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Preventing Cognitive Decline in the Older Adult

Jacob Donnett, Taylor Richter, Karissa Rossow

University of Mary

NUR 342: Gerontologic Nursing

Professor Cindy Weigum

April 8th, 2022

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Preventing Cognitive Decline in the Older Adult

Cognitive decline can be delayed in individuals as they age. Cognitive impairment can

show in an individual in many ways, some so subtle one wouldn't even think it is happening.

Examples of cognitive impairment in an individual include forgetting things more often such as

important appointments or gatherings, losing one’s train of thought when making decisions,

planning activities, or accomplishing tasks, experiencing difficulties navigating one’s way

around familiar environments, exhibiting poor judgment, or being impulsive. Although these

may seem minor, they can grow into something more. If events continually occur, one should

speak up either to the individual directly or to someone who is able to address the issue, such as a

caregiver. Reasons for cognitive decline in older adults include medications, hormone

imbalances, vitamin deficiency, psychiatric conditions, substance abuse, injury, or

neurodegenerative conditions. In any of these cases it is important to keep a close eye on the

individual for changes. There are many ways to prevent cognitive decline early on in life

including changes in diet, exercise, mental stimulation exercises, and keeping an active social

life.

Simple lifestyle modifications like exercise, diet, and rest have been shown to decrease

the incidences of dementia and cognitive decline as well as keep an individual healthier overall

for longer. The first lifestyle modification that can be made to avoid cognitive decline and the

instance of dementia is exercise. Exercising several times a week for 30 to 60 minutes has been

shown to improve memory, reading, judgment and thinking skills for individuals with cognitive

impairment (Mayo, 2021). According to Mayo Clinic, exercise can decrease an individual’s risk

of Alzheimer’s and dementia by increasing blood flow to the brain and increasing the size of the

hippocampus, which is associated with memory and memory formation (Mayo, 2021).
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The second lifestyle modification that has been shown to decrease the incidence of

cognitive decline is an individual's diet. Eating the correct foods can help an individual support

their brain and cognitive function and keep their body in balance nutritionally. The

Mediterranean-style diet is a popular diet recommended for adults; it includes eating fruits,

vegetables, whole grains, beans, nuts, seeds, olive oil, fish, poultry like chicken, and dairy

products while limiting the intake of red meats (Harvard, 2021). This specific diet, according to

Harvard Medical School, has been shown to lower the risk of mild cognitive impairment as well

as slow the progression of dementia in individuals who are already exhibiting symptoms.

Additionally, the MIND diet, created by Rush Nutritional Epidemiologist Martha Clare Morris,

ScD, is a hybrid of the Mediterranean and DASH diet. This diet has been shown to decrease

plaque and tangle buildup in the brain and nerves that alter ways of thinking and problem-

solving skills (Fiore, 2021). This diet is beneficial because it allows for “cheat days,” meaning

the individual is allowed to indulge in fast food and sweets once a week. This allows the

individual to eat what they enjoy while still monitoring what they eat most of the time, allowing

them more freedom with decisions. Unfortunately, the topic of diet becomes difficult for low-

income individuals and families. Fruits, vegetables, and meat are not particularly cheap and are

not affordable for much of the population, but even substituting just some of these items into

one’s diet can help make an impact on overall health, well-being, and mental status.

A large diet modification that can be made is limiting the amount of alcohol that one

consumes. Alcohol can have a detrimental effect on one’s cognitive ability and overall wellness.

Alcohol can cause delirium, confusion, and altered judgment when it is abused. According to

Harvard Medical School, though alcohol does not need to be completely cut out of one’s life,

limiting oneself to one drink a day has been shown to lower the risk of dementia (Harvard,
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2021). When one starts limiting themselves at a young age, they are less likely to abuse alcohol

in the future, which decreases the risk of cognitive impairment in older years.

Smoking cessation and sleep also play substantial roles in cognitive health. Smoking

cessation is a lifestyle modification that can be challenging but ultimately incredibly beneficial.

It is important to quit as early as possible before cognitive declines are shown. Additionally, it is

beneficial to allow oneself to get proper rest each night and throughout the day when they feel

fatigued. Lack of sleep can result in altered mental status, poor judgment, lack of awareness, and

confusion. If an individual can have a consistent sleep and rest schedule, they are overall going

to be more cognitively aware of what is going on around them.

Many methods of countering cognitive decline start early in life. The earlier that someone

starts eating the right foods or starting the right diet, exercising daily, quitting bad habits, and

allowing the mind and body to rest, the less likely the individual is to experience cognitive

declines or lose mental function in their older years. Not all of these are income sensitive,

specifically diet, even the smallest changes or alterations in the diet or lifestyle can play a large

role in your life. Family support, individual drive, and support from one’s health care providers

are all necessary to make these needed adjustments. Support and education from one’s nurse is

imperative, and should be a goal that nurses everywhere try to reach.

Just as exercising one’s body keeps them limber and mobile, “exercising” one’s mind is a

method that is proven to prevent cognitive decline in older adults. This type of activity might not

be appealing initially, but mentally stimulating activities can be quite enjoyable. These activities

include playing a musical instrument, visiting museums, reading books, solving puzzles, and

more. According to the National Dementia association in Australia, exercising the brain using

mentally stimulating activities builds reserves and makes connections in the brain (Dementia
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Australia, 2020). Preserving and promoting brain connections can combat the damage that occurs

due to Alzheimer’s Disease and other cognitively detrimental conditions as well as improve

memory, processing speed, and executive function (Krivanek et al., 2021). It is important to

note that mental stimulation promotes cognitive function at any stage of life, but the highest

cognitive function in older adults is associated with those who participate in cognitive activities

in all stages of life. According to a study on successful cognitive aging, “cognitive activity in

midlife was associated with a 34% reduced risk of all-cause dementia.” Later in the paper it was

shown that participation in these activities in later life was associated with a 31% risk reduction

(Krivanek et al., 2021). With this information, one can understand that just as muscles atrophy

when they are not used, so does the brain when it is not used.

