22 Jun Mind Games

A guide for keeping our cognitive abilities sharp as we age

At 44, Sujata Venkateswaran has a tough time spontaneously recalling information and retaining it.

Sometimes she blanks out on familiar facts and names. There are moments when she forgets where she kept certain things, big and small. She has also noticed a shift in the quality and quantity of her concentration and attention span.

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Left right human brain concept. Creative part and logic part with social and business doodle isolated on white background

A former media professional from India’s financial capital, Mumbai, Venkateswaran now lives in Foster City, California. Her time, focus, and brain are occupied with the shouldering of a trio of heavyweight responsibilities. Venkateswaran is the primary household man- ager of her family unit. She’s a caregiver to her aging mother and a mother to two young girls, eight and six.

She is approaching what is commonly described as middle age. As time dissolves into quicksand in her daily life, she says visible memory lapses and other invisible, emerging changes in her brain function are not lost on her.

She reminisces about her younger adult days when she could smoothly manage, supervise, organize, problem- solve, and physically pace around on film sets, day in, day out, as she fulfilled the responsibilities of her full-time job.

But in her present-day older adult life, she says, performing the multiple tasks required by her new role are harder.

“I’m still doing a lot, but the brain feels slower, more tired more quickly,” says Venkateswaran.

Her experience of her brain function slowing down as she ages is one reported by many older adult women as they reach their 40s. Unique to her story are compounding stressors of acculturation, acclimatization, and identity expression that she shares with many other immigrants and women of color in the United States.

Psychologists and neuroscientists say cognition—the brain’s capacity to learn, remember, and make judgments through thought and experience, both physical and sensory—declines in all humans as they age.

“It’s an organic transition that is very much part of a natural, healthy aging process,” says Kisha Holden, psychologist and professor of behavior- al sciences at the Morehouse School of Medicine in Atlanta, Georgia.

In women, the onset of midlife or middle age coincides with menopause. Approximately 1.5 million women enter menopause each year in the United States alone with familiar symptoms like hot flashes and disrupted sleep, but also with potential and subtle cognitive and mood changes, according to the Women’s Brain Initiative at Weill Cornell Medicine.

The Centers for Disease Control and Prevention conducted a survey that asked women above the age of 45 years in all 50 states to self-report subjective cognitive decline, or SCD. One in nine respondents said they had experienced memory problems. Forty-three percent of women with SCD said they had to give up some kind of day-to-day activity owing to the onset of the decline. About the same percentage reported they needed help with house- hold tasks.

Inside the brain, impairments in cognitive function are linked not to a loss of nerve cells, or neurons, but to a specific and relatively subtle alteration in the inter- action between neurons. This interaction triggers a process called neurotransmission. Every thought, sensation, emotion, or idea humans have is caused by the action of neurotransmitters. Further, a synapse is the space between two neurons. Synaptic connections in the brain are vulnerable to weakening with age, scientific studies show.

Although some forgetfulness comes with age, older adult women must take special care not to ignore changes in memory and thinking that may feel of concern, experts say. Women might have proven to be more resilient in the face of cognitive decline than men. But new scientific research reveals some notable findings.

In 2015, researchers from the Alzheimer’s Disease Neuroimaging Initiative shared results of a study of women with mild cognitive impairment spanning eight years that show women decline at almost twice the rate of men and have faster acceleration of decline over time. Psychologists like

Holden say chronic sociocultural, environmental, and biological stressors on women in a  largely male-dominated and racist world intersect with the natural aging process in complex and layered inconspicuous ways. Women of color are disproportionately impacted. Recent studies establish new links between racism and cognitive decline. A team of epidemiologists at Boston University published findings in 2020 that showed women who reported racism and racist discrimination scored lower on cognitive tests compared with women who reported fewer such experiences. Moreover, due to systemic discrimination, women of color have historically been excluded from medical research, leaving them chronically misunderstood, misrepresented, mistreated, and, ultimately, misdiagnosed.

In this milieu, women must take charge of their own physical and mental well-being so they can bridge inequitable gaps and reduce their risk of falling through the diagnosis and treatment cracks. They must begin by reporting behavioral and cognitive changes to a trusted medical practitioner.

The good news is that cognitive decline can be slowed by maintaining good overall health. Experts across the board prescribe a lifestyle targeted toward preserving cognitive function and preventing impairment.

