These days, my husband and I find ourselves relying on each other to finish each other's sentences as we stumble over lingering words in the dark recesses of our memories. The power of two is more likely to fill the gap of a paused sentence.
Small interruptions can throw me off track. My high school student asks for the car keys on my way to the refrigerator. “Now, what was I getting?” A moment like this can show me that aging brings with it a loss of physical and cognitive flexibility as the years pass.
On certain days, my brain can sound like an old shortwave radio. I feel grounded and disoriented as I search to retrieve the names of my old classmates or the title of a 90s song jammed deep within her neural networks. I imagine the flames in their tangled web of gray matter navigating a maze of incompetence.
Navigating daily tasks can be even more of a drag, especially when combined with focusing on other demands like meeting a work deadline or booking a flight. Overloading circuits by shifting attention from one focus to another makes the effects of aging more noticeable.
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Changes occur from middle age
Revealing the ways the brain compensates to make older adults more resilient when we face memory loss and other aspects of age-related decline could help us bounce back more successfully.
But why do some individuals experience early memory loss, while others remain cognitively “young” into old age? A better understanding of the early biology of dementia and Alzheimer's disease can help identify ways to reduce risk. It can stimulate early diagnosis and strategies to maintain cognitive fitness, similar to how we approach cardiovascular health.
The growing field of neurocognitive aging, the study of the brain's complex reasoning and memory functions as we age, can shed light on changes in information processing and reaction time that may precede cognitive decline.
A Harvard Medical School study, published in the Lancet this spring, found that the ability to coordinate competing tasks, called dual-tasking, occurs much earlier than previously thought. When the researchers asked middle-aged adults to perform simple arithmetic operations in response to verbal questions while walking, their findings revealed that the ability to perform two overlapping tasks simultaneously declines starting around age 55.
Although most of us might sigh with relief, relieved that our mid-50s birthday is being postponed for at least a decade before the age of 65, it may actually be the gateway to the golden age of the brain.
Plus: What you can do to reduce your risk of dementia
How can the brain protect itself?
One theory noted by Dennis C. Park and Gerard N. Bischoff of the Longevity Center at the University of Texas suggests that the brain is equipped to protect itself by “recruiting additional circuits that support deteriorating brain function that has become noisy and inefficient.” “.
An individual's education, work and social stimulation also contribute to the “cognitive reserve” that helps maintain abilities in later life. Brain training through computerized platforms such as Lumosity and NeuroNation promises to improve memory and problem-solving skills.
Despite the multi-billion dollar industry that emerged in 2014, whether these apps can live up to the claims remains in question. The results of perceptual training in scientific experiments are mixed or have yet to be proven to be consistent.
Although the skills practiced produce statistically significant improvements, these improvements inconsistently translate into lasting gains in daily life. A recent study cited user experience as a key factor. Older adults performed better on crossword puzzles than on computerized platforms, perhaps because they were less flexible with digital interface games.
The University of California, Riverside, in collaboration with the National Institutes of Health, is recruiting 30,000 volunteers to better understand the effects of gamified memory training to tailor training to different levels of cognitive fitness.
Moving your body affects the brain
Somewhat counterintuitively, the answer to your brain game may not simply lie in mental gymnastics, but in the physical world of moving your body itself. J. Carson Smith, who directs the Exercise for Brain Health Laboratory at the University of Maryland, wondered whether exercise training might further impact the brain's ability to adapt.
When 33 people, aged 70 to 85, some of whom already had evidence of cognitive impairment, participated in a walking program exercising for 30 minutes a day, they performed better on memory and language tests – for example, they were asked to remember a story that had been told. He recites to them.
Smith's team then used functional magnetic resonance imaging (fMRI) to determine the activity of nerve impulses and the statistical probability that their firings are coordinated within brain circuits. After 12 weeks of walking for four days each week, these people's synaptic connections showed stronger “connectivity” or signals within task-specific regions, and stronger cross-talk between larger neural networks.
These findings suggest that one mechanism behind the benefits of exercise, which has long been understood to promote brain health, is enhancing the efficiency and neuroplasticity of brain circuits.
“Our findings suggest that moderate-intensity walking, even in older people and those with mild cognitive impairment, can induce changes in brain networks.” [that are related to improved cognitive function,] “Which can help maintain or preserve cognitive abilities as we age,” Smith said.
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The most vulnerable groups can benefit
In Smith's study, exercise promoted increased connectivity between brain networks that govern attention, memory, and executive function.
There are two networks that are particularly vulnerable to aging: One allows us to sift through complex stimuli to focus attention on the most relevant cues, benefits the default mode network.
The default mode is used during rest when thinking introspectively or daydreaming, and its decline is linked to dementia and the development of Alzheimer's disease.
Cognitively normal adults, two-thirds of whom had a family history of Alzheimer's disease, and who participated most regularly in physical activity, followed by Johns Hopkins, also showed greater fMRI connectivity.
The stronger signals in these people translated into protection against cognitive decline during the study, largely independent of the amyloid pathology and genetics that predict Alzheimer's risk.
While both cognitive and physical engagement are associated with higher connectivity, the effects of physical activity on executive control and default mode networks were different from mental activity, which benefited attention networks.
Practice within your limits
How much and how often do you engage in physical activity is necessary to be effective? Interventions targeted 120-150 minutes of moderate exercise such as brisk walking or jogging weekly, with intensity as important as duration.
A recent small study at the University of Central Otago found that short, six-minute bursts of high-intensity activity increase BDNF, a neuroprotective growth factor essential for brain plasticity, the brain's remarkable ability to rebuild itself at a cellular and molecular level.
Enhancing metabolism and neuroplasticity are likely key to some of the cognitive benefits exercise provides. In general, older people should get out and move within their limits. Mental and physical activities that combine movement and attention, such as tai chi, Pilates and yoga, have been shown to benefit people over 55.
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Playing games such as Wii Sports and Ring Fit is another strategy that researchers are exploring as their interactivity offers the benefits of both physical and cognitive challenges. These highly entertaining games can enhance flexibility and responsiveness and may be specifically designed to improve memory and attention in older adults.
Neurocognitive gerontology presents a very optimistic picture that the brain is modifiable late in life. This should change our thinking because dementia may not be a foregone conclusion of aging.
New developments such as blood tests will make diagnosing Alzheimer's easier and will hopefully bring more information to flag early dementia symptoms to doctors, who can now offer risk-reducing counseling and, for some, treatment.
In the absence of promising drugs that can prevent cognitive loss, interventions such as exercise that can delay progression, including in those who already show mild impairment, should receive our attention.
All too easily, we are seduced by Ozempics and Prevagens, the ease of popping the pill or the exaggerated promise of a “magic bullet” to alleviate our ills when the answer may already be within us.
Dr. Elaine Kornmel, MD, is a radiation oncologist in Boston with more than 34 years of experience in the medical field. I graduated from Yale University in 1988.
This article is reprinted with permission from NextAvenue.org©2023 Twin Cities Public Television, Inc. all rights are save.
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