Cognitive function maintenance -
Other studies also indicate improvement in both healthy and cognitively impaired older adults. While there is evidence that computerized cognitive interventions are beneficial in the cognitively healthy community-dwelling older adult and the cognitively impaired older adult, future research is necessary.
The provider should consider the positive aspects of the patient adopting a constructive activity to engage in ie, the patient using computer-based programs plays an active role in the treatment process and accepts responsibility for his or her own progress.
A recent demonstration highlighted a program designed to determine the feasibility of developing a memory clinic in a nursing facility.
Initially, there were 10 participants, and data were gathered on participants who completed the six-week program with twice-weekly sessions. Participants took daily exams and then chose activities in which to participate.
Individuals varied in familiarity with computer usage as well as the speed in using the mouse and keyboard. Therefore, some users completed more activities than others while some completed only the daily exam, the daily exam plus one activity, or multiple activities.
Overall, the participants reported enjoying the program and the incorporated activities. The participants who completed the program inquired about and expressed interest in taking part in the program in the future. The table below depicts the pre- and postprogram test scores of the Montreal Cognitive Assessment for four participants who consistently attended the program sessions.
Consistency is critical to the degree of patient success during the experience. Clinicians should underscore the importance of regularly performing the activities if the patient hopes for positive results.
Providers can start patients on a simple program such as Brainiversity, and can recommend a more sophisticated program when patients achieve the maximum benefit, become bored, or are no longer challenged. It is important to tell patients that just like medications, cognitive function improvement takes time.
However, patients should recognize that failure is part of success. Patients need to understand that they may fail at first and then improve, and that when the degree of difficulty is appropriately intensified, there again will be a degree of failure.
As stated earlier, a patient who engages in cognitive enhancement programs needs to be presented with an appropriate level of challenge in order to be stressed but not with programs or activities so difficult that he or she could become discouraged from participating.
Higher functioning patients—for example, those with advanced degrees or previously demanding vocations—will have a difficult time with this concept, as they are accustomed to success and may abandon the program under the guise of needing to visit the restroom and may not return.
It is imperative that practitioners clearly explain the trial-and-error or failure-and-success concept to maximize the prospects of overall success in terms of cognition.
She taught the primary grades in several schools staffed by religious organizations and had published 13 books. She currently resides in a personal care home. She participated in all 12 memory fitness center program sessions.
Her cognitive assessment score increased from 22 mild cognitive impairment to 27 normal cognition. On the computer program, she completed the daily exams plus seven additional activities. Her scores increased on the activities she completed more than once.
Although Amy was not diagnosed with an NCD, she was not utilizing her cognitive abilities, causing them to atrophy. He also is an adjunct professor of psychiatry at Penn State University.
Patient Handout: Steps to Keeping and Maintaining Brain Health click to view PDF. References 1. Agronin ME. Alzheimer Disease and Other Dementias. Ferguson RJ, Ahles TA, Saykin AJ, et al. Cognitive-behavioral management of chemotherapy-related cognitive change.
McCall B. Computerized training boosts cognition in schizophrenia. Medscape website. April 30, In the current study, pet ownership, dog ownership, and dog walking were related to slower deterioration in all large domains and all subdomains of executive function except working memory.
All three Trails measures revealed reduced deterioration in executive function for pet owners; two of these measures Trails A, Trails B also deteriorated more slowly for dog owners than non-owners.
Psychomotor speed Trails tests and processing speed Digit Symbol deteriorated more slowly for pet owners and dog owners than non-owners. Further, pet ownership, dog ownership, and cat ownership were related to slower deterioration in language function.
Only cat ownership was related to slower deterioration in verbal memory. One mechanism for the slower deterioration in cognition among pet owners, dog owners, and dog walkers is reduction in stress when an animal is present. Evidence supports a relationship of pet ownership with stress biomarkers and psychological perceptions of stress.
Chronic stress contributes to cognitive decline in older adults Elevations of cortisol due to disruptions in the HPA axis may impinge on hippocampal function associated with cognitive function 47 , 48 , The presence of pets is well known to decrease stress in experimental studies using both stress biomarkers 19 , 48 , 50 , 51 , 52 and subjective scales 53 , 54 , Most of these studies documented the positive influence of dogs, but do not include cats.
Evidence for pets reducing stress biomarkers in older adults during their normal daily lives is derived from ecological momentary assessment, of blood pressure in adults with pre-hypertension to mild hypertension. These differences in stress biomarkers may be related to differences in interaction of cat owners and dog owners with their respective pets and relate to the observed differences in the deterioration in executive function between dog and cat owners as they age.
Two mechanisms, increased exercise and increased social interaction or social support, could explain the relationship of dog walking to slower deterioration in cognition with aging. Previous research showed that within the biological realm increased physical activity improved cognitive function or decreased deterioration in cognitive function 31 , Walking a dog also affects the social realm by increasing social interactions of the dog walkers 57 , 58 , 59 and improves community social capital Differences in deterioration in executive function according to pet and dog ownership and dog walking suggest changes in processing and psychomotor speed.
Dog owners may use these skills more frequently to care for pet dogs. Monitoring dog behavior both within the home and on walks, and reacting quickly to environmental concerns e. Perhaps pet owners need to think and act quickly to care for their pets or prevent their pets from being injured.
This may be more important for dog than cat owners, doing this repeatedly could lead to less deterioration with aging. In the current study, there was no evidence that pet ownership, dog ownership, or cat ownership was related to deterioration in working memory Digits Forward, Digits Backward.
These results contrast with evidence from an experimental study where the presence of a dog was associated with better memory performance in preschool children Within the psychological realm, aging leads to reductions in the ability to attend to stimuli and capacity to inhibit irrelevant stimuli Deterioration in attention Trails A was slower among pet owners and dog owners than non-owners, but not related to cat ownership.
The tasks required to care for a pet may force older adults to attend to some, while inhibiting other stimuli thus providing additional use and practice in this cognitive domain. Attention switching requires that you quickly shift your focus between multiple processes, another function that may be used more in activities related to caring for a dog or dog walking than to caring for a cat.
Dog ownership may require a higher level of practice and implementation of goal-directed behaviors and attention shifting consistent with slowing the deterioration of executive function. In the current study pet ownership, dog ownership, and cat ownership were related to slower deterioration in long-term and verbal memory.
Long-term memory is a vast storehouse of information that a person may retain over extended periods of time and has been conceptualized as a permanent repository The verbal component of this storehouse includes words, labels, and sounds associated with verbal information, whereas the nonverbal component stores information such as images and spatial relationships.
All measures of long-term memory Naming, Short Recall, Long Recall and most measures of verbal memory Naming, Immediate Recall, Short Recall, Long Recall deteriorated more slowly over the ten-year period for pet owners, dog owners, and cat owners. While no studies addressed the relationship of pet ownership to memory, the relationship of chronic stress to poor memory is well established Furthermore increased social interactions with other humans which occur when individuals have pets may help maintain memory by using it to remember people and their animals.
In the current study, non-verbal memory, assessed with Visual Recall, did not change differently with aging according to pet ownership or cat ownership.
Dog ownership was associated with faster deterioration in non-verbal memory. Non-verbal memory deteriorated faster among dog owners than cat owners, suggesting that some aspects of non-verbal memory may be related to cat ownership specifically.
The games people play with their cat may require more verbal memory than activities with a dog. In the current study the measure of language function, Naming, deteriorated more slowly for pet owners, dog owners and cat owners than non-owners with aging.
It is likely that language function is used specifically in pet ownership-related tasks, so keeping pets of all kinds confers an advantage. Lower stress and more opportunities for social interaction may support language function similarly to the way they support executive function. In the current study dog walking was associated with less deterioration in the psychological realm variables of executive function, specifically short-term recall, and psychomotor speed.
Dog walking was not associated with changes in other aspects of executive function or language function. Our findings complement the changes in the social realm demonstrating that dog walking in the community was associated with less loneliness during the COVID pandemic for socially isolated older adults In our previous analysis of BLSA physical function data, dog walking was not associated with reduced deterioration in physical function The physical exercise associated with dog-walking is not a likely explanation for the observed differences in deterioration of cognition with aging among pet owners.
In the current study, moderation analyses did not demonstrate an association of cognitive impairment with the relationship of pet ownership to deterioration in cognitive function with aging. However, almost all the participants were cognitively intact.
By reducing stress, pet ownership may minimize deterioration in cognition, more for those who are mildly cognitively impaired than those who are not. Higher chronic stress was associated with faster cognitive decline in individuals with moderate cognitive impairment but not in cognitively normal participants over 3 years People with worse cognitive function may have already relinquished their pets.
