S2E4. Memory Is Overrated

Lisa Genova is a neuroscientist and author. If you’ve heard of her, it’s probably because she wrote the book “Still Alice” which was made into a movie starring Julianne Moore (who won the Best Actress Oscar for her portrayal) and Alec Baldwin. It was the story of a linguistics professor who develops early onset Alzheimer’s.

Now she’s written another book titled: “Remember: The Science of Memory and the Art of Forgetting.” I read it last week and I recommend it to you. It’s an extremely helpful guide to understanding what memory is and what it is not. This, in turn, provides insight into what changes in memory are normal—and which are not—as we age.

She writes in a breezy, conversational style and makes even difficult topics readily digestible, resorting to jargon only when absolutely necessary. Here are some take-aways:

For starters, we don’t remember everything. We just remember important things. That’s why you probably don’t remember what you had for dinner a week ago Tuesday (unless it was your birthday or anniversary). Even with our brain’s enormous storage capacity, it wouldn’t take long to overwhelm it if we retained everything we experienced, every word we read or heard and every thought we ever had.

In order to remember something, we first have to pay attention to it. Let’s say a truck goes by but you don’t notice what is advertised on its side. You can’t possible remember it later because you never paid attention to it in the first place. As a result, many of the events we label as forgetting are more likely to be things that we never attended to in the first place.

But it’s not enough to just pay attention. You need to react to it, experience an emotion about it, think about it, and link it to previous memories. This is called ‘encoding.’ Fortunately, this process is largely automatic, unless, say, you’re trying to learn a lot of facts for a test. Then rehearsal and other memory tricks (like mnemonics) might be necessary to encode the information.

Attention and encoding alone are still not sufficient to form a memory. You also have to store it. This is where the hippocampus comes into play. It’s the part of the brain essential to lock-in the neural connections that are created when you experience something. This consolidation mostly happens during sleep when strong connections from the day (i.e., those that are in some way meaningful) are stored in memory and weak connections (i.e., incidental inputs that aren’t very relevant to your life) are dismantled and forgotten.

Finally, assuming you’ve paid attention, encoded and stored an event or fact, it doesn’t do you any good unless you can retrieve it from memory. Most of us know this one all too well. That tip-of-the-tongue experience where we know that we know the answer, but just can’t find it. The memory must be relatively strong for us to recall it without any additional cues or hints. That’s why it’s a lot easier to spot the answer when it’s presented in multiple choice format.

Those are the essentials of memory formation, but they don’t tell you anything about the quality or accuracy of those memories. It turns out that our brains do not work like cameras or tape recorders and do not store digitally precise representations. What we encode is unique to each of us as it is linked to our previous experiences and memories. That’s why you can get contradictory eye-witness reports of the same event.

To make matters worse, our memories tend to warp over time and to be changed by later experiences. In fact, each time you tell a story, your memory of it changes a little bit. After a while, your memory can shift from your visual point of view to that of one observing the entire event with you included in it. (I described this in S1E15: Vivid Memories That Aren’t).

There are also different kinds of memory, each with its own separate pathway. Episodic memory is the record of things you have experienced or done. Semantic memory records words and facts. Muscle memory stores physical routines like how to eat with a fork, walk and ride a bike. Muscle memories are among the last to leave us in late stages of dementia.

The type of memory I think we have the most trouble with is prospective memory. This is remembering to do something in the future, like going to the supermarket to buy milk. Haven’t we all thought about an errand we needed to run but then realized at the end of the day that we hadn’t done it? Or, in the example of going shopping above, bought everything else but the milk?

Knowing that memory is so fickle makes it a lot easier to understand and accept the memory mistakes we make as we get older…the kinds that are normal. I think we have a tendency to put memory on too high a pedestal and then beat up on ourselves when we fall short of the unwarranted ideal we’ve created. Don’t get me wrong: memories are very much who we are and I sure as hell don’t want to lose mine. But it’s ok not to remember things going forward because a lot of what happens is not new, novel, important or noteworthy. After all, we’ve seen and been through a lot! 

Or maybe we were distracted or otherwise occupied and just didn’t pay sufficient attention to it when it happened. I’m guilty of this one a lot. Sally will tell me something while I’m engrossed in a puzzle. The odds of my remembering it are not good.  šŸ˜¦

The last chapters of the book are devoted to explaining how memories can be eroded with normal aging and in dementia, along with techniques you can use to eliminate a number of memory errors. First and foremost: make lists. There is no shame in making a list, and just the act of writing the item down makes it more likely you’ll remember it without looking at the list!

The author is not a big fan of doing crossword puzzles which, she believes, only tap into stored knowledge. She much prefers that we allocate our cognitive challenge time to learning new skills because these will grow the most new brain cells and synapses. 

There’s a lot more in the book, but I’ll stop there. Here’s a link to a 14-minute TED Talk she gave which covers a lot of the same material.

Please don’t forget that you want to watch it!

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S2E3. Another Year Older

Yesterday was my birthday. The Big Seven-One. Not that there’s anything special about being 71, but it’s as good a time as any to record some data for my ongoing experiment (see S1E3: ‘My Life Is Now An Experiment’) and reflect upon the changes that have occurred over this past year.

I had just begun writing this blog when I turned 70. My mood was often down as I contemplated the coming decade of cognitive decline (if I was lucky) or dementia (if I wasn’t). What a difference a year makes! Diving into the research to get background information and context for my weekly posts, I soon discovered (to my great delight) that there were things I could do to influence the path my aging brain would take. It changed the focus of this blog from a death watch to a celebration of the emerging science that gives us all hope.

It was around May that I started exercising. Yesterday, I completed my 21st year toward meeting my 30-year goal of being able to jog 2 miles when I’m 80 (see S1E21). Only 9 years to go!  

On the downside of that accomplishment, though, I noticed that my speed has dropped pretty dramatically. It was just 6 years ago that I was running 5K races at a 10 minutes/mile clip, which was my normal jogging pace. Now, on the treadmill, a decent pace for me is 13 minutes/mile. I can go 4 miles at that speed with my pulse at a comfortable 139 beats/minute. I can’t, however, even fantasize about kicking the treadmill speed up to 10-minute miles. This is in no way surprising as I know that we slow down as we age, but it’s a bit of a shock to see the numbers in such stark relief.

Around mid-year I changed my diet, incorporating brain-healthy foods, and I began my quest to lose 41 pounds (S1E29). Yesterday, I weighed in at 146…just 1 pound short of my goal.

Cognitively, I think things have actually improved. Is that even possible? Oh, my thoughts still pop in and out of short-term memory Iike characters in a Harry Potter book, but like those characters, they always seem to be there when I need them.

Of late, I rarely walk into a room and forget why I went there (S1E2). I seldom forget doing something just a few minutes after I do it (S1E6). My recall of friends’ and co-workers’ names from the past is much improved (S1E16).

That’s not to say I’m not making errors because I am. I’ll occasionally reach for the granola container and pick up the coffee bean jar instead, or put vinaigrette on Sally’s salad when I know that she prefers ranch, but it just seems like I’m not making as many mistakes as before. Or maybe I’m just becoming used to those kinds of minor slip-ups and I’m not paying attention to them. It’s also possible that I’m incorporating a variety of accommodations (e.g., paying attention, making lists, doing things as soon as I think of them) that are eliminating a lot of potential slip-ups.

Last February, I had cataract surgery on my doctor’s recommendation. Little did I know that I was also doing something that was brain-healthy by eliminating a risk factor for dementia! I immediately noticed the changes in colors and sharpness, all of which was pretty exciting. But in the last few weeks, it seems my vision has gotten even better. Colors seem even more vibrant and rich. I’m distinguishing more shades. I can’t help but wonder what’s causing it. Is it the jigsaw puzzles I do ever day? Or the exercise? Or the diet? Or the combination of all the brain-healthy behaviors I’ve adopted (S1E41)?

The same goes for my hearing. When I listen to music now, I’m picking up a greater richness in each note sung, even in songs I’ve been listening to for 50 years. For the first time, I’m hearing different instruments and can distinguish different voices. Is it because I’m trying to teach myself how to play the recorder? Or listening to music during my workouts? Or is my new regimen cleaning out brain clutter allowing me to recruit more neurons for my listening pleasure?

Perhaps most surprisingly, I think my sense of smell has also improved. Or at the very least, I’m noticing things more, like the scent of coffee beans, the cinnamon I put into Sally’s coffee, and even my granola when I pour it into the bowl each morning.

The fact that I’m picking up on changes in at least 3 of my senses makes me think it’s more likely that the brain-healthy regimen is working its magic.

I haven’t noticed any declines in my ability to organize and execute plans, follow recipes or problem-solve, but what does jump out is that I seem to have a lower frustration tolerance (S1E5). When doing crossword puzzles, I’m quicker than I was a year ago to google an answer if I get stuck. I have less patience with Sally when we miscommunicate. I’ll quit on learning a new piece of music if I don’t see improvement after the first few tries. I’ll keep an eye on that going forward as personality changes are not a good sign. Other than that, my mood is generally ok.

