What's normal? What's not? Find out what experts say about the cognitive aging process and the secrets of ‘superagers.’
Most of us don’t expect to have the same wrinkle-free skin we had in our twenties or be able to run a mile at our high school pace, but we often expect our memory and other thinking skills to stay the same — or close to it — as we approach midlife and beyond.
But our brains are organs, and just as with other organs in the body such as the heart, lungs, and skin, growing older means age-related changes are a fact of life.
However, although declines in memory and cognitive processing speed can be a normal part of brain aging, they can also be signs of dementia or Alzheimer’s disease. Telling the difference can be challenging, even for doctors, especially when the changes can be gradual and subtle.
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To put it another way, the line between “normal” forgetting, and “cause-for-concern” forgetting can be hard to define.
But knowing how your brain normally changes throughout your lifespan can help to make it clearer what changes in brain functioning may be important to discuss with your doctor or neurologist.
How Your Brain Changes Beginning in Your Thirties
Other changes include less effective communication between neurons, a decrease in blood flow, and an increase in inflammation.
“These types of changes can be linked to physical or health changes that can happen with aging, including conditions such as heart disease and diabetes,” says Molly Mather, PhD, assistant professor of psychiatry and behavioral sciences and a researcher in brain aging at the Northwestern Medicine Feinberg School of Medicine in Chicago.
These changes in the brain can affect mental function, even in healthy older people without any type of impairment or dementia, says Dr. Mather. But there’s also evidence that the brain keeps the ability to change and adapt as we age and even improve in a few key areas, she adds.
The Brain Becomes Less Efficient as We Age
The types of changes that are pretty typical with aging can be described as a reduction in efficiencies, says Mather.
“This would include the types of thinking that requires fast processing, juggling multiple pieces of information at the same time, and remembering new information that doesn’t have any sort of inherent structure or meaning. Those are all tasks that are actually pretty complex and require a lot of coordination between different parts of your brain and different networks,” she says.
There’s evidence that very gradual declines in these areas can start in a person’s thirties, though you may not notice them for a few more decades, says Mather.
At that point, “maybe you don't feel quite as sharp, or things that used to feel easy or routine become a bit more challenging,” she says.
The ‘Middle-Aged Movie Review’ and Other Normal Brain Changes
The ability to master new technology is also a typical complaint, says Joel Kramer, PsyD, professor of neuropsychology and director of the Memory and Aging Center Neuropsychology program at USCF Weill Institute for Neurosciences in San Francisco. “Patients will tell me, ‘Ugh, I just got a new phone, and I have no idea how to work it,’” he says.
Another common struggle is “mental math,” says Dr. Kramer. “Estimating how much the groceries in your basket will cost or calculating a tip may take a little longer,” he says.
There's also something that Kramer calls “middle-aged movie review.”
“That’s where people say, ‘Oh, we liked that movie we saw last week — you know, the one that stars what’s-her-name and that other guy from that show we used to watch?’ That’s pretty common, and some of that is word-finding and some of it is really just memory,” he says.
Mather calls that a “tip of the tongue experience.”
“It’s not coming to your mind right now, but it might pop into your head 20 minutes later, or three days later. That’s a failure of word retrieval more than anything else; it’s not that the information isn’t stored in your brain, but it was hard for you to efficiently pick out that one piece of information,” she says.
Why Did I Just Walk in Here?
Walking into a room and forgetting why you went in there is a classic example of a normal sign of brain aging, says Mather. “Certainly, that happens to me relatively regularly, and I think a lot of people can relate to it,” she says.
As with the other changes mentioned, this may be annoying, but it’s probably a normal sign of aging and not cognitive problems, says Mather. “However, if those things start becoming very frequent or interfering with your ability to carry out daily activities, that's when we start to get concerned,” she says.
If you (or your partner or loved one) grow concerned, it’s a good idea to talk to your provider.
Some Language Skills Can Stay Sharp or Even Improve
Your ability to access information that's been stored in your brain for even a very long time may actually improve, says Mather.
“Trivia is one example. I’ve played Trivial Pursuit games where my older family members remembered answers to things from 40 years ago that they had no idea they still knew. That’s where you’re relying on this long-term storage of knowledge,” she says.
Your ability to do word games and crossword puzzles might stay the same or improve as well, Mather adds.
Although the ability to find the right word immediately might go down, vocabulary tends to continue to increase over time, says Kramer. “In fact, some people think that even as we get into our eighties, our vocabulary can continue to increase,” he says.
Emotional Well-Being Can Get Better With Age
Emotional well-being is a state of good mental health and the ability to remain stable even in the face of challenging situations.
“In some older people, their perspective shifts more towards prioritizing what's important to them. There is often improved emotional functioning, and I think that comes from increased life experience and wisdom to figure out how to cope with different things that come up,” she says.
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‘Superagers’ Have the Memory Abilities of Someone Much Younger
Part of that research involves people donating their brains to research after they die.
“When we examine the brains of superagers under a microscope, we’ve found certain parts of the brain that are larger and have maintained their thickness, and the health of their neurons is better than what you would expect at the age of their death,” says Mather.
Mather is often asked what a person can do to be a superager.
“Although it’s certainly a goal, at this point we haven’t identified clear modifiable factors to have this type of memory ability,” she says. There is one thing that seems to stick out — anecdotally at this point — which is that many superagers have active social connections, says Mather.
“They are usually engaged and involved in different types of activities or social get-togethers that bring them enjoyment, social engagement, and intellectual stimulation,” she says.
What’s Good for the Body Is Good for the Brain
“A lot of the recommendations that we give to improve brain health are essentially the same things that are true for overall body and heart health,” says Mather.
That includes trying to move your body more and sit less, eat a nutrient-dense diet, and avoid heavy alcohol use or other substances, she says.
“Beyond that, staying engaged, learning new things, and finding ways to challenge yourself are all good practices for brain health,” says Mather.