S3E4. Seventy-two…and counting

It was my birthday last Friday and so I suppose some reflections on the view from 72 are in order. 

Seventy-two is a funny age because I don’t think I ever had any expectations for it. After all, it’s not a milestone year like all the years that begin new decades. 

When I was in my late twenties, I thought getting old happened when you were in your fifties. I wrote this about a visit to my parents home:

“They’ve been grandparents for almost 2 years now. Grandparents twice over, that is, and a third expected momentarily. As I stepped through the doorway, I was met by a heavy-sweet menagerie of home-cooked aromas. Outside, it was a crisp spring afternoon; inside it was a trifle too warm. They had both mellowed in recent years, but just now, for the first time, I felt as though I were entering a grandparents’ home. They’re growing old.”

I was 22 and they were 52 and 53.

Back then, I thought 68 was synonymous with decrepitude. That was because elderly friends of my mother had lived with us for a while when I was 10 and the wrinkled husband, who was 68, spoke and moved slowly and only with a great deal of effort. I was delighted to have this image shattered when I sprinted past 68 four years ago.

From my current vantage point, though, it seems like all of us in our 70s are just middle aged. When a celebrity from our cohort dies, I think “Too young” or “Too soon.” When David Crosby died last week at 81, though, I didn’t react that way. He had lived a long and impactful life. I was sad to learn of his passing, but it seemed ok.

I am, nonetheless, growing old. I see it in the wrinkled skin on the back of my hands. I feel it in my bones. I can document it with the heart rate monitor on the treadmill.

A few days after I turned 50, I found myself jogging in a park near my home in Lexington, North Carolina. For  reasons long lost to me, I set a goal of running two miles (at any pace) every year until I was 80. At the time (2001), it seemed like a ridiculously impossible challenge. With each passing year, though, it has started to seem more do-able.

It’s now an annual tradition for me to take up the challenge right after each birthday. For many years it was no problem, but this year was different. I don’t know if it was because I’m getting older or the after-effects of COVID or just being out of shape or a combination of all of the above, but this year I struggled.

Fewer than 5 years ago, I could jog the full distance at a 6 mph clip. This year, though, I knew I couldn’t set the treadmill any faster than 4 mph, which meant it would take me 30 minutes to complete the challenge. 

I was already breathing hard after only ¼ mile and my pulse was up to 126. Just a year ago, my heart rate wouldn’t get up to 126 until I was 2 miles into my workout at a 4.5 mph clip.  

After 15 minutes—halfway there and 1 mile into the run—my pulse was up to 136. Last year that didn’t happen until after I had gone 3 miles.

I had to really push myself to finish the challenge, with my pulse climbing to 151 at the end. That just didn’t happen last year.

So I’ve got my work cut out for me. I know I need to establish a regular workout schedule to get in shape. I’m pretty sure, though, that I won’t be able to get back to where I was a year ago, probably due largely to a long-term COVID effect.

I’m having trouble wrapping my head around that. I had been harboring fantasies of running another 5k, but now I don’t think that’s in the cards.

I don’t like this new trajectory at all. I know I should be celebrating the fact that I’m 72 and I can run 2 miles, but a sense of foreboding is preventing me from taking that victory lap.

I’ll work on it.

On a brighter note, I spent my birthday indulging myself. For breakfast, I had a bagel and lox with all the trimmings, using lox that I had made myself. It was the lox of my childhood, brined instead of the smoked salmon you get at the supermarket. At noon I had an hour-long full-body massage and then feasted on lobster for lunch. That night, Sally and I had a birthday party for 2 in the apartment, with delivery pizza, ice cream sandwiches, music from Crosby, Stills and Nash, and a “1-hit wonder” joint gifted to us by a friend.

Life at 72 is pretty freakin’ good after all!

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S3E3. Brain Eaters

In this season’s first episode, I mentioned that I was in awe of the symbiotic relationship between microglia and neurons. I’m ready to explain why.

Let’s begin with the basics. We’re all familiar with neurons, the sexy cells that connect with each other, transmit electrical signals, store all of our memories and control our abilities to perceive and do things. We have about 86 billion of these cells and they form about a quadrillion (1,000 trillion) synapses with one another. And, yes, we use all of these cells, not just one-tenth of them.

There are about 100,000 miles of blood vessels providing oxygen and nutrients that enable them to work non-stop as long as you breathe.

Please take a moment to embrace the awe inherent in these numbers!

But neurons only comprise about half the cells in our brains. The rest are known as glia. Early on, these cells were just believed to provide a structure within which the neurons could function, like trellises for grape vines in a vineyard. But there are several different types of glial cells and they do a whole lot more than just provide the scaffolding and glue that hold the brain together:

Oligodendrocytes attach themselves to the long axons that stretch out from the neuron bodies and cover them with fatty tissue known as the myelin sheath. This is the brain’s white matter. It acts like insulation on a wire and improves the quality of the electrical impulses. If the myelin sheath breaks down and the signal is sufficiently compromised, that neuron may not be able to communicate with other neurons.

Astrocytes wrap around neurons and are involved in a variety of functions ranging from providing nutrients to enhancing synaptic activity to regulating blood flow to creating neurotransmitters to signaling the presence of invaders which triggers an immune response.

Pretty impressive, huh? Feel free to take another moment to let another wave of awe wash over you.

Then there are my favorites, the microglia. These cells have a variety of roles that change over one’s lifetime. 

It turns out that you are born with way too many synapses and so you experience a period of synaptic pruning where inactive connections are eliminated by microglia who eat them. 

Eat them!

Then as you mature, the microglia take on the role of janitor, cleaning up chemical garbage that accumulates between neurons, including the dreaded beta amyloid. They are also responsible for the primary immune response to local infection and injury. But that’s a two-edged sword: the inflammation caused by an immune response in your brain has been linked to dementia. They also eat damaged neurons as part of their protective role, but sometimes that process runs amok and they eat healthy neurons, as well.

Finally, the glymphatic system has a network of tubes that transports fresh fluid into your cranium, mixes it with the waste-filled fluid surrounding brain cells, and then flushes the solution out of your head and into your bloodstream where it can be excreted. All of this occurs during deep sleep.

The more I think about this elaborate, complex, elegant system, the more awestruck I am.

If any of these types of cells weren’t present, the entire system would break down pretty quickly. Or put another way, we wouldn’t exist if all of these tiny organisms hadn’t evolved together in their interdependent microscopic biome.

Try to imagine the process, played out over hundreds of millions of years, that led to this current iteration. How many combinations and permutations of chemicals stressed under different environmental conditions did Nature experiment with before stumbling upon one that would cause a cell to extend itself out from its body in search of similar cells, thereby giving birth to neurons?

And what does it take for a second…and a third…and a fourth type of cell to evolve that depends upon a neuron for its existence yet enhances the functionality of the host cell itself?

And how did they all come to coexist only inside a cranium?

And if what we see now is the culmination of a billion years of evolution, what will the next billion years bring?

Just thinking about the brain and how it works is truly mind-boggling!

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S3E2. No Shock; Just Awe

Last week I mentioned a video about the role of microglia in maintaining brain health and I said that I was in awe of the symbiotic relationship between microglia and neurons.

That got me thinking about what it means to be in awe of something. One morning this past week, I found myself dawdling in bed, conjuring up images of things that inspire awe in me.

The time I looked up at the sky on a crystal clear winter’s night and saw five planets came to mind. For the first time ever, I could visualize the fact that they were all in the same plane as they circled the sun.

As I stood there, I tried to think about the context in which this was happening. I tried to imagine my standing on the dark side of the earth, looking out at the planets, spinning around a star that is hurtling through a galaxy that is but one of billions in a universe that is ever expanding.

You want awe? That’s awe!

But then I took it in the other direction and imagined billion-year old light from faint stars reaching my eye, triggering an electric impulse down my optic nerve into my brain where it made a multitude of connections that triggered chemical reactions in countless synapses as electrons were traded among atoms that were composed of even tinier bits of matter and charges that floated in an indeterminate quantum soup whose forces control the universe.

Yup. That’s awe, too.

And then there’s the awe inspired by the the colors of fresh-cut flowers on the coffee table rejoicing in the morning sun. 

I stand in awe of musicians whose hand-ear coordination moves their fingers at lightning speed to produce a sequence of a mind-boggling number of notes that seem to defy the standard laws of memory.

Forget about our modern world of digital wizardry, I’m still awed by the magic of radio. Think about it: we can emit an electromagnetic impulse from a single point that expands to occupy every cubic inch of space for miles around in a way that allows anyone anywhere within that range who has a few transistors to detect those oscillations and translate them back into the sounds from which they were made.

I’m in awe of Amazon.com.

Being at the racetrack and watching Secretariat win the 1973 Belmont Stakes by 31 lengths in world record time was the epitome of awe-in-motion. Watching the video still gives me goose bumps.

I’m in awe of the fact that last year, there were 19,603,733 people living normal lives in Chile. No, there’s nothing special about Chile in this context. I could have chosen Namibia (2,658,414) and experienced the same awe. It’s just that I don’t often take time to think about all the things that are going on at any moment, but when I do, it’s often awe-inspiring.

Closer to home, I am in awe of Sally’s resilience, compassion, energy, and uncanny ability to expose the questions lurking within every passing moment.

Finally rousing myself from exploring the wide world of awe, I sat down at the computer to check overnight emails, my Facebook and Twitter feeds, and the headlines from the New York Times. As I scrolled down, there were the usual articles about politics and Ukraine and COVID, but then there was this: “How A Bit Of Awe Can Improve Your Health.”

