A few weeks ago, I was having a geriatric jog, as I am occasionally wont to do, when I pulled a muscle in my lower calf on my right leg. Over the years I have damaged muscles reasonably frequently. Normally you just stop running for a while and revert to walking until the muscle repairs itself. Unfortunately, as you age, that process seems to take longer and longer. As a result my walking recuperation is now more extended. In our friendly little suburb you come to know the walkers and some of them want to walk with you. That’s not so bad, but as well as walk, they like to talk and making conversation at six in the morning about their dogs, relatives and the state of their health is not particularly edifying. So I wish my leg would get better soon!
Most of us decry the ageing process. It’s as if the passing of time robs us of our identity. And for some that may well be the case. If I was to attach my identity to being able to run fast, or drive a ball through the covers, well those attributes disappeared twenty or more years ago.
I suspect, however, that although we have regrets about the diminished physical capability of old age, what most of us fear most is a diminished intellectual capability.
Sometimes, it seems, our judgment is skewed in this regard and in some fields age is not a disadvantage. Mathematicians for example flourish in their youth but historians (appropriately) seem to do their best work in their latter years. As they achieve a greater history of their own they seem to be able to make more sense of history in general.
We, more elderly persons, often are apologetic about our inability to remember things. A study led by Margie Lachman, director of the Lifespan Laboratory at Brandeis University threw a different light on this perceived disability of the aged. The study showed that our ability to recall was not so much age dependant but correlated strongly to the confidence of the participants in recall. If we in fact believed that age impacted on our ability to remember it was a self-fulfilling prophecy.
This is very good news for older people. If we can take steps to raise our confidence in our short term memories we can improve our recall.
I find difficulty in remembering people’s names. (Mind you this is not a function of aging for me it is something I have always been poor at!) If for example I have to introduce a number of people at a function, I will take a little time to go over their names beforehand. Then whether this helps me memorise the names or just gives me confidence that I can do it, I usually then have no difficulty.
Studies also show that an inability to remember words (usually nouns, and often names) seems not to worry younger people. For we geriatrics, we immediately assume it is an indication that we are “losing it”. We beg the indulgence of others for having a “senior’s moment”. As a result we tend to exaggerate our deficiencies which then results in our reduced confidence which in turn, as we saw above, contributes to our forgetfulness.
Of course we can’t deny the fact that as we age our brains change. One of the principal changes relates to demyelination. Myelin is the fatty substance that surrounds the power source – the axons – within each neuron. The level of myelin found in our neurons peaks in our early twenties and then gradually reduces with aging and the reduction accelerates somewhat after sixty years of age. Axons that are well myelinated fire better and consequently are able to produce and sustain neural pathways better. Lachman’s study tells us that biology can be mediated by attitude. It suggests that confidence in our cognitive abilities can possibly even out-weigh the biological factors. She says, “The more you believe there are things you can do to remember information, the more likely you will be to use effort and adaptive strategies and to allocate resources effectively and the less you will worry about forgetting.”
It might even be the case that our perceived failings as seniors are exaggerated by spending too much time with others of similar age who then start to reinforce one another’s worst habits! Beware then the nursing home! Many studies have shown improvement in cognitive capacity of the elderly when they are exposed to children, young people, the disabled and pets.
And when we buy that new gadget we often get a young person to set it up for us because we “don’t know about these sorts of things”. That is not a particular neurological problem associated with aging. Its common name is laziness!
But for the ageing, it is not all downhill. Most of us know elderly folk whom we admire and enjoy interacting with. Yet most of us believe that aging inevitably brings with it deterioration and decline. On some fronts this is true. But elderly brains excel at some things.
Roberto Cabeza, professor of psychology and neuroscience at Duke University has found that the older brain excels at, in technical terms, “cross-functional complementarity”. You might wonder what that means! Academic and author, Cathy Davidson interprets it as “being skilled at sharing knowledge with all kinds of different people, drawn from many different sources with distinctively different levels of credibility and being able from the brew of thought, to come up with creative solutions.”. (I am sure that has clarified it greatly for you!) Whatever! Anyhow it seems that we elderly people have some communications skills that enable us to simplify complexity and consolidate understanding and facilitate problem solving.
We gleaned some hope from that marvellous book by Norman Doidge, “The Brain That Changes Itself”. Here we learnt about brain plasticity. Doidge provided evidence that the brain had the capacity to forge new neural pathways, even in our latter years, to compensate for lost capacities and talents.
Dr Yaakov Stern, professor of neuropsychology at the College of Physicians and Surgeons of Columbia University has spent much of his career studying the most frightening of age-related mental deteriorations, Alzheimer’s disease. From his extensive studies and experience with this most debilitating of mental conditions he has concluded that the single most important thing anyone can do to prepare for the possibility of brain disability is to have a backup plan.
Stern’s team performed autopsies looking at the degree of brain deterioration. They were surprised to find that the degree of deterioration was not an indicator of reduced performance. Many of those studied who showed physical deterioration in the brain did not display many signs of mental incompetence. They concluded that some people have a reserve of intellectual, cognitive, physical and emotional experiences that allow them to create complex and interconnected neural pathways that can be called into service throughout their lives. When brains have established multiple neural pathways and through injury or ageing some are blocked, the brain is able to call into play its neural reserves. According to Stern’s theory, those patients that had cognitive reserves were able to tolerate progressive brain deterioration without manifesting catastrophic behavioural or cognitive symptoms.
Stern has attempted to define the ways we might build such cognitive reserves. His list includes:
• Continuing education
• Meaningful and enjoyable work
• Pleasurable leisure activities
• Physical exercise
• Social interaction
• Learning new skills (particularly learning a new language or how to play a musical instrument)
• Taking up computer skills
Others have advocated doing puzzles like crosswords and Sudoku, playing Bridge or Chess, going back to University and so on. We all hope of course that caring for grandchildren might count. Personally I hope to gain some credits from writing blog essays!