Cognitive decline: The Brain that Changes Itself

Note: I wrote this in 2013 and used Grammarly to spell-check and improve its low. Man! Grammarly is good. Man! Did I make a lot of errors.

The signs were all around me. I just had to look. Which I didn't do until I read Normal Doidge's book The Brain That Changes Itself. Wake up call!Chapter 7, Rejuvenation, changed my life. Doidge talks about the natural processes that cause and that can accelerate the inevitable cognitive decline that accompanies the inevitable process of aging.

Here’s what I’ve learned from this book and others I read later:

Nature drives young people to use up energy, take risks, and learn how to get better. For example, when I walked my grandson Luke to his kindergarten class, he didn't walk. Instead, he ran, skipped, and hopped. He saw some large rocks along the side of the road, and instead of walking, like a "normal person," he jumped onto the first rock and jumped from rock to rock--like a normal kid. His kid drive kept him learning how to move his changing body better and improving his balance. Normal young people like Luke create unnecessary challenges, then use the challenges to drive them to improve.Nothing drives old people like me to challenge ourselves. We’ve had enough, thank you very much. Instead we conserve energy and avoid risks. And so we learn how to get worse.

When I walked with Luke to school, I didn't think of jumping from rock to rock--until I saw him doing it and realized what he was learning and what I was learning. I was learning that I didn't need to improve the complex machinery of my vestibular system to help me keep my balance; I was learning that there were muscles I didn't need to know how to operate, and I didn't need my proprioceptors tuned up.

I was teaching myself to be old.Our brains tell us to do that.

Your brain might tell you it’s efficient. But that’s just the brain’s PR department. If you call brains efficient, you're just sucking up to your brain, and for no good reason. Our brains are not efficient. They are lazy. Brains figure out how to an acceptable result with the least effort. It doesn't do anything it doesn't have to do.When you've got an immature brain in an immature body, surrounded by adults and older kids who can do more than you can, your brain tells you that to survive, you have to LEARN! When society puts kids in situations in which they compete with other kids, then to survive, they have to LEARN! Eventually, you grow up and find a niche, and survival is no longer a problem, and you don't have to keep learning to catch up. You can live well with what you already know.When a brain figures that out, then you're on your way downhill. Once it finds out that it can get just about the same result with less work, it does less. When it figures out that it doesn't need a particular neural network because the skill that the network confers is no longer needed, it decommits the neurons. The process goes on throughout our lives. During the growing up phase, the grain trims less-efficient neural networks, which leaves space for more efficient ones, and new ones. During the growing old phase, the brain trims old networks and replaces them with not much.The PBS show based on Doidge's book gives a compelling example of skill-deaquisition and cognitive decline in the aging. It shows us an old person walking the classic old person walk: legs spread apart for a more stable platform; head down, looking at the feet to ensure that there are no missteps; small stiff movements to avoid imbalance and avoid using unnecessary muscles. Of course, old people don't walk that way simply because they have to: they walk that way because they learn to. And the show explains how that comes about.When babies stumble, they don't slow down; nature drives them to walk and then run and keep up their speed. Nature drives them to learn how to go faster.

When young kids stumble, they pick themselves up and do it again and learn to do it better. Tripping and falling aren't disasters: they're a sign that the need more practice. Sometimes it's good for a laugh.Later on, adults maintained skills but don’t improve thjem. So what if you slow down a little? As long as you're doing not much worse than your peers, you're doing fine. An occasional tumble is no laughing matter, but bodies heal fast enough, and there's nothing to be concerned about. Skills decline, but slowly.When old people stumble, they don't laugh. They've hurt themselves; they heal slowly, and they worry. So they teach themselves a different set of lessons; they slow down; spread their feet; look down rather than up; they take small stiff steps. Arthritis helps. If movement leads to pain--even a little--people limit the way they move to avoid the pain. They move the way old people move.Old people teach themselves to act older than they need to act.After reading Doidge's book at age sixty-something, I realized that I was teaching myself to act old. I watched myself and other people walking down stairs. Young people moved briskly and kept their heads up; occasionally, they’d glance down to check whether their feet were where their brains predicted they were; usually walked down the center of the staircase; sometimes, sometimes took a couple of steps at a time.

Older people—including me—walked down stairs carefully, eyes down, occasionally looking up to avoid bumping into someone; holding the handrail to keep from falling.

The more I walked that way, the more my brain learned I could get away with it.

Unlike younger people, I was in no hurry.I was teaching myself to act slow down; be careful; avoid risks. To act old.I decided to force myself to reverse the process. I would try to walk like a younger person. It was hard. Really, really, hard.

When I took a step or two without looking at my feet, I could feel the adrenaline rushing. I felt anxiety. I felt fear. I had to fight to keep my eyes up for even a second or two.

Then after a while, as I retrained my brain, it got easier.My decline was not just physical decline, I realized. Sure, part of it is physical, but it was cognitive decline as well.

When I was in my thirties, I used to run through the woods, head up, rarely checking my feet. My brain was good enough to process my visual input, build a model of the trail I was running, computing when the root I saw in front of me was about to be under my feet. My brain would adjust my stride, avoiding a stumble. Once in a while, I’d look down to check. Mostly, I didn’t have to.

Even if my body could run that way—which it can’t—my brain would find it hard to do that computation. Since the cost of a brittle-boned mistake is too high, I don’t even try, and so lose whatever ability remains. I don't run the way I used to because my arthritic knees won't allow it. But I also don't do it because my brain won't support me.Doidge's book made me realize the vital importance of attention. Attention is a limited resource; controlling attention is a learned skill. Kids have so much attention that they don't have to control it. They have enough so that they can learn new skills effortlessly. Older people have less attention and have to focus what remains in order to learn and to perform. It gets harder to control attention when you don't practice, and the lazy brains of aging people discover that they can get by without paying much attention.

Every time you slide by, you learn that you can pay even less attention.

And that will accelarate your spiral of decline.I see my waning ability to pay attention in small ways and large. "What did I just say?" Bobbi might have asked, years ago, when she thought I wasn't paying attention to what she was saying—which was pretty much all the time.. I wasn't paying enough attention to have listened to and understood but I had enough excess attention to have recorded at least the last thirty seconds of speech. I could access the recording, recite it back and pretend that I had been listening.

Now I can't do that. So when Bobbi asks, "What did I just say?" I have almost no idea.Back in the day, when I was aware that someone was saying something of interest, I could access a recording of what I had missed for context. No longer.I see many other signs of cognitive decline now that I know what's happening, and I'm doing the only thing that I can do: fight back.Writing this blog is one way of fighting back. It takes a lot of attention to writing 1300 words in a sitting. Forcing my head up when I'm walking downstairs is a way of fighting back. Getting up on the rocks with Luke is a way of fighting back.The bad thing is that it's a losing battle.The good thing is that the battle's fun to fight.Update: 4 years later. Sometimes it's fun to fight. Sometimes it sucks. Note to self: since it's bound to be a losing battle, work harder at making losing fun.

Update: 8 years later. I’m losing more battles but having more fun. Occasionally things suck. But it’s fair to say that I’ve never been happier or more in love with Bobbi.

Related articles

• The Brain that Changes Itself by Norman Doidge

• The Power of Books (And the woman who changed her bra