Cognitive decline is a normal consequence of the age-related changes in the physiology of the brain and the larger senescence every human being experiences. Cognitive decline is often presumed, by the unknowing, to be a precursor to dementia. It is not. Dementia is not a part of normal aging. It represents a group of symptoms caused by disorders that affect the ability to think so severely that it impairs one's ability to perform normal activities like eating or getting dressed. Memory loss is a common symptom of dementia, but memory loss by itself does not mean that someone has dementia. Age-related memory loss as part of cognitive decline manifests itself as the rare occasion, for example, of making a bad decision, missing a monthly payment, forgetting which day it is and remembering later, sometimes forgetting which word to use or losing things from time to time.
Cognitive decline is inevitable, but the extent to which it occurs and the rapidity of onset varies among individuals. In general, the symptoms of cognitive decline associated with age include the following (ranked with the most severe drop with age): Diminished spatial orientation, slower inductive reasoning/slower problem solving, a decline in perceptual speed, decreased numeric ability, and a loss in verbal memory. Interestingly, changes in verbal ability, however, may actually increase and not decline.
When assessing both risk and protective factors to define cognitive aging interventions, health care professionals should examine such various aspects as lifestyle and physical environment, health and medical factors. This assessment can help define the best general evidence-based approaches to interventions aimed at slowing or modifying cognitive decline.
Lifestyle and physical environment factors that can contribute to cognitive decline include, for example, physical activity and exercise, education and intellectual engagement, social isolation, social engagement, diet, vitamins, alcohol, smoking substance abuse, stress and the physical environment challenges due to air pollution and occupational exposure.
The many health and medical factors that modify cognitive decline are significant: Medications, cerebrovascular and cardiovascular disease, delirium and hospitalization, major surgery and general anesthesia, thyroid disorders, chronic kidney disease, cancer, depression, traumatic brain injury, hearing and visual loss, sleep and genetic factors.
Evidence-based interventions used today to slow or modify cognitive decline are not aimed at specific risk factors but are aimed at improving cognition through a combination of interventions that may involve cognitive skills training, participation in the arts, technology-based computer cognitive stimulation, electrical stimulation and pharmacologies/supplements.
In summary, all of these risk factors, protective factors and interventions are the intersecting components for cognitive ageing and psychobiology. Six words can define the center of this intersection: How We Have Lived Our Life.