The intentional application of clinical, pharmacological, or lifestyle interventions designed to alter the predicted course of an individual’s cognitive performance over time, ideally shifting it toward a trajectory of sustained or improved function. This involves proactive management of known risk factors and the implementation of strategies to enhance neuroplasticity and cognitive reserve. The goal is to mitigate the expected age-related decline and maintain a high level of executive function and memory capacity.
Origin
This concept emerges from the fields of preventative neurology and lifespan development, recognizing that cognitive aging is a dynamic process susceptible to influence rather than a fixed decline. The term signifies a shift in clinical focus from treating established cognitive impairment to actively shaping the future path of brain health. It is heavily informed by the understanding of the brain’s inherent capacity for plasticity and repair.
Mechanism
Modification is achieved by targeting key physiological systems, notably the endocrine and cerebrovascular networks. Interventions often aim to optimize circulating levels of neuroactive hormones, reduce chronic systemic inflammation that affects the brain, and enhance mitochondrial bioenergetics. Mechanisms include stimulating the production of neurotrophic factors, improving glucose and oxygen delivery to the brain, and strengthening synaptic connectivity through targeted cognitive and physical exercise.
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