However, most of the participants in the BLSA are high functioning and have few comorbidities suggesting an ability to care for pets. Similarly, those who are most frail may have been forced to give up their pets due to living restrictions.
However, the relationship of pet ownership to reduced aging-related deterioration was consistent whether pet ownership was categorized at the beginning of the ten years or at the time of each cognitive assessment. One would expect a substantial reduction in pet ownership if deterioration in cognitive function led to discontinuation of pet ownership.
It is important to note that the current study examines the relationship of pet ownership to longitudinal changes in cognitive function in community-residing older adults as they age. This is distinct from therapeutic changes in cognition that might occur with interventions in care homes or other venues.
Our findings do not include the presence of the pet during the assessment or an evaluation of how the relationship with the pet may influence the relationships we found. It is important to note that the current study was conducted on a select group of aging adults.
This also prevents in depth analysis of the role of social determinants of health. Further the large percent of individuals who live with others may not represent the overall older adult population. The generalizability of the negative findings with respect to differences in trajectories of change between dog and cat owners also is limited by the small sample sizes.
The contributions of other pet species could not be evaluated due to the small number of individuals who owned pets other than cats or dogs. While moderation analysis provided little evidence supporting the relationship of cognitive impairment to the association of pet ownership with changes in cognitive function outcomes over time, this is worth further exploration in a more varied population.
This study does not investigate whether any of the nuances of pet ownership including pet attachment and pet health or other owner participant characteristics such as marital status or living alone are related to changes in cognitive function, although both being married and not living alone are more common for pet owners than non-owners.
The current study provides important longitudinal evidence for the contribution of pet ownership to the maintenance of cognitive function in generally health community-residing older adults as they age. Older adult pet owners experienced less decline in cognitive function as they aged, after considering both their pre-existing health and age.
Memory, executive function, language function, psychomotor speed, and processing speed deteriorated less over ten years among pet owners than among non-owners and among dog owners than non-owners. Cat owners experienced less deterioration in memory and language function.
Dog walking also was associated with slower deterioration in cognitive function. This study provides the first longitudinal evidence relating pet ownership and dog walking to reduced deterioration in cognitive function with aging for generally healthy older adults residing in community settings.
The datasets generated for this study will not be made publicly available. The study is ongoing, and the data are the property of the National Institutes on Aging. Lamar, M. Longitudinal changes in verbal memory in older adults: Distinguishing the effects of age from repeat testing.
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Download references. Data for these analyses were obtained from the Baltimore Longitudinal Study of Aging BLSA , a study performed by the NIA.
NIA IRP NIH Investigators were involved in all aspects of this manuscript, including the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and the decision to submit the manuscript for publication.
This study was supported in part by the Intramural Research Program IRP , National Institute on Aging NIA , National Institutes of Health NIH.
Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, W. Lombard St. Department of Psychiatry, Center for Human Animal Interaction, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA.
Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA. Eleanor M. You can also search for this author in PubMed Google Scholar. conceived the protocol and analysis and interpretation. and M. facilitated collection of the data.
analyzed the data. EF and NRG wrote the manuscript. prepared the figures and tables. Correspondence to Erika Friedmann. At the time the project was funded, NRG was employed by WALTHAM.
Neither NRG nor WALTHAM were involved in data collection or analysis. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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Thank you for visiting nature. You are using a maintenamce version Carbohydrate Intake Guidelines limited Liver detoxification support for CSS. Maintneance obtain the best experience, mwintenance recommend you use a more up to date browser or turn off compatibility mode in Internet Explorer. In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript. An Author Correction to this article was published on 07 NovemberIntroduction: Several lifestyle Premium-quality pre-workout promote protection against Alzheimer's disease AD mainteenance a person's lifespan.
Although such protective effects miantenance been described for occupational cognitive requirements OCR in midlife, it is maintenajce unknown whether they are conveyed by brain maintenance BMbrain reserve BRor cognitive reserve CR or a combination of them. Methods: We fhnction derived hypotheses for these resilience Carbohydrate Intake Guidelines and tested them in the population-based AgeCoDe cohort and memory clinic-based AD high-risk DELCODE study.
Cogmitive 2high OCRS was associated with fuunction later Cognktive but subsequently stronger cognitive decline in individuals converting to DAT, consistent with CR. Energizing lifestyle supplements found a cross-sectional, age-independent association of OCRS with some Maintenahce markers, but no association maintenabce 1-year-change.
OCR was not associated with the intracranial volume. These results are not completely consistent with those of BR or BM.
Maintenxnce Our results support Adaptogen anxiety reduction link between OCR and CR. Promoting and seeking complex and stimulating work conditions in midlife could therefore Adaptogen anxiety reduction to Cogniitive resistance to pathologies in old age and might complement maitenance measures aimed at Cotnitive pathology.
The occurrence of dementia in old age maintenwnce not inevitable. Even in the highest age groups, some individuals Cognitive function maintenance only limited Weight loss journey Braak et al. This phenomenon has often been linked to concepts, such as Cohnitive reserve and its popular proxy maintenwnce of education Stern, ; Stern et al.
Higher education is associated with a reduced risk of dementia Meng funxtion D'Arcy, and has been shown to mitigate the effects of pathology on cognitive functions Brayne et al. Importantly, cognitive maaintenance beyond childhood and funcfion adulthood, such as occupational cognitive activities in midlife Kröger et al.
Midlife activities mediate maintenancee of the protective association of education Fujishiro et maintrnance. Recently, Pool et al. org that contains a detailed description of job characteristics and maintenanfe. Pool et al. Participants in this study were Cognitice 65 years and above at baseline, were manitenance selected based on cognitive status, and were followed up for 8 years on Adaptogen anxiety reduction.
Maintenanc OCRS offers an another way to study the protective role of midlife occupational cognitive Non-GMO herbal supplements in Cogniitve decline and dementia based on occupational complexity Kröger et functionn.
While both occupational complexity Cobnitive the OCRS measure mainenance some degree the work-related cognitive demands, the OCRS assesses more directly the actual level of performed occupational cognitive maintenancr.
In our Cognitiive, we replicated the analysis of Pool et funcction. and extended it further, as explained in the following functkon. We aimed to extend fundtion research maintnance exploring the specific fuunction mechanisms that may convey funcgion protective role of Cogniitve in cognitive decline.
Research on Cognnitive and resilience has developed Multivitamin for vegetarian diets of three concepts that explain funtion differences in the development of pathologies and Cognltive impact jaintenance cognitive function: cognitive reserve CRbrain maintenance BMand brain reserve BR.
In this study, we refer to the definitions proposed by Stern et al. However, Cognitive function maintenance acknowledge Cognitivr some differences in the definitions proposed funftion other authors may exist Cabeza Immune health maintenance al.
To maintenancw the link between funcyion OCRS and resilience concepts, we derived a set of funxtion on expected associations of the OCRS with different Cognitive function booster in a functio and memory clinic-based cohort. Maintenancf hypotheses are graphically summarized in Figure 1.
Of note, the hypotheses Cogjitive in Figure 1 illustrate expected Adaptogen anxiety reduction in case the OCRS would Natural fat loss strategies act through the respective resilience maintwnance. The empirical pattern of the results is then compared Longevity and relaxation techniques these expectations.
Figure 1. A Hypotheses functkon CR Cognitiev the relationship of the OCRS and CSF AD biomarkers with cognition. B Conitive for BR regarding the relationship of Citrus bioflavonoids and hormone balance OCRS Citrus fruit desserts CSF AD biomarkers funvtion cognition.
C Functikn for BM regarding the relationship of the OCRS w OCRS and CSF AD biomarkers with cognition. D Hypotheses for CR regarding maintennace relationship of the OCRS and brain structure with cognition. E Mainteance for BR Cognitivw the relationship of the OCRS and brain structure with cognition.
F Hypotheses funtcion BM regarding the relationship mainfenance the OCRS and brain structure with cognition. G Hypotheses for CR regarding gunction relationship of the OCRS with longitudinal change in markers of pathology.
H Hypotheses for BR managing glucose levels the relationship of the OCRS with Cognitice change Cognitice markers of pathology. I Hypotheses for BM regarding the relationship of the OCRS with longitudinal change in markers of pathology.
J Hypotheses for CR regarding the relationship of the OCRS and APOE with cognitive decline in general population-based cohorts. K Hypotheses for BR regarding the relationship of the OCRS and APOE with cognitive decline in general population-based cohorts.
L Hypotheses for BM regarding the relationship of the OCRS and APOE with cognitive decline in general population-based cohorts. M Hypotheses for CR regarding the relationship of the OCRS with cognitive decline prior to the onset of dementia of the Alzheimer's type DAT. N Hypotheses for BR regarding the relationship of the OCRS with cognitive decline prior to the onset of dementia of the Alzheimer's type DAT.
