Geriatric considerations - Aging and cognition: Nursing

Cognition describes the process of receiving, storing, sharing and making sense of information which include mental processes such as memory, language, concentration and problem solving cognition can be impacted by one's environment.

Genetics, educational background, health status and age related brain changes. As the nurse, you'll consider age related changes to the brain, the physiologic processes that can compensate for these changes and provide patient centered care to promote brain health in your older adult patients.

Now, as an individual ages, there's typically a general slowing of function of the neuronal processes that doesn't usually interfere with mental function or daily routines.

This slowing and function is different for everyone and is related to changes in brain structure and neurotransmitter function.

As far as structural changes go, there's a decrease in the size and number of neurons which are the nerve cells that receive and send messages throughout the body.

Dendrites which branch off from the neuron cell body and receive signals from other neurons can experience shrinkage and decreased branching.

Other age related changes include a build up of substances like plaque within the neurons and a decrease in myelin, which is the substance that helps the neurons to quickly transmit electrical impulses.

Additionally, there are changes that affect neurotransmitters or chemical messengers such as acetylcholine glutamate serotonin and dopamine that normally allow neurons to communicate with each other.

These changes include alterations to enzymes that synthesize and break down neurotransmitters and changes to neurotransmitter receptor sites.

All right. So the brain can compensate for age related changes by developing cognitive reserve, which is the ability of the brain to maintain cognitive functioning even when it experiences degeneration or damage.

In other words, the stronger the cognitive reserve, the more injury the brain can endure before there's a decline in cognition.

An important component of cognitive reserve is neuroplasticity or the ability of the brain to adapt and change in response to new stimuli.

Neuroplasticity can be either positive or negative. Positive neuroplasticity refers to the brain's resilient capacity to strengthen and reorganize neuronal connections when stimulated by engaging in cognitive social sensory and motor activities that are new and challenging.

On the other hand, negative neuroplasticity is the degradation of neuronal connections due to decreased cognitive stimulation or the effects of a physiologic condition like a stroke.

As the nurse, you'll provide patient centered care to promote healthy brain aging. First, promote cognitive health by assisting your patient to prevent and manage chronic illnesses.

To do this. Implement strategies to help your patient maintain a healthy weight and to achieve optimal control of BP, lipids and blood glucose if needed.

Also provide education and resources for smoking cessation in terms of nutrition, teach your patient that a diet rich in omega three fatty acids and other nutrients like Vitamin E but low in saturated fat and cholesterol can promote brain health.

Specifically, you can suggest they follow the dietary approaches to stop hypertension, also known as Dash diet. Also remember to counsel your patient on the negative effects of alcohol consumption.

Next, remind your patient to engage in regular physical activity since it can increase oxygen in the brain and stimulate helpful neurotransmitter activity also encourage them to get adequate sleep, which is crucial for enhancing and maintaining memory.

Remind them that challenging cognitive stimulation can help to stimulate their brain and increase their cognitive reserve ways to achieve this include playing games, doing puzzles, learning a new language or pursuing a new hobby.

Now, regular social engagement is vital to cognitive health, especially in older adults who are more likely to be isolated due to factors like lack of transportation or retirement to combat this, encourage your patient to stay connected in their community through volunteering for a local organization or taking a group class like painting or cooking.

Finally, ensure your patients and their families understand the difference between normal age related cognitive changes and signs of major neurocognitive impairment like dementia.

Inform them that normal changes associated with cognition may include occasionally forgetting someone's name or temporarily misplacing items.

On the other hand, patterns of memory loss like missing consecutive monthly bill payments or frequently having trouble maintaining conversations may indicate more serious impairment.

All right. As a quick recap, cognition refers to how an individual receives stores shares and makes sense of information.

As one ages, the brain undergoes normal cognitive decline, which can be compensated for by developing and maintaining cognitive reserve, which is impacted by positive and negative neuroplasticity.

As the nurse, you'll provide patient centered care to promote healthy brain aging by assisting your patient to prevent and manage chronic illnesses.

Maintain a healthy diet, engage in physical activity, get adequate sleep and engage in cognitive stimulation and social interaction.

Lastly, you'll ensure patients and their families understand the difference between normal age related cognitive changes and signs of major neurocognitive