what happens to the brain and mind as we get older? dr catherine loveday
TRANSCRIPT
What happens to the brain and mind as we get older?
Dr Catherine Loveday
“A youth who does not respect his elders will achieve nothing when he grows up”
Confucius
INTRODUCTION
Why study the ageing brain?
Increasing no. of people over the age of 65
Research helps us to learn more about the ageing brain so that we can enhance the quality of old age Office for National Statistics
Variations in the effects of ageing
Changes in normal ageing brain not uniform: certain subsets of cells & areas of the brain more prone to age-related damage
Time of onset, extent of physical alterations & effect on intellect differ dramatically from one person to another
Leland McPhie age 95
SENSORY CHANGES Vision:
Lens becomes less flexible & yellowing of lens Cataracts, glaucoma, macular degradation
Hearing Large percentage of people 70 & above, have some hearing loss,
usually at high frequencies Taste & smell
Three-quarters of people over 80 have major difficulties with smell Smell more affected than taste but both linked Taste buds & smell receptors continue to be replaced throughout life so
more resilient Consequences for mental functioning & can be misleading
BRAIN CHANGES - vascular
Changes to the cardiovascular system: Circulation less efficient
brain less well nourished and toxins less efficiently removed
Greater likelihood of strokes and blood clots
Better cardiovascular health leads to better brain health
BRAIN CHANGES – key anatomical changes Overall number of brain neurons
decrease but pattern is not uniform. Parts particularly affected include
limbic system (learning, memory and emotion),
frontal lobes (planning, strategy, working memory)
substantia nigra (movement, reward, learning)
locus coeruleus (stress, panic, REM sleep)
BRAIN CHANGES - Neuronal
Damage to internal architecture of neurons may occur, e.g. neurofibrillary tangles
Areas between neurons may also be affected, e.g. amyloid plaques
Tangles & plaques occur in all ageing brains but are a particular marker of Alzheimer’s disease
BUT, not all neuronal changes are destructive…
Neuronal plasticity
Coleman, Flood & Buell (1987) Net growth of dendrites in
regions of hippocampus & cortex - middle age & early old age
Regression again in late old age. Postulated that initial dendritic
growth represents an effort by viable neurons to cope with the loss of their age-associated neighbours
BRAIN CHANGES- molecular Characterised by increased
numbers of free radicals and oxidised proteins (N.B. Progeria)
Ironically, proteases (enzymes responsible for breaking down oxidised proteins) are themselves oxidised
Studies in rats have shown that maze learning is directly related to numbers of free radicals and oxidised proteins
COGNITIVE CHANGES
Behavioural & cognitive changes surprisingly few Coping strategies may be developed in mid old age -
strengths focused on & lost abilities compensated (probably less effective in v old age)
Few people decline on all mental abilities - by 60s, most people have declined on one or two abilities (typically those used least throughout their life)
Not all individuals decline; few do so at a steady pace – tends to be stair-step (typically related to life events)
So which cognitive functions are affected by age?
Usually some reduction in fluid intelligence (logical problem
solving) memory (especially recall,
source memory, prospective memory and working memory)
processing speed (affects ability to do complex tasks or those with timed element)
executive functions (e.g. planning, disinhibition)
Which cognitive functions are not affected by age?
Knowledge & wisdom continue to grow
Crystallised intelligence remains stable (ability to apply knowledge & skills)
Vocabulary continues to grow Some aspects of memory are
resilient, e.g recognition memory
Piano – DrumEgg – SeedPoem – StatueEnemy – Friend
How to age-protect your brain (1)A healthy body means a healthy brain:
Physical activity, e.g. walking, running (physical & psychological benefits)
Keeping healthy: low incidence of cardiovascular or other chronic diseases
Good sensory systems with aids where necessary
Good diet + antioxidants? Avoidance of ingestion of agents that
interfere with the nervous system (e.g. alcohol, tranquilizers)
How to age-protect your brain (2) Psychological wellbeing is
just as important (direct impact on physical health & cognitive functioning)
Favourable and stimulating environment
Optimism & flexibility Minimising major life
changes in late old age Sleep & relaxation
How to age-protect your brain (3)
Maximise brain power Mental activity: “Use it or lose it!” Use strategies:
Make important things habitual Use memory aids & mnemonics Maximise attention when it
matters Use all senses One thing at a time
Allow more time
How do we detect changes in pathology over and above cognitive changes associated with ageing? Look at overall profile & observe nature & rate of change Eg Alzheimer’s disease begins with noticeable decline in
remembering event-based information. Rate of decline & appearance of new cognitive symptoms can
help to distinguish between dementia & mild cognitive impairment: More memory loss; disorientation for time, place & person; silly
errors in action & speech; depression & anxiety; personality intact Frontal lobe dementia will present first with personality
changes and executive dysfunction Diagnosis very important & also important to identify reversible
dementias
Conclusions Ageing leads to a range of physiological changes
both in the brain and the senses This leads to noticeable decline in some cognitive
functions but growth or resilience in others Keeping physically & psychologically well will age-
protect the brain and using strategies to compensate will also help
Sometimes ageing leads to abnormal brain changes - accurate diagnosis is important