Prime Time (22 page)

—The Wonderful Wizard of Oz

T
HERE WAS THE DAY I WAS SUPPOSED TO BE AT A TELEVISION station to be interviewed about the First Annual World Fitness Day in Atlanta. I was seventy-two at the time, and I felt a huge weight of responsibility on my shoulders. What if the event wasn’t successful? I hadn’t slept well for quite a while, worrying about all the terrible things that could go wrong. I was halfway to Culver City for the interview when I called my office to get the address of the station only to discover that I was supposed to be in Burbank—over the mountain and in the valley, in the exact opposite direction! I knew I was supposed to be in Burbank! My office had told me that several times! Why was I headed the wrong way? Because I forgot, that’s why!

That same day I sat on my glasses, destroying them; I forgot the name of the doctor I was supposed to see that afternoon; and, to top it off, I lost my MasterCard. Had I not been deeply into brain research for this book, I would have sworn I was developing Alzheimer’s disease.

But I knew better. All these mishaps were the result of stress on an aging brain. When I was younger, I probably could have managed it fairly well. Sleep deprivation might have caused me to head in the wrong direction even in my thirties, but I probably would have remembered the doctor’s name and not lost the credit card—and I wouldn’t have needed glasses! I’d been feeling stressed for a while, and I knew that stress causes the adrenal glands to produce high levels of cortisol, which dulls the effects of the brain’s hippocampus, where memory is stored and retrieved. The neurons that transmit messages are destroyed. I swear I could feel my neurons disappearing by the minute!

No wonder I experienced one mishap after another. Once the stressful Fitness Day was over—and, as it turned out, very successful—and once I got back to working out and sleeping well, such problems no longer occurred. They will again, I’m sure. But because of what I’ve learned about maintaining a healthy brain, I make a concerted effort to minimize stress in my life through exercise and meditation. If nothing else, perhaps the desire to protect your brain will motivate you to do the same. (See
Appendix V
, “Guide to Mindful Meditation.”)

Stress isn’t the only thing that’s bad for the brain. So are hypertension, heart disease, diabetes, high cholesterol, mini-strokes, exposure to environmental toxins, severe head injuries, smoking, drinking too much, using recreational drugs, eating an unhealthy diet, and inactivity. While we may be genetically predisposed to heart disease and high cholesterol, for example, choosing a healthier lifestyle that includes body and brain workouts can do much to improve our cognitive function. “Cognitive function” means thinking—reasoning, remembering, processing what we see and feel, planning, and sending signals out to our limbs.

The good news is that clear evidence from functional imaging shows that the brain has great reserves of plasticity. It is capable of adaptation and reorganization, acquiring new skills, absorbing new data, and changing its circuitry in response to the cognitive demands placed on it. Moreover, where there has been a lessening of certain cognitive functions, such as inductive reasoning, spatial orientation, and short-term memory, these functions can be restored with training.

As we age, our brain volume declines, but some parts are more susceptible to loss of volume than others. I learned from the late Dr. Robert Butler, at the International Longevity Center, that there are many pathways for processing thought. “The circuitry in your brain is interconnected in multiple ways,” he told me, “resulting in what neurologists call ‘neural redundancy.’ Think backup systems: When one goes down, another is at hand to help carry the load.” As certain neural networks are broken, the brain searches for new networks. If cognitive functions that have been handled by certain regions of, say, the left frontal lobe are impaired, the right frontal lobe may be recruited to help its neighbor. In stroke victims, for instance, other parts of the brain take over the recovered functions from the parts that are damaged. This is known as “compensatory recruitment.” And it’s good news, because it provides evidence for the elasticity and adaptation of the brain.

