Good Mental Health in Old Age is A Real Possibility

From a policy standpoint, a growing elderly population has become a challenge to our society. However, we maintain we can be moderately optimistic, because cognitive impairment, or worse, dementia, are not always caused by Alzheimer’s disease or are the consequence of major ischemic or haemorrhagic stroke. They are often due to micro-infarcts and/or micro-haemorrhages ("mini-strokes") at the level of small, cerebral vessels, which can cause alterations in brain mass. These may be detected using magnetic resonance imaging (MRI), as white matter hyperintensities, cerebral microbleeds, lacunar infarcts or enlarged perivascular spaces, and lead to cognitive impairment and memory loss [2].