psychiatry, Institute of Mental Health and Hospital, Agra, Uttar Pradesh, India
2 Department of Psychiatry, SN Medical College, Agra, Uttar Pradesh, India
|Date of Web Publication||6-May-2016|
"SHRISHTI", N8/180 118, Rajendra Vihar, Newada, Varanasi - 221 005, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sharma I, Kumar A. Relevance of cognition and cognitive decline in elderly in the new millennium. J Geriatr Ment Health 2016;3:3-5
|How to cite this URL:|
Sharma I, Kumar A. Relevance of cognition and cognitive decline in elderly in the new millennium. J Geriatr Ment Health [serial online] 2016 [cited 2019 Dec 15];3:3-5. Available from: http://www.jgmh.org/text.asp?2016/3/1/3/181908
"The wiser mind mourns less for what age takes away than what it leaves behind."
-William Wordsworth (1770-1850)
In today's age of technological and scientific advancement, cognition and education have assumed great significance. Higher levels of education and cognitive functioning have been linked with higher socioeconomic status and better quality of life. Parents are spending huge amounts of money for higher education of their children so as to ensure job placement, a higher socioeconomic status and better quality of life. However, the path is not easy because of stiff competition. Thus, high level of cognitive functioning/performance seems to be the way to success.
In the new millennium, the way of life of the common man has undergone a sea change. Life has become complex, materialistic, and document-oriented. People have become dependent on several electrical and electronic gadgets. Use of computers, iPads, laptops, internet, mobiles, music systems, television, video cameras, microwave, etc., has become the order of the day and is being used extensively at workplace, in institutions of learning, at home, and also in the community. Higher education, computer skills, proficiency in using internet, including various internet applications; driving, communication skills, written and verbal; good emotional and social intelligence, social networking, and exercise and sports, which embrace various cognitive domains, are almost necessary for activities of daily living. These have been found to be associated with good social functioning and quality of life. Thus, optimal cognitive functioning becomes necessary to ensure acceptable degree of functioning. In the years to come, it may be impossible to function without an optimal level of cognitive functioning.
There is great concern about whether the new technologies have any deleterious effect on the human mind. Harmful effects of radiations on the body (including brain) are well known. Studies demonstrating harmful effects of electromagnetic waves on brain functions have started surfacing only recently. A meta-analysis for neurobehavioral effects due to electromagnetic field (EMF) exposure emitted by GSM mobile phones suggested that EMFs may have a small negative impact on human attention and working memory.  However, in a later study, with a 4-year follow-up, on 871 nondemented older Chinese participants in Singapore, there was evidently no significant deleterious effect of digital mobile phone use on cognitive functioning in older people. On the other hand, the findings suggested that digital mobile phone use may have an independent facilitating effect on global and executive functioning.  The results are intriguing and worthy of further investigation. Harmful effects of Wi-Fi, video games, excessive exposure to computer screens, etc., on cognitive functions are speculated. Despite this, the gadgets have not been dispensed with because they have become a necessary part of lives of people. Nevertheless, there is a need to protect or minimize the adverse effects of modern electronic equipment on the mind.
Age-related cognitive decline (ARCD) has been found to be an inevitable part of increased age in humans and differs in extent among individuals. Although the determinants of the differences in ARCD are not well understood, there is strong to moderate evidence for positive association of decreased risk for cognitive decline and several factors (years of formal education, physical activity, Mediterranean diet, cognitive training, and moderate alcohol consumption) and negative association with another set of factors (traumatic brain injury, mid-life obesity, mid-life hypertension, current smoking, diabetes, history of depression, and sleep disturbance).  Thus, in an aging population, the real challenge is to retain one's brain functions by controlling the modifiable risk factors for cognitive decline and live longer without compromising dignity and quality of life.
