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Cognitive Decline

Dear Friends, Mary and Allen hope this series will be helpful. We reviewed over 200 articles and books for this synthesis. 


We are just starting to share this information and already have received considerable feedback that it helps clients and professionals to develop a more optimistic view than found generally in the media. It will be useful for teaching students about elder clients. Additional copies for forwarding can be obtained from


Counselors and psychologists are NOT physicians, so we do not recommend using this in interviewing practice. Appropriate referral is important. Nonetheless, we have found this a useful handout for those who may be concerned about memory and related issues as it provides an overall of the many types of cognitive aging and cognitive decline. Please feel free to copy and pass these on to your clients.


The Complexity of Cognitive Decline (MAP of Three Counseling Today articles)  We suggest you examine this map and decide which sections you believe most relevant.


Article #1—Defining cognitive decline and its variations: Normal aging and decline>Preclinical issues>MCI> 7 types of dementia (Alzheimer’s represents only 60%). Vascular issues represent 10% but involved in all some way. Central to this series is that each condition is potentially reversible and preventive is vital.



Article # 2 (Three Sections) 

  1. Diagnosis and Reversal.  There is clear evidence in several studies that cognitive decline may be reversed.  There is a real danger of false diagnosis, which leads to fear and increased chance of cognitive decline through not needed stress and worry.

  2. Medications briefly reviewed. As many as 1/3 of prescriptions for cholinesterase inhibitors are inappropriate. The Mayo Clinic focuses on lifestyle, family, pet therapy, support groups, etc. Polypharmacy (too many drugs is all-to-common) and special attention must be paid when taking patients off drugs. The latter is common even in places like the famous McLean Psychiatric Hospital near Boston (as presented in a recent New Yorker article “If the first medication we give does not work, let’s try another.”

  3. Social Justice Issues. Those who are poor, experienced racism, harassment, etc. and suffer severe stressors are more susceptible to cognitive decline and dementias. Early life stress for infants and children sets them on the path to illness and later cognitive decline.





Article 3 (Three Sections)

  1. Genetics and cognition. Genetics are not destiny. Controllable factors can override genes. Those with two copies of the APOE-4 gene have a 50% chance of not acquiring dementia if lifestyle and life experience have led them to health. Finnish study found that APOE-4 gene carriers showed a larger cognitive improvement with a healthy lifestyle, as compared to non-carriers with their usual lifestyle. 

  2. Developmental metabolism. Considered central in mental and physical health and building brain plasticity, metabolism is body chemical interactions—conversion of food to energy to run cells, building blocks of protein, lipids, and enzymes. Mitochondria provide us with ATP, an energy that enables us to talk and move.

  3. The impact of lifestyle and cognition. Research clearly shows how lifestyle builds health and cognitive reserve and resilience. Basic are traits including optimism, emotional regulation, openness to challenge, family and cultural pride. Critical are lifestyle factors (e.g. exercise, nutrition, sleep, meditation/yoga, no smoking.) Social connection and helping others are particularly important.

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