UNDERSTANDING THE CHANGING BRAIN AND MIND AND INCREASING COGNITIVE AND EMOTIONAL WELLBEING
One of the many key messages of the Lancet Commission on Dementia prevention, intervention and care was the need to apply the concepts of fitness and reconditioning to the brain and the mind just as strongly as when thinking about the effects of inactivity on the muscles
- People can form new connections in the brain at any age. The effect of normal ageing on reducing the brain’s ability has been greatly over-emphasised.
- Dementia is not just accelerated normal ageing.
- Alzheimer’s disease is not the only cause of dementia. There are other causes that can be influenced to reduce the risk of dementia, which has got less common in the last twenty years.
What is happening?
The brain can be regarded as just another organ in the body, like the liver or the kidney, and indeed that is what it looks like in a butcher’s shop. However the brain in the butcher’s shop is very misleading because it looks white and bloodless, unlike the liver and kidney, whereas the brain has a very rich blood supply which is of vital importance.
Cognitive functions of the brain
The reason the brain is special is because of the mind, and one way of looking at the brain is that it is like a computer which is able to carry out very complex tasks quickly, and which can also can learn, adapt, and change. The mind is of course influenced by many things other than the brain, but it is the brain that almost always causes disorders like dementia , which are disorders of either the cognitive, or computer aspects of the mind, namely the ability of the brain to remember, to calculate and to make decisions.
Emotional functions of the brain
The emotional aspects of the mind are the feelings, for example of anxiety or depression or loneliness. Disorders of these conditions are usually the result of problems in the mind, not in the brain.
We now know that the brain is dynamic and can change. It is plastic, to use the modern jargon, with the scientific term being neuroplasticity. Doctors who are now over 40 years old were taught as medical students that the brain was static, i.e. that you were born with a number of brain cells and from that point it was downhill all the way. We now know, however, that the brain is like the telephone junction box at the corner of your street, which looks as though nothing much is happening inside but if you get a chance to see inside, there is a different picture – a huge number of brightly coloured wires – often with a telecom engineer sitting there working miracles. In fact, the brain can keep establishing new connections throughout life, learning and adapting at any age.
The four factors that affect the rest of the body – ageing, loss of fitness, disease, and negative beliefs and attitudes – affect the brain and the mind too.
- Ageing does have an effect on the brain. As the brain ages it does quick calculations less well, so older people are generally not so good at games and quizzes that require a quick response. There is also a loss of memory power particularly for events and facts that are recently remembered, but it is very important to emphasise that the changes such as those listed below are not an early sign of dementia.
- Forgetting where you put your phone
- Forgetting where you put your keys
- Forgetting the name of someone you met two days ago
- Forgetting the name of the author of a book that had a huge influence on you thirty years ago
- Loss of fitness is also relevant for the mind, and therefore for the brain, because the brain needs stimulation to form new circuits. Many people experience loss of both cognitive and emotional fitness as a result of isolation, often caused or complicated by deafness. As is emphasised below, the best form of activity for the brain is that which challenges the individual to engage with others, for example running a voluntary group or being a local councillor, or quite simply carrying on working, in fact any activity with a purpose.
- Disease that affects the brain usually affects the mind. Alzheimer’s disease is still a huge mystery but Alzheimer’s disease is only one cause of dementia. The other main cause is vascular dementia, due to impairment of the blood supply the brain. Furthermore, we know that stress and lack of sleep also adversely affects the brain, and that physical activity – as well as improving the blood supply of the brain – has a direct beneficial effect on brain cells. The term Mild Cognitive Impairment (MCI) is used by some people for the early stage of dementia but there is no agreement about the usefulness of this concept.
- Negative beliefs and attitudes play a very important part in the development of dementia. We know that depression and loneliness, often the complications of deafness and blindness, increase the risk of dementia significantly but so too do negative beliefs, for example beliefs such as “There is no point in arguing with someone aged ninety. Just agree with them”. Negative and pessimistic attitudes also affect a person’s mind, attitudes such as “It is better that older people don’t get bad news; it is too upsetting for them and they won’t be able to cope”.
This is summarised in an important report from Harvard Medical School titled the Guide to Cognitive Fitness.
Good news from Harvard Medical School
The brain compensates for a slower processing speed by using more of itself. MRIs taken of a teenager working through a problem show a lot of activity on one side of the prefrontal cortex, the region we use for conscious reasoning. In middle age, the other side of the brain begins to pitch in a little. In seniors, both sides of the brain are sharing the task equally…At midlife you are probably better at the following:
- Inductive reasoning. Older people are less likely to rush to judgment and more likely to reach the right conclusion based on the information. This is an enormous help in everyday problem solving, from planning the most efficient way to do your errands to figuring out why the hot water isn't flowing in the kitchen sink.
- Verbal abilities. In middle age, you continue to expand your vocabulary and hone your ability to express yourself.
- Spatial reasoning. Remember those quizzes that required you to identify an object that had been turned around? You are likely to score better on them in your 50s and 60s than you did in your teens. And you may be a better driver, too
- Basic math. You may be better at splitting the check and figuring the tip when you're lunching with friends, simply because you've been doing it for so many years.
New networks of nerve cells develop as a result of learning because the nervous system is not simply like a set of electric cables running to and from the brain to the foot or the hand or the eye. It is better to think of it as a set of networks, like the London Underground with people who can use it in a million ways, and even find new routes in their seventies and beyond by
- learning new skills, preferably by engaging in purposeful work. Work your brain even harder
- increasing contact and interaction with other people to avoid isolation and depression
- keeping your hearing and your vision as sharp as possible to keep receiving stimulation.
There is more detail in our book Increase your Brainabiity and Reduce your Risk of Dementia