While younger people use one side of their brain for a given functional task—the right frontal cortex, for example—older folks will often use both sides to perform the same task. Their cognitive processes may be slower, but that doesn’t mean they have functional impairment. Are you one of those people who panics every time you call your son by your brother’s name, or your grandson by your son’s name, or when you can’t think of something you should know well—like your stepson’s name—and see it as a sign that you’re about to get Alzheimer’s? Don’t worry, things like forgetting names are not predictive of Alzheimer’s. When I forget a name or a fact, rather than furrow my brow and try to force myself to remember, I let it go—and often as not, it comes to me later. When I think I’ve lost something, rather than panic, I go about my business, and sure enough, it’ll turn up in the purse I carried yesterday, or in the backseat of my car, where I put it two days ago. I’ve learned to relax into memory, if you will.

Brain-imaging technology shows “that not only is normal brain shrinkage less than we feared, but much of what is lost may be judicious ‘pruning,’ ” says Dr. George Vaillant, director of the Harvard Study of Adult Development. He likens this to an attic that has filled up carelessly over the decades but now, with age, we clean it out and select only the most cherished, meaningful items to keep. Dr. Denise Park, director of the Center for Vital Longevity at the University of Texas at Dallas, puts it this way: “You may lose a bit of horsepower, but you are highly efficient as you rely on your knowledge and experience instead. Maybe this is the Prius model of cognitive aging.”
¹

Exercise and the Brain

Science shows us that seniors who have remained fit and who continue to exercise continue to have good brain functioning. Cardiovascular fitness is perhaps one of the best things we can do to maintain our brain health. Even when older people who have never been particularly active engage in moderate exercise, they see their cognitive functioning improve. This is because physical exercise causes an increase in a chemical nerve growth factor that allows brain cells to grow, stimulates the connections between them, and helps in memory function.

Because of the increased obesity and inactivity in the United States these days, it is possible that we will lose, as a country, all the health gains of the last fifty years. Some economists suggest that we could lose it in a single generation. This is frightening when you consider, for instance, that physical health is related to dementia. We might see an increase in the rates of dementia and Alzheimer’s disease. Right now, a conservative estimate is that a quarter of the population over eighty will get Alzheimer’s. Reports show that by midcentury as many as fifty million older Americans may get the disease. While research is under way to prevent or postpone Alzheimer’s, scientists already know that people in their sixties can reduce their risk of Alzheimer’s—by half!—through exercise. This is why, when I work out, I am not just thinking about my body; I’m also thinking about my brain. I want to do everything I can to maintain it, so that if I am one of the fifty million Americans who will get Alzheimer’s, it won’t happen until I am ninety or older, as opposed to when I am eighty-two.

Challenge the Brain

Dr. Denise Park says that “if you are living a life with a high degree of engagement in activities that are cognitively demanding, it may delay the onset of Alzheimer’s a little bit—delay it, not change it. You might still be diagnosed, but putting it off by a couple of years extends your quality of life and benefits you, your family, and even our health care system.”

When it comes to cognitive function—or brain health—education plays a strong role. This is partly because early education positively affects brain circuitry. Also, a well-educated person will tend to engage more in mentally stimulating activities such as reading, chess, and ongoing learning. Higher incomes and mentally challenging types of work also contribute to maintaining one’s cognitive ability.

At a seminar on longevity, Dr. Park explained,

tasks will improve cognition if they continually challenge the cognitive system by making sustained demands on executive function over a prolonged period of time and are relatively novel for the individual performing the task. Just like the person who has had a stroke has to use a different hand to perform tasks to develop new neural networks, it is plausible that performing other novel tasks will do the same for a healthy aging brain. As an example, we think learning to quilt could be stimulating for someone who never sewed before. If you are already an expert quilter, I would suggest learning a musical instrument or some other skill that you find both challenging and fun. It is critical to keep learning and adapting new sequences of complex behaviors. Have fun and try a new domain that broadly stimulates some new neural networks.

