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Cognitive Health

The National Institute on Aging defines cognitive health as the ability to clearly think, learn, and remember. Poor cognitive health can affect an individual's overall health and well being by making daily tasks like cooking, cleaning, taking medication, and managing chronic health conditions more difficult.  ​​​

Cognitive Health and Chronic​​​​​ Disease

According to the Maryland Behavioral Risk Factor Surveillance System, one in 10 Maryland residents over age 44 report experiencing some cognitive decline, such as increased confusion or memory loss. According to the Centers for Disease Control and Prevention (CDC)​people reporting cognitive decline are significantly more likely to live with other chronic conditions, such as diabetes, heart disease, and depressive disorder. ​

​Alzheimer's Disease and Related Dementias (ADRD)

​Alzheimer's disease and related dementias represents an urgent, high burden, and high-cost public health crisis in Maryland. An estimated 110,000 people over age 65 are living with dementia, and their care accounts for more than $1.2 billion in annual spending by Maryland Medicaid. In addition to direct medical costs, family caregivers in Maryland provide over 360 million hours of unpaid care every year.​

Risk Factors​ 

Recent research has identified a number of risk factors associated with brain health, some of which can be changed with behavioral and lifestyle changes and resources and others that cannot be changed.

Risk factors that can be changed:​​​​​

  • Smoking

  • Hearing loss

  • Education

  • Social isolation

  • Physical inactivity

  • Chronic conditions, such as diabetes, hypertension, and depression

  • Binge drinking

Risk factors that cannot be changed:

  • Increasing age

  • Black/African American race

  • Female biological sex

  • Hispanic/Latinx ethnicity

  • Genetic factors

  • History of traumatic brain injury

  • Down Syndrome

10 Warning Signs of Alzheimer’s Disease

​​The Alzheimer’s Association’s 10 Warning Signs of Alzheimer’s Disease

  1. Memory loss that disrupts daily life​

Forgetting events, repeating yourself or relying on more aids to help you remember (like sticky notes or reminders).

  1. Challenges in planning or solving problems

Having trouble paying bills or cooking recipes you have used for years.

  1. Difficulty completing familiar tasks at home, at work, or at leisure

Having problems with cooking, driving places, using a cell phone, or shopping.

  1. Confusion with time or place

Having trouble understanding an event that is happening later or losing track of dates.

  1. Trouble understanding visual images and spatial relations

Having more difficulty with balance or judging distance, tripping over things at home, or spilling or dropping things more often.

  1. New problems with words in speaking or writing

Having trouble following or joining a conversation or struggling to find a word you are looking for (saying “that thing on your wrist that tells time” instead of “watch”).

  1. Misplacing things and losing the ability to retrace steps

Placing car keys in the washer or dryer or not being able to retrace steps to find something.

  1. Decreased or poor judgment

Being a victim of a scam, not managing money well, paying less attention to hygiene, or having trouble taking care of a pet.

  1. Withdrawal from work or social activities

Not wanting to go to church or other activities as you usually do, not being able to follow football games or keep up with what is happening.

  1. Changes in mood and personality

Getting easily upset in common situations or being fearful or suspicious.


Importance of Early Detection and Diagnosis

For many patients and families, there may be misconceptions that the cognitive or behavioral symptoms of dementia are just a normal part of aging. Stigma, shame, and concealing symptoms for fear of others “finding out” are significant barriers to seeking and obtaining a dementia diagnosis. Despite the barriers, there are many benefits to an early diagnosis, such as:

More time to educate patients and families about dementia and dementia care,

  • More time to prepare, plan, and make important decisions about future care,

  • Greater opportunities to participate in research studies,

  • Ability to adjust and set expectations for patients and caregivers,

  • Better disease management, and

  • Improvement in overall care and quality of life.

​Cognitive health screening is an important part of routine medical care, and anyone who is concerned about their cognitive health or experiencing the 10 Warning Signs below should talk to their healthcare provider about completing a cognitive assessment​. Medicare participants ​may receive a cognitive assessment during their Annual Wellness Visit. For more information, please visit https://www.medicare.gov/coverage/cognitive-assessment-care-plan-services​​.

Maryland’s ADRD State Advisory Council and State Plan to Address ADRD

The Virginia I. Jones Alzheimer’s Disease and Related Dementias Council promotes and supports the needs of people living with ADRD and their caregivers, develops and promotes strategies to improve brain health and reduce cognitive decline, and advises the Maryland Department of Health on issues related to ADRD.  


The Council recently released its 2022-2026 Maryland State Plan to Address Alzheimer’s Disease and Related Dementias, a proactive roadmap for dementia partners to comprehensively address ADRD in Maryland.

ADRD Resources

Local Alzheimer's and Dementia Classes and Resources
Alzheimer’s Association- Greater Maryland Chapter
Alzheimer’s Association- National Capital Area Chapter
Alzheimer’s Foundation of America 
CDC’s Alzheimer’s Disease and Healthy Aging resources 
Maryland Access Point- Maryland’s Aging and Disability Resource Center 
National Institute on Aging Brain Health Resources​




For more information: mdh.cognitivehealth@maryland.gov.​​

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