Nurses and nursing students can promote mental stimulation to prevent cognitive decline

in care across the whole lifespan. As mentioned above, “exercising” one’s brain years before

they are considered an older adult increases cognitive function once one is an older adult. Nurses

can share this information and explain mentally stimulating ideas to anyone at any time, but it is

especially useful information to share with those who are at higher risk of developing dementia

and other cognitive illnesses. The information can be shared both actively and passively. For

example, a nurse can educate their patient directly while caring for them, or they can create an

educational board and some puzzles that can sit in their waiting room and be consumed by

whomever is interested.

Social activities are another way that older adults can help reduce cognitive decline.

According to a study done by Biomedcentral Geriatrics (BMC), when older adults engage in

social activity, they have a lower risk of cognitive decline when contrasted with older adults who

do not engage in these activities. The study proposed two different types of social activities:
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formal and informal. “Formal activity describes an activity with formal organizations such as an

alumni society, based on specific objectives and focusing on the achievement of a goal; informal

activity includes interactions with family, friends, and neighbors” (Lee & Kim, 2016). The study

found that older adults that participated in formal activities had a reduced likelihood of cognitive

decline versus older adults that were not. This can be attributed to the fact that senior centers and

other formal activities are often centered around cognitively and emotionally stimulating

activities. It can be said that when a group of older adults are participating in cognitive and

emotional stimulating activities, they will have a lower likelihood of cognitive decline. An

interesting finding of the study was that older adults who had face-to-face interactions had

reduced cognitive decline if the older adult was able to reciprocate the support received. For

example, an older adult that is less independent with their activities of daily living had a less

positive outcome because they felt like a burden, while older adults that felt they could

contribute to their friends and family had a more positive outcome. The study concluded that

overall social activities, either being formal or informal, reduced the likelihood of cognitive

decline.

Though cognitive decline is often something that is inferred with advancing age, this

study showed that cognitive decline can often be suppressed if the proper measures are taken by

the older adult to maintain a social life. Something that is often overlooked in the older adult is

their need to be social. Nurses might assume that when older adults have some cognitive decline

it means that they do not know as much and do not want to be social. This mindset is proven to

worsen cognitive decline in the older adult. Cognitive decline is shown to be reduced when older

adults are more involved in social activities. Human interaction is vital for the mental as well as

the physical health for the adult. Caregivers and nurses need to encourage older adults to do
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activities that involve other people. In places such as nursing homes, older adults often do not see

anyone besides their caregivers for most of the day. Typically, there are many different activities

that occur within nursing homes such as bingo, arts and crafts, and religious services. If the older

adult is at home or is unable to visit with people, phone calls or Facetime with friends and family

are a great solution. Human beings are naturally social beings, and if humans are deprived from

other humans, it can more than affect their cognitive health, it can affect their spiritual and

physical health as well. It is important that caregivers and healthcare professionals consider the

social support that older adults have and encourage them to be social to prevent cognitive

decline.

In conclusion, cognitive decline as one ages is not inevitable for those who are at risk.

There are numerous lifestyle modifications that are shown to decrease the likelihood of this

outcome, such as specific diets, exercise, smoking cessation, adequate sleep, mental stimulation,

and social activity. These modifications should be encouraged by all healthcare providers, but

especially nurses, as they are dedicated patient advocates and educators. Nurses should

implement this preventative education in care of all patients, but especially those who are most at

risk. Together, health care professionals can help older adults live full and engaged lives.
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Works Cited

Dementia Australia (Ed.). (2020). Dementia Q&A 6 - Mental Exercise and Dementia. Dementia

Australia. Retrieved April 7, 2022, from

https://www.dementia.org.au/sites/default/files/helpsheets/Helpsheet-DementiaQandA06-

MentalExercise_english.pdf.

Fiore, N. D. (2021, September 20). Mind diet linked to better cognitive performance. Rush

University System for Health. Retrieved April 6, 2022, from

https://www.rush.edu/news/mind-diet-linked-better-cognitive-performance.

Harvard Health. (2021, January 2). Protecting against cognitive decline. Retrieved April 6, 2022,

from https://www.health.harvard.edu/mind-and-mood/protecting-against-cognitive-decline.

Krivanek, T. J., Gale, S. A., McFeeley, B. M., Nicastri, C. M., & Daffner, K. R. (2021).

Promoting Successful Cognitive Aging: A Ten-Year Update. Journal of Alzheimer's

disease : JAD, 81(3), 871–920. https://doi.org/10.3233/JAD-201462.

Lee, S. H., & Kim, Y. B. (2016, September 27). Which type of social activities may reduce

cognitive decline in the elderly?: A longitudinal population-based study. BMC Geriatrics.

Retrieved from https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-016-0343-

x.

Mayo Foundation for Medical Education and Research. (2021, May 12). Alzheimer's disease: Can

exercise prevent memory loss? Mayo Clinic. Retrieved April 6, 2022, from

https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/expert-answers/

alzheimers-disease/faq-20057881.