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Reflecting on Cognitive Decline and Aging

Since starting our journey to create a personal training studio for Active Aging, I have talked to many folks who say "I don't need you", "I am healthy, thanks", "My balance is fine", and "I am supposed to feel like this", without appearing to have taken an inventory of their capabilities (their decline in their ability to perform activities of daily living). Some sprint past me, some walk, some shuffle, some use a walker, some are in a wheelchair. We (myself included) seem to be very good a glossing over a wide range of health troubles to declare we are still able to do whatever we want regarding our physical capabilities. When I ask how folks are doing cognitively (thinking, reasoning, remembering), the answers I get are the complete opposite. They say things like "My mind is completely gone", "I can't even remember my wife's name", "I don't remember where I just parked". Not a single person I have talked to in the last 5 months has told me they are fine when it comes to their cognitive health.

So Why the Stark Contrast? My apologies to everyone who thinks I have the answer, but I have absolutely no idea!! I will leave it to somebody else to delve deeper into that part. I just thought the observation was worth sharing! But Seriously.....

  • Financial cost to the US. The monetary cost of Dementia in the United States exceeds $159 Billion annually, according to a study conducted by the RAND corporation, with the largest cost being that of long term home-based or institutional care.

  • Financial cost to Families. From a study published in the Journal of American Geriatrics Society, "from time of diagnosis total lifetime cost of care for a person with dementia was $321,780 (2015 dollars), with families incurring 70% of that total cost burden.

  • Intangible cost of cognitive decline. When we talk in terms of dollars, it is easy to see the associated cost. The intangible costs are the hardest to quantify, but without a doubt they are the most important to consider. Personal torment, broken relationships, and physical decline rob both the person with cognitive decline as well as everyone who loves them. Perhaps the reason we joke about our memory loss, etc. is because we do not wish to face the emotional realities associated with all of that.

Risk Factors It is unarguably stated that the state of our current selves is directly related to past events and decisions. Factors that increase cognitive decline include:

  • Traumatic Brain injury

  • Mid-life obesity

  • Mid-life hypertension

  • Current smoking

  • Diabetes

  • History of Depression and Sleep Disturbances (lower evidence)

Factors that decrease cognitive decline include:

  • Years of formal education

  • Physical Activity

  • Mediterranean Diet

  • Cognitive Training

  • Moderate Alcohol Consumption

Is Cognitive Decline Hereditary? Studies definitely vary on this subject. While one study suggests up to 70 percent of the variation observed in cognitive abilities during aging are attributable to genetic factors, another study from the Alzheimer's Society reports that genetic factors only directly cause the disease in a very small number of families whose members have dementia. My bit of input to this is to just ask the question, "Is the answer even important?" At this point, we are still unable to parse out the genetic trash our ancestors heaped upon us, so we are best served working on the things under our control. What Can We Do? I heard a saying in my childhood that has come back to me thousands of times and has served me well. "The best time to plant a tree is 20 years ago, the second best time is now!" Please don't ever get into the notion that it is too late to make change, whatever that may be. There is always something that can be done to improve your situation. Let's look to the lists above to create an action plan for combating Cognitive Decline. Some of the items listed above cannot be easily corrected, but there is always something that can be done!

  • Physical Activity- Short bouts of high intensity interval training (HIIT) have been shown to have a greater impact on cognitive function that that of long duration exercise (walking, jogging). You may think you cannot perform (HIIT) style activity because you use a walker, or are bound to a wheelchair. To that I say "O Contrair!"

  • Cognitive "Training"- Short bouts of high intensity cognitive training (HICT) have also been shown to have a greater impact on cognitive decline compared to reading, talking and other mental activities of less strenuous nature. What exactly constitutes "High Intensity"? High intensity activity is that which places a sense of urgency and unexpectedness to the activity. Many board games such as Pictionary would be considered to be HICT.

  • Dual Task Training- Dual Task Training (DTT) is the performance of Cognitive and Physical activity at the same time. DTT has been shown to improve cognitive ability, agility, balance and quality of life over and above that of performing either HIIT or HICT separately. Less challenging examples of dual task training would include counting backwards by "threes" while walking. A high intensity example might include moving your hands in opposite circles while thinking of animal names that start with the letter M.

  • Nutritional Changes- We all seem to be confused today about what we need to be eating and what we should avoid. Let's just take a "low hanging fruit" perspective on this. What if we simply stopped eating processed food? I assure you this one simple step will completely change how your body functions.

Let us Help! The last thing I want to happen is for my blog posts and newsletters to come off as a series of "infomercials". On the flipside of that, I would be doing you a huge disservice if I did not offer you a tangible solution! Our company, Fit-Rx, exists for the sole purpose of helping folks age to the best of their ability, both physically and cognitively. We offer several services and modalities, and each and every one of them were specifically chosen to produce the best results. While we currently have many aspects of dual task training implemented into our personal training, we will soon have another offering specifically created to provide optimal results and fantastic tracking. Please take a moment to look at this video for information about our Smartfit Cognitive Training system!

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