O Hypotheses for BM regarding the relationship of the OCRS with cognitive decline prior to the onset of dementia of the Alzheimer's type DAT. We derived hypotheses for three different settings: a available direct measures of pathology and cognition in a memory clinic cohort; b no data on directly assessed pathologic markers but information on a genetic risk factor for pathology and cognitive decline in the general population; and c information only on cognitive trajectories in individuals developing dementia of the Alzheimer's type DAT.
For the latter case, we systematically derived the expected trajectories of the development of pathology and cognitive function for individuals with either high or low resilience in each concept Supplementary Figure 1.
To specify hypotheses on the expected cognitive trajectories aligned to the onset of DAT, the derived prototypical cognitive trajectories were then moved graphically along the x-axis time until both trajectories aligned at a hypothetical dementia onset Supplementary Figure 1Figures 1M — O.
We also discussed the caveats for interpretation in each setting with regard to the operational definitions proposed in the literature.
In our study, we defined CR as the brain's ability to actively adapt to the presence of pathologies and mitigate their impact on cognition, leading to higher cognitive functioning than expected based on pathologic brain changes Stern et al.
We consider this phenomenon to be a characteristic of CR. Furthermore, CR has been operationally defined as an amelioration of the effect of pathology on cognition; accordingly, a high level of a CR marker should relate to a weaker association between a measure of brain pathology and neuropsychological test performance Stern et al.
First, we used data from the memory clinic-based German Center for Neurodegenerative Diseases DZNE Longitudinal Cognitive Impairment and Dementia Study DELCODE Jessen et al. We focused on two groups of pathology markers: 1 cerebrospinal fluid CSF biomarkers indexing AD pathologic changes i.
Regarding cognition, we focused on memory function, which is the most severely affected cognitive domain in AD, linked to AD and other neuropathologies Wilson et al. In addition, we assessed global cognitive functioning to examine the consistency of the findings when including data from other cognitive domains.
Therefore, this cohort provided data to perform a recommended test for CR Stern et al. If the OCRS mainly acts through CR, higher OCRS should be associated with a reduced association i. Second, we aimed to assess the association between OCRS and cognitive decline in a population-based cohort of elderly individuals without dementia at baseline.
This population-based cohort may allow for better generalizability of the results on OCRS, although a direct assessment of pathology is lacking. However, APOE-ε4, a strong genetic risk factor for AD Genin et al. Using such a risk factor for pathology is less precise than using a direct measure and can thus only provide putative evidence for a link between OCR and CR.
Considering this limitation, it can be predicted that if the OCRS mainly acts through CR, higher OCRS should be associated with a reduced association of APOE-ε4 with cognitive decline, since the impact on pathologic changes should be mitigated in individuals with high CR.
Statistically, this would be represented by a statistical interaction between APOE-ε4 and OCRS regarding cognitive decline Figure 1J. Third, we aimed to derive hypotheses on the link between OCR and CR in longitudinal cohorts without a direct assessment of pathologies or genetic risk markers as proxies.
Notably, this can provide only low-level evidence for a link to CR compared to the empirical tests, including directly measured pathology.
In this setting, we propose that the trajectory of cognition before and after the onset of dementia in individuals developing DAT should be examined. Importantly, all individuals who progressed to DAT developed some pathology.
Therefore, assessing the trajectory of cognition in these individuals allows for the study of the adaptation of the brain to the progressive development of pathology. For individuals with a high CR, the predicted cognitive trajectories with progressively developing pathologies have been well-described Stern, Herein, high CR should generally relate to an initially higher cognitive level and a later onset of cognitive decline from individual-specific, previously stable levelsbut a stronger cognitive deterioration afterward Figure 1Mleft plot.
A stronger decline after symptom onset is expected due to the larger amount of pathology accumulated before the onset of pathology. When aligning these trajectories graphically to the onset of dementia Figure 1Mright plota later onset, afterward, a stronger cognitive decline is expected for individuals with high CR.
Interestingly, such a trajectory has already been demonstrated for individuals with higher education, a well-known proxy for CR Amieva et al. We additionally assessed whether there was evidence for a link between the OCRS and two other resilience concepts, BR and BM.
In the following paragraphs, we provide definitions and empirical tests of the link between these concepts and how they relate to tests of the link to CR. In line with previous definitions Stern et al. Herein, BR is the quantity of neurobiological capital available at that point in time and does not include any processes related to interindividual differences in changes in brain integrity i.
More available resources i. BR requires a link between certain brain features as an indication of neurobiological capital and cognitive function. Intracranial volume has historically been used as a proxy for BR Stern et al. Since high BR may increase the threshold to passively tolerate pathology, it operationally relates to individual differences in cognitive function and the risk of decline at a given level of pathology Stern et al.
First, in the memory clinic-based sample, we assessed the association of the OCRS with markers of brain structure that are related to cognitive function i. If OCRS acts through BR, there should be a cross-sectional association with these markers Figure 1E. In contrast, if the OCRS mainly acts through BR, it should not relate to any longitudinal changes in brain markers in old age, as those changes are attributed to a different resilience concept [i.
We, therefore, examined the association of OCRS with changes in brain markers over a 1-year follow-up. If OCRS acts through BR, there should be no association with longitudinal changes in the markers of brain structure or pathology Figure 1H.
In addition, we tested the expected positive association of OCRS with intracranial volume, a proxy marker of BR that is not affected by pathology-related brain changes. Furthermore, if OCRS acts through BR, it should not be associated with cross-sectional levels or longitudinal changes in AD biomarkers since BR would not predict a direct effect on the development of neurodegenerative pathologies Figures 1B,H ; Stern et al.
Notably, the link between OCRS and markers of neurodegenerative pathology and brain integrity is not part of the CR concept Figure 1G bearing the possibility that CR and BR may act at the same time.
Therefore, the hypotheses described above focus on an additional aspect regarding the possible mechanism underlying the association of OCRS with reduced risk of cognitive decline. Similar to CR, BR can influence the association between pathologic changes and cognition Stern et al.
However, the suspected mechanism may differ from that of CR. A high BR would result from high neurobiological resources that may passively buffer the impact of pathology on cognition until the depletion threshold of these resources.
In contrast, CR is perceived as an active adaptation of cognitive processes to pathology, leading to the maintenance of high cognitive function. Both the proposed mechanisms can result in a reduced effect of pathologic alterations of proteins in the brain on cognition in cross-sectional data.
Thus, if the OCRS acts through BR, a higher OCRS should be associated with a reduced association of AD biomarkers with cognition due to the buffering effect of higher neurobiological resources Figure 1B.