One more thing: my hair is a lot longer…but it’s also a lot thinner! The other day I was running my hand over my head and I felt something cold on my scalp. It was my fingers! I never had that happen before, but then again, my hair has never been this thin before. 

Both my grandfathers had male-pattern baldness and so it amazes me that I escaped that fate. For whatever reason—my receding hairline notwithstanding—it’s been a good run. And that’s one more thing for which I am grateful as I begin my seventy-second trip around the sun.

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S1E47. A Granola Ritual

Breakfast has become my favorite time of day since I started making my own granola. I traveled that path because I couldn’t find any granola in stores or online that didn’t have added sweeteners (I’m pretty fussy here as I don’t even accept honey or maple syrup as ‘good’ sugar).

A quick google search told me that it was easy to make and that you could customize it to suit your taste. Here’s what I wound up with:

1 cup each of chopped walnuts, pecans and almonds

1 cup unsweetened coconut flakes

Ā½ cup each of chia and flax seeds

1 tablespoon cinnamon

1 teaspoon each of turmeric, cumin and ginger

1 teaspoon vanilla

Ā½ cup olive oil

Mix all the dry ingredients together in a large bowl, then drizzle in the olive oil and vanilla and toss until the nuts are coated and the seeds stick to them. Spread the mixture out on a cookie sheet (no need for parchment since there is no sugar to stick to the bottom) and bake for 25 minutes at 300 degrees. Voila…granola!

(Disclaimer: There is nothing magical about this recipe other than every ingredient providing some nutrient that is protective of brain health. Feel free to add rolled oats, as every other granola recipe includes them.*** I leave them out because I’m on a pretty extreme diet that eliminates all grains, but you don’t have to do that. There’s nothing wrong with adding sunflower or pumpkin seeds, either, but they’re just not my cup of tea.)

What’s with the spices you say? To be honest, I don’t think I can taste them at all, except maybe for the cinnamon. The other three are all listed as top spices for fostering brain health. By adding them to the granola, I guarantee myself a small daily dose.

The ritual part comes when I prepare breakfast each morning, I start with Ā½ cup of granola (at this rate, the above recipe lasts for about 3 weeks) and then add dried and fresh fruit. Once again, everything I add is brain-healthy and the fruits provide plenty of sweetness:

1 dried fig, chopped

1 prune, chopped

Ā¼ apple, chopped

15 red grapes, halved

6 raspberries or blackberries

A handful of blueberries

Enough flax milk to fill the bowl

(Disclaimer #2: There’s nothing magical about these proportions, either. Why 6 raspberries? I’ll be damned if I know!)

There is just something about chopping a sun-dried fig that makes the entire experience feel religious. You have to do it slowly and purposefully. There’s almost a zen to it. As I add the fresh fruit, the event takes on the aura of preparing an offering to the gods as it’s been detailed in some ancient sacred scripture. Intensifying the spirituality of the moment is the situation: this takes place at around 9:30 every morning as I break my 14-hour fast from the night before. All that’s missing is a prayer or mantra!

Once assembled, I thoroughly mix everything to make sure that the fig and prune bits don’t stick together and their sweetness is distributed throughout the bowl.

And then comes the eating. I remember when breakfasts were so hum-drum that I read the newspaper or a book or the back of the cereal box while mindlessly shoveled the food into my mouth, barely tasting it. No way I can do that with this feast!

Every bite is different. I want to luxuriate in and linger over every spoonful. Each taste begins with teeth crashing down on the chopped nuts while waiting for the tart explosions of the berries. The crunch of the apples is omnipresent, but it’s the always surprising sweet burst of the fig and prune bits that is the piece de resistance.

I savor every chew. I think of nothing else while I’m eating. It’s too good to miss a nanosecond of it!

And best of all—I know this will sound silly—but I feel healthy while I’m eating it. I know I’m doing something good for my brain. Each swallow reminds me that I am ‘feeding my head’ in the best way possible. It’s quite the ritual!

*** In fact, the definition of ‘granola’ is rolled oats mixed with a variety of other ingredients. Technically, then, this recipe isn’t even granola!

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S1E46. I Am Not A Fanatic!

I’ve spent the last six months building a brain-healthy lifestyle by adjusting my diet, exercise and sleep routines, building cognitive challenges into each day, and trying to spend more time socializing. It came together bit-by-bit, day-by-day, until I had a system that pretty much governed every aspect of my existence, right down to monitoring and controlling the quality of the air I breathe in the apartment.

I’m more than happy to talk with people about what I’ve been doing and why (to whit, this blog), but I try really hard not to proselytize, for there’s nothing worse than the zealotry of a new convert who corners you in a conversation. So if I start going down that path, please let me know, as it is not at all my intention.

On the flip side of that coin, I’m uncomfortable when friends and family feel obligated to protect my journey by adjusting their behaviors to accommodate my lifestyle choices. I bristle whenever I hear, “Will there be anything you can eat if we go to that restaurant?” 

It’s not that I don’t appreciate their caring about me. I do. But I don’t feel as though I’ve earned their deference. It’s not as if I have a medical condition and will get sick if I go off my diet. It’s not a part of my religion, either. I won’t be denied entry into heaven if I eat a piece of cake. My body is not a temple and it will not be defiled no matter what I shovel into it.

I’m merely choosing to be a picky eater…and the consequences of that are 100% on me, along with the responsibility.

As far as I can tell, the downside of going off my diet is that I lose a little bit of time in the long-term project of cleaning the gunk out of my brain that can cause cognitive decline. I spent seventy years accumulating it, but I haven’t seen any research that quantifies how much time I have available to me to clean house.

So how much damage did I do over the last four days when I fell off the wagon? We went to the Bahamas to see the University of Connecticut women’s basketball team play in a tournament. I made a half-hearted effort to be faithful to my protocols, but staying at a vacation resort triggered a “you’re-on-vacation-go-for-it” reflex that had me making all sorts of unwise choices.

Alcohol is a no-no (except for about 5 ounces of red wine with dinner), but I couldn’t resist the allure of a Bahama Mama. Just one knocked me for a loop, but that didn’t stop me from trying a different restaurant signature cocktail each night!

Bread. I haven’t had bread in months except maybe to taste a sandwich that Sally had ordered. But there was no way I was going to say “no” to the breads and dipping oils that came with each meal. Same for pasta, which is the only thing I really miss in my new regimen.

Then there was the grotesquely sweet s’mores dessert with vanilla ice cream, chocolate fudge, marshmallow sauce and graham crackers. I’m surprised it didn’t trigger insulin shock in my sugar-deprived brain.

I didn’t observe my overnight fasting routine.

I had a rough night sleeping the night I had a Coke with dinner. In general, I’m pretty sure my increased sugar intake disrupted my sleep cycle big time.

In general, I over-ate, felt stuffed a lot and got hungry a lot sooner between meals.

Although we did a fair amount of walking, I didn’t really make an honest effort to try to exercise. The only time my heart got a workout was during the games which were all close and exciting.

Finding our way around the sprawling resort was quite the cognitive challenge, though. So was figuring out what to do when the air conditioning stopped working in our room. It took a while, but it dawned on me that perhaps the on-off switch is controlled by the doors to the balcony. Apparently, for the sake of energy efficiency, the air shuts off when you open the doors to the outside. It goes back on when you close them.

On the other hand, I didn’t realize until our third day there that all of our restaurant charges included a 15% gratuity. The wait staff must have laughed all the way to the bank each time I had added 20% to that!

So now I’m home and getting back into my routine. How much damage did I do? There’s no way to tell, but I doubt that I hurt my cause very much. It was interesting to see how quickly my body reacted to the changes…and not in a good way. It makes me more appreciative of the new path I am traveling.

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S1E45. Subtle Changes

Just like that…it’s gone! Now you think it; now you don’t. POOF!

It’s quite the magic trick…making thoughts disappear like that. If only I knew how I do it!

Following up on the second blog I posted last December, I’ve noticed that I no longer experience the phenomenon of walking into a room and forgetting why I went there. There’s been a subtle shift. It’s morphed into something a little different.

What happens now is that I completely forget my original intent. For a moment, I don’t even realize I’ve forgotten it. Instead, I’ll do something else that needs doing in that area just as if that had been my purpose. Only after I’ve started that task do I realize that I had another purpose…and then it comes back to me. For example, the other day, I walked into the kitchen and started to unload the dishwasher before I remembered that the reason I went into the kitchen in the first place was to make some tea.

It’s only a fleeting experience, so there is no real down-side to it, and there is the benefit that I get things done that I obviously had deferred. Clearly, though, something has changed.

It reminds me a little of a video I saw about a form of ADHD that is caused by cognitive decline and dementia. It documented the story of a woman who couldn’t get anything done around the house because she was constantly being distracted by other needs before she could complete the previous task…and this went on all day.

Fortunately, what I’m experiencing is nothing like that. I catch on to what’s happening pretty quickly and I complete all the intended tasks…both the original and the newly-discovered.

