Lifestyles and Cognitive HealthWhat Older Individuals Can Do to Optimize Cognitive Outcomes
Loss of cognitive function and the development of dementia are among the greatest concerns confronting older individuals. As populations around the world age, the global prevalence of dementia is predicted to increase substantially from an estimated 35.6 million in 2010 to 65.7 million in 2030, and 115.4 million in 2050.1 In the United States in 1990, Alzheimer disease ranked 25th in terms of disability-adjusted life-years lost. In 2010, it ranked 12th, with the greatest median percentage change of any of the leading 30 diseases.2The burden of mild cognitive impairment (MCI) is even larger.3 Discussions between physicians and patients about strategies to prevent cognitive decline and dementia have become commonplace, and there is great interest in new evidence of lifestyle modifications that might improve cognitive aging and prevent the onset of dementia. These lifestyle modifications include exercise, dietary changes, cognitive training (ie, “brain games”), and multimodal treatments. A meta-analysis of observational studies found that the modifiable risk factors that have most consistently been associated with a reduced risk of dementia include higher educational attainment, increased physical activity, and avoidance of smoking.4
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