- As people age, they will lose some brain cells, and brain volume decreases.
- Healthy behaviors have been shown to slow down the progression of cognitive impairment.
- Ways in which you experience your life add to the group of strategies that can help protect cognitive functioning in old age.
Aging for the lucky among us is inevitable. Our brains shrink and the resultant cognitive slippage is scary. There are well-established ways to increase your chances of a good trajectory for cognitive aging—or at least to slow down the progression of cognitive impairment. They include
- physical and mental exercise (old brains like a challenge);
- positive social relationships;
- diets that are fiber-rich and include nuts;
- low alcohol intake;
- not smoking; and
- healthy sleep.
These strategies are behavioral. How you “live inside of yourself” is a different story.
Fortunately, there are ways in which how you experience life can help protect your cognitive functioning.
I spent several years interviewing senior psychoanalysts considered wise by their peers to discover what they had learned about human nature and the ingredients of good psychotherapy. What became clear along the way was that these high-functioning seniors, whose ages ranged from 74 to 103, had also figured out how to maintain their mental sharpness.
Trick No. 1: Play
Playful interventions can promote brain plasticity and cognitive reserve. While well into their 80s, “Dr. N.” played violin in a string quartet and “Dr. S.” played tennis, it was from a third practitioner, “Dr. B.,” that I learned this mind trick.
As we drove 40 minutes from the train station to my house, this 90-year-old psychoanalyst who had come (with her dog!) to be interviewed talked about getting her driver’s license again and buying a house in the country. Noting she didn’t have her hiking shoes on, she assured me with a smile that the ones she was wearing were good enough if we did some hiking later after the interview. It was clear, however, that physically she could no longer hike, and her stated desires were the stuff of playful shared fantasy. Here’s the trick: The young play at being grown up; as an elder, you can play at being young. The mind is fertile ground with imminent space to play.
Trick No. 2: Resilience
“Genius is the activity which repairs the decays of things,” wrote poet Ralph Waldo Emerson. With age comes inevitable loss: of persons, work, and bodily function. Resilience is recovering from losses, getting back up after being knocked down.
Interestingly, all the wise psychoanalysts I interviewed had endured hardships and traumas, and many had early losses. These people were able to rebound.
“Dr. S.” was 93 when we met. Her husband passed away when she was a young mother of five, and she coped by continuing to speak to him out loud. Her trick was to keep those who are no longer in the present, present. “Dr. B.” lost her husband without warning from a massive heart attack. A woman without other family, she felt all alone, “like 2001: A Space Odyssey,” she said. After a year or so, she took a trip to a remote part of the world, where the terrain matched how she felt inside. She stayed for a day or so, taking in the full starkness of the environment. Her trick was to find a place in nature that mirrored her internal state, and by doing so, she felt shored up and able to go on.
Trick No. 3: Emotional Balance
I spoke with “Dr. B.” from the time she was 99 until shortly before her death, just shy of 104. Her wisdom about emotion spoke volumes: “I have many thoughts about the future, and I remember the past with both joy and sadness but without nostalgia. I am grateful for being able to live in the present with what feels like an appropriate mixture of awe and despair, of hope and dread.” Depression and anxiety negatively impact cognitive function, which includes a lessening of memory function, concentration, and attentional abilities.
The mind trick is to accept that in life we have both positive and negative emotions (sometimes about the same situation) and to gravitate toward the positive. This is called “affect optimization.” Elders who learned this trick do not hyperfocus on the negative and all that is wrong. Rather, they integrate negative experiences into an overall positive whole.
Trick No. 4: Purpose
Find meaning and purpose. Research has shown that purpose in life delays dementia onset (and mortality) by several years. At 100, “Dr. B.” talked about getting instruction so that she could be more computer literate. “I’m going to get to know the beast!” she said, so that she could teach a course in the fall via Skype. Well into his 80s, “Dr. S.” started a wisdom group at his local place of worship for people to share their life’s wisdoms. In her 80s, “Dr. F.” decided to write fiction. “Dr. O.,” a holocaust survivor in her 90s, speaks to groups about her experience during the Holocaust to educate the next generation so that they “Never Forget.”
Throughout life, mental health is rooted in protection. We protect ourselves in love, at work, and at play. In old age, protecting our minds is a very wise thing indeed. Protection is in preparation and a useful pneumonic device to help you remember to protect yourself is P.R.E.P.: play, resilience, emotional balance, and purpose.
Baum-Baicker, C. (2017) Defining clinical wisdom. Journal for the Advancement of Scientific Psychoanalytic Empirical Evidence JASPER INTERNATIONAL, 2 (1), 71– 83.
Boyle, P., Wang, T., Yu, L., Barnes, L., Wilson, R., Bennett, D. (2022) Purpose in life may delay adverse health outcomes in old age. American Journal of Geriatric Psychiatry 30(2), 174–181.
Emerson, R.W. (1844). Essay: Second Series, The Poet.
Livingston, G., et. Al. (2020) Dementia prevention and care: 2020 Report of the Lancet Commission. Published online 2020 Jul 30. doi: 10.1016/S0140-6736(20)30367-6
Sima, R. (2023). What super-agers show us about longevity, cognitive health as we age. Washington Post, 4-12-23.
Universite de Geneve (2023). How music can prevent cognitive decline. NeuroImage Reports, April 17, 2023.