New Views of Mind/Brain Aging

Darlene V. Howard, Ph.D.

Georgetown University
Davis Family Distinguished Professor, Emerita
howardd@georgetown.edu

National Press Foundation

March 14, 2018

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 Roadmap
• A fine time to be old

• The aging mind & brain

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 A fine time to be old . . . .
• There are a lot of us

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 A fine time to be old . . . .
• There are a lot of us
– Camaraderie
– Political clout
– Opportunity to redefine what it means to be old
• Technology
– Help to maintain independence
– Facilitate contact with loved ones & current events
• Society more accepting of diversity
– Universal access
• New discoveries about the aging mind & brain

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 The Old View
1 All cognitive functions decline with aging

2 Old brains operate the same way as young, only less

efficiently

1 There is nothing we can do about age-related

declines

2 Alzheimer’s disease is just accelerated aging, and

there is little hope of conquering it

NONE OF THE ABOVE IS CORRECT

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The New View . . .

1-Cognitive loss is selective

• some components decline
• but others don’t
• people differ

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 Cognitive loss is selective: some abilities
decline but others improve, and people differ
High
• What declines?
– Speed
– Long-term memory & learning
• most kinds
– Executive control & working
memory
– Word finding/retrieval

Low

• What is spared/improved?
– Vocabulary & world knowledge Age
– Some aspects of problem solving & decision making
• Interpersonal & real-world ill-defined problems
• Delaying rewards in decision making (including financial)
– Regulating emotions
Note: Gradual across adult years
Data from Park et al 2002
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 People Differ
Fast

Speed

Slow

Salthouse, Psychological Review, 1996

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 Regulating Emotion:
Happiness & Depression Curves
http://www.economist.com/node/17722567

Just google “happiness curve”

Often called “subjective well-being”

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 "This is the best time of my life. I love being
old. . . . Because I am more myself than I
have ever been. There is less conflict. . . I
am surer of what my life is all about, have
less self-doubt to conquer.”
– May Sarton At seventy: A journal

So . . . cognitive loss is selective

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 The New View . . .

2-Old brains often do things differently

from young
• Brain loss is selective
• The brain seems to adapt to its own aging
• Lifelong neural plasticity—experience
dependent

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Brain Loss: Also Selective

Naftali Raz
Wayne State

Kristen Kennedy
U T Dallas

Karen Rodrigue
U T Dallas

Raz et al Cerebral Cortex (2005)

 Old brains often do things differently from young

Data from Braver et al 2009

D
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Is bilateral activation good or bad?
• Debate on this,
– Older brains appear to be working harder than
young
– Nonetheless, evidence indicates is often good
• Older people with bilateral show better memory
performance
• Temporarily “lesioning” the second hemisphere often
hurts memory performance
– Lesion via Transcranial Magnetic Stimulation (TMS)
– TMS demonstration:
http://www.wwnorton.com/college/psych/psychsci2/content/activities/ch04a.asp#movie

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 Lifelong Neural Plasticity
• Normal aging doesn’t lead to loss of neurons
• Throughout life, we can grow
– new blood vessels (angiogenesis)
– new connections among neurons (synaptogenesis)
– new neurons (neurogenesis)
• Hippocampus
• This lifelong neural plasticity is experience
dependent

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 The New View . . .

3-We can do a lot to slow or prevent

age-related declines

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Promoting Healthy Cognitive/Brain Aging
– “Brain games” (typically computer-based)
– Social engagement
– Diet
– Physical exercise
– Lifelong bilingualism
– Meditation
– Taking on new learning (e.g., photography, new
language)
– Teaching & practicing reasoning skills
– Attitudes toward aging

– Best documented so far????

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 Aerobic Exercise
• Typical randomized clinical trial type study
– sedentary older adults (age 60-79)
• All get exercise class
– 3 days per week, 45 min/day, 6 months (or more)
– based on 2008 DHHS Physical Activity Guidelines
• Randomly assigned to two groups
– Aerobic (walking)
– Anaerobic (stretching and toning)
– Cognitive/Brain Measures (before, during, after training)
– Gray and white matter volume
– Brain activations
– Cognitive functions (e.g., working memory, executive function)
– Findings: Aerobic improves more than the anaerobic

Data from Erickson et al (2011) University of Pittsburgh

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 Experience Corps
(Social Engagement?)
http://www.youtube.com/watch?v=UrTJDXW0_0I&feature=related
Description of EC

http://coah.jhu.edu/research/projects/Experience_Corps_pages/
Baltimore’s EC Home Page

http://www.youtube.com/watch?v=dxN47eKtB88&feature=related
Advantages for older adults

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• 2 year-long
randomized clinical
trial with 111
participants

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 Clinical Trials of Lifestyle Changes
• Growing number of studies showing effects on
– task performance
– brain function and structure
– subsequent lifestyle changes
• Exciting because of broad advantages for
individual and society
• But . . .
– Hard to know what is causing changes—often loose
controls
– Very expensive to conduct
– Can be hard to get funded

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NAP.EDU

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 The New View . . .

