WASHINGTON— How can cognitive health be maintained and protected as we age?

While public health organizations have traditionally concentrated on physical health, the Centers for Disease Control and Prevention, along with partners in both the private and public sector, would like public health organizations to start focusing on how cognitive health can be protected and promoted.

Released by CDC and the Alzheimer’s Association in 2007, “The Healthy Brain Initiative: A National Public Health Road Map to Maintaining Cognitive Health,” proposes 44 actions to promote cognitive health, including the call for more research into how cognitive health can be protected. The report is directed toward federal agencies and organizations and outlines an approach to addressing and translating the emerging science on cognitive health to the general public in an effective way.

“What the Road Map was designed to do was to step back and say, ‘Where are we in the research? Where are we in terms of what the public is saying and what the public needs?’” said Lynda Anderson, Ph.D., Director of the Healthy Aging Program in the Division of Adult and Community Health in the National Center for Chronic Disease Prevention and Health Promotion at the CDC.

Protecting Cognitive Health

Cognition, according to CDC, is a combination of mental processes that includes the ability to learn new things, intuition, judgment, language and remembering. Cognitive decline can range from mild cognitive impairment to Alzheimer’s disease and other dementias. Many people fear a loss of cognitive health; in fact, the report found adults are more than twice as likely to fear losing their mental capacity as their physical capacity.

The report emphasizes that the public health community must make cognitive health a priority and invest in its promotion. Public health can play an important role in disseminating information on cognitive health and helping the public understand what are valid ways of helping maintain cognitive health and what are myths.

While there are still many questions that research needs to answer, studies have suggested that there may be preventative measures that individuals can take to help maintain their cognitive health. At a 2006 meeting held by the Alzheimer’s Association and CDC, national experts concluded that factors that may be associated with maintaining cognitive health include preventing or controlling high blood pressure, maintaining a healthy weight and cholesterol levels, preventing diabetes, avoiding smoking and being physically active.

The report points to areas where more research is still needed. Among the top priority actions is the need for controlled clinical trials to determine the effect of reducing vascular risk factors on lowering the risk of cognitive decline and improving cognitive function. Controlled clinical trials are also needed to determine the effect of physical activity on reducing the risk of cognitive decline and improving cognitive function in general, and, specifically what frequency, duration and type of physical activity is most effective in enhancing cognitive function.

“One of the things that we are still doing is understanding the science. That work is evolving. But clearly we know that if you talk about promoting healthy aging, we would place physical activity up at the top,” Dr. Anderson said.

The report also calls for the creation of a web-based cognitive health clearinghouse to provide consumers and healthcare professionals with cognitive health information and tools.

What is the Public Thinking?

The first priority action that the report calls for is determing how diverse audiences think about cognitive health. This is an area that CDC has been working to address. “How does the public think about these issues, talk about these issues, how do we frame these issues to make sense?” Dr. Anderson said.

This, she said, is critical in reaching audiences with prevention messages and formulating programs as more science emerges on cognitive health. “How do we talk about these things and how do we link these things to other health conditions that have common risk factors?”

One way in which CDC is learning about the perceptions that people have of cognitive health is through research conducted through the Healthy Aging Research Network. This CDC-funded network includes experts in aging from nine universities who are conducting prevention research on older adult issues, including cognitive health. This group has done research into what terms people use in describing cognitive health.

“What they have been able to look at is, what are the terms that the public would use to describe cognitive health,” Dr. Anderson said. “One of the findings, for example, ‘staying sharp,’ [is a] term that the public would use. What is neat about this qualitative work is that they have really diverse groups across geographic areas. They have found that there are variations in these different groups in how they think about maintaining cognitive function and how they describe it.”

“So it is not as simple as getting out one message, but how do we begin to talk about this to different diverse groups?” she concluded.