Answers to four questions Americans ask about cognitive decline

June 27^e‘Donald J. Trump / Joseph R. Biden debate was notable for many reasons, including that they are the oldest presidential candidates in American history. It’s about concerns about cognitive decline. Specifically, people want to know whether Trump at 78 or Biden at 81 are ready for a four-year, high-stakes job that requires enormous energy and mental commitment.

Debate watchers on both sides of the political island expressed concern that Biden stumbled over many answers and lost his train of thought several times. The immediate panic is whether Biden’s faltering words are a harbinger of cognitive decline that will affect his ability to lead effectively for another term.

Here are answers to four questions people should ask about cognitive decline.

1. What is cognitive decline?

Cognitive decline is a deterioration in mental functioning. It can manifest as memory loss (for example, trouble remembering events or names) or language problems (for example, difficulty finding words or difficulty following a conversation). Concentration problems may occur. As it gets worse, people become disoriented, sometimes even lost in familiar places and confused about what date it is.

2. What causes cognitive decline?

Some cognitive decline is part of normal aging. Yet cognitive decline can also mean that the brain becomes damaged, deteriorates, or both. Progressive decline can affect the ability to think and function independently. Neurodegenerative diseases – including Alzheimer’s and Parkinson’s – can manifest as cognitive decline, just like other forms of dementia.

Chronic health conditions that affect the brain’s blood flow and the way it uses energy can cause or worsen cognitive decline. For example, high blood pressure, high cholesterol, diabetes and mental health problems such as anxiety and depression are risk factors. Other triggers include head injuries, substance use, genetics and vitamin deficiencies.

Poor sleep and high stress, which undoubtedly come with the job of the US president, can not only lead to cognitive decline, but also worsen its symptoms.

3. How is cognitive decline diagnosed?

Diagnosing cognitive decline requires a comprehensive evaluation. That starts with a detailed history and physical. Examples of specific to test include the Mini-Mental State Examination, the Montreal Cognitive Assessment (MoCA), the Mini-Cog or in-depth neuropsychological tests, which are typically administered by healthcare providers. Labs and imaging tests can help rule out other problems such as infection and stroke.

The key to the diagnosis may be what others observe. Interviews with family members or colleagues help clarify how a person’s cognition fluctuates, especially during stressful situations or at the end of the day. Biden noted that he was sick with a cold during the debate, which could be a reason for his poor performance.

Illness or lack of sleep can have an influence cognition even young health professionals, but especially older adults like Trump and Biden. Importantly, a single episode of fluctuating cognition does not definitively diagnose its cause, define its progression, or predict a specific rate of decline.

4. How can cognitive decline be prevented and treated?

Cognitive decline can be both prevented and treated by eating a healthy diet – including fruits, vegetables and whole grains – and engaging in regular aerobic exercise and strength training.

Engaging in regular cognitive activities and social interaction can also help prevent the decline, as can ensuring 7 to 9 hours of sleep per night. sleep. Stress management such as meditation, yoga and even therapy may also slow the decline. An intensive one lifestyle A recent clinical trial found that interventions involving diet, exercise, socializing, and supplements reveal and even reduce symptoms of Alzheimer’s disease.

While presidents get a lot of social interaction, their schedule, travel and constant demands are stressful for everyone, especially those with aging brains. The demands of the job may require an older president to prioritize activities that optimize rest, reduce stress levels and provide regular exercise.

Despite promising lifestyle studies, new medicinesand other therapies (e.g., rehabilitation) cannot completely cure most cognitive decline. Prevention can only delay its onset. Treatment aims to slow the decline, control symptoms and improve quality of life.

Ultimately, the American public does not have enough information to decide whether either candidate has cognitive decline. Also, there is not enough data to predict how their decline, if any, might develop over the next four years. What is certain is that voters will be closely watching Trump and Biden’s performance in speeches and interviews in the coming months for clues. Cognitive decline is likely to remain a central issue in voters’ minds in November if both candidates remain in the race.