There has been a growing body of recent research into cognitive decline among middle-aged adults
There’s no question that cognitive decline takes a toll on older adults, but according to new research, patients are not without weapons to battle early cognitive decline.
According to the Centers for Disease Control and Prevention (CDC):
- the prevalence of subjective (self-reported) cognitive decline is 11.7% among adults ages 65 and older
- 41% reported difficulty with normal daily activities
- 35% needed help with household tasks
- less than half had discussed their cognitive issues with their health care provider1
None of these facts should come as any surprise to DCs who treat older patients. However, even middle-age adults can show signs of cognitive decline. As part of the same CDC survey, the prevalence of cognitive decline among adults between the ages of 45 and 65 was 10.8%.1
There has been a growing body of recent research into cognitive decline among middle-aged adults. Furthermore, there have also been interesting studies looking at ways to protect the middle-aged brain against cognitive decline. Let’s take a closer look at how common this phenomenon may be, as well as how to help middle-aged patients protect their cognitive skills.
When does cognitive decline start?
It is well established that the symptoms of Alzheimer’s disease and other forms of dementia most commonly appear later in life. However, pinpointing the pathology that eventually leads to dementia can be more difficult.
For many years, the common wisdom was that such a decline often started at approximately age 65. However, a 2021 study from the journal Alzheimer’s & Dementia proposes that cognitive decline in middle age should be seen as the starting point for Alzheimer’s disease and other dementias, and could start as early as two decades prior to actual symptoms.2
In order to show this, the authors of the article looked at a set of data from adults between the ages of 50 to 64, which included self-reported cognitive scores. In looking at the scores over time (an average of eight years), the researchers noted that almost 9% of their population sample showed rapidly declining cognitive function over time.2
Protecting cognitive function in middle-aged patients
Another recent study from the journal Neurology reported results from a large study of more than 2,000 middle-aged participants (average age 46) to determine the effect of omega-3 levels on cognitive markers of aging.3 Additionally, researchers identified participants who carried the APOE4 genetic variant, which is associated with a higher risk for Alzheimer’s disease.
Higher omega-3 levels were associated with larger hippocampal volumes and better abstract reasoning. Furthermore, study participants with the APOE4 genetic variant and higher omega-3 levels had less instances of small-vessel disease in the heart, which may often lead to both cognitive impairment and heart disease.3
The paper published in Neurology is particularly compelling because it used magnetic resonance imaging (MRI) technology, rather than self-reporting, which can be subjective. Hopefully, future studies can combine the best of both self-reporting surveys and MRIs to obtain a more complete picture of when and how cognitive impairment affects middle-aged people.
- Centers for Disease Control and Prevention. Subjective cognitive decline among adults aged 45 years and older. Accessed Dec. 23, 2022.
- Zhu Y, Zissimopoulos JM, Crimmins EM. Cognitive decline at middle age. Alzheimer’s & Dementia. 2021;17:e056007.
- Satizabal CL, Himali JJ, Beiser AS, et al. Association of red blood cell omega-3 fatty acids with MRI markers and cognitive function in midlife: The Framingham Heart Study [published online ahead of print, 2022 Oct 5]. Neurology. 2022;99(23):e2572-e2582.