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On a recent trip I arrived at my destination airport and was greeted by a driver who was picking up several of us going to the same meeting. Quickly I was seated next to a medical school professor who has written multiple books on caring for those with Alzheimer’s disease. To my surprise, he mentioned that he does not regard Alzheimer’s as a single diagnosable disease. I asked him to educate me as we rode to our destination, and though we were both exhausted from over-night trans-Atlantic travel, he obliged. If I understood correctly, Alzheimer’s disease is looking like it isn’t a single disease with a common causal history and impact. Rather, it is functioning like an umbrella term for several different brain conditions that impact our memory, attention, and ability to reason and direct our actions. On this account, Alzheimer’s disease is part of a group of dementias. He also mentioned something that I had discovered in my own reading on the cognitive neuroscience of the aging person: even if not all disordered thought is a normal part of getting older, some may turn out to be inevitable.
This conversation turned out to be very timely. Shortly afterward, the world witnessed a very public event that has raised the profile of the aging brain: the American presidential candidates debate. The United States’ two leading candidates for president are the oldest ever at 78 and 81 years old. One of the greatest leaders in the Bible, Moses, did his best work as a senior citizen, but many Americans are concerned about the age of the candidates. Particularly, a large majority polled after the debate expressed that President Biden is too old to serve another term. Many are concerned that he may be suffering from a form of dementia and wonder if it is disqualifying. But a non-trivial number of Americans are also uneasy about President Trump’s age. Are there things you can do to maximize your chance of reaching your 80s and being more like Moses?
I have just been recording a series of short videos concerning how we can take steps to age well. I have called it my “AFTER 65 series” and you can find it on my YouTube channel. I offer a number of suggestions in the AFTER 65 series of videos. Each letter of AFTER stands for a topic in the series: Activity, Fun, Thought, Eating, and Relationships. These videos were inspired by the aging of my own dad and my regular interaction with many retired people in my neighborhood and in my wife’s line dance classes (a really great activity for aging brains and bodies, by the way!). With the right preparation and attitude, our likelihood of having productive, enjoyable lives into our eighties and even nineties may be high. Major drops in cognitive functioning commonly occur in the decade from age 60-70 years old, but this normal change does not lead to anything we call dementia, at least not right away. Many people remain cognitively able into their nineties and beyond.
If my expert informant is correct, all of us who live long enough will eventually show signs of dementia, even if some show signs much earlier than others. We will start finding it harder to maintain attention, to learn new information, and to recall names and words. Our control over our body will diminish. Disturbingly, these failings may begin as hard to predict ‘malfunctions’ that don’t characterize our experience all day every day, but come and go intermittently. Some times of day may be more disordered than others.
What seems to keep some people from showing clear signs of natural declines is how much cognitive reserve they managed to build up earlier. People who have spent a lifetime learning, thinking, and having new experiences, tend to have something that looks like a buffer against cognitive decline. People who were highly intelligent earlier have some IQ points to spare. If you managed to avoid childhood concussions, all the better. Of course, staying physically healthy is important, too. Our brains need good nutrition, exercise, and sleep like the rest of our bodies. There is no shame in taking naps!
As with any part of our bodies, the brain shows signs of deterioration with aging, even setting aside strokes and injuries which we are more likely to accumulate over time. The myelin sheath, a fatty membrane that surrounds neural axons, thins with aging, thereby slowing the speed of electrical signals moving from cell bodies through the axon to other neurons or to muscle tissue. This degrading of myelin is one way in which our brains slow down as we age. And so, as a normal part of aging, we don’t process and retrieve information as quickly. Elderly people are generally no match for young adults in tasks that require rapid responses. And yet, with aging we can accumulate more and more knowledge and become more adept at finding connections among the vast network of ideas and experiences that we have. Young adults may have more “fluid intelligence,” in finding novel solutions to problems quickly, but older adults may have vast “crystalized intelligence,” to draw upon to judiciously use knowledge, facts, and experiences to solve problems and generate insights.
The bad news for both major presidential candidates is that whatever declines they are showing now are unlikely to markedly reverse with a rest, change in diet, or other accommodations. Whether they are “up for the job” depends very much on how they and their teams decide what their jobs look like. For instance, evidence exists that jet lag becomes more harmful and disorienting to us as we age. It seems prudent for whichever candidate that is elected to engage in very few over-seas trips. Whether President Biden or Trump are elected for a second term, America should not expect it to look like the presidency of someone in their 40s or 50s.
A similar lesson applies to all of us. In addition to preventative steps to reduce our cognitive decline, part of aging well is adjusting our lives to play to our strengths and not fall prey to our weaknesses. We should marshal our wisdom and experience to be judicious in how we manage ourselves in our twilight years, so we are ready and able to respond to what adventures God has for us — even if it isn’t to lead a nation.