: Cognitive function maintenance| Cognitive Maintenance - The Critical Thinking Co.™ | Cognitive function maintenance a Diagnosis Cognifive the neurological exam, mental mintenance exam, and cognitive and neuropsychological testing results indicate Carbohydrate Intake Guidelines NCD, a diagnosis is necessary. A stronger decline after symptom onset is expected due to the larger amount of pathology accumulated before the onset of pathology. Books eBooks Bundle Savings. Reuter-Lorenz, P. CAS PubMed PubMed Central Google Scholar Celone, K. |
| Physical activity and the maintenance of cognitive function | The term cognitive function is used to describe the scope of mental capabilities resulting from the interaction of certain thought processes within the cognitive domain, including: perception, memory, intuition, reasoning, awareness, judgment, attention, spatial acuity and language. Although the effects of these changes are rarely beneficial, the good news is that age-related progressive decline in mental functioning is not inevitable. But we have to be proactive! In other words, there are ways for adults to Empower the Mind! Dementia vs. Normal Aging The purpose of this article is to explore methods and techniques helpful in combating cognitive decline, regardless of its cause. According to The Merck Manuals www. However, as a result of the normal aging process, even otherwise healthy older adults may experience some degree of cognitive impairment. Although this reduced mental ability can be problematic at times, it is not necessarily considered dementia. The American Medical Association www. org gives examples of how to distinguish typical aging from dementia. For example, they describe the sometimes-subtle difference between the occasional word-finding difficulty and the complete inability to recall the instance when the memory loss was first noticed. Another example describes the distinction between the person who, through frustration, may be unwilling to learn how to operate new appliances and the individual who has simply become unable to learn new devices. In no particular order, examples include:. As stated earlier, cognitive maintenance is a proactive process that utilizes a variety of methods to stave off deterioration of cognitive function. These methods address our lifestyles according to three interacting categories: physical, psychological and mental. We say "interacting" because a modification in one area will usually have ramifications in another. For example, a successfully implemented campaign to reduce stress psychological is expected have a positive effect on hypertension physical. Physical Healthy Mind in a Healthy Body The Franklin Institute www. Greater blood flow to the brain equates to increased nutrient and oxygen levels as well as more efficient waste removal. Proper treatment of certain medical conditions is essential to maintaining cognitive function. For example, untreated vascular disease is more likely to result in stroke — and, of course, stroke is one of the leading causes of cognitive impairment. Other conditions that require ongoing consideration include: high blood pressure, diabetes, obesity, smoking, limitation of alcohol, chronic inflammation and hormone imbalances, e. Psychological Emotional Well-Being Certain psychological factors, such as: stress, worry, anxiety and depression, can develop in the person who realizes a cognitive slowdown is occurring. One technique, helpful in minimizing these unwanted emotional factors, is to arrange for participation in some type of social network. The Memory and Aging Center at UC San Francisco www. edu describes how social support networks allow aging people the opportunity to share their challenges and experiences with others of similar age. Such a situation provides validation for their feelings, a sense of fellowship and a more enriched living environment. what happens if the brain is exercised regularly. Can a cognitive decline be delayed or possibly even prevented? Or more positively, can cognitive function actually be enhanced in the older adult? org reports that brain weight decreases with age starting in early adulthood. For many years, this brain-weight loss was considered irreversible. It was believed adult mammals were incapable of regenerating new brain cells. The long-held theory was that neurogenesis — the birth of neurons — was limited to the fetal or in utero developmental stage. The Society for Neuroscience www. org reports that thousands of neuronal cells are produced each day in an area of the brain called the hippocampus, a structure involved with learning and memory. Knowing that the human brain can, to some extent, regenerate itself, we consider whether or not this knowledge can benefit cognitive maintenance. We know the brain produces an overabundance of these cells, as most of them do not survive to be incorporated into a functioning neural pathway. So the question arises, what does cause these newborn brain cells to be integrated into a new or existing neural network? The Journal of Neuroscience www. net theorizes that the function of adult hippocampal neurogenesis is to enable the brain to accommodate continued bouts of novelty. Scientific American www. com states that learning, particularly learning requiring a great deal of effort, will keep these new neurons alive by enlisting them into service. So, it seems any effort to stretch and expand our existing cognitive bandwidth will effectively result in an increased number of brain cells. And if harnessed properly, these neuronal reinforcements can be expected to slow, and possibly even prevent cognitive decline. Since cognitive function is a product of several different interacting thought-processes, employing activities specifically designed to stimulate the brain in each of these categories will have a positive effect on overall mental functioning, or brain fitness. Initial recommended areas of focus include: memory, reasoning and language. Here's what some of our customers have said regarding the use of The Critical Thinking Co. I am a year-old female. I served in the U. The BLSA study and the addition of the human-animal interaction questionnaire were approved by the National Institutes of Health Intramural Research Program Institutional Review Board IRB. All participants provided written informed consent prior to participation. The current study uses data from participants who were aged 50 years and above when they completed their first human-animal interaction assessment index visit and who had completed at least one BLSA assessment in the previous ten years or completed a second BLSA assessment prior to March The index visit data includes both pet ownership retrospective and BLSA contemporaneous cognitive function up to ten years before the survey visit. Time from the index visit to the survey visit ranged from one to ten years during which the participants completed BLSA visits at regularly scheduled intervals. Participants also performed cognitive function assessments during their regularly scheduled BLSA visits for 3 years after the survey visit. Cognitive data from the index visit serve as the baseline for examination of changes in cognitive function with aging. Multiple sets of questions elicited information about pet ownership including a ten-year pet ownership history questionnaire and dog walking behavior from the pet ownership module of the Health and Retirement Study HRS 34 , These questions were administered during BLSA visits from March through March The assessment uses a standardized neurocognitive battery of reliable and well validated tests that are sensitive to small changes in cognitive function. The BLSA cognitive assessment includes tests of several large cognitive function domains including executive function and language function as well as more specific domains of executive function: processing speed, verbal, non-verbal, and working memory, and attention. The California Verbal Learning Test 36 is a test of verbal learning and memory. Participants were read 16 shopping items, four from each of 4 sematic categories, over five learning trials. Three measures were derived and used in this study: Immediate Recall total number of items recalled across the five learning trials ; short-delay free recall Short Recall: number of items recalled immediately after being read an interference shopping list , and long-delay free recall Long Recall: number of items recalled after a min delay. Higher scores indicate better recall. The Benton Visual Retention Test Visual Recall 37 is a measure of short-term non-verbal figural memory and visuospatial ability. Participants studied line drawings designs of one to three geometric figures, for ten seconds each. They then immediately drew the design from memory. The designs become more difficult over the ten designs. The total number of errors provided the score for Visual Recall. Lower scores indicate better performance. Executive function refers to a set of cognitive control processes that facilitate goal-directed behavior and are considered to be essential to navigating nearly all aspects of human life including occupational and career success, interpersonal relationships, physical and mental health, and day-to-day functioning Psychomotor speed and processing speed are domains within executive function. Processing Speed is the time it takes for a person to perform a mental task. Trail Making A Trails A and B Trails B 40 are tests of perceptuomotor speed, visuomotor scanning Trails A and Trails B , attention Trails A , and concentration and set shifting Trails B. In Trails A participants drew a line to connect randomly arranged numbers from 1 to 25 in sequential order. In Trails B participants drew a line to connect alternate randomly arranged numbers 1—13 and letters A-L in sequential order e. Participants were asked to be as quick and accurate as possible. Scores represent the number of seconds it took for completion; lower scores indicate better performance. A lower difference between the two scores Trails B-A also indicates better performance. Digit Span Test Digits Forward Digits Forward and Backward Digits Backward 41 are measures of short-term memory span Digits Forward and executive function, specifically working memory Digits Backward. With Digits Forward, participants were read increasingly longer lists of digits which they repeated in forward order. With Digits Backward participants were read increasingly longer lists of digits which they repeated in reverse order. The scores for forward and backward were the total scores with a maximum of 14 in each direction. Higher scores indicate better performance. Digit Symbol Substitution Test Digit Symbol 41 is a measure of psychomotor speed, executive function and visual-perceptual integration. Participants were given a code sheet with numbers from 1 to 9 with symbols matched to each. They used the codes to insert the symbols below each number. The number of correct symbols placed below the numbers within 90 s provides the score with higher scores indicating better performance. The Boston Naming Test Naming 42 is a measure of language function including confrontational naming and semantic recall. Participants were asked to identify and name a series of line drawings of objects. The drawings begin with common objects and end with infrequent ones. Incorrect answers were cued by providing a stimulus cue for perceptual errors and a phonemic cue for semantic errors. The score on the test was the number of items identified correctly without cues, thus higher scores indicate better naming. Aging and comorbidities are typically associated with decreasing or impaired cognitive function These variables were chosen a priori as potential confounders to the relationship between pet ownership and cognitive function as pet owners were younger and had fewer comorbidities than non-owners. Comorbidity scores represent how many of eight conditions [heart disease including angina pectoris, myocardial infarction, heart failure, angioplasty, coronary artery bypass graft , diabetes, pulmonary disease, cerebral vascular disease, lower extremity arthritis, lower extremity pain, minor functional