Talk about serendipity!

Or was it? Just a few days earlier, I had typed the first draft of last week’s episode and wrote that sentence about being in awe of microglia. Is it possible that one of the cookies The Times has placed in my computer monitors my typing and uses that information to select articles for my feed? If so, I am DEFINITELY in awe of that technology!

I’ll never know whether it was serendipity or cyber stalking, but in any event, the article was most interesting. First of all, it provided a definition of what awe is which validated my morning’s mental meanderings:

Awe is the feeling of being in the presence of something vast that transcends your understanding of the world.”

Nice. Simple. Clear.

The article went on to explore the emerging research suggesting that a daily dose of awe can be healthy for you. Needless to say, non of these studies had yet been done when I was in graduate school from 1996-2001, and we spent no time discussing the emotion of awe in class. Awe was the furthest thing from anyone’s mind on the acute inpatient psych wards where I worked for 10 years where most patients were battling for survival and not self-actualization.

But awe does seem to have value in contributing to a sense of well-being, lowering stress and enhancing happiness. Although the proper ‘dosage’ of awe (both in frequency and intensity) hasn’t yet been determined, there is evidence that a couple of moments each week may be beneficial.

How do you get those moments? The key seems to be in mindfulness, or just taking time to think about what is happening, where you are, and what you are doing in a context greater than yourself. For example, you could put your internal dialog on pause while brushing your teeth tomorrow morning and ask yourself: “How did this water get here?” I’ll give you a hint: start with water evaporating from the earth’s surface and rising into the air to form a wisp of vapor in search of a cloud.

As you can see, it doesn’t take much…awe is all around us just waiting to be unleashed. 

I wasn’t able to find any research directly linking dosing yourself with awe and brain health, but, clearly, it can’t hurt you, and it sure does feel good when it happens, so you might as well go for it!

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S3E1. Another Opening, Another Show

Welcome to Season 3! Where does the time go? And what on earth will this year bring?

For those of you who haven’t been following this blog from the beginning, here’s a little background. I began writing in December of 2020, at the age of 69, having discarded my latest career as a political activist and wondering what I would do with the rest of my life.

I must have been feeling a bit down, because the future I saw was one of either (1) a slow march towards my demise with the inevitable declines in physical and cognitive abilities that are part of normal aging or (2) developing a dementia—the greatest fear of pretty much everyone who makes it this far—and slowly disappearing into a living oblivion. My thought at the time was to document my decline—no matter which path it took—until I couldn’t write anymore. I thought there might be some value for others if I catalogued my mental slip-ups and tried to figure out whether they were normal or pathological, thus the title “Mistakes On The Journey To Nowhere,” with ‘Nowhere’ being either the vacuum of memory loss or death. Nothing hopeful or uplifting about that world view, eh?

Searching for content for my weekly essays soon led me to explore the research about aging and dementia, a topic I had pretty much ignored in graduate school when I was earning my Ph.D. in clinical psychology in the late ’90s. Much to my surprise (and relief!), I discovered that, although there is no medication that can effectively ward-off dementia, there are things you can do to minimize your risk of developing it. So my writing followed that thread, exploring and documenting the 5 pillars of brain health: diet, exercise, sleep, cognitive challenge and social engagement.

More recently, I’ve begun exploring what it is that actually goes wrong in the brain to cause it to break down as we age. Although I quickly get lost in the chemistry, I’m fascinated by the elegance of the various biological systems that have evolved to make this most complex and vital of organs work so effectively for as long as it does.

So if you haven’t been here from the beginning, now might be a good time to go back and check out the first two seasons. Here’s the link to the first episode: S1E1. Happy Box. At the end of each episode, you can scroll down to find the link to the next. It might make for some fun binge-reading on a long winter’s night.

So now I’m on the cusp of turning 72 and still writing a 750+ word essay every week. I suppose that’s fairly good evidence that whatever ‘senior moments’ I’m having are probably age-related and not indicative of anything more sinister. I can still think creatively, research, find words, spot errors and edit, avoid using the same words repeatedly, and put together a coherent narrative. So far, then, so good. And the simple act of doing so is good for my brain health as it presents a cognitive challenge for me each week.

Where will this blog go this year? I haven’t a clue! I’m not writing from some master plan or outline. Each week is an adventure and I don’t know what will tickle my fancy until I get there.

For example, this week I came across a fascinating video that explored the symbiotic relationship between glial cells and neurons. When we think of the brain, we normally only think of neurons, the sexy cells that link up with each other and communicate via electrical signaling to encode, store and retrieve our experiences. But it turns out that there are far more glial cells in the brain than neurons and that, among other things, they clean up the chemical detritus generated inside your skull as by-products of your immune system and daily wear-and-tear. Without these janitors, the gunk in your brain would accumulate until it snarled all your circuits and you succumbed to a dementia. Conversely, the glia are using all this neuron-related trash as food, so without neurons, they couldn’t exist. It’s a perfect symbiotic relationship…and watching the video left me in absolute awe that such a thing could develop over the millennia as we evolved from the first worms with a nervous system to the noble piece of work that is the human brain.

But then I started writing and, as you’ve read, I got sidetracked onto a brief review of the history of this blog and the story about glia was put on the back burner. Maybe, if I remember, I’ll get to it in episode 2. If not, here’s the link to the video: Meet Your Microglia.

I hope this has whetted your appetite for Season 3, even though neither you nor I know where this road trip will take us. In any event, I’m glad to have you riding shotgun!

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S2E52. The 2022 ‘Journey Awards’

The end of the year is traditionally a time to compile ’10 Best’ and ‘Best and Worst’ lists, so I thought I’d take a crack at it with some of the best and worst brain health events of the year for each of the 5 pillars of brain health. I thought about calling the list the ‘MOTYs’ for ‘Mistakes of the Year’ awards, but that didn’t seem to leave much room for celebrating the good news, so I went with the ‘Journeys’ instead.

Here they are:

1. Cognitive Challenge

There was plenty of competition in this category: playing computerized games on BrainHQ, traveling to foreign lands, reading books, writing this blog, and learning to play the recorder. As stimulating as they all were, I’m going with learning to play the recorder as the most rewarding cognitive challenge pursuit of 2022. It’s there for me nearly every day and it’s a rush to be able to play a piece or hit notes that I wasn’t able to master a month before. Learning to play meaningful melodies from across my lifespan never gets old. All in all, a pretty nice experience for a guy whose musical aptitude probably falls in the bottom twenty-five percent!

2. Exercise

One of my favorite lifetime brain health pursuits became an unexpected challenge. I was barreling along during the first three months of the year, working out 5-6 days/week, gaining strength, feeling great and losing weight. Then in April we went out to Minneapolis for the NCAA Women’s Basketball finals and I came down with COVID, which knocked me for a loop. It left me with a weakness that persisted for nearly 6 months. Working out was hard and definitely not enjoyable and I never got back into it consistently. My workouts now, when I do them, are shorter and slower. The weights I lift are lighter. So exercise definitely gets the ‘worst performance in a brain health pillar’ Journey Award for 2022.

3. Sleep

There really was only one contender for this award: my month-long experiment to change my circadian rhythm and sleep pattern in preparation for our Mediterranean cruise. It led to quite novel experiences, like going to bed at 6pm and waking up at 2am, but I think it worked. Upon arriving in Greece, I was tired pretty much when I was supposed to be tired and woke up within an hour of when I was supposed to wake up. The results, though, were somewhat confounded by the fact that I didn’t sleep at all on the plane and spent a couple of days recovering from that sleep deprivation. So now that I’ve figured out the circadian rhythm thing, I’ll have to work a little harder on the sleeping-on-the-plane thing next time we travel abroad.

4. Social Engagement

Thank goodness for Sally! She sets my social calendar and keeps me engaged. Without her efforts, I would definitely meet criteria for ‘hermit.’ But I don’t feel as though I’m meeting my obligations here. I enjoy being out with people and I enjoy listening to the conversations, but I’m finding myself talking less, so much so that Sally has commented on it several times. In fact, it’s gotten to the point that I’m not talking as much at home, either. I can’t quite put my finger on what it is. My mind is going all the time, I can hear just fine, I don’t have any word-finding difficulties and I have no problem following conversations. It’s just that I don’t often feel the need to say anything. Isn’t that weird? Becoming more subdued and withdrawn are often listed as warning signs of an impending dementia and fall under the category of ‘personality changes,’ so there’s that. Come to think of it, I get frustrated and irritated more easily than I did a year ago, so maybe this is something to keep an eye on.

5. Diet

This is a no-brainer: the 2022 Journey Award for best brain health dietary contribution goes to granola! (See S2E50: Granola Revisited). On the other hand, there have been several notable lapses in my regimen. I gave up overnight fasting, not for any empirical reason, but just because I lost the will power to do so once I reached my weight loss target. And now Sally and I are treating ourselves to an ice cream sandwich nearly every night. Again, no reason to do that except for the sheer delight of indulging in a guilty pleasure. This year’s Journey Award, though, for the biggest diet disappointment, was my attempt to drink a small glass of red wine with dinner each night. I conducted a noble months-long search for a palatable, organic pinot noir, but alas, to no avail. As good as it was, I just didn’t like it. And to make matters worse, even nursing a 4-ounce ‘dose’ left me a little tipsy. I reviewed the recommendations on drinking red wine and the bottom line was if you don’t already drink, then don’t start. In my case, it appeared that the neuro-toxic effect of the alcohol was greater than the augmentation of resveratrol effect. Since I eat red grapes every morning in my granola and I’m not a fan of supplements, I dropped red wine from the menu. 

