My healthy old brain

When your editor smiles at you with raised eyebrows, you know something's up. In his hand was a book - The Healthy Aging Brain: Sustaining Attachment, Attaining Wisdom, by Louis Cozolino. Most of the brains in this office are only twenty or thirty something years old at most. Since mine is the only post-seventy year old brain in the place, this was one assignment I would not be able to duck. With surreptitious trepidation, I accepted the book and embarked on a journey not just through The Healthy Aging Brain, but through my own central nervous system.

My first, inwardly-voiced question was: Would I find out if my brain is healthy, and if it is, how could I keep it that way? If not, how could I keep my editor, and the rest of the twenty or thirty something year old brains in this place, from finding out?

The book is written in an informal, almost chatty way that is immensely reassuring if you happen to possess an aging brain. Even if you don't, the book is both interesting and reassuring in what it reveals about the various stages of growth in the brain leading up to "old age" and what happens to the brain as it ages along with the body it's parked in. Cozolino's revelations are solidly based in social neuroscience, his sources are referenced at the end of each section, and all are listed in an appendix at the back of the book.

Cozolino, in fact, takes his primary thesis from neurological research into the aging brain: "The brain was designed to change, so the old adage 'use it or lose it' has a great deal of neural validity," he writes. "The aging brain retains the capacity to birth new neurons and build new brain structures but, just like when we were children, it continues to grow in an experience dependent manner and has to be stimulated by environmental, relational, and internal challenges."

Another of Cozolino's thoroughly-researched insights into the brain's aging: "The two general categories of memory are explicit and implicit. Explicit memory is best described as conscious semantic memory for names, places and events. It is the loss of these forms of memory that are traditionally considered to be the hallmarks of aging. Implicit memories do not require conscious awareness or semantic labeling. Early attachment, fear conditioning, and other emotional memories fall into this category, as well as procedural memories such as riding a bicycle or playing a musical instrument. In contrast to the general loss of explicit memory, procedural and emotional memory are relatively unimpacted by aging (Churchill, Stanis, Press, Kushelev, & Greenough, 2003; Rypma & D'Esposito, 2000)." My "senior moments" began to make sense.

Cozolino, a Pepperdine University psychology professor, begins The Healthy Aging Brain with the developmental cycle of the brain from birth through adolescence. His description of how the brain of an infant changes to acclimate itself to the world is fascinating. And if you've raised one or two adolescents in your life, or vividly remember your own teenage years, Cozolino's depiction of what occurs during that period confirms what you already knew - the adolescent brain is a dangerous thing. "Adolescents become intoxicated with their own power while simultaneously suffering from impairments of impulse control," Cozolino writes.

Cozolino then traces the development of the brain from adolescence onwards so that you begin to understand exactly how brains mature, and you get perspective on some of your own behaviors at various ages along the way. We do, for example, continue to build neuronal pathways as long as we remain active both mentally and physically, a relatively recent revelation shared by researchers. Other research shows that mental exercise is the key to building new neuronal and synaptic structures in the aging brain. Reading this, I immediately thought of octogenarian Nobel Laureates, scientist Oliver Smithies and author Doris Lessing, both active and productive at an advanced age. Keeping your brain healthy is a lot like improving your tennis game, Cozolino implies, take it out there on the court and practice with it!

Cozolino reveals that many of the signs of aging that you thought might be yours alone are shared by all; he tells the story of his grandmother who experienced a shock whenever she looked in a mirror because she expected to see a vibrant, twenty-year-old woman, not the wrinkly, white-haired matriarch she had become. The self, he points out, does not age.

The brain does, but not in ways that should elicit fear. With age comes that great intangible: wisdom. Many cultures honor their elders, seeing in them not just a bridge to the past, but a way of seeing the world that is wiser and more balanced than the way younger individuals view their world. Cozolino explains that there is a shift in power, if you will, from the amygdala - the brain region responsible for controlling our most primitive reactions (fight or flight) - to a more balanced cooperation between the amygdala and the OMPFC or orbitomedial prefrontal cortex, which is involved in social behavior, emotional regulation, and motivational drive. With the OMPFC rising in cranial stature, we old ones seem wise because our emotions are more under control. We tend to be more interested in those around us and in the events of the past and are well able to articulate what we think.

If you have occasional fears of losing your marbles as you age, I highly recommend reading The Healthy Aging Brain. This book, reassures readers that mental deterioration need not accompany growing old, and to that end, Cozolino even provides an appendix (52 Ways to Avoid Hardening of the Categories: A Program of Personal Experiments) listing 52 different activities to keep older brains vibrant. Among his more appealing suggestions:

"Play with children whenever possible."
"Go to a new restaurant and eat something that sounds a little strange."
"Try a week without television."
"Spend a day at your local animal shelter."
And my absolute favorite...
"Take every opportunity to contradict stereotypes about older adults."

The Healthy Aging Brain: Sustaining Attachment, Attaining Wisdom, Louis Cozolino. W.W. Norton & Company, New York, 2008. 380 pp. ISBN: 978-0-393-705-13-3. ?22.00.