difficulty, and exertional pain while walking] the participant affirmed experiencing An 11 item mini mental state examination MMSE was used to assess overall cognitive status at each study visit Descriptive statistics were used to portray the participants and their baseline characteristics. Characteristics of pet owners and non-owners at initial human-animal interaction assessment within the BLSA and at the first time for which both pet ownership and BLSA functional data are available were compared using t-tests for normally distributed continuous variables, Wilcoxon rank sum test for non-normally distributed continuous variables, and chi square tests for categorical variables. Differences in baseline cognitive function between cat and dog owners and dog owners who walked and did not walk their dogs were examined similarly. Changes in cognitive function according to pet ownership could be examined beginning with contemporaneously recorded historic records of cognitive assessments in the BLSA within the ten-year period covered by the retrospective pet ownership history section of the human-animal interaction assessment. Pet ownership history was matched with cognitive assessments for the ten years prior to the BLSA survey visit and with simultaneous human-animal interaction and cognitive function assessments from March of through March of Pet ownership history follow-up ranged from ten to Prior to multivariable analysis, data were cleaned and examined for outliers and normality. Trails B was natural log transformed, Trails A and Trails B-A were Winsorized at a high of s and a low of 0 s, respectively, and natural log transformed, Naming was reflected by subtracting raw scores from 61 maximum score plus one and then natural log transformed to attain normality. Intraclass correlations indicated considerable dependence ranging from 0. Linear mixed models LMMs with random intercepts and repeated measures for participants were used to examine changes in cognitive outcomes with aging and to compare the changes according to pet ownership status. Age and comorbidities were included as covariates in all LMM analyses. Separate LMMs were used to examine the association of pet ownership, dog ownership, and cat ownership with changes in each cognitive function outcome with aging. LMMs that simultaneously included cat ownership and dog ownership were used to examine the independent associations of cat and dog ownership to longitudinal changes in each cognitive function outcome. A third series of LMMS was used to compare the associations of cat ownership versus dog ownership with longitudinal changes in cognitive function outcomes. Similar LMMs were employed to examine the relationship of dog walking to overall cognitive function outcomes and changes in the cognitive function outcomes. Lastly, LLMs examined differences in changes in cognitive function outcomes according to pet ownership between those who were and were not cognitively intact. We calculated the difference in change in outcomes over ten years between pet owners and non-owners and divided this by the raw baseline outcome standard deviation. For transformed variables, the standard deviation SD of the transformed variable was used in the calculation. Analyses were conducted with SPSS 28 IBM, Armonk NY and Stata SE 16 College Station, Tx. A total of BLSA participants met the inclusion criteria. Ages when they at the survey visit ranged from Most participants were White Participants were highly educated; most The sample predominantly was married Of the participants at the survey visit Most of the dog owners At the index visit Table 1 , participants were generally in good health with a mean of 0. One hundred eighty-eight Among the dog owners, 58 Pet owners were significantly younger and had fewer comorbidities than non-owners Table 1. Pet owners were less likely than now-owners to be Black Notably, 8 people lived in foster or assisted living communities and none of them kept pets. MMSE scores did not differ significantly according to pet ownership status. At the index visit, unadjusted cognitive function measure scores differed between pet owners and non-owners. Immediate Recall, Short Recall, Long Recall, Digits Forward, Digits Backward, and Digit Symbol were higher and Visual Recall number of errors , Trails A seconds to complete , and Naming number correct, reflected prior to normalization were lower for pet owners than non-owners Table 1 , indicating better performance on these measures for pet owners. Trails B and Trails B-A did not differ. At the index visit assessment, individuals who owned dogs but not cats dog owners exclusively and individuals who owned cats but not dogs cat owners exclusively shared similar demographic characteristics Table 2. Index visit cognitive function variables did not differ significantly between cat owners exclusively and dog owners exclusively. All cognitive function outcomes in unadjusted analyses deteriorated significantly as participants aged Table 3. Pet ownership moderated the changes in cognitive function as participants aged after controlling for age and comorbidities Table 4. Changes in selected measures of cognitive function with aging: comparison of pet owners and non-owners. Note ln in axis label indicates a natural log transformation was applied. In separate analyses controlling for age and comorbidities, both dog ownership and cat ownership were related to changes in cognitive function Table 4. The trajectories of changes with aging were generally in the same directions for dog owners and cat owners, with dog and cat owners experiencing less deterioration in cognitive function than non-owners. A combined analysis including both dog ownership and cat ownership as independent predictors allowed for simultaneous comparisons with individuals who owned neither cats nor dogs. This adjusted analysis yielded results like those for the separate analyses Supplemental Table 1. The relationship of pet ownership at index visit to changes in cognitive function with aging produced generally similar results to those obtained with pet ownership at the time of each cognitive assessment used as the independent variable in the analysis. The relationships of index visit cat ownership and dog ownership to changes in cognitive function produced different results Supplemental Table 2. The differences in trajectories of changes in cognitive function, according to pet ownership status after controlling for age and co-morbidities were like those reported in Table 4. Taking the pet ownership results together, pet owners exhibited less deterioration in cognitive function than non-owners. However, examining the independent relationships of cat ownership and dog ownership to changes in cognition did not show an association of either dog or cat ownership with changes in cognitive function. Comparison of changes in cognitive function of dog owners exclusively own only dogs and cat owners exclusively own only cats with aging adjusted for age and comorbidities Table 5 demonstrated only one significant difference between the groups. Comparison of changes in number of errors on the Benton Visual Retention Test with aging: comparison of dog owners with cat owners. More than half of dog owners indicated they walked their dogs. At the index visit demographic characteristics and number of comorbidities of the dog owners who walked their dogs and those who did not did not differ Table 6. Dog walking was related to changes in cognitive function with aging controlling for age and comorbidities Table 5. Cognitive function improved for dog walkers and deteriorated for non-walkers Fig. Comparison of changes in selected measures of cognition with aging: comparison of dog owners who do and do not walk their dogs. In the current study the participants were generally cognitively functional. All except 41 of the participants In LMMs controlling for age and comorbidities, cognitive impairment did not moderate the relationships between pet ownership and changes in most of the cognitive function outcomes, the exception being Long Recall. Long Recall improved among pet owners who were not cognitively intact but not in other subgroups. In this study using data from the Baltimore Longitudinal Study of Aging, pet ownership, dog ownership, and cat ownership and dog walking were related to the maintenance of executive function and language function, and memory, except working memory, in generally health community-residing older adults as they aged. The use of measures of specific cognitive domains enables examination of the relationship of pet ownership to changes in specific types of cognition. This contrasts with a longitudinal study of community-residing older adults in which cat ownership was not related to the development of the dichotomous outcome of developing mild cognitive impairment after adjustment for potential confounders In addition, the current study explores changes specific to dog ownership and cat ownership as well as to overall pet ownership. In the current study, pet ownership, dog ownership, and dog walking were related to slower deterioration in all large domains and all subdomains of executive function except working memory. All three Trails measures revealed reduced deterioration in executive function for pet owners; two of these measures Trails A, Trails B also deteriorated more slowly for dog owners than non-owners. Psychomotor speed Trails tests and processing speed Digit Symbol deteriorated more slowly for pet owners and dog owners than non-owners. Further, pet ownership, dog ownership, and cat ownership were related to slower deterioration in language function. Only cat ownership was related to slower deterioration in verbal memory. One mechanism for the slower deterioration in cognition among pet owners, dog owners, and dog walkers is reduction in stress when an animal is present. Evidence supports a relationship of pet ownership with stress biomarkers and psychological perceptions of stress. Chronic stress contributes to cognitive decline in older adults Elevations of cortisol due to disruptions in the HPA axis may impinge on hippocampal function associated with cognitive function 47 , 48 , The presence of pets is well known to decrease stress in experimental studies using both stress biomarkers 19 , 48 , 50 , 51 , 52 and subjective scales 53 , 54 , Most of these studies documented the positive influence of dogs, but do not include cats. Evidence for pets reducing stress biomarkers in older adults during their normal daily lives is derived from ecological momentary assessment, of blood pressure in adults with pre-hypertension to mild hypertension. These differences in stress biomarkers may be related to differences in interaction of cat owners and dog owners with their respective pets and relate to the observed differences in the deterioration in executive function between dog and cat owners as they age. Two mechanisms, increased exercise and increased social interaction or social support, could explain the relationship of dog walking to slower deterioration in cognition with aging. Previous research showed that within the biological realm increased physical activity improved cognitive function or decreased deterioration in cognitive function 31 , Walking a dog also affects the social realm by increasing social interactions of the dog walkers 57 , 58 , 59 and improves community social capital Differences in deterioration in executive function according to pet and dog ownership and dog walking suggest changes in processing and psychomotor speed. Dog owners may use these skills more frequently to care for pet dogs. Monitoring dog behavior both within the home and on walks, and reacting quickly to environmental concerns e. Perhaps pet owners need to think and act quickly to care for their pets or prevent their pets from being injured. This may be more important for dog than cat owners, doing this repeatedly could lead to less deterioration with aging. In the current study, there was no evidence that pet ownership, dog ownership, or cat ownership was related to deterioration in working memory Digits Forward, Digits Backward. These results contrast with evidence from