4-Alzheimer’s Disease (AD) isn’t just

accelerated aging, and we can do a lot
to delay the onset of symptoms

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 AD isn’t just accelerated aging
• Different patterns of brain loss in aging & AD
– loss of neurons in AD, but not in normal aging

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 AD isn’t just accelerated aging
• Different patterns of brain loss in aging & AD
– loss of neurons in AD, but not in normal aging
– different pattern of brain changes
• The bad news
– Drug trials continue to be discouraging
– Treatment starting too late in disease?
• Brain pathology (plaques & tangles) starts decades before any
cognitive symptoms appear
• New drug trials trying to target earlier before cognitive symptoms
• Some good news
– Lifestyle matters
– Incidence of dementia

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Good news: Lifestyle factors matter
• (Some?) lifestyle factors that promote healthy
cognitive aging may delay the symptoms
and/or brain pathology of AD
– E.g., attitudes toward aging, lifelong bilingualism

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 Attitudes and AD Biomarkers

Becca Levy

• Participants: All dementia free at baseline neuroimaging test

• Methods:
– Measured Age stereotypes in 1968
• Attitudes toward old people scale, e.g., “Old people are absent-minded.”
– Collected brain measures over subsequent decades
• Hippocampal brain volume via MRI (yearly up to 10 times)
• Plaques & tangles (via brain autopsy after death)—biomarkers for Alzheimer’s disease
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 • N=158
• Those w/ negative stereotypes had
steeper decline in hippocampal
volume
– 3 times rate of decline compared to
those w/positive stereotypes
– adjusting for age, sex, education,
self-rated health, well-being,
number of chronic conditions, and
intracranial volume.
• Limitation:
• correlational
• N=74
• Those w/ negative stereotypes
had significantly higher
composite-plaques-and-tangles
scores
– adjusting for age, sex, education,
self-rated health, well-being, and
number of chronic conditions
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 Good news: Dementia Incidence
• The incidence of dementia has declined over
the past 3 decades Cumula ve Hazard Rates for Demen a
(# per 100 people)
4
3.5
3
2.5
2016
2
1.5
1
0.5
0
1970's 1980's 1990's 2000's

• 44% decline in incidence over last 3

decades
• only among those with at least a high
school diploma
• we don’t know why

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 The New View
1 Cognitive/brain loss is selective
– some components decline but others don’t
– people differ

1 Old brains often do things differently from young

– brain loss is also selective
– the brain seems to adapt to its own aging
– lifelong neural plasticity—experience dependent

1 We can do a lot to slow or prevent age-related declines

– Lifestyle matters

2 Alzheimer’s disease isn’t just accelerated aging, and we can do a lot to

slow the onset of symptoms
– Though a long way to go

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 Thank you &
congratulations!!g

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Extra Slides Follow

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• Suggestion for general psychology reading: Current
Directions in Psychological Science

• Short (3-4 pages) reviews by leading researchers

• A journal of the Association for Psychological Science

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 Population Pyramids
http://www.worldlifeexpectancy.com/world-population-pyramid

1950
1995 2050

65-year-olds 85-year-olds 36
 Cognitive loss is selective: some abilities decline but
others improve, and people differ
Good

Poor

Data from Park et al (2002) 37

 2003, Journal of Personality & Social Psychology

• Linguistic Inquiry and Word Count (LIWC)

• Two studies:
• Writings produced by 3000 research participants ranging in age
from 8-85 (cross-sectional)
• Writings of 10 novelists/playwrights/poets over past 500 years

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With increasing age found . . . .
– Fewer self-references
– More future-tense & fewer past-tense verbs
– More positive & fewer negative affect words

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 Alzheimer’s Disease Neuroimaging Initiative (ADNI)

http://adni.loni.usc.edu/study-design/background-rationale/ 40