Article – Building a Better Older Brain

3 March, 2017

An article from from Building a Better Older Brain, Marc E. Agronin M.D., Psychiatric Times, January 2017

Patient FYI

Consider the following question: at what age do you think you made better decisions — at age 18 or at your current age?

Most people do not need to reflect long on their answer and choose their current age, since years of accrued knowledge and experience have brought them a more mature and wiser perspective.

But consider a follow-up question: do you think your decision-making will be better or worse when you are in your 80s and 90s?

On the one hand, our aging brains will not be as efficient or nimble in late life, since we all experience a modest decline in certain cognitive abilities. On the other hand, barring major brain damage, we might continue to grow and develop other cognitive powers because of and not in spite of aging. How can we understand and leverage this process in order to build a better older brain?

If we measure our cognition by looking at discrete neuropsychological abilities on standardized testing, we see 2 key trends emerging with age. Fluid intelligence — defined by problem solving, reasoning, logic, and pattern recognition — begins to decline in middle age and is characterized by slower processing speed, more frequent memory lapses, less efficient multitasking, and a decreased ability to suppress or inhibit distracting stimuli. In contrast, crystallized intelligence — defined by knowledge, vocabulary, skills, and experience — remains stable or increases into late life, with a much later period when declines might occur.

These changes correspond to declines in neuronal metabolism and increasing neuronal death, yet at the same time neurons can continue to form connections and revise and reroute networks. The main tipping point for many individuals lies in the dramatically increased risk of Alzheimer disease and other neurocognitive disorders. Prevalence rates exceed 50% of the population aged 85 years and older. If we can avoid (and one day cure) dementia in late life, there is an opportunity to build a better brain through the ongoing development of several age-conferred strengths.

There is no magic pill or fountain of youth that can build a better older brain, but there are several key strategies. Studies of centenarians and other long-lived persons from the so-called “blue zones” around the world emphasize the role of active physical and social lifestyles, being connected closely with other people and communal groups, a local and largely plant-based diet, and well-developed senses of purpose, gratitude, confidence, and tolerance.

Physical activity does not need to involve intense body-building or marathon running but a more moderate approach such as walking, swimming, gardening, dancing, or other enjoyable activities several times a week. Aerobic activities provide the most benefit: improved cerebral blood flow, reduced cortical atrophy, and increased release of neural growth factors. Atrophy = brain cell death. Increased nerve growth factors = protecting brain cells and growing new brain cell connections. Brain fitness may involve regular structured activities, including computerized modules (i.e. daily), but may also involve regular, enjoyable intellectual pursuits that cross-train our mental abilities, such as learning a new language, starting a new hobby, or attending lifelong learning programs (college).

The Mediterranean diet maximizes brain-healthy foods (leafy green and other vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil, and wine) and minimalizes brain-unhealthy foods (red meats, butter and margarine, cheese, pastries and sweets, and fried and fast foods). The MIND diet combines a Mediterranean diet with the DASH diet (designed for lowering weight and blood pressure) and has been associated with a reduced incidence of Alzheimer disease.

We must also keep in mind that our attitudes toward aging can influence our brain health. Ellen Langer’s “counterclockwise” study of older men showed that an immersion in an environment that reminded them of younger days and forced them to think and act like their younger selves had a significantly positive impact on their overall health and function in just a few weeks.