In a way, it’s an improvement from a year ago. I recall my purpose a lot faster than I used to and without having to sustain a focused effort. But it’s still bothersome that I forget it in the first place.

A more problematic variation of this occurred the other night when we were out to dinner with friends. We were at an Asian restaurant that had a unique style of serving your dinner. They didn’t serve everyone at once. Instead, they served each order as soon as the cooks finished preparing it. As a result, some of us got our main courses first and our appetizers last. Some of us were served quickly and some had a longer wait. If I had to guess, I would say that salads were served the fastest, then came fried foods, and finally noodle dishes that required boiling. And the delivery speed for each was determined by the volume of orders coming in from the other patrons.

We all ordered and soon the food began to arrive. Two of us received our salads first while the others waited. Gradually, more dishes appeared. I was still hungry after I finished my salad and so I tried one of Sally’s chicken wings. Some fried tofu was being passed around and I tried that, too. After a while, I wasn’t hungry anymore.

Finally, the last member of our group was served, but along with his order came a huge bowl of tom yum soup. Nobody claimed it as theirs…until it dawned on me that I had ordered it!

In the half hour between ordering it and its being served, I had completely forgotten all about it. If I had remembered, I never would have sampled all those other dishes.

So that’s the bad news.

The good news is that I’ve noticed an improvement in another domain: remembering names. You might recall that I was having difficulty with that task back in April (“The Name Game”). Now names of people from my past seem to be cropping up in my head without a lot of effort. And when I do try to come up with a name, it seems to be within easy reach.

So what does all this add up to? I’ll be damned if I know!

The promise of a brain-healthy lifestyle is that it will slow the progression of cognitive decline. Around 40% of dementias can be prevented in this way, or so the research suggests. Another way of looking at it is to say that your rate of cognitive atrophy is slowed to the point that you die from other causes before you qualify for a diagnosis of dementia. Don’t get me wrong…I’m not complaining. Dying before you dement is a good thing!

What’s more, the research doesn’t say how long you have to be implementing the 5 Pillars before you see tangible results. Some studies have a 6-month time frame while others measure the impact of lifetime habits. 

And since we don’t know what my cognitive status would have been had I not changed my habits six months ago, we can’t really measure the success/failure of the program.

And so my journey continues… 

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S1E44. Probiotics…really?

I have never been what the marketers call an ‘early adopter.’ In fact, I fit pretty solidly into the group of people they identify as ‘laggards:’ those who only purchase things after they are well-established.

I’m pretty skeptical about most new products and consider them fads until proven otherwise. Growing up, I rejected the hula hoop and Elvis Presley. More recently, I believed the cell phone would never catch on. (Who on earth would want to talk to people in the aisle of a supermarket where everyone could hear the conversation???)

My initial reaction when I first heard the word ‘probiotics’ was “Really?” I had never warmed to the idea of eating organic foods and considered it a fad popular among liberal elites (even though I am a card-carrying member of that group). Introducing probiotics to the equation was crossing too many lines for me.

So I paid little attention to it until I started my research into brain health. I bristled when it first came up in my reading. All my alarms were going off as I learned about the gut microbiome that contains thousands of different organisms that are essential for digestion and creating the chemical compounds that are vital to brain health. Conversely, a poorly-functioning microbiome can generate neurotoxins. 

That caught my attention.

But as I delved deeper, I wasn’t convinced that the research has yet advanced to the point where we can definitively say that enhancing a certain group of bacteria is beneficial. There are just too many different organisms and too many combinations and too many potential interactions to say for sure, IMHO. Then there is the testing that indicates a lot of products marketed as probiotic supplements don’t contain what they claim and, worse still, what they do provide is not absorbed by your gut.

As is my tendency, I backed off a few steps and looked for a level of engagement that matched my comfort zone, given the data. 

A simple guideline that made sense to me was that you should include some fermented foods in your diet as they contain naturally occurring beneficial probiotic organisms that have long been consumed in various cultures. 

I tried kimchi, but hated it. Then I made a batch of sauerkraut and loved it. (It’s easy to make: just massage some kosher salt into a bowl of shredded cabbage, weigh it down, cover, then let it sit on the counter until it tastes right. It’s a whole lot better than commercial sauerkraut. It’s now my go-to afternoon snack, mixed with a little seaweed salad.

But I didn’t stop there. A word kept cropping up in my reading that I didn’t recognize: kefir. I checked it out and discovered it was a fermented milk product (like yogurt) and generated a number of probiotic organisms. The problem for me, though, was that I had given up dairy.

After thinking about it for a while, I decided that the potential benefits outweighed the negative impact of milk and milk fat, especially in small quantities. I gave it a try and it was delicious.

Since I had made my own yogurt for ten years at our B&B, I knew that my next project would be to make it myself. I ordered a kefir maker from Amazon which was basically a 2-quart glass jar with a perforated lid to allow for air circulation. It came with a packet of ‘kefir stones’ which contain the microbes that convert milk fat into the beneficial probiotic organisms.

I discovered that there was a product called ‘A2 milk’ which is supposed to be a little healthier than regular milk, so I bought some to make my kefir. It’s pretty simple: pour the milk into the jar, add the kefir stones, and let it sit on the counter for about 24 hours. For flavor, I added a pint of pureed strawberries to a quart of kefir. (Somehow, I had dropped strawberries from my diet, opting for blueberries and raspberries, instead. This corrects that oversight.)

It turned out wonderfully! It’s a little tart, so I add a packet of stevia to Ā½ cup of my homemade strawberry kefir and drink it for dessert each night. 

It took less than a week before I noticed a healthy change in my digestion. Wow…color me surprised!

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S1E43. No Comment

“Pressured Speech” is a symptom of mania. It happens when your mind is racing at 100 mph and you feel the need to tell everyone all the epiphanies you’re having about how the universe works.

On the other end of the spectrum is “Poverty of Speech.” It’s one of the negative symptoms of schizophrenia and occurs when your brain grinds to a halt and you have very little to say. It also occurs in advanced dementia.

Most of us function somewhere between the two ends of that vast spectrum most of the time.

The reason I’m writing about this is that talking with people is the essence of social engagement, and social engagement is one of the five pillars of brain health.

As I mentioned in Episode 41, I think I’m knocking it out of the park on 4 of the 5 pillars, but that I need improvement in the social engagement domain. This past week, though, I found myself engaging with others on more days than not…and that gave me an opportunity to observe myself.

But before reporting findings, it’s important to establish my baseline because, as you will recall, dementia symptoms are measured against your previously normal behavior and abilities.

I’ve never really been a social person. I don’t think I’ve ever called anyone and said, “Hey, wanna hang out today?” On the other hand, I usually enjoy being with others when the opportunity presents itself.

I’ve never been comfortable meeting new people (is anyone?) and I never learned how to ‘work a room,’ even when my job description called for it. I never learned how to introduce myself to a stranger. I have a congenital disdain for ‘small talk.’

So how on earth did I ever have a career as a psychologist, you ask? No problem! In that role, it was understood that people would seek me out and they would do the talking while I listened… and I was a very good listener. 

Same for when we ran the B&B. My wife was the extrovert who would meet people upon arrival and have a glass of wine with them. By the next morning, after I had cooked and served them breakfast, they had a thousand questions for me which I was more than happy to answer.

On the other hand, when I do have something to say, you can’t shut me up! So much so that when I chaired meetings of the Kennett Area Democrats, Sally would frequently have to give me the pointer-finger-drawn-across-the-throat sign to let me know I needed to wrap things up.

So how did I do this week?

As is my style, I found myself more than happy to listen. I didn’t feel pressured to impress anyone or to say anything witty. I had no trouble following conversations, but neither did I feel compelled to compete for the floor. If the conversation moved on to another topic before I had a chance to say my piece, I just shrugged it off with an “Oh, well.”

Now that I’m reflecting upon it, though, it appears that throughout my life it wasn’t unusual for someone in a group discussion to say, “Wayne, you’ve been awfully quiet. What do you think?”

This past week, my mind was going all the time. I was thinking about what I was hearing and enjoying the company. I felt comfortable and relaxed. It’s true that I spoke less than the others in the room or at the table, but that was because I just didn’t have a lot to say.

Sally noticed and asked if I was feeling ok. That tells me I must have been talking even less than usual. I didn’t have a good answer for her. Was I tired from my workout or not getting my afternoon nap? Maybe. Is my cognitive processing speed slowing down so I’m not finding relevant content to offer in a timely fashion? Possible.

In any event, it bears watching.

So, with nothing more to say on the topic at this time (!), I’ll close with two tangentially related quotes that come to mind:

Better to remain silent and be thought a fool than to speak and remove all doubt. –Abraham Lincoln 

Talk less…smile more. –Aaron Burr in the musical ‘Hamilton.’

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S1E42. Smart…Not Brave

In your 20s, 30s and 40s, you were often rewarded for taking bold steps. If you failed, bouncing back was hard work, but nonetheless do-able.

My sense is that at 70, though, I don’t have a lot of room for error. As the old adage goes, I need to be measuring twice and cutting once. Sally and I have coined a phrase that we use to remind ourselves of our new status whenever we face a choice with a potentially steep down-side: “Smart…not brave.”

