'Successful Aging' Techniques Help Seniors Overcome Decline in Cognitive Processes

The human brain, during "the golden years," experiences various changes which result in a decline of the cognitive processes, mostly noticed in an elderly person as modest decreases in reasoning, mental flexibility, the ability to perform multiple tasks at the same time, and an overall slowing in mental speed.

Brain changes spurring such deterioration include nerve cell loss, decreases in blood flow, alterations in chemical messages and receptors, appearance of aging "markers" and an overall shrinkage. Although these changes contribute to this expectable decline in brain function, most healthy older adults can be as capable as middle-aged people and can anticipate the continuing capacity to enjoy life.

"We know a great deal about helping older adults age optimally," says Dr. Nelson Gruber, a psychiatrist with the Harris County Psychiatric Center and an associate professor in the department of psychiatry and behavioral sciences at The University of Texas-Houston Medical School. "There is every reason to be optimistic about good mental health and functioning in older age."

One of the keys to overcoming the challenges brought about by the impact of an aging brain on the mind is learning how to compensate to a reasonable degree for any new weaknesses, Dr. Gruber says.

Senior citizens noticing a decline in their "fluid" intelligence, based on the mechanics of brain functioning such as mental speed, coordination and flexibility, can put to use their "crystallized" intelligence, derived from accumulated life experiences, knowledge, skill and wisdom. "You are older and wiser so you don't have to go through as much because you already know how to handle many challenging things," says Dr. Gruber.

Thinking and reasoning can be a little slower for the elderly so Dr. Gruber recommends breaking down complex tasks, narrowing the focus and allotting extra time for each chore. "If you have trouble reading a map, take extra time to plot it all out," he says.

If forgetfulness becomes a problem, the answer may lie in using rhyming memory cues to complete a quick run to the grocery store. The phrase "One/bun, two/shoe, three/tree" may be used to remember butter on a bun, a loaf of bread inside a shoe and spaghetti hanging from a tree, and so on. The rhymes become mental anchors and help associate things that need to be recalled at a later time.

It is important that older adults remember to live life to its fullest, but at the same time recognize the reality of the development of new limitations.

"As you get older you are going to develop those cognitive decreases," says Dr. Gruber, who serves as the attending psychiatrist for HCPC's geriatric unit. "Still, the more mentally active you stay, the more you can delay them or minimize them. Staying mentally active doesn't mean you are not going to `lose it.' In fact, you are going to be losing it, but you can dramatically impact the loss rate."

Below are a few more tips from Dr. Gruber on "successful aging":

• Stay open to diverse and new experiences. New activities keep the mind active.
• Take care of your body. Remember to exercise, maintain a healthy diet, and make preventive medical care a priority. These activities are basically the pursuit of wellness.
• Keep up with and use technology. Computers for example get your mind working, provide you with a new skill, occupy your time, prompt you to think about new things and through chat rooms potentially provide for many social connections.
• Learn ways to manage stress and use them. Make time for rest, quiet time, meditation, spirituality, music and humor. Do not abuse alcohol or drugs.
• Cultivate your reserve physical and mental capacity. If you know you will be going through a stressful time, give yourself feedback such as "I can do this" or "I can manage." Stress does not help the aging process. Also, the physically healthier you are or the more physically intact you are, the more your body can withstand the stresses and strains. "There are certain capacities emotionally, mentally, physically that deal with stress; and, if you exercise, develop and train them, you are more resistant to it," Dr. Gruber says.
• Develop and nurture a support network. Join an older age support group or meet friends for a meal. Affiliation is important to maintaining mental well being.
• Find ways to transition formal work skills into "new work." A few months after retirement seniors may feel like they have gotten their break or that they have had a chance to catch their breath. Quiet retirement may not be as attractive as first imagined so volunteering or finding a second type of work (on your own terms) can prevent potential boredom and keep your mind stimulated.

More and more people in society will have to begin exploring the best ways to lessen the impact of the decline of cognitive processes since the population is expected to continue "graying." The number of older Americans has tripled since 1900 and in 1997 there were 33 million Americans over 65.

The average American life expectancy is now 76 years of age, but if senior citizens reach 65, statistics show that more than likely they can count on an additional average of 15.5 years of life, Dr. Gruber says. In Houston, there are currently approximately 260,000 adults over 65.

Although affecting a small portion of the population over 65, changes in the human brain can be so severe that they can produce psychiatric disorders. Major depression affects 1 percent of the elderly; bipolar disorder, formerly called manic-depression, 2 percent; anxiety disorders, 5.5 percent; schizophrenia, .5 percent; substance abuse, 2 percent; other mood disorders, 3 percent; minor depression, 10 percent and dementia, 7 percent.

"Certainly there is a range of psychiatric disorders in the elderly, but cumulatively it is a relative small percentage," Dr. Gruber says. "This is further diminished when one considers that nearly a third, or about 10 percent, of the psychiatric disorders of older adults can be attributed to a mild depression. Simply put, the vast majority of older adults do not have dementia or a major psychiatric disturbance."

Still, myths persist about old age. Some of the generalizations are that the period in late life is depressing, an unsound body is an unsound mind and that seniors can't learn new things or skills, etc.

"Most older adults are reasonably happy, socially involved in the community and most can learn and enjoy new physical and mental skills," Dr. Gruber says. "Even having a chronic illness, physical disability and various infirmities does not mean that the mind needs to be discounted. You could still have a very clear, youthful and sharp mind.

"There is a large variability and definitely the way one takes care of oneself has a lot of impact as to how one gets old."

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©2006 Texas Medical Center

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