And that’s my brain health year-in-review best and worst list, the 2022 Journey Awards.

Thank you so much for reading the blog. I hope it’s been helpful, interesting and/or entertaining. If so, I’d appreciate it greatly if you’d recommend it to your friends and family at www.MistakesOnTheJourneyToNowhere.com. It might be a nice change for them from bingeing on Netflix.

Wishing you a happy and brain-healthy New Year!

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S2E51. Cholesterol? Bah! Humbug!

What kind of a Scrooge blogs about cholesterol on Christmas Eve eve when he should be decking the halls, harking the herald angels and making spirits bright?

Uh…that would be me!

I didn’t plan it this way, it’s just that I had my annual physical last week and my cholesterol is high, so my primary care provider put me on a statin. Some holiday gift, eh?

I’m a bit befuddled by it all. In my late 50s, my cholesterol numbers were good, but of late, they’ve been hovering at the high end of the safe zone or a little above. I have no idea what changed.

About 2 years ago, I tried taking a statin and it worked. Shortly thereafter, though, I began my quest to lose 40 pounds and to eat a brain healthy diet, which includes foods to help control cholesterol. So I came off the medication and did the experiment to see if weight loss, exercise and diet could bring my numbers into line.

I’ve been eating all the right things for about 18 months now: almonds, olive oil, asparagus, beans, blueberries, tomatoes, avocados, cacao powder, eggplant, apples, and salmon. And then last year, I added oats, oat bran and oatmeal to my daily regimen. On the flip side, I don’t eat fatty meats, full-fat dairy products, or junk food, all of which can raise LDL.

I worked out religiously and lost 40 pounds.

I was pretty sure my behavior had earned me a spot on the lipid screen Santa’s “nice” list, but instead, I got coal in my stocking. 

Since it didn’t work, I did a post-mortem.

Getting COVID last April definitely threw a wrench into the works. It left me weaker and unable to do the intensity of workouts I had been doing up until then. To make matters worse, I went off my diet during our cruise last month. I’ve gained back 12 pounds.

I decided to face reality and accept the fact that I probably needed the medication, but there were still a few things that were confusing me, and I wanted some answers.

In spite of the overall bad news, there were two bright spots in my blood work. First, it appeared that my efforts had paid some dividends in terms of raising my good HDL cholesterol level. I had succeeded in raising it to 60 mg/dL, which is very good. Consequently, my LDL/HDL ratio was also an excellent 2.4. 

So I could make the case that the reason my total cholesterol had moved into the danger zone (219) was that my HDL had increased…which is a good thing. 

So why did I need medication?

I asked my PCP about it when we met and she explained that the American Heart Association developed a formula for predicting the likelihood of heart and vascular disease emerging within the next 10 years. It takes into account factors such as age, gender, smoking history, blood pressure and total cholesterol levels. Their guideline is that your risk factor should be below 7.5%

She typed my numbers into her computer and swiveled her display around to show me the results. My risk factor was at 16.7%.

I felt like I had just been visited by the Ghost of Christmas Yet To Come.

That sealed the deal. I’m now taking a statin.

What made the decision easier was that I had checked out the research on statins before going for my check-up. For several years, there had been concern that taking a statin could have a side effect of reversible cognitive problems. On the other hand, there were studies suggesting it could provide protection against age-related cognitive decline. So which was it?

A recent study appears to have resolved the conflict: the negative side effect is more likely to appear in those under 45 while the protective benefits seem to accrue to those over 65. 

What a nice stocking stuffer!

So why does someone interested in brain health care so much about cholesterol anyway?

There are about 100,000 miles of blood vessels in your brain and their primary job is to provide oxygen and nourishment to each and every one of your 100 billion neurons and 1 trillion glial cells. So you want to do your very best to make certain that nothing impedes the ability of those arteries to deliver their precious cargo. Cholesterol is the grinch in this story that can gum up the works by sticking to arterial walls and restricting blood flow which, in turn, damages or kills cells.

So now you know what I know.

And on that note, I’ll close by wishing a Happy Christmas to all, and to all a good night!  

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S2E49. Indelible Memories

I’ve written about the fickle nature of memories in S2E4: Memory is Overrated and S2E46: What Will I Remember?, but today I’d like to address the flip side of that coin: indelible memories.

The recent heart-wrenching announcement that Roberta Flack has ALS and can no longer sing brought up a fond memory of my brief encounter with the superstar in 1977.

I was the manager of Newark Symphony Hall, a 3,285-seat historic landmark theater in downtown Newark, NJ. It was a Saturday and the show that night was two up-and-coming soul artists: Phyllis Hyman and Peabo Bryson. 

There was a rumor going around that Mick Jagger and Roberta Flack might show up as they were both just across the river that night in New York City and were friends with Phyllis Hyman. It was just a rumor and I didn’t think much of it.

The show began a little after 8pm. It wasn’t a sell-out, but there was a nice crowd of around 1,800. It was about 20 minutes after the show had begun, the audience was seated, and I was talking with the doorman at the main entrance to the theatre.

Suddenly, a group of patrons presented themselves at the door, having come down from the balcony, probably trying to move to better seats in the orchestra section. It wasn’t all that unusual for people to do that and there were plenty of available seats, so it wouldn’t be a problem to accommodate them.

The doorman stopped them from entering and they were giving him a hard time, so I stepped in and tried to mediate. I told them that I’d let them in but they first had to show me their ticket stubs from their balcony seats.

Directly in front of me was a heavy-set African-American woman with her hair in dreadlocks wearing a floppy beach hat, enormous sunglasses and a white print muumuu. She kept shaking her head and saying, “I don’t believe this! I don’t believe this!”

I was in the middle of explaining it again when I heard the elevator from the balcony open and another group of people presented themselves. I looked up and saw Mick Jagger.

OMG! I immediately realized that I had been standing there arguing with Roberta Flack!  

I apologized profusely and led them all into the theater. She was kind enough to tell me not to worry about it and that it was no problem.

Once they were inside, I rushed to find my partner, Roberta, whom I had hired to be our house photographer, to tell her to be on the lookout for them and to get some pictures. She found them all backstage and took the picture of Phyllis, Roberta and Mick at the top of this post. (Note: email subscribers can click here to see the picture.)

But that’s not where the story ends. During Peobo Bryson’s set, Roberta ran into Mick standing all by himself, leaning against a colonnade at the back of the orchestra section, watching the show.

With all the confidence in the world, she went right up to him and asked if she could take some pictures. He said he was really tired, but she begged him—I mean, literally begged him—for just 1 minute of his time…and he agreed!

For 1 minute, it was just the two of them: he posing and making faces; she snapping photos as fast as her index finger could go. It was the dream of a lifetime come true for Roberta, albeit a dream she had never even dared to dream.

After the concert was over, she was packing her camera bag and getting ready to leave when she discovered that she hadn’t had any film in the camera during her exclusive photo shoot with Mick Jagger. She was inconsolable for days!

Postscript:

Two years later, Roberta and I were married on that same stage. There were no famous performers in attendance that afternoon, but the New Jersey Symphony Orchestra was and they played Mendelssohn’s Wedding March for us.

It’s now 43 years after that event and Mick is still performing, but Roberta passed away in 2010, losing her 3-year battle with cancer. Yesterday would have been the 49th anniversary of our first date which we always celebrated as our ‘traditional’ anniversary.

As I said, some memories are indelible.

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S2E48. Decision-Making

Judgment, problem-solving and decision-making are closely related activities that require a higher level of processing than, say, memory or attention, because they  require you to invoke a group of brain processes simultaneously.

To do these things successfully, you need to create and maintain a space in working memory where you pull-up and examine memories of similar situations and evaluate them for their relevance and importance to the question at hand. Frequently, you must do this under time pressure (which invokes processing speed) and in the face of strong emotions which obstruct the entire process by narrowing your ability to think things through.

Decision-making tasks activate both the hippocampus and the pre-frontal cortex, both of which are early targets of the dementing process. It’s no wonder, then, that we start making errors of judgment about the same time our memory starts to fail us.

A few weeks ago, Sally brought some breakfast pastries home from a nearby French bakery. Upon their arrival, I ate half the cheese danish.

Later that evening, I was craving something sweet and reached for the other half. I paused, though, because it is our custom to split delicacies like this and I had already eaten my half. 

Cue the decision-making process:

I knew this particular pastry was really good and I was not all that interested in the chocolate croissants she had also brought home. A vague ‘memory’ popped into my head that Sally didn’t really like cheese danish and preferred chocolate croissants.

“That’s what I’ll do!” I thought, “I’ll eat the rest of the danish and not have any of the croissants to make up for it.”

That, of course, was a bad decision, especially since Sally was sitting right there and all I had to do was ask her if I could have the other half of the danish. Somehow, I forgot to pull up the memory that says you let people decide for themselves instead of deciding for them.

A week later, I was making Sally a grilled cheese sandwich in the toaster oven. It was lightly browned on top which was exactly how she likes it, so I lowered the door and slid a spatula underneath one slice to remove it. Unfortunately, though, I only succeeded in sliding it to the back of the oven.

Using a potholder, I pulled the rack out a few inches and tried again. I got one slice out but then managed to push the other slice off the rack at the back of the appliance where it landed vertically on the heating element.

