As our brains age, we're less likely to think as quickly as we used to or remember things as well. NIH research has made progress uncovering hints about how to keep our brains in shape as we age. But with more Americans living longer, NIH's research portfolio needs to identify and develop proven strategies to preserve brain health as people grow older. A new report by an expert panel suggests a number of promising avenues for further research into maintaining or enhancing both cognitive and emotional function as people age.

The report stems from the trans-NIH Cognitive and Emotional Health Project, which was established by NIA, NIMH and NINDS to identify the demographic, social and biological determinants of cognitive and emotional health in older adults. The project formed a panel of experts, the critical evaluation study committee, to analyze the existing scientific literature and identify factors involved in the maintenance of cognitive and emotional health. Based on this analysis, the committee was to outline strengths and weaknesses in our knowledge and offer suggestions for future research opportunities.

The committee looked for large longitudinal cohort studies that considered a wide variety of demographic, psychosocial and biological factors and their effects on both cognition and emotion, predominantly in people age 65 or older. Examples of outcomes included cognitive performance and decline. Measures of emotion included the presence of depressive symptoms, anxiety symptoms and resilience. The committee eventually identified 96 papers from 26 studies for further analysis.

The report, published in Alzheimer's and Dementia: The Journal of the Alzheimer's Association, concluded that several factors appear to be associated with the health of the aging brain. These include education, cardiovascular health, physical activity, psychosocial factors (such as emotional support, social engagement and stress), chronic illness and genetics. Overall, the committee identified more than 40 factors that may play a role. They also raised many possibilities for potential interventions.

Of particular note was cardiovascular (CV) disease. An increasing number of published studies suggest that traditional risk factors for CV disease are also risk factors for cognitive decline. Modifiable lifestyle factors that may help stave off cognitive decline thus include diet, smoking, physical activity, alcohol intake and sleeping habits. The group stressed that research aimed at directly testing such interventions deserves more attention.

The committee also highlighted the ties between emotion and cognition. A history of symptoms such as depression or anxiety, for example, is associated with both poorer cognitive and emotional health in late life. Either the relationship between emotion and cognition is bidirectional or they are affected by a common underlying process. Since the two are inextricably linked, the report concludes, future research in the field would be well served by studying them simultaneously.

NIH is intensifying the search for strategies to preserve brain health as people grow older. This report helps to illuminate a number of promising avenues. For more information, see http://trans.nih.gov/CEHP.