So I put on sneakers before I climb a ladder instead of going barefoot. I use a cart to bring in the groceries instead of trying to make a single trip carrying all the bags in my arms. Although I normally walk the three flights of stairs up to our apartment, I’ll take the elevator when I’m carrying a package. Get it? Smart…not brave.

But nowhere is my new age-appropriate approach more visible than in my exercise routine.

I’ve been running/jogging on-and-off since I was fourteen. Up until now, my goal was always the same: run farther faster. That meant pushing myself in my workouts, running at an ever faster pace, and running greater distances.

My event in high school was the 2-mile. I was never any good at it, but I worked hard and earned the respect of my teammates. I scored enough points in track meets to earn my varsity letter in my junior and senior years.

In those days, it was all about guts and glory. Pushing yourself to go beyond your limits. There was a phenomenon we called ‘the rigs’ (short for ‘rigor mortis’) which occurred during the sprint to the finish when you had already given your all. Your arms and legs would refuse to respond to your screams to go faster. It seemed like you were moving in slow motion. You were helpless as other runners passed you.

It was a state of oxygen deprivation. Your heart can only pump so much blood to your muscles, but you had exceeded its limit…and you still had 100 yards to go.

If I were to exert that kind of effort today, it would probably be the end of me! Fortunately, though, there is no need to try because my purpose in running has now changed dramatically. It’s no longer farther faster. I’m now running to live longer with a high-functioning brain. That makes all the difference in the world.

I no longer need to work out at my maximum heart rate. Twenty to thirty beats per minute below that will more than suffice to guarantee a free-running and fresh supply of blood to my brain and thereby reap the cognitive benefits of exercise.

Consequently, the toughest part of establishing my new routine is to resist the temptation to add distance or to run faster in each workout. I have to keep reminding myself to be smart, not brave, and that the new goal is 150 minutes/week of exertion…not running a new personal best. In essence, the goal is now the workout itself and not my running performance on race day.

The new approach spills over into my weight training, too. Up until now, the goal of lifting was to support my running. There were certain muscle groups (e.g., the ones you use in the motion to pump your arms and to run up hills) that I wanted to be bigger, stronger, and to have more endurance.

The goal of weight training in a brain-healthy lifestyle, however, is not bigger and stronger muscles. The goal is to engage more neurons and to develop more synapses. You do this, not by lifting more weight, but by doing a variety of different exercises at a challenging but comfortable weight. There’s actually a study that found this approach to be more supportive of brain health than the traditional muscle-building type of workout.

As luck would have it, the upper body resistance machines in our fitness center are all constructed so you can do each exercise with both hands or with either hand separately, and there are usually two different grips you can use.

I take advantage of this design feature in order to engage as much of my brain as possible. I’ll do one set of 15 repetitions using both arms, and then 1 set of 15 each using my left arm alone and then my right arm alone. I’ll also vary the grip.

I’ve now been doing weight training for six months and this past week was the first time I increased the resistance. Smart, not brave, as I can’t afford to pull, tear or injure any of my body parts. I don’t even want to think about how long the recovery period might be. The beautiful thing, though, is that I don’t have to push the envelope anymore.

My final concession to my ‘smart, not brave’ approach is to work out four days in a row and then take a day off to let my body recover. I’ll be honest, though: I have to keep reminding myself that the goal is 150 minutes/week and not exercising every day.

So far, it all seems to be working. Once I finish losing all the extra weight I’ve been carrying (30 pounds gone; 10 to go), I know I’ll start thinking about running some 5k races in the spring. It will be interesting to see how I handle it. I hope I’ll be smart…not brave!

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S1E41. A Brain-Healthy Lifestyle Is…

…a full-time job!

When I first started learning about brain health back in May, I would come across the phrase ‘lifestyle changes’ pretty often. It referred to the likelihood that if you were a typical American, you would probably have to adopt several changes to your current lifestyle if you wanted to ward off cognitive decline and dementia.

These were things like changing your diet to minimize intake of sugars and saturated fats, and getting off your butt and exercising several times each week.

I thought: “Piece of cake…I can do this!”

I’ve been implementing those ‘lifestyle changes’ for about six months now and…you know what? Those changes make up the better part of my day! Don’t get me wrong. I’m not complaining. I enjoy implementing the recommendations… but it’s turned into a full-time job.

Here is an accounting of what my new ‘lifestyle’ looks like from the perspective of the number of hours per day devoted to each of the five pillars of brain health:

1. Exercise: 1.7 hours. I’m working out six days each week. My workouts themselves take between 40-60 minutes, so I’m easily surpassing the 150-minutes/week brain health recommendation. But let’s add to that total my cool-down time (when I drink a pint of pomegranate juice mixed with filtered water) and the time it takes to shower. That gives me about 12 hours/week, or 1.7 hours/day devoted to my exercise regimen.

2. Diet:  2.0 hours. I’m still learning how to eat right which means that I’m still researching diet recommendations and recipes. Then there’s the grocery shopping, prep time (I’m now making my own granola and sauerkraut), cooking, and the actual eating. I’d say that this consumes an average of 2 hours each day.

3. Cognitive Challenge: 6.0 hours. I start my day by doing crossword and jigsaw puzzles. Figure 2Ā½ hours there. I try to get half an hour of recorder practice in daily (but don’t always succeed) and then Sally and I listen to a vinyl album each night after dinner. Let’s call it 1 hour daily for music. Add another hour for reading books. I would like this to be a daily routine, but so far it’s more likely to be binge-reading the week before book club meets. I’ll add an hour for on-line activities like social media and reading the newspaper. Finally, I spend about half an hour each day thinking about, researching and writing this blog. If my math is correct, that adds up to 6 hours/day.

4. Social Engagement: 1 hour. This is my brain health weak spot. Compared to Sally who is out-and-about most of the day nearly every day, I am a veritable recluse. But I do manage to get together with others about twice each week. Although I work out in our apartment’s fitness center, there is rarely anyone else there. Same for when the pool was open. On nice days, my jogging path is the ā…“ mile loop around the building and I wave or say hello to everyone I see. On rare occasions, I will share the elevator with someone. None of this adds up to a ‘relationship,’ though, nor does it meet the criteria for ‘social engagement.’ So let’s be generous and round up to an average of 1 hour/day of ‘real’ social interaction with someone other than Sally.

5. Sleep: 9 hours. No…I don’t get 9 hours of sleep each night. It’s more like 7-8. But we do get in bed at 10:30pm and usually get up around 7:30am. This allows for time to fall asleep, wake up a few times in the middle of the night, lie awake for a little while in the morning before getting up, and still log the recommended 7-9 hours of solid sleep. It also facilitates our intermittent fasting schedule which has us stop eating at 7:30pm which is 3 hours before going to bed.

Here’s what it all adds up to:

1.7 Exercise

2.0 Diet

6.0 Cognitive Challenge

1.0 Social Engagement

9.0 Sleep

There you have it: 19.7 hours per day devoted to my newly-adopted brain healthy lifestyle. That leaves about 4 hours free for other pursuits. In the spirit of full disclosure, though, I’ll admit that I allocate about 1Ā½ of them to my nap!

Now the question is: What will I do with all that free time?  šŸ˜€

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S1E40. Road Trip

Growing up in the 50s, I knew the names of a number of famous people without knowing what it was they had done to earn such notoriety. Their names alone came to stand for excellence in their chosen fields: Enrico Caruso, Rudolph Valentino, Albert Einstein and Pablo Picasso, to name a few. The highest praise one could bestow on an aspiring singer would be to say: ‘He’s a regular Caruso.’ On the other hand, a common way to say someone wasn’t the sharpest knife in the drawer was to say: ‘He’s no Einstein!’

Frank Lloyd Wright was one of the names I learned without knowing anything about him other than that he was an architect. In fact, I still didn’t know much more about him until this past week. But that changed when we decided to combine our fall foliage viewing with the 4-hour trip to his most famous residence, Falling Water.

But why, you ask, am I writing about Frank Lloyd Wright in a blog about dementia? Good question! It’s true that his best work was done when he was in his 80s, but that’s not why I’m writing about him.

One of the brain health findings I’ve come across is that travel to new places may be protective. It stimulates all your senses in a variety of ways which help stimulate brain cell growth. As we began planning our getaway, though, it occurred to me that you have to be functioning at a pretty high cognitive level in the first place to execute a road trip.

For starters, you have to have the desire and interest to go somewhere and not be overwhelmed by the logistics of actually doing it. In this case, the initiative came from Sally who said she wanted to do a road trip to see the leaves turn and I connected that with a suggestion some friends made a few years ago about going to Falling Water.

But it’s not like we can just get in the car and take off like we might have done in our teens and twenties. At this age, if we go somewhere on the spur of the moment without telling anyone, we might find our car make, model and license plate number flashing on the interstate in a ‘Silver Alert!’

Instead, we do our background research and make a plan. When will peak foliage occur? How long will it take to get to Falling Water? What days do we have free? Where will we stay? Do they have guided tours once we get there?

