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This essay examines a series of Coca Cola advertisements that offer insight into notions of neighborhood and community in the U. It focuses on the relationship between the U. Good Neighbor policy and a ad set in Panama. The author argues that a significant relationship existed between U. Invoking a broad understanding of imperialism that stresses economic, political, cultural, and ideological aspects of imperialism, the author draws on the work of Edward Said, Michael Doyle, and Amy Kaplan. The essay includes a detailed analysis of the Coca Cola ad set in Panama, but concludes by looking at a series of post-WWII ads and their implications. One example is the early Civil Rights movement in the U. The soda fountain might often have been associated with innocence and nostalgia for small-town life in the U. Civil Rights battles. Access to content on Oxford Academic is often provided through institutional subscriptions and purchases. 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Not a MyNAP member yet? Register for a free account to start saving and receiving special member only perks. This chapter explores interventions that are aimed at improving cognition or slowing cognitive decline but that are not aimed at specific risk factors. Among the many approaches that fall into this category are cognitive stimulation through memory and other cognitive skills training, participation in the arts, technology-based cognitive stimulation, electrical stimulation, medications, and chemical stimulation such as the use of nootropic drugs or supplements. The chapter reviews studies that examine the effects on cognition of combining several interventions e. There has been considerable scholarly and commercial interest over the past several years in the question of whether cognitive stimulation, either through such everyday activities as completing crossword puzzles, participating in a book club, playing card games, learning to play a musical instrument, and learning a new language see Chapter 4A or through more formal training, can assist in the maintenance or enhancement of cognitive function as people age. A second, equally important question is whether cognitive stimulation and training will transfer to real-world activities and tasks i. For example, can a computer-based memory training program help people better remember their shopping list, medical and other appointments, and the names and faces of new acquaintances? Fortunately, an increasing number of randomized controlled trials RCTs are assessing whether cognitive training, such as adaptive computer-based programs, can create improvements in trained performance and whether the benefits of such training will transfer to untrained tasks and skills. In general, these studies reveal that older adults can indeed benefit from training, albeit often at a slower rate than younger adults do Baltes et al. Transfer effects benefits for untrained-for tasks are often quite limited, as a study by Ball and colleagues illustrates. In this study, the largest RCT of cognitive training to date, 2, older adults were randomized among three training groups training for memory, reasoning, and speed of processing and a no-contact control group. Participants did improve on the trained tasks and other measures of these processes. However, no significant transfer occurred between the trained and untrained cognitive processes e. Interestingly, the benefits of training were still observed for the reasoning and speed-of-processing groups, as compared with the control group, after 10 years. Participants in each of the three training groups also reported less difficulty with instrumental activities of daily living IADLs , although no differences were observed for the performance-based everyday activities Rebok et al. The IADL results should be interpreted with caution, since they might be partly attributable to expectancy differences between the training groups and the no-contact controls Boot et al. Another major focus of the cognitive training literature has been on improving working memory also see Chapter 2 , on which many other cognitive processes depend Bopp and Verhaeghen, ; Hale et al. It is now relatively well established that young adults show near-transfer effects with working memory. However, the transfer results for older adults have been mixed, with some studies failing to observe any transfer, even to similar memory tasks Dahlin et al. A number of factors that might mediate transfer have been suggested, including age, health, general cognitive ability, baseline performance, motivation, and expectancies Boot et al. Another approach to strengthening cognitive skills for older adults has been the use of video games, which employ a somewhat different set of training strategies than the computer-based training. For example, Anguera and colleagues worked with video games incorporating cognitive. A study by Smith and colleagues used a commercially available adaptive cognitive training program focused on auditory detection, discrimination, and comprehension. The researchers compared an