an experimental study where the presence of a dog was associated with better memory performance in preschool children Within the psychological realm, aging leads to reductions in the ability to attend to stimuli and capacity to inhibit irrelevant stimuli Deterioration in attention Trails A was slower among pet owners and dog owners than non-owners, but not related to cat ownership. The tasks required to care for a pet may force older adults to attend to some, while inhibiting other stimuli thus providing additional use and practice in this cognitive domain. Attention switching requires that you quickly shift your focus between multiple processes, another function that may be used more in activities related to caring for a dog or dog walking than to caring for a cat. Dog ownership may require a higher level of practice and implementation of goal-directed behaviors and attention shifting consistent with slowing the deterioration of executive function. In the current study pet ownership, dog ownership, and cat ownership were related to slower deterioration in long-term and verbal memory. Long-term memory is a vast storehouse of information that a person may retain over extended periods of time and has been conceptualized as a permanent repository The verbal component of this storehouse includes words, labels, and sounds associated with verbal information, whereas the nonverbal component stores information such as images and spatial relationships. All measures of long-term memory Naming, Short Recall, Long Recall and most measures of verbal memory Naming, Immediate Recall, Short Recall, Long Recall deteriorated more slowly over the ten-year period for pet owners, dog owners, and cat owners. While no studies addressed the relationship of pet ownership to memory, the relationship of chronic stress to poor memory is well established Furthermore increased social interactions with other humans which occur when individuals have pets may help maintain memory by using it to remember people and their animals. In the current study, non-verbal memory, assessed with Visual Recall, did not change differently with aging according to pet ownership or cat ownership. Dog ownership was associated with faster deterioration in non-verbal memory. Non-verbal memory deteriorated faster among dog owners than cat owners, suggesting that some aspects of non-verbal memory may be related to cat ownership specifically. The games people play with their cat may require more verbal memory than activities with a dog. In the current study the measure of language function, Naming, deteriorated more slowly for pet owners, dog owners and cat owners than non-owners with aging. It is likely that language function is used specifically in pet ownership-related tasks, so keeping pets of all kinds confers an advantage. Lower stress and more opportunities for social interaction may support language function similarly to the way they support executive function. In the current study dog walking was associated with less deterioration in the psychological realm variables of executive function, specifically short-term recall, and psychomotor speed. Dog walking was not associated with changes in other aspects of executive function or language function. Our findings complement the changes in the social realm demonstrating that dog walking in the community was associated with less loneliness during the COVID pandemic for socially isolated older adults In our previous analysis of BLSA physical function data, dog walking was not associated with reduced deterioration in physical function The physical exercise associated with dog-walking is not a likely explanation for the observed differences in deterioration of cognition with aging among pet owners. In the current study, moderation analyses did not demonstrate an association of cognitive impairment with the relationship of pet ownership to deterioration in cognitive function with aging. However, almost all the participants were cognitively intact. By reducing stress, pet ownership may minimize deterioration in cognition, more for those who are mildly cognitively impaired than those who are not. Higher chronic stress was associated with faster cognitive decline in individuals with moderate cognitive impairment but not in cognitively normal participants over 3 years People with worse cognitive function may have already relinquished their pets. However, most of the participants in the BLSA are high functioning and have few comorbidities suggesting an ability to care for pets. Similarly, those who are most frail may have been forced to give up their pets due to living restrictions. However, the relationship of pet ownership to reduced aging-related deterioration was consistent whether pet ownership was categorized at the beginning of the ten years or at the time of each cognitive assessment. One would expect a substantial reduction in pet ownership if deterioration in cognitive function led to discontinuation of pet ownership. It is important to note that the current study examines the relationship of pet ownership to longitudinal changes in cognitive function in community-residing older adults as they age. This is distinct from therapeutic changes in cognition that might occur with interventions in care homes or other venues. Our findings do not include the presence of the pet during the assessment or an evaluation of how the relationship with the pet may influence the relationships we found. It is important to note that the current study was conducted on a select group of aging adults. This also prevents in depth analysis of the role of social determinants of health. Further the large percent of individuals who live with others may not represent the overall older adult population. The generalizability of the negative findings with respect to differences in trajectories of change between dog and cat owners also is limited by the small sample sizes. The contributions of other pet species could not be evaluated due to the small number of individuals who owned pets other than cats or dogs. While moderation analysis provided little evidence supporting the relationship of cognitive impairment to the association of pet ownership with changes in cognitive function outcomes over time, this is worth further exploration in a more varied population. This study does not investigate whether any of the nuances of pet ownership including pet attachment and pet health or other owner participant characteristics such as marital status or living alone are related to changes in cognitive function, although both being married and not living alone are more common for pet owners than non-owners. The current study provides important longitudinal evidence for the contribution of pet ownership to the maintenance of cognitive function in generally health community-residing older adults as they age. Older adult pet owners experienced less decline in cognitive function as they aged, after considering both their pre-existing health and age. Memory, executive function, language function, psychomotor speed, and processing speed deteriorated less over ten years among pet owners than among non-owners and among dog owners than non-owners. Cat owners experienced less deterioration in memory and language function. Dog walking also was associated with slower deterioration in cognitive function. This study provides the first longitudinal evidence relating pet ownership and dog walking to reduced deterioration in cognitive function with aging for generally healthy older adults residing in community settings. The datasets generated for this study will not be made publicly available. The study is ongoing, and the data are the property of the National Institutes on Aging. Lamar, M. Longitudinal changes in verbal memory in older adults: Distinguishing the effects of age from repeat testing. Neurology 60 , 82—86 Article PubMed Google Scholar. McCarrey, A. Sex differences in cognitive trajectories in clinically normal older adults. Aging 31 , — Article PubMed PubMed Central Google Scholar. Ritchie, K. Establishing the limits and characteristics of normal age-related cognitive decline. Sante Publique 45 , — CAS PubMed Google Scholar. Sinnett, E. Assessment of memory functioning among an aging sample. Article CAS PubMed Google Scholar. Small, S. Selective decline in memory function among healthy elderly. Neurology 52 , — Vespa, J. html Beltrán-Sánchez, H. Past, present, and future of healthy life expectancy. Cold Spring Harb. a Zhao, C. et al. Dietary patterns, physical activity, sleep, and risk for dementia and cognitive decline. Article CAS PubMed PubMed Central Google Scholar. Friedmann, E. Gerontologist 59 , — Article Google Scholar. In Handbook on Animal Assisted Therapy, Theoretical Foundations and Guidelines for Practice ed Fine, A. Gee, N. Dogs supporting human health and well-being: A biopsychosocial approach. A systematic review of research on pet ownership and animal interactions among older adults. Anthrozoös 32 , — Fine, A. Involving our pets in relationship Building—Pets and elder Well—Being. In Social Isolation of Older Adults: Strategies to Bolster Health and Well-Being eds Kaye, L. Piolatto, M. The effect of social relationships on cognitive decline in older adults: An updated systematic review and meta-analysis of longitudinal cohort studies. BMC Public Health 22 , 1—14 Kretzler, B. Pet ownership, loneliness, and social isolation: A systematic review. Psychiatry Psychiatr. Our Faithful Companions: Exploring the Essence of Our Kinship with Animals Alpine, Google Scholar. McNicholas, J. Dogs as catalysts for social interactions: Robustness of the effect. Psychol 91 Pt 1 , 61—70 Bernabei, V. Animal-assisted interventions for elderly patients affected by dementia or psychiatric disorders: A review. Pendry, P. Public Health 17 , Brelsford, V. Can dog-assisted and relaxation interventions boost spatial ability in children with and without special educational needs?. PLoS ONE 10 , In Animal Assisted Therapy: Theoretical Foundations and Guidelines for Practice ed Fine, A. Applebaum, J. The impact of sustained ownership of a pet on cognitive health: A population-based study. Aging Health 35 , — Branson, S. Examining differences between homebound older adult pet owners and non-pet owners in depression, systemic inflammation, and executive function. Anthrozoös 29 , — Biopsychosocial factors and cognitive function in cat ownership and attachment in community-dwelling older adults. Pet ownership patterns and successful aging outcomes in community dwelling older adults. Pet caretaking and risk of mild cognitive impairment and dementia in older US adults. Anthrozoös 35 , — Curl, A. Gerontologist 57 , — PubMed Google Scholar. Bibbo, J. Pets in the lives of older adults: A life course perspective. 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| Maintenance, reserve and compensation: the cognitive neuroscience of healthy ageing | Carbohydrate Intake Guidelines brain changes Cognitive function maintenance aging healthy mainhenance general trends, individual Fujction and modifiers. Reisberg, B. Neurology 34, — Snyder Eds. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Article PubMed Google Scholar Lövdén M, et al. Successful aging 2. |
| Memory Maintenance | Cognitive reserve in ageing and Alzheimer's disease. Neuroimage 60, — Making a diagnosis, conducting a medication review, prescribing medication, and assessing and correcting sensory deficits form the cornerstone of cognitive rehabilitation. We assumed that the function of the DR may require activities in a variety of regions including the hippocampus and the nearby medial temporal structures. Aging Dis. |
Cognitive function maintenance -
In addition, a within-network decline in functional connectivity has also been reported in other large-scale functional networks, including the salience network SN , executive control network ECN , attention network, sensori-motor network SMN and the visual network VN involved in primary processing Onoda et al.
Although such canonical networks showed decreases of within-network connectivity, between-network connectivity of some pairs of these networks somewhat increases Meier et al.