And there was one more big decision to make: which car would we take? My Volvo gets better gas mileage, but Sally’s Subaru has a much bigger windshield for viewing the scenery. We opted in favor of the view, but that introduced a layer of risk. She had run over a nail two weeks earlier and one tire was leaking air. She took it to the dealership and they put in a plug, but it didn’t stick. They had to re-do it twice. Was it really safe to drive? What if it went flat en route? We decided to roll the dice.

The weekend before our scheduled departure, I did a YouTube search and found great documentaries on the story behind the building of Falling Water and the life of Frank Lloyd Wright. On the eve of our departure, we watched Ken Burns’ 2-part biography of Wright on PBS. After 60 years, I finally now know why his name is synonymous with modern architecture.

Next up was finalizing the game plan: figuring out what time to leave in order to get to the first tour on time; packing (clothes appropriate for the forecast weather, medications, computers); turning off the air conditioning in the apartment; setting the alarm to wake up on time.

If you can do all of this planning and scheduling, your cognitive abilities are pretty much intact.

If you can shift your plans because you met someone on a tour who gave you a good recommendation, you are functioning well.

If you can keep your balance for two hours on a rock-strewn trail booby-trapped with tree roots hidden by fallen leaves, you are doing well.

If you can find your way back to the trailhead after missing a turn on your hike, you’re doing well.

If you can cut your stay short because it was impossible to sleep on your bed’s sagging mattress at the B&B, you’re functioning well.

Realizing that you miscalculated when the leaves would turn, if you can drive north in search of peak foliage without a map, keep moving in the right direction and find a hotel in Ebensburg, Pennsylvania, you are doing well.

If you can survive meals at local eateries like See-Mor’s All-Star Grill and Hoss’s Family Steak & Sea House, you can be thankful that you dodged a bullet.

If you can keep your sense of humor during all of this, you are doing extremely well.

But most importantly, if you can embrace with wide-eyed wonder and amazement a Frank Lloyd Wright designed home, you have much for which to be grateful!

Postscripts:

  1. That leaky tire didn’t give us a lick of trouble during our 500-mile adventure.
  2. Having travelled four hours west in search of foliage, we finally found it on the way home…2 hours north in the Poconos.

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S1E39. Our 10th Anniversary

When I think of it all at once, it’s a blur…a blink of an eye…where did the time go?

Last Friday was the 10th anniversary of our seeing each other again after a 41-year hiatus. Sally and I were first boyfriend/girlfriend in my senior/her junior year in high school (1968). We dated on and off for a little less than two years and then drifted apart. It was more than four decades before we saw each other again, thirteen months after my wife of thirty-six years had passed away.

It’s mind-boggling to think that it’s been ten years already, but when I break it down, a lot happened.

I was 60, so this anniversary is also a chronicle of my 60s (not to be confused with THE 60s). During that time, I went from clinging to my 50s to anticipating my 80s.

I ended my career as a practicing psychologist six months after our rendezvous and moved from a mountaintop North Carolina retreat near the Tennessee border to her home in the Brandywine River valley about forty-five minutes from downtown Philadelphia.

After leaving psychology behind, I had a 10-year career as a political activist before leaving that to start writing this blog ten months ago.

The nation went from Obama to Trump to Biden. Can you say: ‘Whiplash?’ We marched in demonstrations in Washington, Philadelphia, West Chester, Media and Kennett Square. I was elected to the Kennett Square Borough Council and became chair of the Kennett Area Democrats.

When I moved in with Sally, I inherited a sprawling family, a close circle of friends and a book club. We went from Sally’s condo to our own home to a 2-bedroom apartment as the decade ended.

Thanks to her love of music, I attended more concerts in the last ten years than I had in my first sixty.

Sally lost a cherished brother and sister-in-law and I a beloved aunt. Both of my dogs wandered over the rainbow bridge. Several good friends and too many of our high school classmates passed away. The world lost Muhammad Ali, Stephen Hawking, Robin Williams, Nelson Mandela, Mary Tyler Moore, Aretha Franklin, Elizabeth Taylor, Maya Angelou…

We attended our 50th high school reunions.

The Eagles won a Super Bowl; after winning the World Series in 2008, the Phillies haven’t been to the playoffs since I moved here. The UConn women’s basketball team won four national championships.

We traveled to Iceland, France, Costa Rica, Canada and went on a Caribbean cruise. At home, we visited every state on the eastern seaboard and made the trip to San Diego to attend my niece’s wedding.

I weighed 145 pounds when Sally arrived for her visit. I had weighed 135 in high school. In the last two years, my weight ballooned up to a COVID-assisted 186. I’m now back down to 158 with a goal of revisiting 145.

My hair was short in 2011. Now I have a ponytail. My hairline continues to recede.

Hospitals and I had been strangers until seven years into the decade when I had my gall bladder removed. The staff was amazed that this was my first hospitalization in sixty-seven years.

I had cataract surgery last year.

The decade ended with a pandemic. On this anniversary, we were both wrestling with the side effects of our booster shots.

The digital communications revolution swept the planet and cell phones now rule our lives. I may be one of the few people left who refuses to carry one. On the other hand, I gleefully embraced GPS as the remedy to my directional disability and the passport to the wider world outside my door.

As a child, I remember reading about the fabulous bazaars of Persia where you could buy strange and exotic goods from the Orient. Now there is Amazon and not only can you buy anything, but you can have it delivered to your door overnight.

I gave up my 15-year old Chevy Cavalier with 120,000 miles on it for a 6-year old Volvo with fewer than 7,000.

And those are just the milestones that jump out at me.

In sum, I re-created myself and built a brand new life with Sally.

A lot happens in a decade…even if it doesn’t feel like it at first glance.

__________

S1E38. Debunking Myself

Confirmation Bias” is a tendency we all share to seek out and value information that is consistent with our pre-existing beliefs. It is probably responsible for a lot of today’s polarization because–thanks to the internet–we can find like-minded news and information sources on any topic that will tell us exactly what we want to hear and thereby deepen our commitment to it.

It’s important to be aware that we are all prone to this and to intentionally seek out information that conflicts with our beliefs. It can keep us from going off the deep end, remind us that none of us have a lock on knowledge, and that there’s a reasonable chance that we are wrong. It’s humbling…and that’s a good thing.

In previous posts, I’ve reported on my reading and research and described the lifestyle changes I’ve implemented in pursuit of long-term brain health and preservation of cognitive function. I hope I’ve done that without proselytizing. If I have gotten obnoxious or self-righteous about it, please let me know, for that is not my intention.

This week, I spent some time reading articles that conflict with my emerging approach. As I quickly discovered, The New York Times has been running a series debunking health food claims for many years. It was helpful to see a different perspective. Here are a couple of the items they reviewed:

Do you need to drink 8 glasses of water a day?

Nope.

There’s water in everything we eat and there’s nothing magic about downing a Ā½ gallon a day. If we need water, we get thirsty. If you drink some water when you get thirsty, you will be fine. There’s no evidence that drinking more than that confers any special health benefits.

I was actually pleased to learn this. Throughout my life, various people who care about me have urged me to drink more water. Whenever I tried it, though, I felt bloated and uncomfortable. I’ve only ever experienced dehydration once and that was at the finish of a 5k run in 93 degree heat when I was 63 years old. So I’ll let my confirmation bias kick in on this one and continue to drink when I’m thirsty.

Is turmeric good For you?

Turmeric has been a staple of Ayurvedic medicine for millennia, but there is little modern research to support its efficacy in the wide array of maladies for which it is recommended. 

Although its chemical properties would suggest it has value, there seems to be a problem in actually getting it absorbed into your bloodstream.

Thinking back over my reading these past few months, it occurred to me that a fair number of recommendations for including a variety of things in one’s diet were based on laboratory trials or studies on mice. The author’s would present that as their evidence. In fact, though, that is jumping the gun a bit. The gold standard is trials on humans that have been replicated. So some food suggestions need to be taken with more than a few grains of salt.

I’m still going to add turmeric to my cooking, but I’m not going to go crazy over it.

Should you take fish oil supplements?

Probably not. Eating more fish (especially sardines, anchovies, herring, mackerel and fresh-caught salmon) is a much better way to get what you need.

Does fasting help in losing weight?

Yes…but not for the reason you might expect. You can check it out here.

My biggest take-away was to beware of exaggerated health claims. In general, they tend to be based on thin (if any) evidence. The concepts and the theories behind many recommendations seem sound, but it’s exceedingly difficult to actually prove efficacy in clinical studies.

The other pillars of brain health (exercise, cognitive challenge, social engagement and sleep/stress management) appear to have a more robust research base than many of the dietary recommendations. But even in those areas, we continue to learn about how much or how little, what types, and when is most beneficial.

So work your plan…but stay informed…and stay flexible!

Postscript: Re-reading this draft prior to publishing, I noticed something. Although I read the cited articles in an attempt to debunk myself, that isn’t at all what happened. I wound up latching on to the elements in each article that supported my preconceptions. In other words, I fell victim to the confirmation bias I warned you about in the opening paragraphs. 