experimental group to an active control group that watched educational videos 1 hour daily for 40 sessions. Older adults in the active group improved, relative to the control group, on auditory measures from the Repeatable Battery for the Assessment of Neuropsychological Status as well as on other measures of attention and memory. Effect sizes were generally small to modest, and a subset of these effects was maintained over a 3-month period Nouchi et al. Not all video game-based cognitive training programs have been as successful, with some failing to find any transfer of training effects Ackerman et al. Research on the use of video games designed for enjoyment rather than specifically for cognitive training has produced a mixed pattern of effects in older adults, with some showing transfer effects Basak et al. In this report the committee does not attempt to compare one approach to cognitive training with another; rather, it considers the overall literature on this topic. The committee recognizes that future studies will better inform the research community and the general public about the effectiveness of these approaches to training, especially in whether the skills they support transfer to everyday tasks and challenges. Ongoing debate by experts in the field about the utility of commercial cognitive training games Cognitive Training Data, ; Stanford Center on Longevity, points to the need for careful evaluation of these efforts. Given the early stage of research in this field and the need to demonstrate and validate transfer effects from cognitive training products to real-life situations, consumers need information from independent evaluations of commercial cognitive training products. Questions to be examined by consumer organizations and evaluation researchers include. Furthermore, the committee recommends a review of regulatory policies and guidelines see Recommendations section and the development of consumer product evaluation criteria for cognition-related products see Chapter 6. In summary, the literature on cognitive stimulation and cognitive training is promising, in that studies have shown that older adults can improve on trained abilities, albeit often at a slower pace than that of younger adults for an exception, see Kramer et al. Studies of the transfer of training effects to other tasks have had mixed results, with few showing transfer effects extending to tasks that are dissimilar to the training tasks including transfer to real-world tasks and skills. As the developers of cognitive training products strive to demonstrate the benefits of these products in real-life situations, claims regarding the effectiveness of their products will require careful evaluation by consumers and in regulatory review. Engagement in the arts has been gaining increasing interest as a potential intervention to maintain or improve a variety of aspects of health, including cognition. The state of the science regarding the impact of participation in writing, theater, music, dance, and visual arts has been reviewed Noice et al. Much of the published literature reports the results of studies employing quasi-experimental and intervention designs. Moreover, many of the studies have substantial limitations in design and implementation e. Methodological rigor might be improved by creating teams of researchers who have content and research expertise. However, many of the studies have inconsistent results or do not show persistent benefits. A 6-month, once-weekly dance intervention was found to improve many aspects of cognitive and physical function along with subjective well-being, without causing any improvement in physical fitness Kattenstroth et al. Furthermore, virtually no studies directly compare different arts interventions. In summary, despite the limitations of existing research, the results are promising. Additional studies on the influence of the arts on cognitive health are needed that have the methodological rigor that teams of researchers with expertise in the arts, cognition, and methodology can bring. Continued controversy exists on the usefulness of medications and pharmacologics for preventing cognitive decline and for enhancing or improving cognitive function in older adults. Several medications evaluated over the past decade are thought to have cognitive-enhancing properties either directly or through disease modification. Although a few have been found to slow cognitive decline in older people with dementia, the few controlled studies in people without dementia have had mostly mixed or no results. The majority of these studies are observational, have some methodological shortcomings in design, and vary widely in how they measured cognitive function. This section highlights a few specific pharmacologics and introduces the category of nootropic medications. As noted in Chapter 4B , there also are a number of medications that can cause cognitive decline. Cognitive outcomes have been examined as secondary outcomes in some studies, but few studies have focused specifically on cognitive outcomes. A prospective cohort study looked at the effects of low doses of acetylsalicylic