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A Penn Medicine blog post looks at the Institute of Medicine (IOM) report on cognitive aging which was released last week.

Writer Lee-Ann Donegan says, “The subject of aging is something I’ve thought about a great deal this week, having just celebrated a milestone birthday. But the thing that gets me upset much more than my own aging, is the aging of my parents and older relatives. This week, the Institute of Medicine (IOM), an independent organization that advises the government and the public on health decisions, published a report on a relatively new concept known as “cognitive aging.” ”

Ms. Donegan spoke with Jason Karlawish, MD, acting co-director of the Penn Memory Center, about the report.

“The report differentiates the processes of cognitive aging from those of neurodegeneration,” says Dr. Karlawish, one of 16 authors of the report, all of whom are national leaders in aging research and practice.

In addition to explaining cognitive aging, the report also provides actionable steps supported by research that people can take to maintain cognitive health as they age.

Read the IOM’s entire report, Cognitive Aging: Progress in Understanding and Opportunities for Action.  

The Institute of Medicine has released Cognitive Aging: Progress in Understanding and Opportunities for Action, a report on the public health dimensions of cognitive aging. The report, released on April 14, 2015, is timely. The U.S. population is rapidly aging and individuals are becoming more concerned about their cognitive health. Older adults view “staying sharp” as perhaps one of their most important health care goals.

Prepared by the Committee on the Public Health Dimensions of Cognitive Aging, the report assesses examined definitions and terminology, epidemiology and surveillance, prevention and intervention, education of health professionals, and public awareness and education.

Jason Karlawish, MD, associate director of the Penn Memory Center and director of the Penn Prevention Research Center’s Healthy Brain Research Center — a member of the CDC supported Healthy Brain Network dedicated to surveillance, education, awareness and empowerment that promotes brain health — was a member of the report committee.

“This report is a beginning,” Dr. Karlawish explained. “ Over the last 30 years we have made substantial progress in understanding the causes of neurodegeneration. Alzheimer’s disease has gone from a hidden disorder, to a front and center national concern. Now, we need to pay the same attention to cognitive aging.”

Cognitive aging is a process of gradual, ongoing, yet highly variable, changes in cognitive functions that occur as people get older. Age-related changes in cognition can affect not only memory but also decision-making, judgment, processing speed, and learning.  “Among our key findings was that both human and animal models show how in cognitive aging, neurons are not working as well, but they’re not dying.” Dr. Karlawish noted that this is important because “Synapses may be sick, but there’s a chance they can get well again.”

The report’s findings and recommendations address steps individuals, health care professionals, communities and society can take to promote cognitive health:

• Increasing research and tools to improve the measurement of cognitive aging.

• Promoting physically activity; reducing and managing cardiovascular disease risk factors, including high blood pressure, diabetes, and smoking; and regularly discussing and reviewing with a health care professional the medications that might influence cognitive health.

• Expanding public communications efforts around cognitive aging with clear messages that the brain ages, just like other parts of the body; cognitive aging is not a disease; cognitive aging is different for every individual (there is wide variability across persons of similar age); some cognitive functions improve with age, and neurons are not dying as in Alzheimer’s disease (hence, realistic hope is inherent in cognitive aging); and finally, there are steps that patients can take to protect their cognitive health.

• Developing and improving financial programs and services used by older adults to help them avoid financial exploitation, optimize independence, and make sound financial decisions.

• Health care systems and health care professionals should implement interventions to insure optimal cognitive health across the life cycle including programs to avoid delirium associated with medications or hospitalizations.

• Determining the appropriate regulatory review, policies and guidelines for products advertised to consumers to improve cognitive health, particularly medications, nutritional supplements, and cognitive training.

The report, a slide set,  and a four-page key point summary, are free and available for download at www.iom.edu/cognitiveaging.

Nature Medicine recently looked at efforts to improve patient access to results from clinical trials in which they’ve participated. In an April 7, 2015 article published online, writer Shraddha Chakradhar highlights the Penn Memory Center’s annual Thank You Breakfast for research participants, and spoke with Jason Karlawish, MD about the PMC’s efforts to loop patients back in to the research process.

Shraddha Chakradhar writes: Before instituting the breakfasts, Karlawish was struck by how participants viewed themselves in the research process. “Participants often used comparisons to being a research monkey or guinea pig and other nonhuman animals to describe their role in the research process,” Karlawish says. “It was as if their humanity was in some sense removed, but they were still willing to participate” in research, he adds.