I guess I’ll have to try harder next time!  šŸ˜€

_________________

S1E28. Potholes On Open Highways

It seems fitting that the road on the journey to nowhere should be riddled with potholes. Here are a few that I bounced over during the last few weeks. I’m guessing that you’ve hit a couple of these yourself!

  1. We were getting ready to leave the pool and Sally handed me my t-shirt. I put it on backwards.
  1. We changed pharmacies when we moved, but I keep saying ‘CVS’ instead of ‘RiteAid.’
  1. Sally wanted to attend a ZOOM event that she thought began at 7. I said it was from 5-7 and that she had missed it. It turns out I confused the time of her event with another activity. She was right, but because she listened to me, she missed it.
  1. I was talking with my sister and mentioned that I had attended Bertie’s book club earlier in the day. Startled, she asked, “What???” I repeated that I attended Bertie’s book club. It wasn’t until she asked me a third time that I realized what I was saying. Bertie was my first wife. It was Sally’s book club I had attended. It happened again a week later when I told the pharmacist I was picking up a prescription for my wife. He asked me her name and I said “Roberta Crane.” I was aware of the error even as I was saying it.
  1. In the morning, I start the coffee, take our mugs out of the dishwasher and put the rest of the dishes away. One day I was running late, so I took the mugs out with the intention of emptying the dishwasher after we had had our coffee. You guessed it: I never unloaded the dishwasher.
  1. Why do I make so many mistakes brewing coffee in the morning??? After starting the coffee maker, I retrieve the half-and-half from the refrigerator, measure it into our mugs and then warm it for 30 seconds in the microwave. On Wednesday, though, when I went to the refrigerator, I couldn’t find it. I searched a second time. Then I asked Sally if she had finished it when she made her second cup the day before. She hadn’t. I went back into the kitchen and immediately saw it sitting on the counter. Apparently, I had taken it out of the refrigerator at the beginning of my coffee-making routine instead of at the end…and totally forgotten I had done so in the interim.
  1. This one happens a lot: I ask Sally about something and she’ll say, “Don’t you remember when we…” and then I immediately remember it. It seems my recognition works but my recall memory shorts out on a regular basis.

Thankfully, my life isn’t all potholes. Sometimes it’s more like cruising on an open highway. Sometimes there are bursts of creativity. Sometimes it’s a matter of deep concentration on a task and doing it correctly. Sometimes it’s just figuring stuff out. To whit:

  1. I ordered a 71″x74″ shower curtain printed with the image of Renoir’s ‘Dance at Bougival.’  Neither Sallly nor I liked it in the bathroom…but we both love the image. Two days later, it occurred to me that it might work over the couch in the living room where we have a twenty-foot ceiling. Wow…just stunning…thereby confirming the old saw that there’s a fine line between creativity and insanity!
  1. When we moved, we made the decision to keep our LPs and 45s and try to hook up the old turntable I’d been carting around since the 70s. Getting it to work set off a furious flurry of overnight orders from Amazon: amplifier, pre-amp, speakers, speaker wire, adapters, and more adapters. But that was only the beginning. Then came the task of connecting all our electronics: smart tv, amp, turntable, dvd player and dual headphones. It generated a rat’s nest of tangled wires, but everything works. As I write this, I’m still waiting for delivery of a pair of bluetooth speakers.
  1. Once I had the electronics figured out, we needed a tv stand to house everything. Sally ordered one from Amazon and it fell to me to assemble it. I approached the task with great trepidation as I have never been able to make sense of do-it-yourself assembly instructions, no matter how well written and illustrated. I invariably put something in backwards or upside down, or use the wrong size screws. But this time was different. Everything I saw before me made sense and I had every confidence in what I was doing as I worked slowly and double-checked the diagram before proceeding to the next step. Two and a half hours later and voila: picture perfect assembly on the first try!

And so the journey continues…

__________________

S1E24. Scary & Scarier

Sally’s question hit me like a ton of bricks:

“When did you decide not to put cinnamon in the coffee anymore?”

I was too stunned to answer her.

Just a week earlier, I had posted a blog about making coffee and had spent a lot of time thinking about my brewing routine. In all that time, not once did the idea of putting cinnamon in with the ground coffee cross my mind. Not once.

Although that had been my routine for at least a year prior to posting the blog, it had been completely beyond my capacity for recall. It was locked in a room somewhere in my brain, emerging only after Sally’s question opened the door that facilitated its escape.

This wasn’t just simple momentary forgetting that yields to a few minutes of concentrated effort (or walking away from it and having it pop into your head an hour later). This was gone. It was the first time it had ever happened to me and it was scary.

Looking back, I have an idea about when it happened. During our recent move, there was a period of about 3 weeks when the coffee maker had been packed up and moved to the new apartment but we were still living back at the old house. Since I couldn’t brew our own coffee, we went out each morning to get our daily fix. When we did finally move into the apartment and unpack, I began brewing coffee again…but without the cinnamon.

It appears that, my routine having been broken, my brain unpacked my decades-long routine of making coffee instead of the more recent cinnamon-laced version.

This past Saturday morning, I put the cinnamon out with the other coffee paraphernalia and installed the 2.0 version of my personal coffee brewing app.

As for Sally’s question, she finally got the answer when she read this draft.  

As upsetting as that experience was, it got worse, because it happened again.

I bought this MacBook Pro about a year ago and was tickled to discover that it had a fingerprint recognition security feature called ‘Touch ID.’ Instead of typing in my password, I merely press a key with my right pointer finger and voila…I’m in! A related feature allows the computer to remember my user name and password for various sites and lets me use Touch ID to automatically enter all that information. Each time I use it, I hear Louis Armstrong singing: “And I say to myself, what a wonderful world!”

Of late, though, I found myself getting irritated because I was constantly typing in my computer’s password in order to access the auto-fill feature for user names and passwords. Somewhere along the way, I had completely forgotten about the Touch ID option. Thankfully, when I updated my operating system this week, a window popped up asking me to enter my computer’s password in order to activate the fingerprint ID feature. That prompt was all I needed to get back on track.

But why did I need that reminder? Why was I unable to recall that option on my own? Unlike the coffee episode, I was never separated from my computer, so that shoots down my hiatus theory of forgetting. 

Although I am once again appreciative of the fact that I can let my fingerprint do the typing for me, I’m having a hard time putting a positive spin on this. My best guess is that it’s not part of normal aging.

______________________

S1E23. Why Am I Writing This?

It was a fair question that my nephew Zach (Sally’s sister Lynn’s son) asked me over cake at the graduation party for my great nephew Nate (Sally’s brother Tad’s daughter Skye’s son). 

I had already explained my motivation back in December in Episode 3: My Life Is Now An Experiment (https://tinyurl.com/4epzfffc), and so it seemed like a good time to reflect back on a half year of blogging to see if I still felt the same about this project.

Zach (a political science professor at Haverford College) had raised the question in the broader context of the meaning (or lack of it) of the things we do and the notion of ‘legacy’ or what will be remembered about us (if anything) two, three or four generations from now.

We had already agreed that not much of what we do in our lifetimes will last very long into the future (to whit: think about what you know about your great grandparents)…but that that didn’t really matter. We do things that have meaning for today…and that’s enough.

My primary reason for writing this blog is to provide data that might be helpful to researchers trying to diagnose and treat age-related cognitive decline and dementia. My hope is that by tracking and reporting my mistakes over the course of a decade, I will leave a record that either describes normal aging or the onset of dementia, and no matter how it turns out, that such a first-hand report will have value.

That assumes an awful lot, though. What are the odds that such a researcher will (1) stumble across my notes, (2) discern a meaningful pattern in what I recorded, and (3) convert that insight into a useful tool for diagnosis or treatment? As Sally is fond of saying in these situations, the likelihood lies “somewhere between zip-a-dee and doo-dah!”

Over these first 6 months, though, one thing I’ve learned about myself is that I also do this—and I’m being brutally honest here—for the clicks. It appears I’m a click junkie!

Each week, I spend money to advertise the new post on Facebook and Google. Whenever someone clicks through to the site, I can see on my WordPress blog dashboard not who they are, but which episodes they read and what country they are from. It’s exciting to know that there are folks all across America who have stopped by, and people from Ireland, Canada, India and Sweden who are frequent readers, too.

It’s comforting when they leave comments describing their own experiences that are similar to mine. They make my journey less lonely and it’s nice to know that I’ve made someone else’s journey a little less lonely, too.

I especially appreciate it when a reader signs up to follow the blog. It’s the ultimate validation for me as a writer: you liked the content enough to want to see more and to have it delivered directly to your inbox every Friday to make sure you don’t miss an episode.

And in the blogosphere, the number of followers you have is the gold standard for measuring success. Success would be nice, but I have a long way to go to achieve it and I don’t really expect it.