Several studies have also reported the relationship between cognitive decline and network changes, e. However, the target age and the number of subjects included were limited in each study, and the findings were inconclusive. What are the different factors influencing successful aging? Can these factors be identified based on the characteristics of brain-imaging-derived metrics such as brain volume and connectivity?
The purpose of this study was to identify such characteristics by investigating the relationship among aging, brain volume, brain network changes, and cognitive function in healthy subjects.
For this purpose, healthy individuals who maintained relatively good cognition were enrolled in the study. Within age groups, ranging from 20 to 70 years, an equal number of subjects were included. Although voxel based morphometry VBM analysis was performed as the first step, network analysis using rsfMRI represented the main part of this study.
RsfMRI is a useful method to visualize various large-scale networks in the brain by examining the synchronization of the blood oxygen level dependent BOLD changes in different brain regions during rest, i. Our hypotheses are as follows: 1 Even in healthy subjects with total score of the cognitive screening test within normal range, some variations of the sub-items in the cognitive test may reflect association with aging.
Some sub-items may show differences with age that parallel with the structural differences, whereas others may show the maintenance of these scores, independent from the structural differences.
Through these analyses, we will identify the different conditions necessary for the maintenance of good cognitive function during aging, that is, the different conditions for successful aging. All participants were healthy volunteers who joined in response to the recruitment using leaflets and the website of the BMRC.
Inclusion criteria for the original project were as follows: older than 20 years, not pregnant, had no episode for MRI contraindications, no brain diseases such as cerebrovascular diseases, brain tumor, head injury, depression, and schizophrenia. They provided written informed consent before joining the study.
Between and , more than 1, volunteers participated. From the pool of volunteers, a total of participants, consisting of 10 men and 10 women in each of the 6 age groups, 20s, 30s, 40s, 50s, 60s, and 70s, were randomly chosen.
in structural MRI as identified by Japanese board-certified neurologists HW, KH, and KK and neurosurgeon SM , 3 ACE-R total score less than 83, and 4 incomplete imaging data. The mean age for all participants was The average number of years for education was The percentage of participants who smoked were In term of head motion, which typically affect the estimation of the functional connectivity, the mean frame-wise displacement FD values Power et al.
The number of subjects with mean FD greater than 0. No participants had mean FD greater than 0. T1 anatomical images and rsfMRI data were obtained from all participants. MRI scanning was performed using a Siemens Magnetom Verio Siemens, Erlangen, Germany 3. During rsfMRI scan, the participants were instructed to close their eyes but to stay awake.
A Japanese version of ACE-R was performed to evaluate cognitive function for all participants. Participants who obtained 82 points or less in total score were excluded from this study because of the possibility of dementia.
In addition to the total score, the scores for each of the five cognitive domains, the sub-score of verbal fluency such as semantic or phonological word recall, the sub-score of memory such as memorization, delayed memory, and recognition, and the sub-scores for others were also documented.
Image preprocessing for the anatomical T1WI and rsfMRI dataset was performed using Statistical Parametric Mapping SPM12, Wellcome Trust Center for Neuroimaging, London, United Kingdom running on Matlab Ra, MathWorks, Natick, Mass, United States. The T1WI images were first segmented into component images including gray matter GM , white matter WM , and cerebrospinal fluid CSF , among others, by the segmentation approach included in SPM Bias-corrected T1WI and the transformation information from subject space to MNI Montreal Imaging Institute space were also obtained during segmentation.
For rsfMRI dataset, we excluded the first 5 volumes in the series in order to account for the effects of the initial scanner inhomogeneity. Slice-time correction was then performed relative to the middle slice slice 20 , and the images were realigned to the mean functional volume.
The mean volume, together with the realigned functional images, were then co-registered to the bias-corrected T1WI anatomical images. The co-registered functional images were normalized to the MNI space using the transformation information obtained during segmentation, resampled to have an isotropic voxel resolution equal to 2 x 2 x 2 mm 3 , and smoothed using an isotropic 8-mm full-width-at-half-maximum FWHM 3D Gaussian filter.
Finally, the preprocessed data were then bandpass filtered within 0. All preprocessing were performed using in-house Matlab scripts as reported previously Bagarinao et al. The preprocessed dataset were used in the succeeding analysis.
In addition, sub-items of cognitive function in the ACE-R were also examined. Next, regression analysis was performed for each factor with significant correlation with age.
We examined two regression models. One is linear in age, and the other is quadratic. The appropriate regression model linear vs. The total volumes of GM, WM, and CSF were calculated using the segmented components of the T1-weighted images. Global calculation was performed using TICV. We also examined the association between GMV and the score of the DR, which showed the highest significant relationship with age in the above correlation analysis, under two different conditions.
In one condition, age and the TICV were included as covariates, while in the other condition, age was excluded. Xjview 1 was used to examine regions with significant association with age or the score of delayed memory in the resulting statistical maps.
Automatic anatomical labeling AAL was used for the anatomical name of the identified region. To evaluate the relationship between factors associated with aging and brain functional networks, we used dual regression analysis. The preprocessed rsfMRI datasets from the subjects were temporally concatenated, and group independent component analysis ICA was performed using the MELODIC software from the FSL package Jenkinson et al.
Thirty independent components ICs were derived across the whole sample, extracted, and visually compared to a set of reference RSN templates 2 Shirer et al. In dual regression analysis Filippini et al.
These time courses were then used as temporal regressors in a second regression analysis to generate subject-specific maps associated with each group IC. Using the constructed subject-specific maps, regression analysis was performed with the cognitive function scores, year of education, age, gender, and GMV set as regressors.
In another condition, the DR score was used instead of the memory score. Statistical analysis of each component map was performed using a non-parametric permutation test permutations , and regions with connectivity showing statistically significant association with each respective factors were identified.
All statistical maps were corrected for multiple comparisons using FWE correction with threshold free cluster enhancement. The other domains, language and fluency, were not significantly correlated with age.
The education year also demonstrated negative correlation with age, which reflect the relatively high college enrollment rate in younger generation and was, therefore, excluded for further regression analysis.
For the regression analysis of each factor with age, we examined two regression models - linear and quadratic. The vertical axis showed the volume and the score of each subject as a standardized z-score, and the horizontal axis is age. The appropriate regression model, shown as solid line, was identified using both AIC, BIC, and R2.
AIC, BIC, and R2 values for the two regression models of each factor are summarized in Table 3. Among the different cognitive function scores, the DR score showed the highest significant relationship with age.
The score of visuospatial ability showed mild linear change with age, but the R2 value was small, and its change was not reliable. The other two cognitive domains language and fluency did not show significant relationship with age. Figure 1. Figure 2.
Table 3. A summary of AIC, BIC, and R2 values for the two regression models of each factor. With VBM, a strong negative correlation with age was observed in many regions across the cerebral cortex. The maximum negative correlation was found in the right posterior central gyrus.
Areas with negative correlation with age were widespread and bilaterally observed in the lateral frontal cortices, the lateral temporal cortices, the lateral occipital cortices, the parietal cortices, the cingulate gyrus, the areas surrounding the intraparietal sulcus, and the medial temporal areas including the hippocampus Table 4 , upper row in Figure 3.
Figure 3. VBM results. These regions overlapped with the part of the areas showing negative correlation with age lower row in Figure 3. However, in the analysis where the age was also included as a covariate, no region survived. In the first step of the dual regression analysis, 18 resting networks were extracted Figure 4.
Those networks included the ventral and dorsal DMN, the right and left ECN, the anterior and posterior SN, the precuneus network, the dorsal attention network DAN , lateral DAN, the dorsal and ventral SMN, the basal ganglia network BGN , the language network LN , the auditory network, the primary, medial, and higher VN, and the cerebellar network.
The negatively correlated regions in each network were shown in Figure 5 , and the anatomical location and voxel counts of those regions were summarized in Table 6. On the other hand, 10 networks did not show significant correlation with age. Figure 4. The 18 resting networks extracted at the first step of the dual regression analysis.
DMN — default mode network; ECN — executive control network; Rt — right; Ant — anterior; Post — posterior. Figure 5. Resting state networks, shown in white, with within-network functional connectivity values that negatively correlated with age.
Table 6. Anatomical regions decreasing functional connectivity with age in the canonical RSNs. The regions with positive correlation in the SMN were almost the same in the memory and the DR Figure 6 , Table 7.
Furthermore, the score of the fluency was found to be positively correlated with 4 networks, the right ECN, the primary visual, and the dorsal SMN Figure 6 , Table 7.
