Older but wiser: protecting our brain health as we age — and keeping a positive outlook
If we lead a stimulating life, involving formal or informal education, social interaction or interesting jobs or hobbies, we can maintain brain function as we age. Pic: iStock
Senior citizens are typically portrayed as frail, with stiff knees, dodgy hips, and brains that no longer function at the speed they once did.
However, getting older doesn’t have to mean a steady physical and cognitive decline. It is possible to age well, and we can maximise our chances of doing so.
Eighty-year-old Dr John Rowe believes we can. He still works as a professor of health policy and ageing at New York’s Columbia University.
He was involved in a ground-breaking research project that followed a group for six years, beginning when they were 75.
“Prior to this study, we assumed that the natural course of ageing was downward,” he says.
“But from the age of 75 to 81, only half of our participants declined: 25% maintained their high level of function, and the other 25% actually improved a bit.
"This proves that how we age is highly variable and that it’s possible to age successfully, so that we maintain our physical and cognitive functions, avoid significant illness, and continue to engage with others and society.”
How we age depends on a complex web of factors, including genetics, environment, and lifestyle choices.
Dr Cathal McCrory, professor of life-course development and ageing at Trinity College Dublin, says that blood tests can now estimate people’s biological age.
“That’s not the number of candles they blow out on their birthday cake, but the age of the tissues and cells in their body,” he says. “The available evidence suggests that genetics only affect 30% of how we age.
“The rest is down to lifestyle factors and the social environments in which we live. That varies from person to person, and much of the pace at which we age is under our control.”
Prof Aideen Sullivan is the director of UCC Futures, a research programme dedicated to advancing the understanding of brain disorders and ageing.
“Apart from a few specific genes strongly associated with age-related brain disorders, like Alzheimer’s or Parkinson’s, modifiable risk factors are probably more important than genes when it comes to brain ageing,” Sullivan says.
So what are these factors? McCrory cites smoking. “Those who have smoked for more than 30 years have been shown to age 10 years faster than their peers,” he says.
The health of your blood vessels — and subsequent risk of heart attack, stroke, and dementia — is another. “The two things to do here are to exercise more and eat healthily,” says Sullivan.
“That helps to manage blood pressure, cholesterol, and blood-sugar levels, all of which also protect against vascular damage in the brain.”
Avoiding alcohol and managing stress also helps, she adds.
Rowe emphasises social interaction. “Strong connections with others bring terrific benefits to cognition and physical and psychological health,” he says. “Isolation is toxic.”
It’s important to look after our eyes and ears, too. “Vision and hearing loss have been identified as major factors for dementia,” says Sullivan.
“Hearing well also allows us to fully participate in society, contributing to general wellbeing and quality of life.”
McCrory says it’s helpful to view older age as a time of continued growth and development, and he gives the cellist Pablo Casals as an example.
“A student once asked him why he still practiced so hard at the age of 80 and his reply was, ‘Because I want to get better.’ Now that’s successful ageing.”
Yet, we do have to face facts. Getting older inevitably takes a toll on our brains.
“Brain cells (neurons) cannot divide and renew like other cells in the body,” says Sullivan.
“The neurons we’re born with stay with us throughout our lives. They’re not replaced when damaged, and that loss of neurons and neuronal connections leads to brain shrinkage as we age.”
There is also the issue of inflammation, which gradually builds up in the body and brain, “in a process known as inflammaging”, says Sullivan.
“The resulting inflammatory molecules can also affect the function of the brain.”
How this impacts us depends on the area of the brain that is affected.
Sullivan compares the brain to the body’s control centre, with different regions controlling activities like memory, emotion, and sensory and motor function.
“Some individuals become more forgetful, while others experience changes in their emotions or have problems with speech or movement,” she says.
But many people maintain brain function and live full lives despite sustaining age-related neuron loss.
Our cognitive reserve could be a possible reason for this.
“If we lead a stimulating life, involving formal or informal education, social interaction or interesting jobs or hobbies, we can maintain brain function as we age,” she says.
Also, doing crosswords and puzzles, learning languages, and reading can keep our brains fit and agile.
Psychologist Maureen Gaffney, author of the self-help book , wants older people to remain positively engaged with the world.
“The word ‘retirement’ has connotations of withdrawing, but while older people may pull their energy back from working professionally, that energy should be redistributed to other things, like family, friends, hobbies, and activities they enjoy,” she says. “They will have so much to give.”
Some element of decline is to be expected, Ms Gaffney says. “You may not play badminton as well as you used to or tot up sums in your head as quickly, but what you gain in old age often compensates for these small deficits.”
She lists wisdom as an example. “Older people have been around the block and have more experience to draw on,” she says.
“So they become good at spotting patterns and predicting likely outcomes. This makes them valuable resources that people can draw on for advice, when it comes to decision making.”
Studies, such as one by the University of Michigan in 2010, show that cognitive functions — for example, conflict resolution and emotional regulation — also improve with age. People aged over 60 could better empathise with and compromise with others.
This is a sign of what Dr Rowe calls “the longevity dividend”, a concept that recognises how much older people can contribute to society if only we set aside negative, ageist attitudes and allow them to engage.
While ageing can affect people differently, its impact can be intensified by ageism.
“We often patronise older people,” says Gaffney.
“We call them ‘love’ or raise our voices when speaking to them. Even our road signs depict them as figures leaning over sticks. These are all small, niggling things, but, cumulatively, they convey that old age means decline, and if we internalise that message, we can begin to feel old.”
That matters, because how we feel about our ageing process affects how well we age.
“A 2002 Yale University study found that those who had an optimistic approach to ageing were more likely to live longer and in better health,” says Gaffney.
“Up to seven and a half years longer. If we want to live long and satisfying lives, we should be telling ourselves, and society should also be telling us, that it’s completely possible for us to do so.”
At the outset of the pandemic, older people were identified as one of the groups at highest risk of health complications and death if they contracted covid.
However, a Stanford University study carried out in 2020 suggests that their age and life experience may have helped them to cope better than their younger counterparts.
The study was conducted as the virus was spreading rapidly throughout the US.
It surveyed a random sample of 945 Americans aged between 18 and 76, asking them about the frequency and intensity with which they experienced a range of both positive and negative emotions.
It found that the older people were, the better they could regulate their emotional wellbeing and handle stress.
This ties in with previous studies that showed the upsides of ageing. One of these advantages is an increasing tendency to focus on the positive. A growing body of research shows that the longer we live, the more we are inclined to look on the bright side.
The same Stanford University researchers carried out a seminal study on this topic. In 1987, they interviewed 300 nuns about their lives and returned in 2001 to interview them again.
When they did, they observed an interesting phenomenon: the oldest nuns remembered things as being much more positive than they had described them initially.
They named this tendency to concentrate on sources of happiness while downplaying sources of sadness as “the age-related positivity effect.”
The effect has been replicated in studies since. Research published in 2014 combined data from 100 studies to show that when processing information, older adults lean towards optimistic information while younger people focus more on the negative.