Smoke started to billow from the unit and I remembered thinking, “Oh lord, will it set off the smoke alarm? Will it blare throughout the building? Will the automatic sprinklers be triggered?”

I knew I had to act fast and decided that if I was really careful, I could reach in and pull it out, which is what I did. The melted cheese, though, was hotter than I anticipated, and my arm reflexively jerked as I was withdrawing it from the oven, tapping the hot metal for just an instant.

But an instant is all it took to singe my skin and leave a 1 inch burn on my forearm.

Once I had Sally’s sandwich safely removed to a serving plate, it dawned on me that there had been a pair of aluminum salad tongs in plain view, sitting in a crock not a foot away from where this all unfolded. How could I not have thought of using the tongs?

Hopefully, the burn has permanently seared that piece of learning into my brain for quick access next time.

As I write this, I’ve made another decision. This time, though, it was a deliberative process that unfolded across the span of a few weeks.

One day, Sally announced that she was going to get her hair cut short after having let it grow out during COVID. I joked that that meant I should get mine cut, too, for the same reason. But then I started to think seriously about it.

I recall making a decision when COVID hit between letting my hair go long or getting a buzz cut that I could maintain with my beard trimmer. It was a coin-toss decision then, but I decided, what-the-hell, Sally has never seen me with long hair and it might be fun to have a pony tail.

So that’s what I did. And although I liked the pony tail, I didn’t like the look when I ‘let my freak flag fly,’ which was exactly the look that Sally adored.

But when I look in the mirror with my hair flying in all directions, I didn’t see me. Add to that the shedding all over the apartment and the maintenance (I actually started to dread taking a shower because it took so long to shampoo and condition it), and the decision pretty much made itself.

So my hair comes off next week. We’ll use a longer attachment on my trimmer than I use for my beard and see how that works. It won’t take long at all for us to learn whether doing it that way instead of going to the barber was a good decision or not!

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S2E47. Guest Blogger: Sally!

Have you ever wondered what it’s like to live with someone who is semi-obsessed with brain health? Although she didn’t sign up for that job when we re-connected after 41 years in 2011, Sally has found herself in just that position over the course of the past two years. Although skeptical of my latest career tangent, she has shown amazing flexibility and acceptance of the path I’ve led us down. So I asked her if she’d like to write an episode of what it’s like to ride shotgun with me. Here’s what she had to say:

“who knew that wayne’s changing his behavioral and mental approach to brain health would have so many real benefits for my health, too?  

a once “i’ll-never-eat-that” food option is now one of my favorite side dishes. i’d previously tried kale in various iterations but never found it palatable. but that was before wayne discovered the magic of massaging it with a little salt and olive oil. what a difference! 

and then there’s quinoa, for which my attitude had always been: “just not gonna happen.” but lo and behold, now i really enjoy the nutty flavor and look forward to it in many dishes.  

kefir? it took me years to eat yogurt and this was a step beyond that. when wayne told me what it was, my gut reaction was: “no way.” it had no appeal for me whatsoever. but then he made some and now i eagerly enjoy it every night as our after dinner drink.   

we are on this journey together. as you know, his change in habits goes well beyond food. we’ve lowered the night temperature in the apartment, constantly evaluate the air for impurities, and have adjusted the darkness in our bedroom so as to promote better sleep.    

his recent experiment to change his circadian rhythm was so funny to watch! he religiously went to bed an hour earlier than the night before until he was going to sleep at 6pm and waking up at 2am. goodness! i would just shake my head and laugh as he said good night when it was still light out. luckily, my reading didn’t bother him and his turning all the lights on at 2 am didn’t bother me (i was in the bedroom and he in the living room). the reviews are mixed as to whether it was a successful venture, but it proved to me that this man will try almost anything to better his health and mind and soul.  

i never envisioned these kinds of changes in lifestyle but it’s about damn time!  exercising and eating healthy foods just makes good sense. and i love this man so i know we will continue to explore how to be healthy for as many years as we have left to us.” ***

Thank you…and back at ya!

But regarding the question of how many years we have left to us, she’s known my thoughts about that since our first date after re-connecting. We were both 60 at the time, and I asked her what she was planning on doing for the next 60 years. That makes it 11 down and 49 to go! She’s done well adapting to quinoa and kale, but I don’t think she’s quite wrapped her head around the idea of celebrating our 120th birthdays together!

*** Note: No, those are not typos in Sally’s essay. She has eschewed the use of capital letters ever since reading e.e. cummings when she was fifteen….and that was something I had trouble wrapping my head around when I was a freshman at Brown and reading her letters from home!

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S2E46. What Will I Remember?

About 25 years ago, when I was in my late 40s, my wife and I spent a week in Venice. Reflecting back on that trip, though, I only have a handful of memories…certainly not a week’s worth. Which makes me wonder: How much of our just-completed 12-day journey will I remember 25 years from now, when I’m 96?

I slept well every night with a lot of dreaming both on the trip and the week after, and I didn’t experience any anxiety or depression, so my brain has no excuse for not consolidating a lot of memories. 

I’m pretty sure I’ll remember that we visited Greece, Montenegro, Croatia, Slovenia and Italy, but the names of the ports are already eluding me. Without looking at the itinerary, I can name Athens, Santorini, Corfu, Dubrovnik, Zadar, Koper and Venice, but I already need help to fill in Katakolon and Kotor. I’ll be happy if I can recall 5 out of 9 a few years down the road.

One thing I know that I am certain to remember is tasting the fruit of a cactus that was growing alongside a cobblestone street. I picked one pod from a cluster and split it open with my thumbs to reveal its juicy, bright purple meat. It tasted bitter so one taste was enough. After dropping it on the ground, though, I noticed a smear  of juice on my hand and so I licked it.

BIG MISTAKE!

Immediately, I felt the prick of a hundred tiny needles all around my tongue and the inside of my mouth. Unseen by me, the fruit was protected by a legion of tiny spikes that had come off in my hand when I opened it. That one lick transferred most of them to my tongue. Lesson learned…and never to be forgotten! (On the walk back to the bus, our tour guide identified the plant. It was an aptly-named prickly pear cactus!)

On the other hand, I already can’t remember on which excursion it happened. 

I probably won’t forget the olive trees, which I had never seen before, that were as ubiquitous in Greece and Croatia as are vineyards in France and corn fields in rural Pennsylvania.

I tried to replay in my mind our tour of Lubljana, Slovenia, and did pretty well. Sally was impressed with the detail of my recollection. But I’m unable to recall the other excursions with as much certainty. A few images pop up, but I know that there is a lot I’m forgetting, and I have trouble connecting the images to the locations. Reminiscing with Sally should help remedy some of that.

Telling friends about our adventure should foster preservation of some memories. It will be interesting to see which experiences emerge as important enough to share.

The pictures we took will also help, but only if we look at them from time to time. The photos I’ve posted to the blog’s web site are the one’s I’m most likely to recall in the future because of their association with the blog in addition to the visit itself.

I’ll remember that the former Yugoslavia broke into 6 nations: Montenegro, Croatia, Slovenia, Macedonia, Serbia and Bosnia-Herzegovina. All 4 of the tour guides we had in the first 3 of those countries mentioned it and I realized that I was completely ignorant of that recent history, so I made an effort to commit it to memory.

I sat agape watching people walk by at the port in Kotor, Montenegro, stunned at their height. It turns out that they have the 3rd tallest population in the world. I felt like Gulliver in Brobdingnag…which should be unforgettable.

I’ll remember the rubbing alcohol taste and spreading warmth throughout my chest from drinking grappa. I won’t remember any of the paired wines from our gourmet on-board dinner.

I’m pretty sure I’ll recall the glass-making demonstration in Murano. We bought an art glass paperweight that is sure to remind us.

In all likelihood, though, I’ll forget the vast majority of the experience. Like my Venice trip a quarter of a century ago, there will probably be fragments, but not enough to conjure up the full 12-day trip.

Already—just a week since our return—much has faded. Memories are mischievously mingling and blending with one another, so I have difficulty sorting out what happened when and where.

But I’m going to try my level best to preserve the humbling awe I felt as I beheld the elegant majesty of the Parthenon, and the quiet thrill that surged through me as I stood on the starting line for the foot races at the original Olympic stadium where the games were held for more than a thousand years. 

I believe in the maxim that it’s not the destination, but the journey that matters. I’d like to augment that sentiment by suggesting that it’s not the memories (which can fade) but the experience (knowing that you did it) that really matters. And so I’m hopeful that a quiet warmth will still well up within me when I’m 96 and someone mentions Montenegro—even if I can no longer picture it in my mind’s eye—and I’ll smile.

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S2E45. Home Again, Home Again!

Greece, Montenegro, Croatia, Slovenia, Venice, West Chester, Pennsylvania!

As wonderful as the accommodations were on our trip, it was great to sleep in our own bed last night, especially after having woken up at 4am in Venice to begin the journey home.

4am in Venice. That’s 10pm in West Chester. It’s just mind-boggling that I had to get up at exactly the same time that I would normally be going to bed. 

The flights home were quite the challenge. Did you know that Venice airport is a ‘silent’ airport? No announcements over the public address system until you get to your gate. It was borderline serene walking through the terminal.

Our first flight was a 2½ hour hop to Heathrow Airport in London. We arrived on time, but due to a labor shortage, there was no one to connect the walkway to our plane, so we sat on the tarmac for half an hour…which resulted in our missing our connecting flight to Philadelphia.