acid on women who had high cardiovascular disease risk and were free of dementia; the women given the acetylsalicylic acid showed smaller declines in Mini-Mental State Examination MMSE scores than a comparison group, but the differences in scores were small. There were no differences between the groups for risk of dementia Kern et al. Study participants taking acetylsalicylic acid declined on several measures Waldstein et al. Studies of the effects of hormone therapy on cognitive function have found very small or adverse effects. A 4-year RCT of hormone treatment in postmenopausal women with cardiovascular disease did not find improvements in cognitive function compared to the use of a placebo Grady et al. A Cochrane review of 16 double-blind RCTs showed no effects of hormone replacement therapy either estrogen alone or in combination with progestagen in preventing cognitive impairment Lethaby et al. Participants in the meta-analysis were followed for an average of 4 to 5 years, and some negative effects were found after 1 year of estrogen replacement therapy and 3 and 4 years of the combined form. Continued controversy exists regarding the hypothesis that hormone replacement therapy may confer cognitive and other benefits depending on the timing, formulation, dosage, and duration of treatment, and additional research is needed Maki, Some have argued that cognition and verbal memory, in particular, may benefit from early hormone therapy, although this may apply only to specific combinations of hormones Maki, ; Sherwin et al. Several trials are under way to attempt to address some of the questions regarding hormone therapy safety and to ascertain its impact on cognitive outcomes. The KEEPS Cognitive and Affective Study is a multicenter clinical trial investigating the benefits of hormone replacement therapies administered to perimenopausal women. This study includes women 42 to 58 years of age. Final results have not yet been published NIH, Nootropics are a broad range of medications, supplements, and nutriceuticals that aim to stimulate cognitive performance or facilitate learning. Most have not been evaluated in clinical trials of older people without dementia and are not focused on preventing or remediating decline. Nootropics have been classified by their mechanism of action into 19 separate categories Froestl et al. Some are intended to enhance cognition directly, whereas others are reputed to enhance neuronal health. Accordingly, many studies of presumed nootropics have focused on specific situations e. Classes of nootropics for which some evidence exists about their efficacy in people who do not have dementia include. The potential harms of medications and pharmacologics also need to be considered, including bleeding and effects on the central nervous and gastrointestinal systems. The committee did not identify evidence that nootropic compounds lead to long-term improvement or the preservation of cognition. Studies that have looked for any cognition-enhancing properties of these substances have been limited by various methodological shortcomings and the risk of bias, including the lack of a consistent and standard definition for improved cognition, a paucity of RCTs, variability in the measurement of cognitive change or improvement, the short-term scale of the follow-up, and variations in drug formulations, dosages, and duration of treatment. Some of the studies cited above were designed to evaluate other questions or conditions such as cardiovascular disease or dementia. The studies that showed minor improvements in cognitive measures did not demonstrate clinically important changes, and their impact on cognitive functioning and daily life was less clear. In conclusion, although. No currently available medication, either prescribed or over-the-counter, has been shown to effectively delay cognitive decline or enhance or promote cognition in healthy older adults. Gingko biloba, an herbal extract used as a part of traditional Chinese medicine, is sold as a nutritional supplement Birks and Grimley Evans, Numerous mechanisms have been proposed for its possible benefits, including antioxidant effects, mitochondrial protection, the promotion of hippocampal neurogenesis, decreasing blood viscosity, and the enhancing of microperfusion in the brain Amieva et al. In a prospective study of 3, cognitively healthy French men and women who were age 65 years and older at baseline and who were followed for 20 years, the scores of gingko users declined less than did those of non-supplement users on the MMSE Amieva et al. By contrast, in a large RCT conducted in 3, Americans age 72 to 96 years, twice-daily supplementation with mg of gingko did not affect the rate of change in scores on the MMSE compared with study participants receiving a placebo, over 6 years of follow-up Snitz et al. A recent meta-analysis that examined the effects of gingko on cognition did not separately examine the subgroup without dementia or mild cognitive impairment Tan et al. Given the current results of RCTs, gingko is not considered effective in preventing cognitive decline. Coffee and