Experience on cognitive health education for the elderly

This matter has never been as simple as "instilling disease prevention knowledge in the elderly". We must first understand the real concerns of the elderly and balance medical professionalism and adaptability to daily life. Only then can we really help them - there is no universal "perfect solution", only one that is suitable for different elderly people's life scenarios will be effective.

To be honest, I made a silly mistake at the beginning. For my first lecture, I specifically looked for the Mild Cognitive Impairment (MCI) Prevention and Control Guidelines published by Peking University Sixth Hospital. I carefully made a 40-page PPT. From the pathogenic mechanism to the screening standards, I felt professional. But just after 20 minutes of lectures, Aunt Zhang, who was sitting in the front row, raised her hand: "Girl, I can't remember any of the letters and scores you mentioned. You just said that I forget to bring my keys when I go out every day. Am I going to get Alzheimer's disease?" ”

I got stuck on the spot. Later, when I talked with colleagues, I discovered that the academic community currently has different tendencies in the direction of popularizing cognitive science in the elderly: one group insists on "standardized output" and believes that only by accurately transmitting unified diagnostic standards and intervention specifications can the elderly be prevented from being misled by pseudo-popular science. ； The other group advocates "scenario-based adaptation" and believes that the elderly's reception ability is limited, and the professional terminology must be broken down into vernacular that they can understand. The last word is that they can use it. Both sides are supported by clinical data, and even though they have been arguing for several years, there is no absolute right or wrong.

Later, we simply asked Dr. Li from the Department of Neurology of the community hospital to change the content together. We put aside all the MCI and cognitive function scores, and first divided the elderly's most concerned question "whether forgetting things is a disease" into three scenarios: "After returning home from shopping, I remembered that I forgot to buy soy sauce. I can remember it by turning around. Don't worry, it is a normal poor memory."； Standing in the kitchen with soy sauce, I thought for a long time that I didn’t know what I was going to do with it, so I had to take the time to go to the hospital for a screening. ； If you can't find your way home after leaving the house, don't delay and ask your family to accompany you for a checkup. ”Just these three sentences, when the lecture ended that day, many old people chanted, "I understand this time." Uncle Li, who always suspected that he had cognitive impairment and suffered from insomnia every day, found out after checking that he had "forgot to buy soy sauce". The next day he came over with the medicinal wine he brewed to thank me. Later, he took the initiative to be our "mobile propagandist" and told his old friends these three sentences in the pavilion of the community every day. They were even more popular than what our staff said.

What’s interesting is that in the past, we followed the mainstream popular science content to promote brain training, distributed Sudoku puzzle books to the elderly, organized everyone to memorize ancient poems, and specially bought a lot of puzzles. However, after doing it twice, no one came. Aunt Zhang told me privately: "Girl, I've been afraid of doing questions all my life when I went to school. When I get older, I have to be forced to do arithmetic. The more I do, the more annoying I am. It's not as comfortable as going to square dance for me." ”This incident has touched upon another controversial point in the academic community: Many past studies have believed that only structured brain training with a fixed frequency and fixed intensity can delay cognitive decline. However, in the past two years, more and more clinical follow-up studies have found that as long as the elderly are actively willing to participate in brain-using activities, whether it is playing mahjong, planting flowers and plants, or telling stories to children when taking care of their grandchildren, the effect is no different from doing Sudoku or memorizing words.

We simply changed the "brain training class" into an "old craft class". Uncle Wang, who can repair bicycles, taught us how to repair small objects, Grandma Liu, who can weave baskets, taught us how to weave vegetable baskets, and Aunt Zhang, who loves making pastries, taught us how to steam flower rolls. We just played like this for more than three months. During the six-month follow-up at the community hospital, the average cognitive function score of the elderly who participated in the small class was actually 0.8 points higher than that of the group of elderly who insisted on doing puzzles before. Don't you think it's interesting?

The longer I do this, the more I realize that many times when we do cognitive health education for the elderly, we always like to ask the elderly what they should and should not do from the perspective of "professionals", but forget that they have their own way of living in this life. Some elderly people just like to sit in the pavilion, play chess and chat with their old friends every day, and some just like to plant flowers and raise birds at home. There is no need to force them to live according to the so-called "health standards." Last week, when I passed by the gate of the community after get off work, Aunt Zhang gave me a handful of green vegetables she had grown herself and said, "Thank you, girl. Now I no longer think about my dementia every day. I plant some vegetables every day and chat with my old sisters. It feels very comfortable."

In fact, to put it bluntly, there are so many lofty principles that can help the elderly relax and live a good life every day. Isn’t this the most fundamental purpose of our cognitive health education?