Heathrow is a sprawling city. Once we got into the terminal, we had to take a bus, a tram, an elevator, 2 escalators and then walk about a quarter mile to get to our gate. The security lines were long and the technology to move through the various passport and boarding pass checkpoints confusing. Fortunately, though, signage was clear and we muddled our way through in our sleep-addled state.

Once aloft, I decided to sleep as much as possible on the 8-hour flight while Sally decided to stay awake the whole time. We arrived in Philly around 5pm and we both went to bed at 9pm. It will probably take us 2-3 days to get back into our normal routine.

Reflecting back, the journey was both a feast and an assault on our senses, cognitive abilities and biological rhythms. Just the thing the doctor ordered for dementia prevention!

The sights and vistas were breathtaking across the 5 countries we sampled, topped off by the 27-hairpin turn climb to the 3,000 foot view from a mountain top in Montenegro back down to our ship in the turquoise harbor below.

We discovered that sunrises and sunsets don’t get old, no matter where or how often they are viewed.

The various on-board lectures and tour guide narratives filled our heads with new information about the last 4,000 years of history across the region. By the time we did the tour of St. Mark’s Basilica in Venice, I just couldn’t absorb another byte of information. Fortunately, it was our last day.

Food was a ceaseless adventure. Between the on-board options (ranging from buffet to gourmet with paired wines) and the tastes of local cuisines on land excursions, our taste buds joyously put in a lot of overtime. 

Music was everywhere, from the guitarist in the nightclub to the Beatles songbook in the theater to the violin and cello duo in the atrium to the pianist in the lounge to the string septet concert in a 15th century church on the lagoon in Venice.

I’ve already described in depth the assault on our circadian rhythms as we adjusted to time zone changes. Add to that the assault on my gut biome that I believe was precipitated by my drinking caffeinated coffee every morning. After a few days, I was able to restore a bit of routine to my diet by replacing my usual breakfast granola with muesli and a plate of fruit. On the other hand, I continued to consume more sugar, flour, butter and bread than I had in months.

We didn’t have to worry about performing a lot of mental arithmetic to convert currencies as the euro and dollar are at parity right now. I was surprised, though, at the wide varieties of credit card readers that I confronted. Sometimes it took me a while to figure out whether to tap, swipe, scan or slide and where on the device to do it. Cashiers, though, were more than willing to guide me through it.

All in all, it was quite the adventure. We didn’t get lost during any of our free time (which surprised us) and we managed to muddle our way through every situation we confronted, even if it took us 2 or 3 passes to get it right.

To be honest, I’ve had enough neural stimulation in the last two weeks to last me for a while. I’m definitely looking forward to re-establishing my hum-drum routine and sticking with it…until the next time!

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S2E44. Greece!

We made it! We’ve spent the last several days island-hopping around Greece and as I write this we’re docking in Dubrovnik. I’ll be honest: I haven’t focused much (if at all) on brain health. I’ll assume you can understand why. Nonetheless, I’ll try to put together a few thoughts before heading out on our next excursion.

I felt I was prepared for the flight last Friday, having adjusted my sleeping and eating rhythms to accommodate 5 of the 7 hours we would cross during the flight. Serendipitously, Greece set its clocks back by one hour for daylight savings time the night we arrived, so I was gifted one more hour of transition time. What was left to absorb, then, was minimal: just 1 hour, or the equivalent of flying from Chicago to New York.

Unfortunately, I wasn’t able to get much sleep on the plane. I used a neck pillow, lavender oil, loose-fitting clothes, and I ate a banana, but all to no avail. The engine noise, fellow passengers conversing loudly, and the impossible task of getting comfortable all conspired against me. Consequently, I was not a happy camper the next morning when we landed in Athens.

The good news, though, is that I don’t think I felt any effect of the time zone changes. Once I caught up on my sleep, I was fine.

Sally, on the other hand—having not made any effort at all to prepare for the time-shift—was…fine!

It seems that for both of us, the quality of the previous night’s sleep was far more impactful than the 7 time zones we had crossed.

Traveling is a brain-healthy activity because it presents a variety of unique cognitive challenges. Going on a cruise provides those opportunities in spades.

First off, there’s getting oriented on the ship. It took me several days to figure out how to find the important locations: our room, the different restaurants, and the theater. Oh, you could find your way around by reading the signage, but I wanted to be able to do it on my own.

First, I figured out that the various restaurants, although they were on different decks, were all at the back of the boat while the theater and the main lounge were at the front. These landmarks replaced north (theater) and south (restaurants) in my personal navigation system. Then I noticed that the even numbered rooms were ‘west’ and they got higher as you traveled from ‘north’ to ‘south.’ So as long as I could keep an image in my head of where the theater was (‘north’), I could figure out where anything else was whenever I emerged from an elevator.

Conversely, after only 2 days, Sally just knew which way to turn to get to where we were going.

Then there are the excursions with guides who present volumes of information along the way, on-board lectures, adjusting to at least a dozen different accents spoken by members of the crew, and absorbing the sights and vistas themselves. Add to that sampling new foods and meeting new people and you’ve created an intense synapse-stimulating environment.

On the other hand, maintaining a brain-healthy diet just ain’t gonna happen! I’ve been like a kid in the proverbial candy store pigging out at the buffets on sweets, pastries, carbs, meat and more alcohol than I’d consumed in a very long time. Leafy green vegetables? Nope. On the positive side, I am eating a boatload of fish and I’m making an effort to dose myself with fruits every morning at breakfast. I’m not at all looking forward to stepping on the scale when we get home.

We walk a lot on our daily excursions. Even though I don’t find myself breathing hard, I’ll assume that I’m getting my 30-minutes of cardio every day. There is a ¼-mile jogging track around the boat and a fitness center with treadmills and resistance machines, but I’m tired enough at the end of the day without pushing my limits with intentional exercise.

So I hope you’ll excuse me if I leave it at that for now and get back to the task of thoroughly enjoying this trip. I know…it’s a tough job…but somebody has to do it!

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S2E39. The 50th Reunion

We were 21 and 22 years old. It was our last semester at Brown University. There were 7 of us: 4 girls and 3 guys. We shared the left half of a duplex at 43 East Manning Street in Providence, Rhode Island. It was 1972.

Five of us got together on Cape Cod this past weekend for our 50th reunion. We came from Oregon, California, Massachusetts, Connecticut and Pennsylvania. On Friday, we zoomed with the 2 missing classmates who live in New York and California. Although various combinations of us had gotten together over the years, this was the first time we had all been together since graduation day a little over half a century ago.

It was remarkably easy being together again in a shared living space. We brought photos and journals and letters we’d kept. We reminisced about how our group formed during the first 2 years at Brown, about our time on East Manning Street, and about the years since.

We shared memory after memory of our days together. Some of the stories were new to me. No one remembered everything. Some remembered more than others. 

Some memories were pulled into consciousness from the deepest of slumbers. Others were made richer and more complete by hearing different perspectives of the same event. 

There was one memory that only I of those who were there remembered. It was a sunny, crisp fall day during our sophomore year and we decided to walk to the Seekonk River which wasn’t very far away. On that afternoon, ripe milkweed pods were opening and the breeze was lifting the seeds out of their husks. Hundreds floated in the air all around us. It was snowing milkweed! I had never seen anything like that before, nor have I since.

I filled my pockets with the feathery fliers even though I didn’t know at the time what I would do with them. A few days later, I found a clear wine bottle and pushed them into it with a pencil. It was a sculpture…a work of art! 

I kept that bottle through the years, brought it with me to the reunion, and told the story of how it came to be. As I sat looking at it, the Jim Croce lyric “If I could save time in a bottle” popped into my head and I realized that that is exactly what I had done.

I have no pictures from that period, so looking through the albums was, to me, astonishing. My visual memories were weak, faded, and in soft focus. Looking at those surprisingly unfaded color photos was like dusting off my own history, restoring it, and mounting it on the wall. I had forgotten how young we were.

Paraphrasing Hillary Clinton, it occurred to me that it takes a village to not only make a memory, but to preserve it.

In 2001—29 years after our time together and 21 years ago—I had occasion to try to capture our experience on paper. Here’s part of what I wrote:

“It was a time of passions expressed and passions denied; a time of independence, intimacy, intensity, and insufferable debate…but never, ever, indifference…Did any of us know that in that shortest of times we had permanently stitched ourselves into the fabric of each other’s lives?”

We toasted the good fortune that first brought our unlikely band together and we toasted the serendipity that allowed us to celebrate it a lifetime later. As we did so, we made more memories to carry with us to a future reunion: walking on the beach, avoiding poison ivy in the cranberry bog, making dinners, eating ice cream in an old schoolhouse, listening to oldies, doing a pot gummy, and visiting with 2 other classmates who were in the area.

And, of course, we took lots of pictures to share with the pair who could not attend and to fill an album that will help preserve these new memories for all of us.

I don’t think anyone wanted it to end. We joked about having a 75th reunion, but quickly realized we would be in our mid-90s, and so we decided we might want to do this again a little sooner than that.

In 1973, just one year after we graduated, Marvin Hamlisch wrote and Barbara Streisand sang ‘The Way We Were:’

“Memories

Light the corners of my mind

Misty watercolor memories

Of the way we were

Scattered pictures

Of the smiles we left behind

Smiles we gave to one another

For the way we were

Can it be that it was all so simple then?

Or has time re-written every line?

If we had the chance to do it all again

Tell me, would we?

Could we?

