加载中…
个人资料
宝贝寅墨
宝贝寅墨
  • 博客等级:
  • 博客积分:0
  • 博客访问:44,296
  • 关注人气:101
  • 获赠金笔:0支
  • 赠出金笔:0支
  • 荣誉徽章:
相关博文
推荐博文
谁看过这篇博文
加载中…
正文 字体大小:

How a Health Care Provider Can Help Seniors  Mainta

(2014-03-06 06:08:11)
标签:

杂谈

Xu., H.
Algonquin College

How a Health Care Provider Can Help Seniors

Maintain Healthy Brain Function

     "Age-related cognitive decline is common and may lead to substantial difficulties and disabilities in everyday life." (Wolinsky, Vander Weg, Howren, Jones, & Dotson, 2013). Fortunately, research indicates that cognitive decline is not an inevitable part of aging (Ahlskog, Geda, Graff-Radford, & Petersen, 2011). Health care providers are in a unique position to help seniors minimize cognitive decline (Williams & Kemper, 2010) through introduction of cognitive training, facilitation of appropriate physical exercise, and provision of a diet in accordance with established research. According to Ahlskog et al. (2011), “cognitive vitality is essential to quality of life and survival in older persons”. Health care providers must therefore do their utmost to provide seniors with the support they need to maintain healthy brain function.

     Several modifiable risk factors associated with cognitive decline have been identified; health care providers can introduce cognitive training regimes for seniors that have been shown to mitigate them and thus protect or even improve cognitive function into advanced age (Ahlskog et al., 2011). Impairments in working memory and sustained attention can culminate in the brain having difficulty ignoring irrelevant information, and this has been identified as a potential leading factor in cognitive aging (Anguera et al., 2013). Elderly adults subjected to a therapeutic racing game designed to address this were able to realize multitasking scores “beyond those achieved by untrained 20-year-old participants, with gains persisting for 6 months.” (Anguera et al., 2013) Importantly, it found that the sustained performance benefits extended to other untrained sustained attention and working memory exercises. Park et al. (2013) tested the hypothesis that declines in working memory, episodic memory, and reasoning ability may be mitigated by exposure to novel, cognitively demanding activities. At conclusion of a 3-month program, they found that in comparison to those who were placed in social activities or low-demand tasks, those who took part in sustained study of quilting or digital photography had enhanced episodic memory. Yet another study hypothesized that visual speed of processing training could improve processing speed and result in improved scores across a range of cognitive tests (Wolinsky et al., 2013). Participants in the speed of processing training measured 1.5 - 6.6 years in delayed cognitive decline across five separate cognitive assessments. The success of these therapies in mitigating cognitive decline is a testament to the plasticity of the aging brain. With a growing body of tested regimes available, health care providers are in a position to help seniors mitigate cognitive decline and reach their greatest potential.

     While the elderly “represent the most sedentary segment of the adult population” (King, Rejeski & Buchner, 1998), research suggests that it would be appropriate for health care providers to promote exercise training as a means to improve brain function in those who may be beginning to struggle with cognitive impairment (Heyn, Abreu, & Ottenbacher, 2004). The possible cognitive impact of aerobic exercise has been a subject of research. Erickson et al. (2011) conducted a randomized controlled trial of seniors and found that a year of aerobic exercise led to “significantly larger hippocampal volumes and better spatial memory.” Other studies have measured the efficacy of resistance training as a means of improving cognitive function in the elderly. Cassilhas et al. (2007) found that in accordance with previous studies, moderate or high intensity resistance training resulted in “an improvement in short- and long-term memories,” and “better functioning of the central executive.” They note that an increase in insulin-like growth factor-1 (IGF-1) serum concentrations may have been responsible for this improvement, since higher levels have been observed to correlate with superior cognitive performance in the elderly and mechanisms for this have been hypothesized. Bringing together some of the above findings, Smith et al. (2010) observe that while aerobic exercise is ineffective at improving working memory, despite the benefits it confers on attention, processing speed, executive function, and memory. However, they found that pairing aerobic exercise with strength training improves working memory and results in a greater improvement to attention than that which can be attained by aerobic exercise alone. Particularly in those who may not otherwise be active, promotion of physical activity is an important strategy in the prevention of cognitive decline.

     Research suggests that certain dietary components may have a positive impact on brain function (Desideri, Kwik-Uribe, & Grassi, 2012); research exploring the cognitive effects of various diets on seniors over time is now providing a growing base of knowledge that health care providers can put to use in the fight against cognitive decline. Yasuno et al. (2012) suggest that the brain “readily undergoes oxidative damage, and long-term oxidative stress likely contributes to declining cognitive processes”. In accordance with this hypothesis, adherence to a Mediterranean diet containing high amounts of olive oil, vegetables, fruit and fish has been linked to a significantly lower incidence of dementia or Alzheimer’s disease (Opie, Ralston, & Walker, 2013). Specific antioxidants with more complex properties have also been the target of study. Devore, Kang, Breteler, & Grodstein (2012) have found that high berry intake “appears to delay cognitive aging by up to 2.5 years.” They suggest that a high concentration of various flavonoids such as the anthocyanidins prevalent in brightly coloured foods may be responsible for this protective effect. Identification of nutritional deficiencies can also play an important role in combatting cognitive decline. Vitamin B-12 deficiency has been identified as responsible for cognitive disorders that are sometimes attributed to normal cognitive aging (Fillit et al., 2002). Selhub, Morris, Jacques, & Rosenberg (2009) have suggested a mechanism for this whereby high serum folate levels in relation to vitamin B-12 status results in anemia and cognitive impairment. It may thus be appropriate to develop some understanding of nutritional interactions in addition to isolated requirements. These and other advances in our understanding of nutrition in the elderly are making it possible for health care providers to promote a diet that has been shown to minimize cognitive decline.

