Cognitive health education for the elderly includes

The content of cognitive health education for the elderly includes five core modules: basic cognitive science, interventional risk prevention and control, individualized cognitive training, family care support for cognitive impairment, and psychological adjustment for the elderly. It is by no means as simple as "preventing Alzheimer's disease" in public perception.

Last week I was at a community free clinic. As soon as I set up my stall, I was grabbed by my sleeve by 72-year-old Aunt Zhang. Holding a notebook full of small words, she asked in the first sentence, "Girl, I forgot to water the flowers yesterday. Am I going to get Alzheimer's disease?" ”

This is actually the first misunderstanding about cognitive health that most elderly people have, so basic science education is the first lesson in all health education - we will first help you distinguish the difference between "normal aging amnesia" and "mild cognitive impairment (MCI)": For example, it is normal to forget to put the key, and you need to be vigilant only if you forget that the key is used to open the door.； It's normal to forget to buy soy sauce when you go out. It's normal to forget what you want to do when you walk to the gate of your community, or even to find your home before you need to see a doctor. Interestingly, the academic community has always had different views on the intervention point: many scholars in neurology believe that as long as the pathological diagnosis standards are not met, additional intervention is not needed to avoid unnecessary psychological burden on the elderly. ； However, most practitioners in geriatric psychiatry and rehabilitation departments support early screening and early intervention. According to the 3-year tracking data of our center, elderly people who start intervention during the MCI stage can delay the progression to Alzheimer's disease by an average of 3-5 years.

To be honest, rather than worrying about "am I going to get sick?", what is more practical is content that can intervene in risk prevention and control. We don’t just chant the slogan “Eat a light diet and exercise more”. We use real cases of elderly people in the community as teaching materials: For example, Uncle Li, who lives in Building 3, has a 20-year history of hypertension. He always thought, “I don’t need to take medicine if I’m not dizzy.” It wasn’t until we showed him the data that long-term blood pressure fluctuations of more than 20mmHg can cause more damage to the hippocampus of the brain than smoking a pack of cigarettes a day for 10 years, that he obeyed the doctor’s advice and adjusted his antihypertensive medication. The controversy over dietary prevention and control is even greater. Scholars who advocate the Mediterranean diet recommend that the elderly eat more deep-sea fish, olive oil, and nuts. However, many Chinese elderly people cannot tolerate raw or cold deep-sea fish in their stomachs, and they are not used to the taste of olive oil. In practice, we usually compromise and recommend that everyone eat 1-2 walnuts a day and steamed seabass or crucian carp twice a week. According to our follow-up data, the effect is not significantly different from that of the elderly who adhere to the Mediterranean diet.

Oh, by the way, many people think that cognitive training means asking the elderly to memorize numbers and do puzzles. This is not true. I have seen 81-year-old Uncle Wang, who has never been to school in his life and cannot read or count. However, he squats in the gazebo of the community and plays chess with others every day. He also likes to ponder new chess records. Last year, he took a cognitive function test and his score was higher than many 70-year-old people. We never insist on a uniform model when training the elderly: those who love square dancing will memorize new dance steps, those who love taking care of children will help memorize their grandchildren’s interest class schedules, and those who love cooking will make a grocery shopping list every day, or even spend 10 minutes a day copying two lines from their favorite plays. As long as it is an activity that interests you and requires a little brain use, doing it for 15 minutes a day is much more useful than being forced to do a puzzle you don't like for half an hour.

Many people don’t know that more than half of our cognitive health education audience are family members of the elderly who have already developed cognitive impairment. I met an aunt before. Her husband had just been diagnosed with mild cognitive impairment. She forced her husband to memorize English words every day, saying, "People say memorizing words helps to train your brain." As a result, they quarreled over everything, and her husband hid when he saw her picking up the vocabulary book. Later, we adjusted the plan for her: her husband had been a chef all his life, so we asked him to make a grocery shopping list for the next day every day. After shopping, he would calculate how much it cost and whether the change was correct. After only 3 months, his wife could already go to the vegetable market to buy vegetables by himself, and the relationship between the two of them has improved a lot. There are also differences in the concept of care for the elderly with cognitive impairment: the old school of care advocates "correcting mistakes". If the elderly says that he is going to pick up his adult child from school, he must tell him "You remember wrong, the child has already been working", which often makes the elderly cry. ； Nowadays, the mainstream care concept advocates "guiding according to the situation". Following his words, "The child will finish class later today, let's go buy his favorite sweet and sour pork ribs and wait for him." This will not only make the elderly feel frustrated, but also avoid more serious cognitive decline caused by emotional excitement.

The last thing that cannot be avoided is the content of psychological adjustment. I have been doing this for almost 6 years, and the biggest headache is not the old people forgetting things, but the shame of the old people - many old people wave their hands when they hear "cognitive training" and say, "I'm not stupid, why do I practice this?" Therefore, when we start classes now, we never say "Today we will talk about how to prevent Alzheimer's disease" as the first sentence. We all say with a smile, "Today we are going to learn how to make our brains work better. Next time there is a promotion in the supermarket, you can remember the prices better than others, and you can even grab eggs." In the past, the academic community did not pay enough attention to psychology. New research in the past two years has shown that the cognitive decline rate of elderly people with long-term depression and anxiety is 2.7 times that of elderly people with stable emotions. So now we set aside half of each class time for everyone to chat, talk about interesting things about raising children recently, and talk about the new square dance, which is more effective than ten pages of PPT.

Hi, to put it bluntly, cognitive health education for the elderly has never been about putting health shackles on the elderly, nor is it asking everyone to live to be 100 years old and still remember as well as young people. It is nothing more than to help everyone remember what they want to remember and live the life they want when they can live independently.