Memories

May be beautiful and yet

What’s too painful to remember

We simply choose to forget

So it’s the laughter

We will remember

Whenever we remember

The way we were

The way we were”

But we didn’t forget the painful parts. It was a unique combination of laughter and sadness and youth and intimacy and time and place that created the unbreakable bonds that we still feel so strongly today.

And to answer the song’s question, yes…I would do it all again. In a heartbeat!

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S2E38. Dementia Prevention: Brain Games

The notion that playing brain games on your computer can help prevent dementia is rooted in the research on neurogenesis and neuroplasticity.

Neurogenesis is the process whereby you can grow new brain cells at any age. Neuroplasticity is the process whereby you can grow new connections between neurons.

In theory, then, anything you do that (1) grows new brain cells, (2) increases the number of synapses between neurons, (3) strengthens cells and/or (4) protects them from harmful chemical interactions should all help slow down the process of cognitive aging. The recipe is pretty simple: bulk up your brain mass while minimizing the things that can cause it to atrophy. 

But it’s not just a theory. The research supports this view.

Exercise grows new cells, increases synaptic connections and strengthens the quality of transmission of electric impulses from cell to cell by thickening the axon’s myelin sheath.

A brain healthy diet provides nutrients that support neurogenesis as well as antioxidants that help clean up neuron-killing chemical detritus (e.g., beta amyloid and tau) that are residuals of your body’s immune response (i.e., inflammation).

Sleep expels toxins that accumulate on a daily basis and also increases the strength of neuronal connections (synapses) which form long-term memories.

When we engage in cognitively challenging activities—especially new and novel tasks—we create more connections. That is why reading a book, learning to play an instrument or to speak a new language, and navigating around a different environment (e.g., traveling) are all brain healthy activities.

But what about playing computer games? The evidence is spotty, but it seems that there might be something there. Enough, anyway, to justify millions of dollars of new research to try to nail down just what it can and can not do.

In S2E29: Brain Training Is Hard Work! I discussed the intense effort I expended during my first week of working with the BrainHQ program. Now, 9 weeks later, I have some data I can report.

First, let me say that I over-did it. Playing these games for an hour each day was exhausting. However, it did allow me to quickly work my way through all 29 tasks covering 6 different functions: attention, brain speed, memory, people skills, intelligence and navigation. After 5 weeks, I dropped down to 30-minute daily workouts, which was much more manageable.

So how did I do?

The program provides you with a percentile ranking that shows how your performance compares to others in your same-age cohort. After 9 weeks, my scores have leveled off and I’m not seeing any more improvement. I placed at the 89th percentile overall among 71-year olds, with individual domain scores that range from the 86th to the 94th percentile.

What is valuable about this is that I now have a baseline measure of my mental status. Going forward, if I maintain my 89th percentile ranking relative to my same-age peers, it will mean that I am aging normally. If that number drops, it will mean that my cognitive decline is a cause for concern. If it goes up, it will be a cause for rejoicing as it will suggest that I am not experiencing the expected pace of cognitive decline.

That information has practical value, too. It appears that measurable and accelerating cognitive decline starts to appear about 6 years before a diagnosis of dementia is usually made. If I continue to play these games on a regular basis over the coming years, my scores should serve as an early warning system of any emerging cognitive problems.

The alternative, of course, is to get a full neuropsychological workup every year. Playing computer games is a lot cheaper and more fun, though.

The knock on using brain games to promote brain health is that, although you can get better at the games, your new learning does not generalize to everyday life and so it has no clinical or practical significance, even if your scores continue to improve.

This past Sunday, though, I actually had a real-life experience for which I directly attribute my success to one of the games I’ve been playing. 

In this game, designed to enhance your speed of visual processing, the computer screen is divided into 8 pizza slice shaped segments. Images of 11 birds are then briefly flashed all at once around the periphery. One of the birds, however, is different from the rest. For example, it might have a white body instead of a rust-colored body, or a white wing instead of a black wing. The task is to click on the slice of the screen where the odd bird appeared.

The more I played this game, the better I got. After a while, I was stunned at how accurate I was with only the briefest glimpse of birds on the screen.

Which raises the logical question: So what?

I’ll tell you what! Last Sunday, we were having breakfast at the home of Sally’s son and daughter-in-law. Tammy mentioned that she had seen a bird fly away from their backyard bird house, but couldn’t tell if it was a blue jay or a bluebird. 

As we stood around talking in the kitchen, out of the corner of my eye through the sliding glass doors I saw the flash of a bird in flight. It was only a flash of color that lasted less than a second, but I was able to process its shade of blue and size, realizing immediately that it was a bluebird.

Impressive, huh?

Then we moved outside to eat breakfast. While we were seated around the table, Sally’s grandson Ryan (who recently graduated from college) brought out a bottle of champagne to make mimosas. When he popped the cork, it rocketed through a gap in a vine-covered fence and landed on the lawn beyond. I was the only one who saw where it went. 

Pretty cool, eh?

OK. So it’s no big deal…but it does suggest that something good is happening inside my head thanks to my computer game playing. 

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S2E37. This Is Your Brain On Pot

In the interest of full disclosure:

I first tried pot at the end of my freshman year at Brown. The following semester was when I indulged the most. I was not considered a ‘head’ or ‘freak’ by any stretch of the imagination, but I would take a hit when offered and my longish hair and goatee fit the profile of those who merited an offer. 

I was terrified of getting busted, so I never bought any of my own, but always made contributions to the kitty. 

There was no real research about marijuana usage at the beginning of the 70s, just strong opinions based on folklore and urban legend. ‘Reefer Madness’ taught us that pot was a gateway drug to heroin, but whenever someone told me that junkies started with pot, I’d reply that pot users all started with milk. End of conversation!

I smoked enough to have a decent complement of weed stories to tell over the course of the coming decades, but I cut back dramatically during the second half of my sophomore year when I had a close encounter with depression and my therapist advised me to give it up.

I used pot sporadically over the course of my last two years at Brown as I settled on beer as my go-to party drug. In the 50 years since graduating, I think I’ve gotten high maybe 15 times, at most.

Which brings us from the 70s to my 70s where the marijuana world has changed dramatically.

Pennsylvania has legalized cannabis for medical use and so Sally got a prescription to treat her insomnia. For reasons unknown, edibles are not offered in PA, so we drive over to New Jersey where both medicinal and recreational pot is available, including edibles in the form of gummies. Would it surprise you to learn that we picked up some recreational edibles while we were there?

Getting high is different from what it was lo those many years ago. Don’t get me wrong. It’s still fun: music packs a strong emotional wallop, ripples on the surface of the pool are infinitely interesting, and the food is…well…you know!  Nonetheless, it’s different. It’s no longer part of a cultural movement. It doesn’t hold the same promise of self-discovery and revelation.

And some things just plain suck. For example, back in the day, you’d start to tell a story and then forget what you were going to say. That didn’t happen when you weren’t stoned and so it was really funny when it did. Now, though, I can lose my train of thought when I’m stone-cold sober, which is irritating enough, but when it happens while I’m trying to have a good time, it really pisses me off!

There was concern back in the day about possible long-term cognitive effects of regular marijuana use, but the research hadn’t been done yet. Fifty years later, there is still a dearth of information, but a few studies stand out.

Long-term chronic use is associated with reduced prefrontal brain volume. Heavy use has also been found to lower cognitive performance among teenagers several weeks after their last high. However, it appears that the effects of marijuana use among older Americans have been largely ignored. A 2019 review of the literature summarized the thin evidence this way:

“Marijuana (with chemical compounds THC and CBD) causes impairment in short-term memory; increases heart and respiratory rates, elevates blood pressure; and contributes a fourfold increased risk for heart attack after the first hour of smoking marijuana. These effects may be pronounced in older Americans with compromised cognitive or cardiovascular systems.”

These effects, though, are experienced while you are stoned. There is next to nothing to be found about long-term effects on the brain. Interestingly—and counter-intuitively—there was one study I came across suggesting that marijuana use might be helpful in recovering from brain injury, as it appears to have neuro-protective qualities!

Other articles mentioned the problem of driving under the influence because reaction times are impaired which leads to more accidents, as well as the respiratory problems associated with smoking pot which, while not as damaging as cigarette smoke, are still rough on your lungs.

So what’s a Baby Boomer to do? 

First, edibles appear to be easier on your body than smoking weed, but it will take a lot longer to get high, so be careful about dosing. 

Second, don’t drive or operate heavy machinery while stoned! 

(Learn more about these 2 points here: https://www.nytimes.com/2022/04/12/well/live/driving-while-high-marijuana.html )

Third,  although ‘chronic’ usage (apparently more than 16 times per month) has been shown to be harmful, there are no reported studies about occasional use. That doesn’t mean that it’s not bad for you, it just means that it hasn’t been studied. But if you have to choose between alcohol (which is a known neurotoxin) and marijuana (which isn’t), well, that appears to be a no-brainer. 

Of course, you always have the option of abstaining from mood-altering chemicals altogether, which is probably the safest position you can take when it comes to maintaining brain health.

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S2E35. The Fog Of Memory

It was the spring of 1986. I had quit my job in Newark, NJ, and we had moved out to Tyler Hill, PA, where we were renovating an 1847 farmhouse with plans to open a B&B by the 4th of July weekend.

I was in one of the bedrooms on the 2nd floor where I was removing more than a century’s worth of floral print wallpapers. The work was slow and painstaking, first soaking small sections in a solution of vinegar and water and then scraping it carefully so as not to gouge the plaster beneath it.