Managing the blog (e.g., rooting for content each week, writing a 600+ word episode, converting it to a podcast, refining and implementing the advertising plan, interpreting the results, and interacting with readers) keeps me busy in ways that push my cognitive envelope. In itself, it should provide a measure of protection against decline. But I also find it intriguing to monitor myself so I can catch as many errors as possible, try to better understand what causes them, and to divine what clinical implications (if any) they might have.

It’s work, but it’s fun.

Getting back to Zach’s question, after six months, several reasons for writing this blog have emerged: a desire to help in some small way, the rewards of having my work read and appreciated, and the joy of doing it.

Thanks for asking, Zach!


S1E19. My Screening Test

In the third episode ‘My Life Is Now An Experiment’ (https://tinyurl.com/3j6vaf7x), I described myself and this blog as an ongoing experiment, recording data that could later be evaluated to determine if my experiences represented normal aging or the path to dementia.

It’s not a ‘real’ experiment, of course, and that made me think that it might be valuable for me to apply to participate in a real clinical trial…and so I did.

My Facebook feed is overrun with invitations to participate in a variety of studies and so I responded to one. I received a telephone call a few days later which was described as a ‘pre-screening interview.’

I was told about the experiment and asked if I was willing to take medication, undergo periodic testing including MRIs and blood samples, and travel to a testing site periodically for ongoing assessments. I was more than happy to do so. 

The person on the phone asked what kinds of problems I was having and I related some of the information I’ve posted in this blog. She wanted to know if there was a caregiver available who could accompany me and so I had her talk with Sally.

I was informed that someone would contact me to arrange an in-person appointment for an actual screening.

I was delighted!

Last Friday, I drove an hour to the nearest testing site (this is a nationwide study) for my assessment. The office was located on the first floor of an unassuming building. I presented myself to the receptionist and was asked to complete a standard form detailing my medical history. As I did so, I smiled inwardly because the form required me to write the date on each of 8 pages. I chuckled because I knew that one of the standard assessment tests that is frequently used to screen for cognitive impairment asks you to give the current year, month, and date…and here I was practicing the answers to 3 of the questions!

The physician performing the assessment ushered me into his office a few minutes after I turned in my completed forms. He went to great lengths to make me feel comfortable, explaining that this interview would be very informal and not like a normal visit to the doctor. He explained that his practice contracts with drug companies to recruit participants in research projects.

He then asked me if I was having problems with my memory and I told him about my recent experiences. He then explored what kinds of accommodations I was using.

We talked a little about my career as a psychologist and my volunteer political work over the last decade.

At this point, my gut feeling was that I was not sufficiently impaired to be selected for the study, i.e., I had flunked the interview! But he asked if I’d like to go ahead and have him administer the screening test, and I, of course, said ‘Please do.’

As I had guessed, the instrument he used was the Mini-Mental Status Exam (MMSE). I had administered it often in my work, but if you had asked me, I would only have been able to name a few of the items from memory…like the ones asking about today’s date. However, I did recognize each question as he asked it.

(I’d like to pause here for a moment to ask a favor of you. Even though it’s easy to google the MMSE and download all the questions, I’m going to ask you not to do that. If you should ever find yourself being evaluated, you want the testing to be as accurate as possible. Knowing the questions and, far worse, practicing the answers would contaminate the results and contribute to an inaccurate diagnosis. And that is why I am encouraging you to use some constraint here.)

I wanted to do my best (even though that might result in my not meeting the impairment criteria for the study) and so I decided to take my time and double-check my responses before answering.

There are a couple of questions that ask you to perform tasks in your head using working memory. I was a little surprised at the amount of effort it took, even though I got the right answers.

There was one task that I was on the verge of messing up, but I caught myself in time and corrected my mistake.

There was another question I answered correctly, but realized afterwards that I hadn’t considered a critical element of the solution when formulating my response. 

Final result: I only made 1 mistake. If I had made 3 mistakes, I would have met the criteria for further testing.

The doctor told me I did not qualify for this study and we chatted a few minutes longer. He offered advice for maintaining cognitive health, including learning new things, eating lots of colorful vegetables and berries, exercising and staying socially engaged.

He thanked me for offering to participate and I thanked him for the work he was doing.

I drove home with mixed emotions. I was disappointed that I hadn’t gotten into the study, but relieved that the errors I was making didn’t yet meet criteria for an impairment.

So far, so good.

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S1E16. The Name Game

No…not the Shirley Ellis 1964 version (“Nick, Nick, bo-Bick, bo-na-na fanna fo Fick…).

I created a new version after noticing I was blocking on names in everyday conversation. Although I clearly knew who I was talking about, when it came time to say their name, I would blank out and it would take me 5-10 seconds to retrieve it.

That got me thinking about remembering names in general. There are plenty of articles on the web about how to better remember names when you are first introduced, but I couldn’t find anything about how to recall names of people who were well known to you.

So I decided to test myself by trying to remember names of people who I hadn’t seen in years.

I started in 1972 (the year I graduated from Brown) and tried to recall names up to about 2011 when I left North Carolina to move to Pennsylvania to be with Sally. 

I had no trouble at all conjuring up mental images of their faces. After all, these were people with whom I had long-term relationships, like professors, co-workers and neighbors.

A few names appeared right away. For the most part, though, I had to work hard to find them. I would often get the first name fairly quickly, but it might take me 15 minutes or more to find their last name. Having done this for a week, I’ve successfully recalled dozens of names from my past, with only 2 remaining unidentified.

All of which got me wondering about what was going on in my brain. 

Memories of faces and memories of names are stored in different places in our brains. Designing and implementing a strategy for finding both and linking them takes place in another area altogether. And then there are the pathways that connect all three regions.

So what did I learn about myself by playing the game? First, I can recall a lot of faces. More accurately, I can recall important faces. There are hundreds of patients I saw as a psychologist and guests I hosted at our B&B who didn’t leave retrievable memory traces.

Second, although they are hard to find, my memory for names is pretty good, too. The memory of the name is intact as is the pathway connecting it to its face.

Third, my ability to create a task, develop a strategy and implement it is also working well. I tried multiple approaches when my initial search failed: going through the alphabet to test first letters (similar to how knowing the first letter of an answer in a crossword puzzle makes it easier to solve), trying to recall how many syllables were in the last name, replaying memories of my interactions with the person instead of just viewing their face in my mind’s eye. And then there were the times when I just gave up…and the name popped into my head ten minutes later!

But it wasn’t like I could go straight to the file folder where I knew the answer was. Most of the time I was staring into empty space, knowing that the answer was not where I was looking. I could feel when I was wrong and also when I was on the right path. When I did unearth the correct name, it was as if all the associated circuits lit up simultaneously and I instantly knew for certain that I was right.

So if I had to guess, I would say that my weakest link might be the pathways connecting the involved modules. It would make sense (to me, anyway) that they had atrophied over the years for lack of use.

But is this normal aging? I have no clue! In my brief web search, I couldn’t find any published research about this subject. The failure to connect faces with names and identities is well-documented in Alzheimer’s Dementia, but I couldn’t find anything about difficulty making those connections earlier in life being a risk factor.

So if you decide to play the game, please let me know how you make out. I’d love to hear about your experience.

In the meantime, feel free to reminisce a bit with Shirley Ellis’ memorable  lyrics:

The name game. Shirley! Shirley, Shirley

Bo-ber-ley, bo-na-na fanna

Fo-fer-ley. fee fi mo-mer-ley, Shirley!

Lincoln! Lincoln, Lincoln. bo-bin-coln

Bo-na-na fanna, fo-fin-coln

Fee fi mo-min-coln, Lincoln!

Come on ev’rybody, I say now let’s play a game

I betcha I can make a rhyme out of anybody’s name

The first letter of the name

I treat it like it wasn’t there

But a “B” or an “F” or an “M” will appear

And then I say “Bo” add a “B” then I say the name

Then “Bo-na-na fanna” and “fo”

And then I say the name again with an “”f” very plain

Then “fee fi” and a “mo”

And then I say the name again with an “M” this time

And there isn’t any name that I can’t rhyme

Arnold! Arnold, Arnold bo-bar-nold

Bo-na-na, fanna fo-far-nold

Fee fi mo-mar-nold. Arnold!

But if the first two letters are ever the same

Crop them both, then say the name

Like Bob, Bob, drop the “B’s”, Bo-ob

Or Fred, Fred, drop the “F’s”, Fo-red

Or Mary, Mary, drop the “M’s”, Mo-ary

That’s the only rule that is contrary

And then I say “Bo” add a “B” then I say the name

Then “Bo-na-na fanna” and “fo”

And then I say the name again with an “”f” very plain

Then “fee fi” and a “mo”

And then I say the name again with an “M” this time

And there isn’t any name that I can’t rhyme!

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–Wayne

S1E15. Vivid Memories That Aren’t

“I’m at Mom’s condo. The police are here. They won’t commit her. Can you please talk to them?”

It was a frantic call from my sister Lorna in Florida. My 83 year-old mother had assaulted her aide and the police had been called. We knew she was dementing, but she refused to move into assisted living. It was only a matter of time before something like this happened.