The incidence of Alzheimer's disease (AD)  and minimal cognitive impairment (MCI)  increases with age. There is a significant increase after the age of 60. Apart from this, there is a wealth of evidence to show that AD is positively linked with MCI.  On the brighter side, good cognitive reserves delay or prevent the manifestations of AD.  Memory-enhancing drugs have not been found helpful in persons with MCI, but cognitive remediation interventions ,, have been shown to improve cognitive functions. However, the effects are not long lasting and do not generalize. Besides, outcome measures varied with neuropsychological tests used with little theoretical justification of ecological relevance. 
Few professionals such as doctors, advocates, and musicians may continue to work during senescence as long as their health permits. However, for the vast majority of persons in jobs, retirement and pension often lead to a noncognitively stimulating lifestyle and restricted social network. This worsens the ARCD.
Another social change that cannot be overlooked is the disintegration of the family system from extended, to joint, to nuclear, to 1-2 member families. It is not uncommon to find a senior citizen living either alone or with his/her spouse, especially in big cities. These senior citizens generally do have any access to their family members to meet the ordinary demands of life. For them, their intelligence and level of cognitive functioning are the only support, which can facilitate an optimal level of functioning in the community. During childhood, young age, and adulthood, if one is inapt in certain cognitive tasks, help is easily available from parents or others but not so during senescence.
Thus, the need of the present day is to sensitize people about the importance of cognitive functioning in all the phases of life but more so during senescence. A lifestyle which promotes higher level of cognitive functioning/cognitive reserve should be promoted during the early years and the same should be carried into adulthood and senescence. After retirement, older people should make efforts to continue with a cognitively active life as much as possible. Intensive research is needed to find out the nature and extent of deleterious effects of modern life (electronic gadgets) on the human brain and ways to protect human beings from the same. The increasing use of robots in technology is a step in this direction. Modifiable risk factors for cognitive decline need urgent attention and must be controlled as much as possible. There is a need for developing user-friendly cognitive remediation packages for patients with MCI or other types of neuropsychiatric disorders. Last but not least, maintenance of cognitive functions has become increasing important and desirable to the human society with an aging population, the real challenge being to live long with dignity.
| References|| |
Barth A, Winker R, Ponocny-Seliger E, Mayrhofer W, Ponocny I, Sauter C, et al.
A meta-analysis for neurobehavioural effects due to electromagnetic field exposure emitted by GSM mobile phones. Occup Environ Med 2008;65:342-6.
Ng TP, Lim ML, Niti M, Collinson S. Long-term digital mobile phone use and cognitive decline in the elderly. Bioelectromagnetics 2012;33:176-85.
Baumgart M, Snyder HM, Carrillo MC, Fazio S, Kim H, Johns H. Summary of the evidence on modifiable risk factors for cognitive decline and dementia: A population-based perspective. Alzheimers Dement 2015;11:718-26.
Hedden T, Gabrieli JD. Insights into the ageing mind: A view from cognitive neuroscience. Nat Rev Neurosci 2004;5:87-96.
Pinto C, Subramanyam AA. Mild Cognitive Impairment: The Emerging Frontier in Elder Cognition. Dementia Decoded. New Delhi: Kontentworx Publishing Ltd.; 2014. p. 18-37.
Alzheimer′s Association. 2014 Alzheimer′s disease facts and figures. Alzheimers Dement 2014;10:E47-92.
Stern Y. Cognitive reserve. Neuropsychologia 2009;47:2015-28.
Wilson RS, Mendes De Leon CF, Barnes LL, Schneider JA, Bienias JL, Evans DA, et al.
Participation in cognitively stimulating activities and risk of incident Alzheimer disease. JAMA 2002;287:742-8.
Valenzuela MJ, Sachdev P. Brain reserve and cognitive decline: A non-parametric systematic review. Psychol Med 2006;36:1065-73.
Martin M, Clare L, Altgassen AM, Cameron MH, Zehnder F. Cognition-based interventions for healthy older people and people with mild cognitive impairment. Cochrane Database Syst Rev 2011:CD006220.
Hampstead BM, Gillis MM, Stringer AY. Cognitive rehabilitation of memory for mild cognitive impairment: A methodological review and model for future research. J Int Neuropsychol Soc 2014;1:1-17.