tea, purportedly because of their caffeine content, are central nervous system stimulants, which increase alertness and arousal. In laboratory studies of older rats, 8 weeks of coffee-supplemented diets resulted in enhanced performance on psychomotor testing and on a working memory task; the most beneficial dose was equivalent to 10 cups of coffee per day Shukitt-Hale et al. Based on further tests in which caffeine alone did not appear to explain all of the enhanced cognitive effects, the authors concluded that other bioactive compounds in coffee may play a role Shukitt-Hale et al. In humans, short-term studies of caffeine have demonstrated improved perceptual speed and vigilance Childs and de Wit, In a recent labo-. Reviews of prospective studies have found considerable variation in their results Arab et al. In a comprehensive review, 3 of 11 prospective studies and 4 of 7 cross-sectional studies found associations between caffeine intake and cognitive outcomes, with these associations being more consistent among women and for coffee consumption Beydoun et al. Some studies found modestly reduced levels of cognitive decline associated with caffeine intake, especially coffee, while other studies showed non-significant or no associations or evidence only for coffee intake, or benefit only for women or specific exposures. For example, in the Cardiovascular Health Study 2, women, 2, men , tea and coffee intake were associated with less cognitive decline in women but not in men Arab et al. Both animal and human short-term interventional studies support the beneficial effect of caffeine on some aspects of cognition. However, the published studies do not permit conclusions about dose or duration or about whether the effects are enduring or only short term. Data on long-term benefits are only observational and inconsistent. The dose and source e. Recent studies have suggested that transcranial direct current stimulation tDCS may improve learning and cognitive performance by modulating the excitability of cortical brain networks Coffmann et al. Surface-anodal tDCS increases excitability in the cortex near the positive electrode through weak but coherent polarization of the membrane. Long-term potentiation has been proposed as a possible mechanism for the longer-term and behavior-enhancing effects of tDCS Nitsche and Paulus, For example, a small study with the electrode over the right temporal parietal cortex resulted in improvement in the ability to retain object—location learning at 1 week Floel et al. Application over the right dorsolateral prefrontal cortex was associated with increases in the proportion of performance errors that were consciously detected Harty et al. A number of theoretical and methodological issues require further study. For example, although animal studies have begun to reveal the biophysics of direct current stimulation Bikson et al. In summary, tDCS shows some promise for enhancing learning and selective aspects of cognition, but further testing for both safety especially for long-term application and efficacy is needed before tDCS can be recommended for improving cognition and before it is known which situations are appropriate for such stimulation. Given that some of the modifiable risk factors for cognitive decline are interrelated and that an intervention with multiple components might be more beneficial for cognitive health than one involving a single factor, multi-domain interventions are emerging as a new strategy. Of the six completed multi-domain trials described below, four have produced cognitive improvements through a combination of physical and mental activities. Two trials found that combining physical activity and cognitive training among healthy older adults was more effective at improving cognitive test scores than either intervention alone Fabre et al. Another trial examining physical activity and vitamin E supplementation found improvements in cognitive outcomes associated with physical. Among participants in the Mental Activity and Exercise MAX trial, which evaluated mental and physical activity interventions, global cognitive function improved over time, but there was no difference between intervention and control groups Barnes et al. Two other trials, one evaluating a physical and cognitive activity intervention among older adults at risk for cognitive decline Legault et al. Overall, findings from multi-domain trials look promising, although conclusions cannot yet be drawn regarding any additive or synergistic effects from targeting multiple factors or about which domains yield the greatest effect. At least seven multi-domain trials have been recently completed or are currently under way, and all have included a physical activity component. Two combined cognitive and physical activity Gates et al. Another trial among frail older adults is examining the benefits of omega-3 supplementation alone or in combination with physical activity, cognitive training, and social activities University Hospital Toulouse, , and two trials involve behavioral interventions targeting mental activity and lifestyle factors related to cognitive health such