From the moment we are born, we begin to age. When we hear the term “aging,” many of us hear a synonym for “decline” when we should be hearing change. A child does not fear getting older. A child welcomes aging, knowing that this process brings with it new and exciting opportunities.
As we age, our bodies change in many ways (some more pleasant than others!). All of our organ systems change at each stage of life. Just like other organs, our brains age and change too. Cognitive aging is a process of gradual change in cognitive abilities as people get older. These changes do not reflect disease but rather expected changes in how the brain works due to the aging of the brain and its associated structures.
There is great variability in how people age. No two people age in the same way or at the same rate. However, individuals with chronic diseases (i.e. diabetes, high blood pressure, high cholesterol, liver and kidney disease, heart disease, atrial fibrillation), particularly poorly managed chronic diseases, often experience changes in brain function sooner than those without these conditions. Some conditions (i.e., obesity, sleep apnea) put individuals at an even higher risk for poor cognitive aging.
As we age, we can expect many changes. The most common cognitive changes are slowed processing speed and diminished working memory. Reduced processing speed, being slower to work through a task or problem, can make completion of daily tasks more challenging. While response time may be slower, accuracy of responses and performance should not be compromised. For example, an older adult may solve an algebraic math problem more slowly than someone much younger, but the healthy aging older adult likely will still arrive at the correct answer. Working memory (the ability to hold, process, and mentally manipulate information) also is likely to change with typical aging. For example, healthy aging older adults may have more difficulty writing down a phone number being read to them. Reduced processing speed and working memory may affect attention and memory, as these higher level skills are necessary for concentration, efficiency of thought, as well as encoding and retrieval of information. These inefficiencies may be more pronounced in new situations or when the individual is under stress. Inefficiencies are less apparent when engaging in highly practiced or familiar activities.
“When we hear the term “aging,” many of us hear a synonym for “decline” when we should be hearing "change."”
A myth continues to circulate that poor memory “is just part of getting old.” When we perpetuate this myth, we normalize cognitive decline and, in doing so, discourage others from investigating changes in cognition as they age. If we believe that confusion and poor memory are to be expected and reflect a healthy aging process, we miss opportunities to get ourselves and our loved ones important treatments and supports. Modest forgetfulness may be expected as we age but this forgetfulness should not extend to important activities (i.e. forgetting to close and lock doors, forgetting names of familiar people). We should not expect profound memory loss (rapid forgetting of new information and/or forgetting of remote, personal information), inability to complete previously simple tasks (dressing, cooking, keeping a schedule), or persistent confusion in old age. Should you or your loved one begin experiencing any of these, this could be a sign that something more serious could be occurring. Should you notice significant changes in you or your loved one’s thinking, memory, driving performance, motor functioning, or ability to complete everyday tasks, you should seek consultation from your primary care physician.
Despite the aforementioned inefficiencies, aging can also bring with it several positive changes. Wisdom and knowledge appear to increase as we age. The collective knowledge of our lives is utilized and applied in late adulthood. Happiness has been shown to peak in youth as well as in late life. It appears that as we age, our capacity for appreciation and happiness increases while stress and distressing emotions like anxiety, worry, and anger tend to decrease. Older adults are also able to successfully employ compensatory strategies to minimize decline, which allows some individuals to function well despite brain changes associated with aging.
Have you ever heard the phrase, “You can’t teach an old dog new tricks”? Well, actually, you can! Research shows that among healthy older adults, the capacity for new learning is very robust. Neuroplasticity (the brain’s ability to change with new learning/experiences) persists throughout the lifespan making it possible for people of all ages to strengthen their cognitive abilities. Engaging in new learning by exposing oneself to new activities and intellectual challenges may serve to improve brain health as we age.
So, what does optimal cognitive aging look like? Individuals who age well cognitively share some important characteristics. Optimum agers maintain generally high energy and activity levels, they exercise, they eat a balanced diet, they have lower incidence of chronic medical conditions, they have regular medical check-ups, and have larger and more diverse social networks with whom they interact with regularly.
Often, we focus our energy (and our money!) on staving off the outward signs of aging (wrinkles, age spots, thinning hair, etc.). As a society, we spend millions annually chasing the elusive fountain of youth. Science tells us that we can impact our ability to age well through simple, and often inexpensive, changes in behavior. To improve brain health across the lifespan and increase your odds of being an “optimum ager” we recommend:
1. Engagement in regular physical activity.
Walking even modest distances can provide enormous benefit.
Invest in a pedometer and set daily step goals to keep you motivated.
Reduce time spent being sedentary. Limit “screen time” in favor of activities that require you to move.
2. Reduction and management of cardiovascular disease risk factors.
As stated above, exercise to the extent healthy and appropriate for you.
Eat a balanced, healthy diet. Check out the MIND Diet!
Manage stress in healthy ways.
Regularly engage in pleasurable activities.
Meditate! Take time just to breathe and relax.
Seek help for chronic stress, depression, anxiety, etc., if needed.
If you take medications, take them as prescribed. Follow doctor’s instructions on how best to manage your health conditions.
3. Discussion and review of health conditions and medication that could impact your cognitive health with a healthcare professional.
Increase your understanding of how your health conditions might affect your brain. Take steps to improve your self-management of your health.
4. Maintenance of social and intellectual engagements. Be a lifelong learner!
Join a club or local group related to something you are interested in.
Make time to regularly socialize with old and new friends.
5. Getting adequate sleep and seeking treatment for sleep disorders if present.
None of us can escape aging (read: change) but each of us can take steps to improve our brain health and overall wellness.
This piece is part of a special brain health initiative curated by Dr. Ali Rezai of The Ohio State Wexner Medical Center. For more, visit The Huffington Post’s Brain Health page.