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Now more of us can count on more time evading the dementia ball



You turned 65 and left middle age. What chances do you have of developing cognitive impairment or dementia in the coming years?

New research on "cognitive life expectancy" – how long older adults with good or declining brain health live – shows that men and women over 65 years old live more than a dozen years in good cognitive health, on average. And over the last decade, this time span has widened.

In contrast, cognitive challenges arise in a more compressed time frame later in life, with mild cognitive impairments (problems with memory, decision-making or thinking skills) about four years on average and dementia (Alzheimer's disease or other related disorders) exceeding 1

½ up to 2 years

Even when these conditions emerge, many seniors maintain a general sense of well-being month at the annual meeting of the Population Association of America, according to recent, recently presented research results.

"The majority of cognitively impaired years are happy, not unfortunate," said Anthony Bardo, a co-author of this study and associate professor of sociology at the University of Kentucky-Lexington

Recent research shows the following:

The Most seniors do not have cognitive impairment or dementia. Of the Americans 65 and older, about 20 to 25 percent have mild cognitive impairment, while about 10 percent have dementia. Kenneth Langa, expert in demography of aging and professor of medicine at the University of Michigan. Risks increase with advancing age, and the proportion of the affected population is significantly higher for people over 85.

Langa's studies show that the prevalence of dementia has declined in the US – a trend observed in developed countries around the world. A new study by researchers at Rand Corp. and the National Bureau of Economic Research concludes that 10.5 percent of US adults aged 65 and older in 2012 had dementia, compared with 12 percent in 2000.

Because the population is older However, the number of people suffering from dementia is increasing: an estimated 4.5 million in 2012 compared to 4.1 million in 2000.

More years of education, associated with better health of mind and body, seem to be on the rise to contribute to this phenomenon.

But profits are unevenly distributed. Remarkably, college graduates can spend more than 80 percent of their lives after the age of 65 with good cognition, according to a new study by researchers from the University of Southern California and the University of Texas at Austin. For people who have not completed high school, the number drops to less than 50 percent.

This study looks at the older population as a whole and can not predict what will happen to a particular individual. Still, it helps to get a general sense of what people can expect.

An expanding period of good brain health. With longer lives and lower rates of dementia, most seniors enjoy more years of good-sense living – a welcome trend.

Two years ago, Eileen Crimmins, AARP Department of Gerontology at the University of Southern California's Leonard Davis School of Gerontology and colleagues documented this shift in the United States in research that includes data on adults 65 and older from health and retirement Study used.

In 2000, she found a 65-year-old woman could expect 12.5 years to live well with perception, four years with mild cognitive impairment, and 2.6 years with dementia on average. A decade later, in 2010, the period of good cognition had grown to 14.1 years, with 3.9 years of mild cognitive impairment and 2.3 years of dementia.

For men, the figures for 2010 are different: 12.5 years with good perception after 65 years (compared to 10.7 in 2000); 3.7 years with mild cognitive impairment (as in 2000); and 1.4 years with dementia (compared to 1.8 years in 2010).

Improvements in education and nutrition, better control of high blood pressure and cholesterol, cognitively demanding middle-aged jobs, and social involvement later in life can all contribute to this extended period of good brain health, the study noted.

Probably coexists with impairment. Bardo's research adds another dimension to this literature by addressing two questions: Do older adults with cognitive disorders feel they have a good quality of life and, if so, how long?

His study, which has not yet been published, focuses on happiness as an important indicator of quality of life. The data comes from thousands of adults aged 65 and over who participated in the Health and Retirement Study between 1998 and 2012 and were asked if they were happy "all / most of the time" or "some / no time" in the past week [19659020] These responses were combined with information on cognitive impairments derived from tests that examined the ability of seniors to recall words and count backwards.

The results suggest that cognitive impairment is not a deterrent to happiness. From the period in which seniors were cognitively impaired, about 5.5 years on average, they reported that they were happy for 4.8 years – about 85 percent of the time. Of the 12.5 years older adults have spent in good cognitive health, they report that they were happy almost 90 percent of the time.

Conclusion: "Cognitive impairment is not synonymous with dissatisfaction," said Bardo. Still, he warned that his study was not focused on how happiness correlates with the extent of impairment. Certainly, people with moderate to severe dementia have serious difficulties in their lives, as do their caregivers.

Amal Harrati, an instructor at the Faculty of Medicine at Stanford University, said Bardo's paper appears methodically sound, but wondered if older adults with cognitive impairment can be trusted to report reliably on their satisfaction.

Langa from the University of Michigan said the findings "fit with my overall experience and my sense of treating elderly patients in my clinical work." In the early stages of cognitive impairment, people often begin to focus on enjoying family and being in the "here and now" while paying less attention to "the little frustrations that get us in our daily lives," he wrote an e-mail answer to questions.

As cognitive deterioration worsens, I think it's more likely that one becomes unhappy, possibly because of the progressive pathology that can affect certain brain regions and behavioral problems "hallucinations and paranoia," he added.

Jennifer Ailshire, assistant professor of gerontology and sociology at the Leonard Davis School of Gerontology at the USC, found that happiness is often tied to the personality traits of an individual. This measure "does not necessarily reflect how people with cognitive disabilities interact with other people or their environment," she commented.

Laura Gitlin, Dean of the College of Nursing and Health Professions at Drexel University in Philadelphia, observed that happiness is just one element to live well with cognitive impairment and dementia. In the future, she suggested "there is much to do" to find out what will contribute to greater well-being and a positive quality of life in older adults under these conditions.

KHN coverage of these topics is supported by John A. Hartford Foundation, Gordon and Betty Moore Foundation, and the SCAN Foundation

Kaiser Health News (KHN) is a national health news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation, which is not associated with Kaiser Permanente.


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