“The other thing that people underestimate,” continued Dr. Park,

is the unique demands of social interactions. In a social situation, it’s really inappropriate not to remember someone’s name, or what they told you the day before about their grandchildren, and there is thus actually quite a bit of cognitive demand. I would put social interaction as an important element of stimulation. To enhance cognition, you need to be productively engaged in activities that demonstrate sustained activation of your working memory, reasoning, and other higher-order cognitive functions. These are all primarily frontal cortex functions—the most flexible, plastic area of the brain you have to be using those areas of the brain. Think of a guy who is multitasking at work. He’s on the phone; he’s at the computer; he is planning for his upcoming meeting. This would be very demanding of neural function, and I would venture to guess that this productive engagement would enhance cognition (as long as the stress level did not become destructively high). The couple that’s familiar with each other, sitting around and having a great time at the beach, chatting and telling old stories, are probably not facilitating their cognition very much.

Here are some examples of brain exercises you might consider:

• learn anything new: a new language, a new hobby, a musical instrument;
  
• meet new people who involve you in conversation;
  
• memorize poetry;
  
• learn new words every day;
  

…and, as I have said, get physically active. All of these activities can be successfully begun anytime, including later in life.

One more thing: Estrogen therapy, if begun while a perimenopausal woman is in her late forties or early fifties, can improve and protect the brain. Hormone replacement is so controversial, and its effects vary with the individual, so it’s best to consult a doctor. Still, Cynthia Gorney wrote in the
New York Times Magazine,
“It makes new cells grow. It increases what’s called ‘plasticity,’ the brain’s ability to change and respond to stimulation. It builds up the dendrites and number of dendritic spines, the barbs that stick out along the long tails of brain cells, like thorns on a blackberry stem, and hook up with other neurons to transmit information back and forth. The thinning of those spines is a classic sign of Alzheimer’s.”
²

In the next chapter, I will tell you some really good and interesting news about aging.

CHAPTER 9

Positivity: The Good News Is You’re Getting Older!

We are all happier in many ways when we are old than when we are young. The young sow wild oats. The old grow sage.

—WINSTON CHURCHILL

G
UESS WHAT? YOU CAN PRETTY MUCH EXPECT TO BE HAPPIER at eighty than you were at twenty! Regardless of whether you are male or female, married or single, employed or not, or have your children living with you! Regardless, in other words, of events in your life. Surprising, huh? Especially given all the things that can start to go south with age—for example, buttocks, joints, valves, skin, hairlines, and social networks!

Nonetheless, a 2008 Gallup poll showed this result after interviewing 340,000 Americans aged eighteen to eighty-five. Dr. Arthur A. Stone, a professor of psychology at the State University of New York at Stony Brook, who led the study based on the poll, isn’t sure why this uptick in well-being occurs.
¹
Could it be psychological changes? Alterations in brain chemistry or endocrine changes? No one really knows. What appears to be certain is that between the ages of eighteen and fifty, those interviewed tended to feel more sadness, stress, worry, and anger—and then,
vavoom,
beginning at fifty, life seemed to take an upward turn.

This has been my personal experience as well, although I became more aware of it at age sixty than at fifty. As I said in an earlier chapter, one of my main character traits as a younger person was a tendency to melancholy. On top of that, I was wound pretty tight. The ten years I spent with Ted Turner (from ages fifty-two to sixty-two) taught me more about laughter and letting go than almost anything ever had before. In fact, I’ll tell you a secret: I wouldn’t have been able to be as funny playing Jennifer Lopez’s mother-in-law in
Monster-in-Law
had I not had that time with Ted, who made it possible for me to learn to laugh at the outrageous and to see that over-the-top can be endearing.

But it has been more than ten years now that Ted and I have been apart—from ages sixty-two to seventy-two—and I continue to notice how much more positive I have become … joyful, even. Most things that would have run me up the wall with anxiety or sent me to bed with depression roll right off my back now. Very few things really stress me anymore. Well, children and grandchildren can still cause stress! As they say, “You are only as happy as your least happy child.” But for me, it’s not anywhere near what it used to be, and when stress comes, it doesn’t linger.