Celebrate the Facts!
The population of the United States is aging, and the implications are immense. Popular misconceptions about aging cloud the perception of what is possible for older people. Contrary to folk belief and erroneous historical research, loss of cognitive ability is not inevitable. Older people can continue to remember, learn, and maintain brain health well into advanced years.
Today, more than 46 million older adults age 65 and older live in the U.S.; by 2050, that number will grow to almost 90 million. Between 2020 and 2030 alone, when the last of the baby boom cohorts reach age 65, the number of older adults will increase by almost 18 million. By 2030, 1 in 5 Americans will be 65 years old and over.
Despite the importance of understanding aging and cognitive decline, one cannot find much authoritative data. What is the age-related degeneration in learning? What environmental factors correlate with reductions or preservation? Does everyone decline as they age on a predictable, linear slope? Can an aging person preserve cognitive abilities with environmental measures, and if so, what are those activities or lifestyle changes that help? What does the data say if one screens populations for genetic conditions such as heart disease, diabetes, and vascular dementia?
Conventional wisdom preaches one’s ‘learning curve flattens’ with age. In the context of aging, the statement essentially means learning ability declines with age and is synonymous with ‘you can’t teach an old dog new tricks.' The idea is an aphorism and is meaningless out of context.
The literature suggests there are declines in learning ability with age. However, the situation is much more nuanced, and much of the data debunk conventional wisdom parroted by media, physicians, and the population at large.
Confirmation bias is the tendency to process and analyze information so that it supports one’s preexisting ideas and convictions. One wonders if the relative lack of authoritative research is mostly about societal preconceptions.
One big area conventional wisdom is wrong is the relationship between age and language learning ability. Most people and clinicians say age is a major and maybe the most important factor in learning a second or foreign language. Conventional wisdom says children acquire a new language easily and quickly, and such endeavor is near-impossible.
Older learners are less likely than young children to learn a new language. Studies relating age to language acquisition reveal that age differences reflect differences in the situation of learning rather than in the ability to learn. Empirical data confirm adults can become highly proficient, even fluent, speakers of additional languages, and that ability does not decline with age.
Learning a second language is a monumental feat. At times, the process involves learning many new words, pronunciations, conjugations, tenses, and even alphabets. However, the fact that adults learn new languages at the same rate as children indicates that learning abilities can remain robust despite aging.
Cognitive is a jargon word used in this trade. The word cognitive means of, relating to, being, or involving conscious intellectual activity (such as thinking, reasoning, or remembering). Maintaining an intellectually engaged and physically active lifestyle helps retention of cognitive abilities. Cognitive training studies prove that older people can improve cognitive skills by thinking and remembering.
In a massive study of people of European ancestry aged at least 60 years without dementia at baseline, participants with high genetic risk and unfavorable lifestyle scores had a significant hazard ratio for all-cause dementia. However, a favorable lifestyle was associated with a lower risk of dementia, and there was no significant interaction between genetic risk and a healthy lifestyle.
Much of the misinformation about age and cognitive abilities stem from the now-debunked myth that one is born with a certain number of brain cells, and once they die, they are gone forever and not replaced. Using this mistaken belief, it follows that the brain is in a state of degeneration, and aging people are on an inexorable path to a nursing home wearing a diaper, provided they don’t die of cancer or a heart attack along the way.
Neuroplasticity is a modern term meaning the brain modifies, changes, and adapts structure and function throughout life. The brain changes based upon the requirements asked of it. A variety of factors affect neuroplasticity, including genetic, cellular, molecular, and environmental factors.
One area confirming neuroplasticity and improvement of preexisting conditions is amblyopia. Colloquially known as lazy eye, amblyopia is the vision in one eye caused reduced by abnormal visual development early in life. Amblyopia develops from birth up to age seven years. It is the leading cause of decreased vision among children. The weaker eye sometimes fixes in an unaligned inward or outward gaze. Conventional wisdom was that the condition was permanent unless addressed early in life.
Recent advances in optical surgery and contact lens correction can sometimes return those eyes to efficacy, allowing the patients to experience three-dimensional vision for the first time, confirming the ability of the brain to adjust to new stimuli.
Studies using magnetic resonance imaging (MRI) and other clinical data indicated that decreasing cardiac function, even at normal cardiac index levels, is associated with accelerated brain aging. Greater arterial stiffness and pressure pulsatility are associated with brain aging, MRI vascular insults, and memory deficits typically seen in Alzheimer's dementia. Cardiac issues can be related to genetics but often are environmental, so one can control one’s destiny by maintaining health.
Even people with symptoms of dementia are not entirely irretrievable. Patients with mild dementia or mild cognitive impairment had better cognitive scores after 6 to 12 months of exercise compared with sedentary controls.
Fast facts about environmental factors in cognition:
Nearly all cases of dementia are the result of a complex disease. In these cases, genes may increase the risk of developing dementia, but they don’t cause it directly. For example, midlife hypertension, diabetes, smoking, and obesity are associated with an increased rate of progression of vascular brain injury, global and hippocampal atrophy, and decline in executive function.
Defensive measures are easy to define and more challenging to put into practice:
There are plenty of ways societal misperceptions about aging and mental skills injure people. First, older people ingrained with the misbelief cognitive declines inevitably might disengage and hasten a decline. Second, employers imbued with this mythology might discriminate against older people. Third, more senior people might misattribute simple mistakes, like misplacing their keys, with symptoms of senility, through their own confirmation bias. Finally, simply worrying about a life-ending in helplessness is corrosive and injurious.
Substantial research and open discussion of the facts will help change the misconceptions. Such is imperative to help aging people live fulfilling, happy lives.
Michael Donnelly investigates societal concerns with an untribal approach - to limit the discussion to the facts derived from primary sources so the reader can make more informed decisions.