It was also pretty mindless. After a while, I started to replay memories. I was 35 at the time, so my just-ended career in Newark, high school and college years, and growing up were not all that long ago.

I seemed to be watching the movie of my life playing in reverse. The farther back I went, the faster the reel seemed to spin, until I saw my baby pictures in my mind’s eye and the movie ended.

I felt inexplicably exhausted, so I lay down on the floor and closed my eyes…and a feeling of relief swept over me. Suddenly, I felt unburdened by my past and all the emotional baggage that came with it.

I soon realized that all those memories were no longer as close and vibrant as they had been just a few moments before. It was as if I had packed them all into boxes and moved them up to the attic. 

Whatever happened that day was not intentional on my part, but it seems to have repeated itself every 10 years when I switch careers. It’s as if I hold on to a ton of potentially relevant information in case I need it, but then put it into long-term storage as soon as I don’t.

It happened again last year when I ended my 10-year career volunteering for the Democratic Party. No sooner had I quit as chair of the local organization than my memories of a decade’s worth of campaigning became remote. They had joined the previous sixty years worth of boxes in the attic of my mind, in a place that I refer to as ‘ago’ to differentiate it from the here and now. 

I envy people who say they remember events as if they were yesterday. I have no such ability. When I rummage around in one of those boxes, my recollections appear as photographs, not movies. And they are definitely not high-def! Many have shifted perspective, so I have a bird’s eye view instead of my actual eye-witness perspective. 

Many memories have been replaced by memories of the photographs of those events which I’ve viewed over the years. It’s a poor substitute, but it’s all I’ve got at this point.

Although I can’t conjure up strong visual images, I have detailed memories of the stories I’ve told about those long-ago events. My semantic memory (i.e., the facts surrounding events) is much stronger than my visual recollections. Auditory memory is pretty much non-existent.

Occasionally, strong emotional memories will surface. A feeling—sometimes triggered by a smell—will overwhelm me. I can’t always place it, but it’s familiar…and usually warm and pleasant.

I remember myself through a fog. I can still make out the shapes of my past, but they’re distant. I know that all of these things are part of me, but I just can’t see them all that well, even though I can describe them in great detail.

I have no idea whether this is normal or not. I don’t think it’s gotten worse with age. I think I’ve always been like this…but I’m not sure because I don’t think I thought about it when I was younger.

Which makes me wonder where it goes from here. 

I’ve been watching a series of lectures on the ‘Joy of Mathematics’ from TheGreatCourses.com. I remember loving math classes in high school and being good at it. I remember the joy of solving equations. I graduated from Brown just 2 courses short of meeting the requirements for a degree in math.

Yet watching these lectures has shown me that the lion’s share of all that learning and studying is completely gone from my memory. I know: use it or lose it. But it still seems a shame. And it raises the specter of vast stores of memories falling into a black hole from which there is no recall.

That possibility makes even foggy memories look really good by comparison!

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S2E33. How To Keep Your Brain Young

I stumbled across a book referenced in an article I was reading and was intrigued by the description of the author: “Professor Kerryn Phelps AM, Australia’s most trusted GP.”

Interesting! A book about brain health by a general practitioner and not a neurologist or neuropsychologist? A consumer of research instead of a creator of research? And from Australia? Because of these anomalies, I wondered if her perspective would differ from everything else I’ve been reading written by Americans with more traditional backgrounds…so I read her book, How To Keep Your Brain Young which was published last September.

Some differences were immediately apparent, such as the spelling of words like ‘foetus’ and ‘coeliac disease.’ When citing research studies, she tends to reference where the work was done instead of the authors’ names, so you come across things like, ‘in a study done at the University of Sydney…’ She seemed to prefer citing work done in Australia, and that was layered on top of references to Australian epidemiological studies and policies of Australian public health agencies. All in all, it was refreshing to see the view from down under.

The most striking thing about this book, though, is the range of topics covered. Although any book about brain health will necessarily cover dementia-related topics, Professor Phelps goes above and beyond in cataloguing the wide variety of things that can affect one’s brain health over one’s lifetime. You might expect a cradle-to-grave approach, but she goes beyond that, not just to pre-natal concerns, but all the way to pre-conception factors that might affect the brain-in-waiting!

Her thoroughness is carried throughout the book with an attention to detail that could only be rooted in the curiosity of someone who found every fact about the brain to be enormously fascinating. She begins with a description of the various brain structures, their functions and the neurotransmitters that drive the system. I have to admit that if I was not already well-versed in those topics, I would have found it very difficult to follow. It’s not that she uses a lot of technical jargon, but that she presents the information in a rapid, unadorned format. ‘Just the facts, ma’am,’ as Sergeant Joe Friday used to say. Her writing is unembellished. There are few anecdotes and personal reflections. There is no poetry in her prose. She writes like a GP speaks: ‘Here’s what the tests show and here’s what you can do about it. I’ve written you a prescription.’

Nonetheless, it’s riveting and breathtaking in its scope. There are short chapters about virtually all the things that can affect your brain in a lifetime, including alcohol, medications, chemotherapy, smoking, anesthesia, gluten, glucose, blood pressure, street drugs, menopause, stress, depression, your gut biome, stroke, brain injury and brain cancer. Factors that don’t merit their own chapters are covered in the chapter on dementia. Oddly, though, she doesn’t address air pollution, toxic chemicals or pesticides.

I thought the best line of the book came in her summary of the effect of using methamphetamines. After detailing all the different ways it kills neurons and affects brain function, she dryly remarks that ‘it really doesn’t have a lot going for it.’

After detailing what proper brain function looks like and inventorying all the things that can go wrong, she settles into a discussion of the things you can do to protect your most valuable organ throughout your lifespan, or as she puts it, ‘how to keep your brain young.’ There are chapters dedicated to cognitive challenge, exercise, diet, supplements, social connectedness, relationships, sleep and mind-body therapies. She also includes a chapter on the brain-enhancing properties of pets, which is something I hadn’t come across anywhere else.

Professor Phelps closes the book with a lifetime prescription for protecting your brain and preserving its performance. It comes down to avoiding brain injury, exercising, optimizing your diet, controlling your blood sugar, managing cholesterol, improving your gut health, controlling your blood pressure, building and maintaining social networks, sleeping soundly, stimulating your mind, taking care of your emotions, being cautious with prescribed medications, avoiding illicit drug use, not overusing alcohol, never smoking, and considering using supplements and herbs.

It seems like a lot until you realize that you’ve got a whole lifetime to figure it out. Obviously, the earlier you start, the better off you’ll be. Nonetheless, the research says that benefits will accrue no matter when you engage.

So, to answer my initial question, the view from down under is pretty much the same as it is from here in West Chester, PA!

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S2E28. Working Memory Workout?

A majority of the mistakes and cognitive errors that I have documented in this blog involve failures of working memory. Working memory is where we hold information online while we manipulate it and/or consider what to do with it. It’s where we hear our internal voice. It’s the central cog in our executive functioning network.

Consequently, it’s not pretty when you start to experience declines in your working memory abilities which, as it so happens, are usually the first to go as we get older.

So I was intrigued by an article in The New York Times last week that reviewed a new book (The Complete Guide to Memory: The Science of Strengthening Your Mind) by neuroscientist Dr. Richard Restak in which he asserts that exercising your working memory can forestall its decline and possibly even restore prior losses. The article covers his 7 key recommendations and you can read it here.

Regular readers of this blog know me well enough to figure out that I downloaded the book and read it this week. It reviews all the usual types of memory and he adds a few new ones of his own construction. He pays more attention to brain structures than most books of this type, but he keeps his narrative breezy and conversational, including examples ‘ripped from the headlines,’ as they say.

He recounts the usual litany of techniques you can use to better remember lists, but I was most intrigued by his lengthy discussion of working memory and exercises you can do to actually strengthen it.

One such exercise was to name all of the United States presidents in chronological order, beginning with FDR. Then do it in reverse order. Then do it alphabetically. Then do it in reverse alphabetical order. If you want to try this, I’ll give you a hint: there are 15 of them.

It took me a little while one sleepless night to master this task. As I did so, I felt like I could actually see the places where my working memory let me down and where answers were swimming nearby but just out of awareness.

He recommended making other lists that you can manipulate in similar ways, and to practice organizing them in your mind every day. 

He also recommended daily practice with what is known as the ‘N-back task.’ The easy-to-do-at-home version of this only requires a deck of playing cards. First, you select two cards that will be your ‘trigger’ cards, say a ten and a three. Then you turn over the cards one by one, look at them, and place them face down in a pile. When one of your trigger cards appears, you have to name the card that preceded it. This is the ‘1-back’ version of the task. After you’ve mastered it, you can make it more difficult by trying to name the card that was two cards before the current card, or ‘2-back.’ 

I immediately pulled out a deck of cards and tried it…and failed miserably at the 2-back version. I did alright with the 1-back version, actually having the most difficulty remembering which were my 2 trigger cards!

This piqued my interest in working memory tasks and so I googled it. I discovered quite a number of sites offering (for a subscription fee) computerized versions of a wide variety of working memory tasks. 

I tried a number of them and quickly discovered how limited my working memory is. I was especially bad at tasks that required me to remember visual images. In fact, I noticed that I retained virtually no memory of the images and had to resort to semantic memory to complete the task, i.e., naming the images that had flashed on the screen and remembering the names, not the pictures.