You can read the full article here.

Steven E. Arnold, MD, director of the Penn Memory Center  and David Wolk, MD, assistant director of the Penn Memory Center, both recently gave presentations at Surrey Services for Seniors in Devon, PA. Dr. Arnold’s presentation “Conundrums in Research on the Aging Mind” and Dr. Wolk’s presentation, “How Early Can we Diagnose Alzheimer’s Disease?” are available for viewing on YouTube. You can find the links below:

Conundrums in Research on the Aging Mind

How Early Can We Diagnose Alzheimer’s Disease?

Surrey Services for Seniors is a non-profit organization offering comprehensive resources, services and activities in Broomall, Devon, Haverford and Media, PA. Their mission is to help older adults live at home with independence and dignity and continue as active members of the community. The PMC presentation series at Surrey continues in April and May:

Friday, April 17, 2015 from 9:30 a.m.– 11:00 a.m.

Cognitive Aging and Cognitive Fitness: a Proactive Approach, Dawn Mechanic-Hamilton, Ph.D.

How can we maximize our cognitive health as we age? We will review the changes expected with typical aging and how we can use compensatory strategies and changes in behavior to maintain cognitive health.
Friday, May 15, 2015 from 9:30  a.m. – 11:00 a.m 

Caring for the Dementia Caregiver: Promoting self-care to achieve better outcomes for the person with dementia, Felicia Greenfield, LCSW

Family caregivers of people with dementia are at increased risk of adverse health including increased stress, anxiety and depression. Self-care for the caregiver is essential for improving not only the health and well-being of the caregiver, but of the person with dementia as well.

To register for these lectures, please call 610-647-9172.  Lectures are free to the public and are held at:

Surrey Services for Seniors
60 Chestnut Avenue
Devon, PA 19333
610-647-6404

The Institute on Aging will host its Visiting Scholars Series featuring Dr. Ann Marie Kolanowski on April 29, 2015. Dr. Kolanowski will present “Behavioral Health In The Nursing Home: Building A Web One Thread at a Time” at the University of Pennsylvania-Smilow Translational Research Center in the Rubenstein Auditorium at 3:00pm.

To register,  please visit  http://www.med.upenn.edu/aging/event-registration.shtml or call 215-898-7801.  This event is free and open to the public; registration is requested.

The Smilow Translational Research Center is located at 3400 Civic Center Boulevard and the Rubenstein Auditorium is on the 1st floor.  Smilow is adjacent to the Perelman Center for Advanced Medicine (PCAM).  For driving directions and parking suggestions, please visit: http://www.pennmedicine.org/perelman/visitor_info/directions.html.

In a Philadelphia Inquirer Op-Ed column about novelist Harper Lee and the surprise news that a second novel of hers will soon be published, Jason Karlawish, MD points to the growing public-health problem of older adults with impaired cognition and the potential for exploitation and abuse that can arise. You can read the column here.

Registration has opened for the 2015 Frontotemporal Degeneration Caregiver Conference

The conference will be held on Friday, July 24, 2015 from 8am – 4:30pm in the Biomedical Research Building II/III Lobby and Auditorium.

The Penn Frontotemporal Degeneration Center invites you to attend a day-long conference for caregivers of persons with FTD and related conditions such as ALS and Corticobasal Degeneration. This conference is open to family caregivers,health professionals, scientists, students and others with an interest in FTD. This conference will include presentations by Dr. Murray Grossman and a team of experts in the field of FTD.

To Register:
There is no charge to attend this event, but space is limited. Pre-registration is required via http://ftd.med.upenn.edu
Program time: 8:00-4:30 PM includes lunch and morning and afternoon refreshments.

Any questions or concerns can be directed to Christine Ray at rayc@mail.med.upenn.edu or 215-349-5873.

Jason Karlawish, MD addressed the National Community Reinvestment Coalition’s (NCRC) Annual Conference –  “Creating a Just Economy” – on March 27, 2015 with his presentation, “The Need for Financial Capability to Build Assets and Wealth.” NCRC promotes access to basic banking services to create and sustain affordable housing and job development in underserved communities. To read about the conference, click here.

Members of Penn Memory Center’s caregiver support group are featured in a Wall Street Journal article about the physical and emotional toll on caregivers as the disease progresses in their loved ones. PMC’s Felicia Greenfield, LCSW, leads the group.  You can read the WSJ article here. For information about the support class, please click here.