A recent multicountry intervention study called FINGER, or Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability, highlights the value of addressing dementia risk factors and presents a strategy to protect brain health, promote overall health and functioning, and reduce the risk of developing new chronic diseases.

According to the FINGER model, regular physical activity, high formal education, intellectually demanding and stimulating work (or occupational complexity), and mentally stimulating leisure activities are preparatory habits that can protect against severe cognitive impairment, dementia, and Alzheimer’s disease. Social interactions and a rich network of connections have also been associated with a reduced risk of dementia and Alzheimer’s.

The National Institute of Aging has some ideas for healthy activities that older adults can undertake to maintain well-being and mental acuity: gardening, playing cards with friends, engaging in art and crafts, learning a new language, and becoming a volunteer in one’s local community can help maintain well-being in older adults. Incorporating these activities in one’s daily life is as important as enjoying them while doing them, experts emphasize.

A major cause of cognitive decline that can be mitigated, notwithstanding age, is pro- longed or extensive use of sub- stances like alcohol, nicotine, some drugs (both prescription and nonprescription), and caffeine. All have a propensity to damage brain cells and cause memory loss and mood dysregulation.

Although men are more likely to consume alcohol in large amounts, biological differences between the two sexes mean that women absorb more alcohol and take longer to metabolize it. Plus, women are more at risk to develop a reverse of alcohol-induced de- pression, namely depression- induced alcoholism, scientific studies find.

The impact of substances on the aging process isn’t fully understood. Plus, as they grow older, women tend to drink less. Still, it is well established by neuroscience that these substances are known to weaken synaptic connections in the brain.

Therefore, healthy aging benefits from early abstinence from alcohol, nicotine, and other drugs and replacing those behaviors with healthy lifestyle habits associated with substantially lower risk for diseases like Alzheimer’s and dementia. For example, you can increase your physical activity, cut down on alcohol consumption, and participate in mentally stimulating activities that build the capacity to conserve and preserve executive brain functions and reduce risk for Alzheimer’s.

Holden warns doctors, caregivers, and older women alike against a one-size-fits-all approach to healthy aging. “We need to recognize, understand, listen, and invest gate the social determinants impacting individual human health,” she says. “As health- care providers, we must carefully listen to what our patients are saying.”

Venkateswaran describes some contours of the path she’s taking to establish what it means for her to stay “busy and sharp” as an older adult woman.

“I think building knowledge and curiosity is very helpful to start with,” she says. “Once I know what might be coming my way, I know both how to prepare and what to expect.”

Some of the inner work Venkateswaran has chosen to invest in over the last few years includes observing mental and bodily changes and making mental notes of acceptance about changing functions, both subtle and drastic.

As a result, she has been consciously building her “thinking muscles” by solving sudoku puzzles.

Then there’s what Venkateswaran describes as “soul food.” “Think of it as that one thing you do for yourself that is yours and yours alone, and that can see you through different phases in your life.”

For Venkateswaran, that is her ongoing practice and instruction of the Indian classical dance form of Bharatnatyam. The dance form combines strenuous physical activity with graceful facial expressions and hand gestures, and is crafted to drive a peaceful, spiritual mind and mind-set.

Researchers from different parts of the world have established that the somatosensory cortex in the human brain, which is responsible for motor control and hand- eye coordination, benefits from a consistent practice of dance forms that incorporate movements and other facets exhibited by Bharatnatyam. “There’s dancing, faith, and then there’s dark chocolate,” says Venkateswaran. “Consumed, of course, with caution and care.” DW

SIDEBAR:

Strengthen That Brain Muscle

Cognitive-stimulation activities for older adults:

• Engage in thoughtful, constructive, and value- creating conversations.
• Meditate every day.
• Draw or build some- thing, or get crafty.
• Pick up a new or old hobby, such as knitting, hiking, birdwatching, or woodcarving.
• Learn a new language.
• Take long walks.

Memory-stimulation activities for older adults:

• To enhance spatial skills, concentration, creativity, and overall problem- solving, put together a jigsaw puzzle.
• To find patterns, solve problems, and develop intuition and creativity, work on sudoku puzzles.
• To enhance recall and retention capacity, work on crossword puzzles.
• To improve focus, recall details, and engage in sound judgment, play concentration card games.

By Aditi Malhotra
Aditi Malhotra is an independent journalist, writer, and educator living in the San Francisco Bay Area. She was born and raised in India.