Neuropsychological tests are very good at isolating and identifying your weaknesses, and these were no exception.

Dr. Restak talked about my condition in his book. It’s called ‘hypophantasia’ which is the inability to retain fleeting visual images in your mind’s eye. Conversely, people who are exceptionally adept at doing this have ‘hyperphantasia.’ My first wife was such a person. She could walk through someone’s house once and later draw a diagram of all the rooms on every floor…to scale! Most of us have abilities that fall somewhere along this spectrum from hyper- to hypophantasia.

This experience alarmed me enough to want to initiate a structured workout routine to try to improve (or at least slow the deterioration) of my working memory. My recollection, though, was that—Dr. Restak’s exhortations notwithstanding—the research is mixed about whether computer games and tasks can actually improve your cognitive abilities. In most cases, it appears that you can get better at the computerized task, but that it doesn’t generalize to improve your ability to perform other tasks of daily living. What was I to do?

Right on cue, I received an email from one of my college roommates, Tom, with an article from The Boston Globe about several large-scale, age-related cognitive studies that are being launched in New England. Among the variables being tested are brain training techniques. The program offered by a company called BrainHQ will be used in these studies.

Well, if it’s good enough for the researchers, then it’s good enough for me! So I went to www.BrainHQ.com and subscribed for a year for $96.00. My intention is to do a 1-hour workout each day…if the frustration from getting too many wrong answers doesn’t overwhelm me.  

Wish me luck!

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S2E26. Losing My Mind

“Every day is new now, with little remembrance of the day before, but with enough memory retained to know there was a yesterday. This is a new way to live and it takes getting used to.”

Thomas DeBaggio, author of the above quote, was diagnosed with early onset Alzheimer’s in 1997 at the age of 57. His book detailing the progression of the illness (Losing My Mind: An Intimate Look At Life With Alzheimer’s) was published in 2000. He went on to write another book in 2002 chronicling his life with dementia, and became a tireless advocate for Alzheimer’s research. He passed away in 2012.

Up until now, all of my posts have focused upon discerning the difference between normal age-related errors we all make and the more problematic mistakes associated with the onset of dementia, as well as preventative measures we can adopt to try to dodge the illness which affects about half of those who make it beyond the age of 85.

Reading this book last week, however, was my first road trip into the world of life with dementia…and it was sobering. 

The book is presented as a braid of three interwoven threads. Fortunately for us, DeBaggio’s first love was writing. He was a journalist before settling into his career growing and selling herbs, which also led to his writing about that experience.

The book is not written in chapters. Instead, paragraphs alternate between the three threads. It’s a surprisingly effective technique that captures the essence of the relentlessly vanishing world in which he lived.

The first thread is his biography. Reading it, I wondered if he wanted to leave a trail he could follow to find himself once his memory of his own personhood failed him. A noble effort, for certain, but doomed to failure as the disease progresses inexorably through its mind-sucking stages which would ultimately rob him of the ability to understand that the story he had penned years before was about him. 

The second thread is a description of his current status as it unfolds over the course of his first three years living with Alzheimer’s. At this point, he still has the introspective awareness to be able to recognize when he is making a mistake or losing a cognitive capacity or experiencing something new and unfamiliar. It is here that I am most thankful for his literary skills…which makes it all the more painful to travel with him as he loses access to his words and to the thoughts that he can’t pin down and retain:

“There is a dullness in my brain now to allow me to stare into silence without an idea or thought breaking the stillness.”

Juxtaposed against his past and his present (and looming future) is a summary of his research into Alzheimer’s disease circa 1999. He details the state of the research with excerpts from scholarly publications. It soon becomes frustratingly apparent that there has been very little progress in the past 22 years.

I’m glad I read this book as it helped better define for me the seamless spectrum that runs from the errors of normal aging to indications of cognitive decline to the early experience of dementia. It’s the transition from making errors that are irritating but readily resolved to awareness of problematic thinking that has real-time consequences to the loss of control of your inner dialogue.

Thankfully, I’m still in pretty good shape. When I woke up Thursday morning thinking about how I would end this episode, I was able to table my ideas and return to them after breakfast without any problem. 

My thoughts don’t simmer in a quantum soup where they live lives measured in nanoseconds and their very existence is always uncertain. 

My computer’s spell-check isn’t working overtime to try to figure out what it is I really meant to type.

I’m nowhere near traveling DeBaggio’s path, yet I am grateful to him for illuminating the way.

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S2E25. The 10 Warning Signs of Alzheimer’s

I’ve been blogging for a year and a half now and, surprisingly enough, have yet to delve into the early symptoms of dementia in their entirety. I’ll correct that oversight below, but before I do, I’d like to add a little perspective.

When you go through the list below, I think you’ll agree with me that there has already been a significant cognitive decline by the time you experience those kinds of problems. Given that we have no treatment that can reverse the effects of dementia, the primary value of diagnosis at that point would seem to be to initiate the transition to some form of assisted living, whether it be in a facility or via support provided by your family.

But there is another really good reason for getting checked out. It’s very possible that the cognitive mistakes you are making have a cause other than dementia. In particular, depression, sleep disturbance, stress and medication interactions can all generate symptoms that mimic dementia. There is great value, then, in ruling out these other causes before you start to fret over beginning your long goodbye.

Having said that, I hearken back to my original intent in writing this blog which was to try to identify indicators that you were slipping well before you get to the debilitated state described in the ‘warning signs’ below. My hope was that perhaps an extra year or two of awareness would give you time to make lifestyle changes that might slow the progression of the illness. What I’m searching for is cognitive errors (my ‘mistakes on the journey’) that are more worrisome than ‘normal aging’ yet not as debilitating as a ‘warning sign.’

As for now, it appears that dementia-related errors are (1) more frequent and (2) more disruptive than those found in normal aging. It’s a fine line, indeed.

With that in mind, I joined a webinar this past Tuesday presented by the Alzheimer’s Association (www.alz.org) titled ’10 Warning Signs of Alzheimer’s’ in hopes of hearing about more subtle indicators of an approaching dementia. 

Spoiler alert: I was disappointed. The material covered was no different than that already posted on their website and, in fact, utilized the same slides. So rather than provide a summary of what I learned, it makes more sense for me to just present the information directly from their website, as I really don’t have anything to add. These are the best guidelines we as laypeople have to differentiate normal aging from dementia. The take-home message is this: If someone you know is exhibiting one or more of these symptoms, it’s probably time for a full diagnostic evaluation.

Here are the 10 warning signs:

1. Memory loss that disrupts daily life.

One of the most common signs of Alzheimer’s disease, especially in the early stage, is forgetting recently learned information. Others include forgetting important dates or events, asking the same questions over and over, and increasingly needing to rely on memory aids (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own.

What’s a typical age-related change?
Sometimes forgetting names or appointments, but remembering them later.

2. Challenges in planning or solving problems.

Some people living with dementia may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before.

What’s a typical age-related change?
Making occasional errors when managing finances or household bills.

3. Difficulty completing familiar tasks.

People with Alzheimer’s often find it hard to complete daily tasks. Sometimes they may have trouble driving to a familiar location, organizing a grocery list or remembering the rules of a favorite game.

What’s a typical age-related change?
Occasionally needing help to use microwave settings or to record a TV show.

4. Confusion with time or place.

People living with Alzheimer’s can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.

What’s a typical age-related change?
Getting confused about the day of the week but figuring it out later.

5. Trouble understanding visual images and spatial relationships.

For some people, having vision problems is a sign of Alzheimer’s. This may lead to difficulty with balance or trouble reading. They may also have problems judging distance and determining color or contrast, causing issues with driving.

What’s a typical age-related change?
Vision changes related to cataracts.

6. New problems with words in speaking or writing.

People living with Alzheimer’s may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have trouble naming a familiar object or use the wrong name (e.g., calling a “watch” a “hand-clock”).

What’s a typical age-related change?
Sometimes having trouble finding the right word.

7. Misplacing things and losing the ability to retrace steps.

A person living with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. He or she may accuse others of stealing, especially as the disease progresses.

What’s a typical age-related change?
Misplacing things from time to time and retracing steps to find them.

8. Decreased or poor judgment.

Individuals may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money or pay less attention to grooming or keeping themselves clean.

What’s a typical age-related change?
Making a bad decision or mistake once in a while, like neglecting to change the oil in the car.

9. Withdrawal from work or social activities.

A person living with Alzheimer’s disease may experience changes in the ability to hold or follow a conversation. As a result, he or she may withdraw from hobbies, social activities or other engagements. They may have trouble keeping up with a favorite team or activity.

What’s a typical age-related change?
Sometimes feeling uninterested in family or social obligations.

10. Changes in mood and personality.

Individuals living with Alzheimer’s may experience mood and personality changes. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, with friends or when out of their comfort zone. 

What’s a typical age-related change?
Developing very specific ways of doing things and becoming irritable when a routine is disrupted.

If these are the 10 criteria by which we are to measure our cognitive health, then I passed my 71½-year check-up with flying colors!

The only item that is close to raising a warning flag is #9: Withdrawal from work or social activities. As Sally has pointed out, I’m not as talkative as I used to be and now have a tendency not to participate in conversations. But it’s not because I’m not following along or can’t find the words or put together a sentence. I would describe myself in those situations as being comfortable and attentive, albeit not actively engaged. To the extent that my silence might represent a precursor to the development of poverty of thought, though, it’s worth keeping on eye on.

So I’ll take my current mental status as a win…and continue to search for earlier warning signs of dementia.

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