What does cognitive health education for the elderly include?

The core content of cognitive health education for the elderly currently mainly covers four categories: popularization of cognitive knowledge, prevention and control of high-risk factors, maintenance of daily cognitive abilities, and family care guidance for cognitive impairment. It is a layered educational content for healthy elderly people, elderly people at high risk of cognitive decline, patients with cognitive impairment, and their families.

I have been doing cognitive health services for the elderly in the community for 5 years and have contacted nearly a thousand elderly people. When I was doing a free cognitive screening last week, I met 70-year-old Aunt Zhang and asked me if she had Alzheimer's disease because she kept forgetting her keys recently. This is also the most common misunderstanding among most elderly people. Therefore, the first thing to explain in health education is the boundaries of common sense related to cognition - Aging is not necessarily normal aging. The difference between benign forgetfulness and pathological cognitive decline is actually very obvious: If you forget where you put your keys and can remember them after being reminded, it is probably normal memory loss caused by age. If you can't even remember whether you have keys or what you want to do when you go out, or even deny that you have forgotten things, you need to seek medical screening immediately.

After figuring out what is normal and what is abnormal, we have to talk about how to prevent it. Many people don’t know that high blood pressure, diabetes, long-term sleep deprivation, and living alone without social interaction are all high-risk factors for cognitive decline. We previously conducted a one-year follow-up with the community health service center and found that the elderly who adhered to salt and oil control for 6 consecutive months and went out to dance for half an hour every day or chat with their old friends had an average cognitive test score 4.2 points higher than those who stayed at home and did not like to go out. These specific prevention and control suggestions are essential content in health education.

Just talking about prevention and control is not enough. Many elderly people will ask "I have forgotten things now, what should I do?" This part is related to cognitive training. At present, the industry does have different views on cognitive training methods: some studies advocate giving slightly higher intensity numerical memory and logic puzzle training to young healthy elderly people, believing that if the stimulation intensity is sufficient, it will have a better effect in delaying cognitive decline. ； Our front-line service providers are actually more inclined to promote life-oriented training methods, such as remembering the prices of the vegetables bought that day, learning to use smartphones to post in WeChat Moments, and playing chess with old friends. There is no need to deliberately sit there and answer the training questions. The elderly can persist without resistance, and the burden is small for the elderly over 80 years old. The 2023 version of the "Guidelines for the Prevention and Control of Cognitive Impairment in the Elderly in China" also mentioned that the appropriate training intensity for the elderly with different ages and different physical conditions is completely different, and there is no need to impose a unified standard. Last month, there was a 72-year-old Uncle Li in our community. He used to worry that he would forget things and become dementia. He was so anxious that he couldn't sleep every day. After attending the class, he learned cell phone photography from his old friend. This time, his screening score was 2 points higher than half a year ago.

In addition to healthy elderly people, families with elderly people with cognitive impairment are also the key groups covered by our health education. Many family members have just begun to face the situation where the elderly repeatedly ask the same question, their temper suddenly worsens, and they can't even find their home. They either think that the elderly is "getting angry on purpose" or they are so panicked that they don't know what to do. This part of the education content is more pragmatic: For example, if you encounter an elderly person repeatedly asking the same question, don't be impatient with "You have asked me 800 times." Instead, you can patiently answer the question once and hand him an apple or point to a program on TV to distract him. ； For example, putting information cards with family members' contact information in the pockets of the elderly's clothes, and replacing gas and hot water faucets with safety locks at home. These practical care skills can help family members avoid many detours.

In fact, the content of cognitive health education for the elderly in various places is still being slowly optimized, and there is no completely unified standard. The core focus is on how to improve the quality of life of the elderly and reduce the care burden on their families. After all, when it comes to cognitive decline, early prevention and early intervention are much better than waiting until serious symptoms appear before seeking medical treatment.