Figure 6. Resting state networks, shown in white, with within-network functional connectivity values that positively correlated with the score of fluency, memory, and delayed recall DR. Table 7. Anatomical regions increasing functional connectivity with cognitive score in the canonical RSNs.
In this study, we evaluated the relationship between aging and cognitive function in a total of healthy subjects consisting of a balanced number of participants within age-groups of 20s, 30s, 40s, 50s, and 70s, who maintained relatively good cognition.
However, no regions have GM values that correlated with the scores of all domains in the cognitive test when age was included as a covariate. We selected subjects whose ACE-R score was above the cutoff and was considered normal in cognition.
Even in such subjects, ACE-R showed variances in some domains and sub-scores with the DR being the most sensitive sub-score for aging. This finding has a clinical importance to interpret the results of ACE-R.
On the other hand, language and fluency were not significantly correlated with age. These findings support the idea that crystalized intelligence is more maintained than fluid intelligence in healthy aging Baltes et al.
In VBM analysis, our results showed that the GMV widely declined with age, even starting from the early 20s. This result is consistent with many previous studies Good et al. Regarding the location of regions showing negative correlation with age, the areas around the central sulcus and the intraparietal sulcus were commonly reported in several literatures Good et al.
In our study, we found a significantly lower GMV in bilateral regions around the central sulcus and the intraparietal sulcus, and bilateral medial temporal areas including the hippocampus in older adults. These changes were also frequently observed even in the stage of mild cognitive impairment MCI Baron et al.
We adopted 83 as the cutoff of ACE-R in this study Mathuranath et al. These individuals may potentially be at the prodromal stage of dementia, that is, MCI, and could have influenced our results. The WMV was known to demonstrate a U-shaped change with age Bagarinao et al.
In VBM, we did not find regions with GMV that correlated with the scores of cognitive domain in ACE-R when age was included as a covariate. This result reflects difficulty to evaluate significant relationship between cognition and morphological changes when simultaneously accounting for the influence of age.
In the analysis without age as a covariate, the DR score positively correlated with the GMV of a relatively wider brain region that included bilateral frontal cortices, bilateral temporal cortices, bilateral insular cortices, and bilateral cingulate cortices.
We assumed that the function of the DR may require activities in a variety of regions including the hippocampus and the nearby medial temporal structures.
However, such a topographic characteristic was not observed in our results. These results should be interpreted with care considering the dependence of both DR and GMV with age.
A study by Takeuchi et al. Diverse cognitive functions may be weakly associated with regional GMV in widespread brain areas, and may be difficult to detect this association in this analysis. Regarding the relationship between the morphological changes of the brain and cognition with age, Schnack et al.
Higher IQ was associated with larger and thicker surface area until around the age of 20, but this relationship weakened from the age of 40 to They also mentioned that individuals maintaining high IQ may form highly efficient formation of brain networks Schnack et al.
Although they utilized the IQ, which has four domains including the language, working memory, visuospatial, and performance speed, the results was similar to ours.
In healthy aging, a decrease in the GMV and a decrease in cognition showed such temporal dissociation and never showed parallel relationship.
The absence of this relationship could not be simply explained by morphological analysis in the brain, and therefore, we supposed that the network analysis was necessary.
More broadly, existing studies have shown that GM continuously declined with age. Thus, it is indeed intriguing that cognitive scores have inverse U-shaped behavior as a function of age, while GMV decreased linearly.
Although speculative, this may point to some possible reserve mechanisms at work, where reserve capabilities are accumulated during childhood and young adulthood. The concept of brain or cognitive reserve Stern, ; Satz et al. Factors such as longer education, greater physical activity, and involvement in demanding leisure activities, among others, affect reserve capacity Cabeza et al.
This possibly drive the relative preservation in cognitive scores before it peaks and started to decline. Since reserve can also manifest in terms of efficient use of neural resources Solé-Padullés et al.
To fully understand the association among brain structure, network, and cognition in the aging brain, more studies are needed. Previous studies have reported that the connectivity within networks, such as DMN, decreased with age Damoiseaux et al. Our results also demonstrated similar within-network connectivity decreases in 8 out of 18 RSNs.
Specifically, the ventral DMN showed significant decrease in functional connectivity, but not the dorsal DMN. Similar results have been previously reported Campbell et al. The functional difference between the two is currently not well understood.
The ventral DMN is more associated with memory, a hippocampus — dependent function Damoiseaux et al. Campbell et al. Their findings showed that the subsystem involving dorsal posterior cingulate cortex PCC to the fronto-parietal regions was relatively maintained in the elderly, whereas that involving the ventral PCC declined in functional connectivity.
The dorsal PCC is a core region in the dorsal DMN, and this could be a reason for the observed discrepancy between ventral DMN and dorsal DMN in our study.
With regards to the LN, which also showed no association between connectivity and age, we found regional similarity of its connectivity to that of the dorsal DMN. Both networks shared common regions in the dorsal PCC and dorsomedial prefrontal cortex Figure 7.
In addition, the LN is associated with language ability, an important part of crystalized intelligence. Therefore, this result may be a reflection of the relative maintenance of crystalized intelligence over age.
In the absence of supporting literature, more studies examining the association between LN and the network associated with crystallized intelligence are needed. Excessive drinking is a major risk factor for dementia.
If you choose to drink, limit yourself to two drinks a day. People who are anxious, depressed, sleep-deprived, or exhausted tend to score poorly on cognitive function tests. Poor scores don't necessarily predict an increased risk of cognitive decline in old age, but good mental health and restful sleep are certainly important goals.
Moderate to severe head injuries, even without diagnosed concussions, increase the risk of cognitive impairment. Strong social ties have been associated with a lower risk of dementia, as well as lower blood pressure and longer life expectancy.
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Can watching sports be bad for your health? These were filmed while changing the exercise difficulty level and exercise speed.
Then, the videos were edited so that the elderly could understand them easily, such as by adding subtitles to the videos filmed, and DVDs explaining the content of the exercises were produced.
The student on the left shows their hand after the leader to ensure victory. A total of 23 elderly people participated in our club, including 5 men and 18 women mean age of Among them, a total of 13 elderly people participated every year, including 3 men and 10 women mean age of Changes in MMSE and FAB scores over time.
There were no significant changes in the MMSE and FAB scores over time. It could not be conducted in due to the shortening of the cognitive function evaluation time caused by the spread of COVID infection. Changes in the average time required were observed for each task, but there were no statistically significant changes over time in all five tasks.
Cognicise is expected to improve cognitive function and suppress the progression of cerebral atrophy by activating the brain, compared to exercises where one only moves the body [ 4 , 5 , 6 , 7 , 8 , 13 ]. Thus, it cannot be said that the activity of our club contributes to the prevention of cognitive decline.
Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution-NonCommercial 4. Edited by Shinichiro Maeshima. DOWNLOAD FOR FREE Share Cite Cite this chapter There are two ways to cite this chapter:. Choose citation style Select style Vancouver APA Harvard IEEE MLA Chicago Copy to clipboard Get citation.
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Chapter metrics overview Chapter Downloads View Full Metrics. Impact of this chapter. Abstract According to estimates by the Japanese Cabinet Office, there will be approximately 6. Keywords community cognitive function evaluation cognitive function maintenance. Introduction The Annual Report on the Aging Society by the Japanese Cabinet Office [ 1 ] estimated that, in , there will be 6.
References 1. Cabinet Office: Heisei 29nenban Koureisyakai Hakusyo. pdf [Accessed: July 31, ] 2. pdf [Accessed: July 31, ] 3.
SECOM CO. pdf [Accessed: July 31, ] 4. Shigemori K. Prevention od dementia by exercise.
Metrics details. Contemporary imaging measures of the human Snake envenomation control Cognitive function maintenance less than half of Traditional medicine rituals differences in Fucntion functioning and change among older Cognitie. Researchers have advanced several Cogniive and concepts to guide research functiion aims to better functtion these individual Cognitive function maintenance in cognitive aging. Coghitive the fundamental measurement model in the empirical sciences as a starting point, we here scrutinize two such complementary theories, brain maintenance and cognitive reserve, in an attempt to clarify these theories, gauge their usefulness, and identify ways in which they can be further developed. We demonstrate that, although both theories are highly useful for spawning theorizing and empirical work, they can be further developed by detailing the theoretical and operational definitions of the concepts that they propose. We propose a few ways forward in these directions. Science has a long way to go in mapping cognition to the brain.
Functiin research maintenancd little risk of infection from functio biopsies. Discrimination at work is linked to high Adaptogen anxiety reduction pressure. Icy fingers and toes: Poor circulation or Raynaud's phenomenon? Every brain changes with age, and mental function changes along with it. Mental decline is common, and it's one of the most feared consequences of aging.
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