I vividly recall talking to the officer from the dining room of our B&B, holding the phone to my ear and pacing back and forth only as far as the cord would allow me. Fortunately, we had no guests at the time.

I told him that I was a licensed clinical psychologist and explained why she needed to be committed. He replied that she did not currently appear to be a danger to herself or others and he could not commit her under Florida’s Baker Act. He told me I was a terrible son for not taking better care of her and that if I didn’t make arrangements for her, he would have no alternative but to handcuff her and arrest her for assault. 

I told him to go ahead and arrest her. When he tried to do that, she did exactly what I knew she would do: she punched him. At that point, the police restrained her, brought her to a hospital psychiatric unit and had her committed. She got the help she needed.

Nearly all of what I just recounted is true, all except my vivid memory of having the conversation in the dining room of our B&B. You see, I didn’t become a clinical psychologist until 5 years after we sold the B&B.

Yet I can see this scene in my mind’s eye as clear as day. I see myself holding the phone…and that should have tipped me off that my memory was faulty, because I could not possibly have seen myself at that moment. I might have seen the table, the door out to the side porch, or my wife, but I would not have seen myself. The perspective of my memory was all wrong.

As memory expert Dr. Elizabeth Loftus tells us, “…once you have an experience and you record it in memory, it doesn’t just stick there in some pristine form you know waiting to be played back like a recording device. But rather, new information, new ideas, new thoughts, suggestive information, misinformation can enter people’s conscious awareness and cause a contamination, a distortion, an alteration in memory…”

So mis-remembering is a fairly common occurrence, but I suspect it can become more of a concern as we age, not because we are subject to new information being received, but because our memories become more fluid and permeable, that is to say, more at risk for being contaminated by a nearby memory.

In the case I just described, I tried hard to recall some other important conversation I might have been remembering that had occurred in that location, but I couldn’t. Then I tried to imagine having the conversation in the house were I actually was living in 2003 when this happened…and I couldn’t. So the mystery of this faulty recollection remains unsolved.

But it does bring to mind a similar, more recent experience. Once again, my memory is distinct and clear. We had just moved to Kennett Square and we went to the grand opening of the local Democratic Party campaign headquarters. It was 2012 and we were eager to work for Obama’s re-election.

No sooner had we stepped inside the door than the party chair walked up to us, introduced himself, and asked where we lived. When I told him, he immediately invited me to join the organization as a committee person for our precinct.

Although I don’t see my wife who is standing beside me in this memory, I feel her presence. The problem is that it’s not Sally. It’s my first wife who had passed away two years earlier. 

That’s the kind of porous, mix-and-match memory recall that concerns me. I have no clue if this is meaningful or not in terms of distinguishing normal aging from the alternatives, but I’ll keep an eye on it. One thing is for certain: it’s definitely a mistake on the journey.

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S1E14. That Was Then. This Is Now.

I wrote this about my parents when I was 22:

‘They’ve been grandparents almost two 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.’

When I wrote that closing line, I meant ‘old’ as a pejorative, not as a compliment.

My father was 52 at the time. He died at 60. My mother lived to be 85, developing dementia a few years before she died.

Paul Simon wrote this lyric into the song ‘Old Friends’ when he was 27 years old:

“Can you imagine us

Years from today

Sharing a park bench quietly?

How terribly strange

To be seventy”

Sally and I are 70. We quietly share park benches. It’s not strange at all.

On the other hand, Paul Simon will be 80 in October.

Our view of aging is curious, isn’t it? How must today’s 20-somethings view us? If we asked Paul McCartney today, would he say that 84 is the new 64? 

In any event, heading toward our ninth decade, the goal is to be active, engaged, wise and interesting…a group of adjectives we don’t normally associate with the degenerative effects of dementia. The good news is that there appear to be things we can do to increase our chances of achieving those goals and of sidestepping our worst nightmare. In fact, we can now reduce our risk of dementia by some 40% by adopting a brain-healthy lifestyle. We can fight back against the prejudices and preconceptions of our younger selves!

Spoiler alert: I’m not one for miracle cures or for buying into ‘secret information that you can’t find anywhere else.’ As a former psychologist and researcher, I trust the science and want to see multiple studies heading in the same direction before I accept a conclusion as valid. So here are 4 recommendations for which there is a body of evidence supporting their efficacy:

  1. Take care of your heart. Your brain depends upon blood flow to provide nutrients and remove debris. There are 400 miles of blood vessels in your brain. You want every inch of them pumping at peak efficiency to prevent neuron damage and maintain synaptic connections. Adopt a heart-healthy diet; keep your stress levels in-bounds; keep your blood pressure and cholesterol levels in check.
  1. Exercise. The current guideline is about 150 minutes of ‘huffing & puffing’ each week (e.g., 30 minutes/day x 5 days). Walking is fine, but you need to work up a sweat and breathe hard. Obviously, this is good for your heart, but I also suspect that its moderating effect on cognitive function is also related to the fact that it engages so many areas of your brain.
  1. Challenge yourself cognitively. Read books. Learn new skills. Change your routine. Solve puzzles. Take on-line courses or, better yet, once we are COVID-clear, take courses in person. There seems to be a ‘use-it-or-lose-it’ aspect to how well our brains age, so try to be open to new experiences and challenges.
  1. Socialize. We are social animals and engaging with others engages our brain in ways well beyond any other activity. Just take a moment to think about all the ways you use your brain when sitting down for a meal with a group of friends. The complexity of negotiating a social context is stunning, invigorating, challenging…and fun! 

That’s roughly where the research stands today. You can reduce your risk of developing dementia by about 40% if you adopt a lifestyle that also happens to be associated with increased longevity. You get double the bang for the buck: more years and better years.

Bottom line: We don’t have to accept the dire predictions of our younger selves. We can marshal the resources that got us this far to get us through the final years of our journey in good stead. It’s definitely worth a shot.

All of which gives a brand new meaning to Bob Dylan’s 1964 lyric:

“…I was so much older then

I’m younger than that now.”

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S1E13. A Baby Boomer’s Worst Nightmare

“Don’t ever let me get like that.”

Sally’s 7-word reaction to the movie said it all.

We had just watched ‘The Father’ starring Anthony Hopkins. It’s the story of an 80-something year-old man in London struggling with dementia. The movie is filmed in a way that forces you to not just observe him, but to experience his confusion for yourself, to get a brief glimpse of what it might be like to have dementia. 

It’s masterful. The performances are superb. It’s painfully important for you to see it.

It immediately forces us to address our worst nightmare: What if we get like that?

Our parents’ worst nightmare was becoming a burden to their children. Themselves children of The Great Depression, they feared financial insecurity that would deny them their independence as they aged. They didn’t want to add the weight of caring for them to their children who would be simultaneously carrying the burden of raising their own families.

But that generation didn’t expect to live long enough to dement. Seventy was considered a ‘ripe old age.’ The prevalence of dementia wasn’t what it is now. 

More than half of us baby boomers will live into our eighties…and the incidence of dementia will increase. It’s our worst nightmare.

If dementia is the path before me, is it possible to prepare for it like I did with retirement? What happens when I stop being me? When is being alive not the same as living? Where are the inflection points?

I’m wrestling with all of those questions.

There is one school of thought that says we are constantly changing throughout our lives and that dementia is just another aspect of that change. You might become different as you dement, but you are still you. 

I don’t think I agree with that.

Our life changes are forged from our experiences that shape how we relate to the world: how we think, feel and act. In normal aging, we continue to grow and adapt to our changing bodies and environment until we die.

The dynamic is quite the opposite in dementia. There is a physical process that is attacking our capacities, our stored memories and our adaptations. It is fundamentally changing how we think, feel and act–not in the furtherance of our ability to survive and cope with our world–but in direct conflict with it.

That’s not living. That’s dying.

Hospice and palliative medicine physician B.J. Miller, In a recent New York Times opinion piece titled ‘What Is Death?’ wrote:

“For some of us, death is reached when all other loved ones have perished, or when we can no longer think straight, or go to the bathroom by ourselves, or have some kind of sex; when we can no longer read a book, or eat pizza; when our body can no longer live without the assistance of a machine; when there is absolutely nothing left to try…If I had to answer the question today I would say that, for me, death is when I can no longer engage with the world around me. When I can no longer take anything in and, therefore, can no longer connect.

I agree with Sally: ‘Don’t let me get like that.’

In the 2014 film ‘Still Alice,’ Columbia University cognitive psychologist Alice Howland (played by Julianne Moore) develops a suicide plan after receiving a diagnosis of early onset Alzheimer’s Dementia. She designs it to be implemented at the inflection point when she loses full agency over her life. Spoiler alert: Her plan doesn’t work.

In ‘One Flew Over The Cuckoo’s Nest (1975),’ after witnessing the life-altering effects of a lobotomy on Jack Nicholson’s character, Chief holds a pillow over McMurphy’s head and smothers him to death. He knew that Mac was no longer Mac and that his life had already been stolen from him.

So it appears that there are a few questions that need to be asked and answered. First, is there a point when dementia meets Miller’s definition of death? And, if so, is there anything we can do about it?

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