as nutrition, physical and social activities, and vascular risk factors HealthPartners Institute for Education and Research, ; National Institute for Health and Welfare Finland, ; Ngandu et al. Yet another trial is evaluating whether an intervention targeting medication compliance, blood pressure control, diet changes, and physical activity will help prevent cognitive decline among those who have had an ischemic stroke Brainin et al. In summary, results from multi-domain trials appear promising. Future studies should provide greater clarity regarding which combinations of factors and which levels, duration, and treatments yield positive benefits for general or selective aspects of cognition. This and the two preceding chapters have described strengths and limitations in the evidence base for preventing and mitigating cognitive decline and promoting cognitive health. The following recommendations offer actions that individuals and their families can take, policy and regulatory efforts that are needed, and priority areas for future research. Examples of the resources available to individuals and their families to make these changes are provided in Chapter 6. Other actions, such as getting adequate sleep, may have a positive impact on cognition, but further research is needed on non-disease-related cognitive effects and on disentangling confounding factors. At present there is a great deal of research focused on cognitive training and on games aimed at improving cognitive function. Individuals of all ages and their families should take actions to maintain and sustain their cognitive health, realizing that there is wide variability in cognitive health among individuals. As noted throughout the chapters, much remains to be learned about the relationship between lifestyle and risk factors and the maintenance of cognitive health throughout the adult life span. While many studies have examined dementia-based outcomes, few have examined non-dementia-related cognitive changes. For some risk factors, there are few high-quality studies examining cognitive aging, including population-based longitudinal studies and RCTs of risk factor modification. Many studies do not include sufficient numbers of older adults for valid inferences. In addition, studies are needed that consider the effects of multiple risk factors and multimorbidity, in order to better understand the cumulative contributions of different risk factors and the impact of risk factor reduction. The assessment of cognitive function is a particular challenge see Chapter 2. Measurement procedures and tasks used to measure cognition improve over time, as does the conception of various aspects of cognition. Careful measurement of baseline cognitive function, preferably at the latent variable level, is needed, as are various measurements repeated over time. Minimizing cultural, ethnic, racial, and socioeconomic biases in the measurement of risk factors and outcomes is an additional concern. The National Institutes of Health, the Centers for Disease Control and Prevention, other relevant government agencies, nonprofit organizations, and research foundations should expand research on risk and protective factors for cognitive aging and on interventions aimed at preventing or reducing cognitive decline and maintaining cognitive health. Among its responsibilities, FTC has authority to examine claims of deceptive advertising. Depending on the category of the product, federal agencies have a range of tools for regulation and review. For instance, when manufacturers wish to shift a medication from a prescription drug to an over-the-counter OTC medicine, FDA follows a process of evaluating safety data that will result in a product gaining or failing to gain OTC status FDA, FDA also has the authority to review new evidence regarding the safety and side effects of medications and can consider a number of remedies in the face of newly documented risks. Depending on the severity of the risk, appropriate regulatory measures could include required changes to product labeling, such as a specific warning of a side effect. More drastic measures might include a shift from OTC status to prescription use only or an outright ban on sales of the product. As discussed in Chapter 4B , antihistamines, sedatives, and other medications that have strong anticholinergic activity, many of which are sold over the counter, have the potential to impair cognition. The risks for older consumers of the OTC products listed above indicate that additional. A reexamination of product labels and OTC status could focus on the cognitive effects of these products for older adults and include a comprehensive review of currently available data regarding adverse events. For products that claim to enhance cognitive function or to maintain current levels of function including cognitive training products, nutriceuticals, supplements, or medications , a review of policies and regulatory guidance is needed. In the passage of the Dietary Supplement Health and Education Act 1 required that dietary supplements be regulated like foods, not drugs, which denied FDA the authority to