Update on Cognitive Health and Dementia

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Presentation transcript:

Update on Cognitive Health and Dementia Victor W. Henderson Departments of Health Research & Policy (Epidemiology) and of Neurology & Neurological Sciences Stanford University Stanford, California, USA General Secretary, International Menopause Society No relevant conflict of interest

Outline I. Normal and abnormal brain aging II. Midlife strategies to prevent abnormal brain aging and cognitive decline III. Cognitive health: potential risks and benefits of menopausal hormone therapy (MHT)

Outline I. Normal and abnormal brain aging II. Midlife strategies to prevent abnormal brain aging and cognitive decline III. Cognitive health: potential risks and benefits of menopausal hormone therapy (MHT)

Normal and abnormal brain aging Normal brain aging (cognitive aging) Changes associated with age that do not cause dementia. Abnormal brain aging (Minimal Cognitive Impairment (MCI) and dementia) Changes associated with age that may eventually lead to dementia. Dementia represents cognitive impairment that interferes with usual occupational and social activities, or with independence. Henderson, Climacteric 2014;17 (suppl 2):38-46. doi: 10.3109/13697137.2014.929650

Cognitive skills change with normal aging Some cognitive abilities are well maintained or improve with age Abilities that draw largely on acquired skills, knowledge, and experience (sometimes referred to as “crystallized intelligence”). Vocabulary is an example that, on average, is better in middle- age than in younger adulthood, and better in older adulthood than middle age. Henderson, Climacteric 2014;17 (suppl 2):38-46. doi: 10.3109/13697137.2014.929650

Cognitive skills change with normal aging Other cognitive abilities decline, beginning insidiously during – or even before – midlife Abilities based on new learning, abstract reasoning, and problem solving (sometimes referred as “fluid intelligence”). Tasks that draw on these abilities tend to be performed better by adults in their 20s than middle-aged or older adults. Henderson, Climacteric 2014;17 (suppl 2):38-46. doi: 10.3109/13697137.2014.929650