All About Aging

An Aging Brain Isn’t a Subpar Brain

Mental lapses people attribute to aging aren’t inevitably dementia and regardless shouldn’t be targets of ridicule

One of the easiest-access targets in U.S. culture — especially in political and comedic commentary — is any hint in someone over age 60 that their brain is “failing” them somehow. A misspeak or a forgotten fact, and we’re off to the political horse races with people tossing around terms like “senile” and “dementia” and “not fit.” We are not a culture that respects aging, even though we are all doing it, and we are definitely a culture that wants to equate signs of aging with “weakness” and “infirmity.”

Yet even when we’re young, we can lose a word, commit a malapropism, or forget a fact. Rick Perry’s most famous debate moment and biggest whoopsie was his inability to recall one of the three agencies he’d promised to starve of funds if he were elected president (it was the Department of Energy). At the time, he was only 61, and there weren’t widespread murmurings that his gaffe resulted from faltering memory function rather than simple failure to fully engage with his own ostensible policies.

People on both sides of the political abyss seem eager to diagnose any older politician who shows the slightest hint of forgetfulness with some version of dementia. Famously, some have claimed that as early as his first term in office, Ronald Reagan was showing signs of the Alzheimer’s disease he was formally diagnosed with in the early 1990s. Yet actual tests clinicians ran on him for the condition reportedly didn’t point to signs of Alzheimer’s until 1993, well after his second term ended.

We all have our moments. Many times a week for about 20 years now, I’ve been forgetting that my glasses are on my head. I find myself looking for my cell phone … while I am talking on my cell phone. Thanks to the vagaries of menopause, I spent a few years experiencing the joy of word-finding, casting about in my buzzing brain, wondering where I’d left the damned thing I wanted to say.

That’s gone now, as I’ve moved past that transient life phase. What isn’t gone is the fact that my brain is aging. All of us have aging brains, which isn’t going to stop until we stop. That doesn’t mean that each of us inevitably will someday hit a functional wall and suddenly lose abilities related to recall and speech. As the descendant of several people who lived well into their ninth decade of life, I can say that it’s possible to lose a word or forget an event here and there and still live out your days without developing dementia.

Even for those of us who do develop one of the dementias, the process is rarely sudden and immediate. It is instead an accumulation and progression over years, sometimes decades. It certainly can’t be diagnosed by total strangers commenting on periodic stumbles or lapses, no matter what our age. And using it for comedic fodder when an older person has a lapse is simply ageist and ableist and empowers people who want to exploit completely uninformative human behaviors for political gain.

For those who live lives centered around speaking to the public, recalling minutiae across a host of subject areas, and living with the pressure of leadership, it’s no surprise that the brain, on the worst days, will show the strain. As anyone who has test anxiety or public speaking fears can tell you, regardless of their age, an overloaded brain is a strained brain and one that less ably accesses information it badly wants to find.

Here are some facts about the dementias, a group of conditions that includes Alzheimer’s disease. The risk for dementia in the United States is about 37% for women and 24% for men, and the average age of dementia onset 83 for women and 79 for men. The first years of dementia are usually taken up with mild impairment, and social factors, such as higher education, being white, and being otherwise socially advantaged reduce dementia risk. So does being married.

Dementia doesn’t describe having all function vs no function. It tends to progress through stages, with blips off and on, and it’s not until later stages that the symptoms become severe. People tend to live their regular, independent lives during the early stages, especially.

The hallmarks of dementia aren’t what people seem to think, either. Although the focus is often on word-finding and recall, dementia encompasses much more because we and our brains are much more than the words we can find or events we can remember. Even in the early stages, the process can manifest as changes in personality, behavior, decision-making, and mood. Interest becomes apathy, openness to new things becomes rigidity to change, even simple decisions become impossible, and trust becomes suspicion.

None of these are manifestations that we will ever capture in stranger at a moment in time, a soundbite from a speech, a video cut and manipulated to emphasize some kind of “weakness.” And we also shouldn’t capture them for the sake of cheap laughs. We’re all getting older. We should act like it.

I am a science journalist and author of The Tailored Brain: From Ketamine, to Keto, to Companionship, A User’s Guide to Feeling Better and Thinking Smarter (“fantastic and timely,” Salon) and of Phallacy: Life Lessons from the Animal Penis (which Pulitzer winner Ed Yong calls “a hilarious tour through a menagerie of dicks, and a ferocious guide to not being a dick yourself”). Find me on Twitter @ejwillingham.