Those who have followed this blog from the first post know that it started out as an effort to document my changing mental status over time. But over the course of the last month, it morphed into an account of my efforts to delay and (hopefully) prevent significant cognitive decline in the coming years.
How did that happen?
When I began writing last December, I assumed that dementia was something you were destined to develop. Either you had the gene or not. You were either lucky or you weren’t. But I soon learned that that was not the case. It turns out that, although there is no treatment or cure for dementia, you can do things to reduce your risk of developing it by 40%.
Bottom line: genetics is not destiny. You can get dementia without the gene and, conversely, not everyone with the gene develops it. The odds are just higher for those with the gene. Overall, about half of us will develop dementia after age 85 if we live that long and if we do nothing to protect ourselves. Making all the recommended behavioral changes lowers your chances of dementing after 85 from 50% to 30%.
Allow me to digress here for a moment to note how amazing it is to even be having this conversation. When I was in my early 20s, the average life expectancy for an American male was around 72. Now it’s over 85. Many of our parents are living into their 90s. It’s no longer unusual to read newspaper obituaries of centenarians. I would not be surprised if the final longevity calculation for my generation of baby boomers turns out to be over 100.
If that’s the case, then at 70, I may have 30 years ahead of me. Thirty years! I find that mind-boggling, don’t you? But all that extra time will be hell on earth if I dement. That’s a pretty strong motivator for changing one’s behavior, don’t you think?
So back to my main point…
There are 3 biological processes that make it possible to influence your cognitive future:
1. Epigenetics. Although your genes set the broad parameters of your life, you can influence how they are expressed, most importantly by controlling what you eat, how often you exercise, and the quality of sleep you get. So although I might be genetically programmed to live to be somewhere between 70 and 120, where I actually wind up will depend upon the lifestyle I assume on the way there. The same goes for brain function and cognitive decline.
2. Neurogenesis. Not that long ago, the common wisdom was that your brain developed until your mid-twenties and after that there was a long, inevitable process of cell loss. I used to joke about not holding in a sneeze because the spike in pressure would kill brain cells. Research in the last few decades, though, has demonstrated that we continue to grow new brain cells right up until we die. We just need to motivate our brains to do so by constantly challenging ourselves.
3. Neuroplasticity. Our brain is a mass of circuits formed by individual neurons connecting with each other. If there is damage to one part of our brain, there is the capacity (within limits) to re-wire ourselves to compensate. So even if a short-circuit develops because of some micro-damage, it’s possible to physically get around it. There’s a built-in resilience, if we can only tap into it. That may be the best news of all!
Those three things give me hope. We’re fortunate in that, just as we are living longer and finding ourselves at greater risk to develop dementia, research is discovering how to manipulate our biology to offer some protection.
And that is why I am changing my diet, exercising regularly, improving my sleep hygiene, doing crosswords and jigsaw puzzles, keeping my stress levels low and trying to socialize more.
While I catalog my behavioral changes to protect against dementia, I’ll try not to ignore the cognitive errors that keep cropping up. This week, for example, it became painfully apparent that I have pretty limited visual memory.
I notice it when I do my daily jigsaw puzzle. I’ll study the picture before starting and describe it to myself verbally: “There’s a blue sky with clouds in the center, then a horizon line of mountains and a wheat field along the bottom, with dark green foliage on the right and light green foliage on the left.”
No sooner do I begin the puzzle, though, than the image of the whole picture disappears. Try as I might, I can’t conjure it up in my mind. I can recall the verbal description, but I can’t see it. Consequently, I match colors and shapes to complete the puzzle without having a sense of what the image is I’m creating. I’m surprised at the end when I see how it all came together!
Once I noticed this was happening, I tested myself by seeing if I could visualize the wall hanging we have of a Renoir painting. Nope. Couldn’t do it. I could clearly see portions of the painting like faces, hands, a hat and a dress, but I couldn’t see the whole thing all at once. There were several large features I didn’t recollect at all…and I’ve been looking at this painting every day for over a month now.
The good news is that I’m pretty sure this is baseline for me and does not represent a recent decline.
When I was in graduate school, we would take the psychological tests we were learning to administer in order to better understand them. I recall doing well on the verbal portions of the Wechsler Memory Scale, but not so well on the visual tasks where you had to remember the items in a picture or a group of faces. How this plays out at a practical level is that Sally will ask me to describe someone I just met and I won’t be able to tell her the color of the person’s hair or eyes, or pretty much any other feature, for that matter.
I suppose I should keep track of this to see where it goes over the next 30 years.