require safety and efficacy data before marketing. FDA can remove clearly dangerous products from the market, but this process is neither fast nor simple. For dietary supplements, FTC and FDA have an agreement outlining the responsibilities of each agency; FDA has primary responsibility for claims on product labeling and point-of-sale materials and FTC has the lead in responsibility for claims made in media advertising FTC, While the regulation of dietary supplements by FDA is difficult, the potential for FDA to regulate cognitive training products is still more uncertain. FDA would have to determine that a cognitive training product meets the definition of a medical device, and that it falls within the category of devices of sufficient risk to require oversight. Devices that may pose a major health risk if they malfunction are a focus of regulatory attention. For instance, FDA plans to oversee mobile apps that perform electrocardiography Cortez et al. Cognitive training products seem unlikely to carry the amount of risk that currently triggers FDA scrutiny. Current FTC and FDA guidelines and regulations allow products that are not medications to make certain general statements about the function of the product but require a substantial evidence base in order to allow specific medical claims that the product is effective in treating a specific disease FTC, October 25, This relates to a wide range of products, including OTC medications, dietary supplements, and cognitive training products. The Food and Drug Administration and the Federal Trade Commission, in conjunction with other relevant federal agencies and consumer organizations, should determine the appropriate regulatory review, policies, and guidelines for. Ackerman, P. Kanfer, and C. Use it or lose it? Psychology and Aging 25 4 Amieva, H. Meillon, C. Helmer, P. Barberger-Gateau, and J. Ginkgo biloba extract and long-term cognitive decline: A year follow-up population-based study. Anguera, J. Boccanfuso, J. Rintoul, O. Al-Hashimi, F. Faraji, J. Janowich, E. Kong, Y. Larraburo, C. Rolle, E. Johnston, and A. Video game training enhances cognitive control in older adults. Nature Arab, L. Biggs, E. Longstreth, P. Crane, and A. Gender differences in tea, coffee, and cognitive decline in the elderly: The Cardiovascular Health Study. Khan, and H. Epidemiologic evidence of a relationship between tea, coffee, or caffeine consumption and cognitive decline. Advances in Nutrition 4 1 : Ball, K. Berch, K. Helmers, J. Jobe, M. 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Nutrient-dense foods and exercise in frail elderly: Effects on B vitamins, homocysteine, methylmalonic acid, and neuropsychological functioning. American Journal of Clinical Nutrition 73 2 Fabre, C. Chamari, P. Mucci, J. Masse-Biron, and C. International Journal of Sports Medicine 23 6 Fairchild, J. Friedman, A. Rosen, and J. Which older adults maintain benefit from cognitive training? Use of signal detection methods to identify long-term treatment gains. International Psychogeriatrics 25 4 Fang, Y. Qiu, W. Hu, J. Yang, X. Yi, L. Huang, and S. Effect of piracetam on the cognitive performance of patients undergoing coronary bypass surgery: A meta-analysis. Experimental and Therapeutic Medicine 7 2 Now available without a prescription. FDA fundamentals. Fertonani, A. Pirulli, and C. Random noise stimulation improves neuroplasticity in perceptual learning. Journal of Neuroscience 31 43 Floel, A. Suttorp, O. Kohl, J. Kurten, H. Lohmann, C. Breitenstein, and S. Non-invasive brain stimulation improves object-location learning in the elderly. Neurobiology of Aging 33 8 Froestl, W. Muhs, and A. Cognitive enhancers nootropics. Part 1: Drugs interacting with receptors. Update Part 2: Drugs interacting with enzymes. Pfeifer, and A. Part 3: Drugs interacting with targets other than receptors or enzymes. Disease-modifying drugs. Dietary supplements: An advertising guide for industry. About the FTC. Gates, N. Valenzuela, P. Sachdev, N. Singh, B. Baune, H. Brodaty, C. Suo, N. Jain, G. Wilson, Y. Wang, M. Baker, D. Williamson, N. Foroughi, and M. Fiatarone Singh. BMC Geriatrics Grady, D. Yaffe, M. Kristof, F. Lin, C. Richards, and E. American Journal of Medicine 7 Hale, S. Rose, J. Myerson, M. Strube, M. Sommers, N. Tye-Murray, and B. The structure of working memory abilities across the adult life span. Psychology and Aging 26 1 Haller, S. Rodriguez, D. Moser, S. Toma, J. Hofmeister, I. Sinanaj, D. Van De Ville, P. Giannakopoulos, and K. Acute caffeine administration impact on working memory-related brain activation and functional connectivity in the elderly: A BOLD and perfusion MRI study. Neuroscience Harty, S. Robertson, C. Miniussi, O. Sheehy, C. Devine, S. McCreery, and R. Transcranial direct current stimulation over right dorsolateral prefrontal cortex enhances error awareness in older age. Journal of Neuroscience 34 10 HealthPartners Institute for Education and Research. Passport to Brain Wellness in Sedentary Adults. Kattenstroth, J. Kalisch, S. Holt, M. Tegenthoff, and H. Six months of dance intervention enhances postural, sensorimotor, and cognitive performance