     Deterioration of cognitive function over time often leads to serious negative consequences in the elderly. Whether or not the decline has already become a significant issue in an individual, professional assistance can be beneficial. Healthy brain function can be extended through the application of tested cognitive exercises, physical activities, and nutritional therapies. “Data are now beginning to form the scientific basis for achieving and maintaining cognitive vitality in late life” (Ahlskog et al., 2011). Professionals are in a position to keep informed of the most effective interventions. In their interactions with seniors, health care providers are in a great position to make positive contributions in the fight against cognitive decline.

 

 

 

 

 

 

 

 

 

 

References

Ahlskog, J. E., Geda, Y. E., Graff-Radford, N. R. (2011). Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging. Mayo Clinic Proceedings, 86(9), 876-884. doi:10.4065/mcp.2011.0252

Anguera, J. A., Boccanfuso, J., Rintoul, J. L. (2013). Video game training enhances cognitive control in older adults. Nature, 501, 97-101. doi:10.1038/nature12486

Cassilhas, R. C., Viana, V. A. R., Grassmann, V. (2007). The Impact of Resistance Exercise on the Cognitive Function of the Elderly. Medicine & Science in Sports & Exercise, 39(8), 1401-1407. doi:10.1249/mss.0b013e318060111f

Desideri, G., Kwik-Uribe, C., Grassi, D. (2012). Benefits in cognitive function, blood pressure, and insulin resistance through cocoa flavanol consumption in elderly subjects with mild cognitive impairment. Hypertension, 60, 794-801.

doi:10.1161/​HYPERTENSIONAHA.112.193060

Devore, E. E., Kang, J. H., Breteler, M. M. B., (2012). Dietary intakes of berries and flavonoids in relation to cognitive decline. Annals of Neurology, 72(1), 135-143. doi:10.1002/ana.23594

Erickson, K. I., Voss, M. W., Prakash, R. S. (2011). Exercise training increases size of hippocampus and improves memory. Proceedings of the National Academy of the United States of America. Advance online publication. doi:10.1073/pnas.1015950108

Fillit, H. M., Butler, R. N., O'Connell, A. W. (2002). Achieving and maintaining cognitive vitality with aging. Mayo Clinic Proceedings, 77(7), 681-696. doi:10.1016/S0025-6196(11)62235-0

Heyn, P., Abreu, B. C., Ottenbacher, K. J. (2004).The effects of exercise training on elderly persons with cognitive impairment and dementia: A meta-analysis. Archives of Physical Medicine and Rehabilitation 85(10), 1694–1704. doi:10.1016/j.apmr.2004.03.019

King, A. C., Rejeski, W. J., & Buchner, D. M. (1998). Physical activity interventions targeting older adults: A critical review and recommendations. American Journal of Preventive Medicine, 15(4), 316-333.

Opie, R. S., Ralston, R. A., & Walker, K. Z. (2013). Adherence to a Mediterranean-style diet can slow the rate of cognitive decline and decrease the risk of dementia: a systematic review. Nutrition & Dietetics, 70(3), 206-17. doi:10.1111/1747-0080.12016

Park, D. C., Lodi-Smith, J., Drew, L. (2013). The impact of sustained engagement on cognitive function in older adults. Psychological Science. Advance online publication. doi:10.1177/0956797613499592

Selhub, J., Morris, M. S., Jacques, P. F. (2009). Folate–vitamin B-12 interaction in relation to cognitive impairment, anemia, and biochemical indicators of vitamin B-12 deficiency. The American Journal of Clinical Nutrition, 89(2), 702S-706S. doi:10.3945/​ajcn.2008.26947C

Smith, P. J., Blumenthal, J. A., Hoffman, B. M. (2010). Aerobic Exercise and Neurocognitive Performance: A Meta-Analytic Review of Randomized Controlled Trials. Psychosomatic Medicine, 72(3), 239-252. doi:10.1097/​PSY.0b013e3181d14633

Williams, K., & Kemper, S. (2010). Exploring interventions to reduce cognitive decline in aging. Journal of Psychosocial Nursing and Mental Health Services, 48(5), 42–51. doi:10.3928/02793695-20100331-03

Wolinsky, F. D., Vander Weg, M. W., Howren, M. B. (2013). A randomized controlled trial of cognitive training using a visual speed of processing intervention in middle aged and older adults. PLOS ONE, 8(5). doi:10.1371/journal.pone.0061624

Yasuno, F., Tanimukai, S., Sasaki, M. (2012). Combination of antioxidant supplements improved cognitive function in the elderly. Journal of Alzheimer's Disease, 32(4), 895-903. doi:10.3233/JAD-2012-121225

0

阅读 评论 收藏 转载 喜欢 打印举报/Report
  • 评论加载中,请稍候...
发评论

    发评论

    以上网友发言只代表其个人观点,不代表新浪网的观点或立场。

      

    新浪BLOG意见反馈留言板 电话:4000520066 提示音后按1键(按当地市话标准计费) 欢迎批评指正

    新浪简介 | About Sina | 广告服务 | 联系我们 | 招聘信息 | 网站律师 | SINA English | 会员注册 | 产品答疑

    新浪公司 版权所有