in elderly without affecting cardio-respiratory functions. Frontiers in Aging Neuroscience Kern, S. Skoog, S. Ostling, J. Kern, and A. Does low-dose acetylsalicylic acid prevent cognitive decline in women with high cardiovascular risk? A 5-year follow-up of a non-demented population-based cohort of Swedish elderly women. BMJ Open 2 5. Kouki, R. Schwab, T. Lakka, M. Hassinen, K. Savonen, P. Komulainen, B. Krachler, and R. Nutrition, Metabolism, and Cardiovascular Diseases 22 7 Kramer, A. Larish, T. Weber, and L. Training for executive control: Task coordination strategies and aging. Edited by D. Gopher and A. Legault, C. Jennings, J. Katula, D. Dagenbach, S. Gaussoin, K. Sink, S. Rapp, W. Rejeski, S. Shumaker, and M. Lethaby, A. Hogervorst, M. Richards, A. Yesufu, and K. Hormone replacement therapy for cognitive function in postmenopausal women. Li, S. Schmiedek, O. Huxhold, C. Rocke, J. Smith, and U. Working memory plasticity in old age: Practice gain, transfer, and maintenance. Maki, P. Critical window hypothesis of hormone therapy and cognition: A scientific update on clinical studies. Menopause 20 6 Meinzer, M. Lindenberg, D. Antonenko, T. Flaisch, and A. Anodal transcranial direct current stimulation temporarily reverses age-associated cognitive decline and functional brain activity changes. 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Caffeine and cognitive decline in elderly women at high vascular risk. Waldstein, S. Wendell, S. Seliger, L. Ferrucci, E. Metter, and A. Nonsteroidal anti-inflammatory drugs, aspirin, and cognitive function in the Baltimore Longitudinal Study of Aging. Journal of the American Geriatrics Society 58 1 Willis, S. Tennstedt, M. Marsiske, K. Ball, J. Elias, K. Koepke, J. Rebok, F. Unverzagt, A. Stoddard, and E. Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA 23 Winocur, G. Craik, B. Levine, I. Robertson, M. Binns, M. Alexander, S. Black, D. Dawson, H. Palmer, T. McHugh, and D. Cognitive rehabilitation in the elderly: Overview and future directions. Journal of the International Neuropsychological Society 13 1 Zelinski, E. Spina, K. Mahncke, and G. Improvement in memory with plasticity-based adaptive cognitive training: Results of the 3-month follow-up. Journal of the American Geriatrics Society 59 2 Zinke, K. Zeintl, A. Eschen, C. Herzog, and M. Potentials and limits of plasticity induced by working memory training in old-old age. Gerontology 58 1 Zeintl, N. Putzmann, A. Pydde, and M. Working memory training and transfer in older adults: Effects of age, baseline performance, and training gains. Developmental Psychology 50 1 For most Americans, staying 'mentally sharp' as they age is a very high priority. Declines in memory and decision-making abilities may trigger fears of Alzheimer's disease or other neurodegenerative diseases. However, cognitive aging is a natural process that can have both positive and negative effects on cognitive function in older adults - effects that vary widely among individuals. At this point in time, when the older population is rapidly growing in the United States and across the globe, it is important to examine what is known about cognitive aging and to identify and promote actions that individuals, organizations, communities, and society can take to help older adults maintain and improve their cognitive health. Cognitive Aging assesses the public health dimensions of cognitive aging with an emphasis on definitions and terminology, epidemiology and surveillance, prevention and intervention, education of health professionals, and public awareness and education. This report makes specific recommendations for individuals to reduce the risks of cognitive decline with aging. Aging is inevitable, but there are actions that can be taken by individuals, families, communities, and society that may help to prevent or ameliorate the impact of aging on the brain, understand more about its impact, and help older adults live more fully and independent lives. Cognitive aging is not just an individual or a family or a health care system challenge. It is an issue that affects the fabric of society and requires actions by many and varied stakeholders. Cognitive Aging offers clear steps that individuals, families, communities, health care providers and systems, financial organizations, community groups, public health agencies, and others can take to promote cognitive health and to help older adults live fuller and more independent lives. Ultimately, this report calls for a societal commitment to cognitive aging as a public health issue that requires prompt action across many sectors. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website. Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book. Switch between the Original Pages , where you can read the report as it appeared in print, and Text Pages for the web version, where you can highlight and search the text. To search the entire text of this book, type in your search term here and press Enter. Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available. Do you enjoy reading reports from the Academies online for free? Sign up for email notifications and we'll let you know about new publications in your areas of interest when they're released. Get This Book. Visit NAP. Looking for other ways to read this? No thanks. Page Share Cite. Or can computer-based, cognitive training improve driving performance and safety? Questions to be examined by consumer organizations and evaluation researchers include Has the product demonstrated transfer of training to other laboratory tasks that measure the same cognitive construct as the training task e. Has the product demonstrated transfer of training to relevant real-world tasks? Has the product performance been evaluated using an active control group whose members have the same expectations of cognitive benefits as do members of the experimental group? How long are the trained skills retained? Have the purported benefits of the training product been replicated by research groups other than those selling the product? ARTS Engagement in the arts has been gaining increasing interest as a potential intervention to maintain or improve a variety of aspects of health, including cognition. To date, some RCT evidence supports the use of theatrical acting,. Racetams e. Cholinesterase inhibitors e. Studies on episodic memory show mixed results. In one study, donepezil reduced the memory and attention deficits resulting from 24 hours of sleep deprivation Repantis et al. Phenylethylamines e. Eugeroics e. Other putative nootropics e. Summary The committee did not identify evidence that nootropic compounds lead to long-term improvement or the preservation of cognition. Supplements Ginko Biloba Gingko biloba, an herbal extract used as a part of traditional Chinese medicine, is sold as a nutritional supplement Birks and Grimley Evans, Caffeine Coffee and tea, purportedly because of their caffeine content, are central nervous system stimulants, which increase alertness and arousal. Recommendation 3: Take Actions to Reduce Risks of Cognitive Decline with Aging Individuals of all ages and their families should take actions to maintain and sustain their cognitive health, realizing that there is wide variability in cognitive health among individuals. Specifically, individuals should: Be physically active. Reduce and manage cardiovascular disease risk factors including hypertension, diabetes, smoking. Regularly discuss and review health conditions and medications that might influence cognitive health with a health care professional. Take additional actions that may promote cognitive health, including Be socially and intellectually engaged, and engage in lifelong learning; Get adequate sleep and receive treatment for sleep disorders if needed;. Take steps to avoid the risk of cognitive changes due to delirium if hospitalized; and Carefully evaluate products advertised to consumers to improve cognitive health, such as medications, nutritionals, and cognitive training. Recommendation 4: Increase Research on Risk and Protective Factors and Interventions to Promote Cognitive Health and Prevent or Reduce Cognitive Decline The National Institutes of Health, the Centers for Disease Control and Prevention, other relevant government agencies, nonprofit organizations, and research foundations should expand research on risk and protective factors for cognitive aging and on interventions aimed at preventing or reducing cognitive decline and maintaining cognitive health. Research efforts should: Develop collaborative approaches between ongoing longitudinal studies across the life span that focus on cognitive aging outcomes in order to maximize the amount and comparability of data available on risk and protective factors. Examine risk factors and interventions in under-studied and vulnerable populations, including people 85 years and older and those with childhood or youth trauma or developmental. Conduct single- and multicomponent clinical trials of promising interventions to promote cognitive health and prevent cognitive decline, testing for both cognitive status and functional outcomes. Assess cognitive outcomes in clinical trials that target the reduction of cardiovascular and other risk factors likely related to cognitive health. Identify effective approaches to sustaining behavior changes that promote healthy cognition across the life span. Recommendation 5: Ensure Appropriate Review, Policies, and Guidelines for Products That Affect Cognitive Function or Assert Claims Regarding Cognitive Health The Food and Drug Administration and the Federal Trade Commission, in conjunction with other relevant federal agencies and consumer organizations, should determine the appropriate regulatory review, policies, and guidelines for over-the-counter medications such as antihistamines, sedatives, and other medications that have strong anticholinergic activity that may affect cognitive function, and interventions such as cognitive training, nutriceuticals, supplements, or medications that do not target a disease but may assert claims about cognitive enhancement or maintaining cognitive abilities such as memory or attention. Login or Register to save! Stay Connected!

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