Reviewed by Terence Jagger
This is a wonderful book, and the real title is the sub-title: A Neuroscientist’s Guide to Ageing Well. It is not in any sense a self help book, but it describes carefully and calmly what happens to our brains as we age – and explains what is fixed, by genetics or early experience, and what we can change, through our own behaviours. En route, Levitin debunks a few ageing myths, and offers a lot of encouraging messages as we age – we get better at some things, and there’s lots we can do to help ourselves stay both mentally healthy and psychologically robust. Perhaps the biggest compliment I can pay the book is that the review should really be as long as the book itself, so much do I want to share and so little is there which can easily be omitted. Daniel Levitin, who is Professor of Psychology, Behavioural Neuroscience and Music at McGill University in Montreal, writes easily and well, and has pitched this book at a general reader who is prepared to follow him through some important science, though the book is never onerously technical.
The Changing Mind is notably honest about what we don’t know, and treats some ideas from both modern research and the alternative fringe with refreshing scepticism. It is in three sections, of which the longest, The Continually Developing Brain, discusses the science behind the natural changes in our brains as we age, and what determines them; it makes it clear that the belief in gradual and inevitable decline is wrong, that some capabilities improve as we get older; and it talks about how we can make a difference through changes in personality (yes, you can change this) and lifestyle. The Choices We Make looks at specific behaviours that we can modify so that ageing is enjoyable as it can be, even becoming the best part of your life. And The New Longevity looks forward, at efforts to increase our longevity, and most importantly, our years of healthy and enjoyable life. Because there’s so much I want to cover, this review focuses on the first section, drawing in thoughts which are reinforced later – but leaving you with a lot to discover when you read the book.
If you would like to see and hear Levitin yourself, I can recommend these two videos – one, a bookstore talk specifically about this book which is clear, engaging and even moving; and a shorter, punchier TED talk (“How to stay calm when you know you’ll be stressed”) which is less directly related to the book but which demonstrates his style brilliantly. And at the end of this review is a photograph of his appendix of 10 guides to action in your life – but do read the book as well, its enlightening and exciting, and has so much more to offer than these guidelines, excellent though they are.
Levitin takes us through the five features of personality – extraversion, agreeableness, conscientiousness, emotional stability vs neuroticism, and openness (also termed intellect, imagination). While much of this seems fixed, and indeed genetics and upbringing have a major and lasting impact, changes can occur either through disease but also our own actions. He also considers the role of memory, which he sees as hugely important; memory is not one skill or attribute, but represents different things and different parts of the brain – memories are kept in many different places for different purposes, and the old are not so prone to lose memory as we think! Some memories become harder to recover (if something is “on the tip of your tongue” he suggests swearing can unblock this, though we have no idea why!). And many memory tests are biased against the elderly. Nevertheless, we need to fight against complacency and passive reception of new information. And we need to fight these with increasing vigilance every decade after sixty. Another practical suggestion is that if we need to remember something, we should draw it – drawing … forces you into the … deep processing that is required. You can also create “cognitive prostheses”, when you use your physical, visible environment to remind you of something – one man keeps his keys in his shoes so he doesn’t leave the house without them (yes, what if you have more than one pair of outdoor shoes?), and I hang a small Japanese towel over a cupboard door so I don’t go to bed leaving food in the oven!
The brain is adaptable and carries on learning all your life – this is neuroplasticity, and you need to both exploit and encourage this: One of the most protective things you can do against aging is to learn a manual skill when you’re young and keep it up. The next best thing is to start learning something new when you’re old. He gives brilliant examples of people wearing prism glasses which reverse left and right, and which they adjust to well enough to drive a car (!) – and then re-adapt back when they take them off. Doing sudoku or crosswords is fine if you enjoy it, but there’s no evidence it transfers any benfits to other parts of your brain – you just get better at sudoku; the important thing is to do new things.
The developmental trend toward abstract thinking is one of the compensatory adjustments of aging that mitigates the decline of our sensory systems. While the ability to learn new things peaks during college years and declines after 40, abstract thinking actually improves with age. Even apart from that decline, the trend towards abstract thinking helps us solve problems that would not be solvable otherwise. Aging is not accompanied by unavoidable cognitive decline. The aging brain changes, changes itself, heals itself, and finds other ways to do things, some of them … actually better that the earlier ways … it harnesses neuroprotective and neurorestorative capabilities.
There is an interesting chapter on emotion – including stress. Emotions are the body’s way of encouraging us to do what is best for us, as biologist Frans de Waal says, they focus the mind and prepare the body while leaving room for experience and judgement. But stress as we complain about it is a very modern concept – stress damage increases with age, but resilience can be learned and taught – this might include coaching, widening social networks, exercise, meaningful and purposeful activity, but it can take some effort, and openness to new experience. And stress’s brother, depression, is not an unavoidable bogey of old age either: the good news is that depression is less frequent among older adults than younger adults, but is frequently not diagnosed and is wrongly seen as a natural part of aging. Some simple solutions turn out here – and elsewhere – to be better than drugs (which can alleviate, then worsen, the issue) or other medical interventions. Sleeping well is better than medication, and distraction is better than rumination and shortens the length of depressive incidents. Levitin is clear that depression is a serious problem and needs treatment – but it does not get worse in age, he says, and may be ameliorated by accessible changes in your life – purposeful activity, exercise, sociability, high quality sleep.
A similar story comes with pain. Chronic pain affects 40-50% of older adults, and while it has a negative effect on lifespan, what hurts (back pain, arthritis) is not what kills (cancer, heart attacks, strokes). And pain is, to a very real degree, in the mind as well as the body – the brain can switch off very severe pain to concentrate on more important things (battlefield injuries for example) or it can generate pain in a part of the body which is either entirely healed – or not even there any more. But it doesn’t get steadily worse with age – it peaks in our 50s and 60s, then declines in our 70s and later (unless the oldsters (Levitin’s own word to capture age and cool in a single word!) are just being more stoical about reporting it, of course). And medicine is not winning the fight; the two best analgesics known to us are exercise and distraction, not drugs or surgery. And this happily marries up with the need for purposeful activity and exercise for general physical and mental health.
Age brings social challenges as well, of course: loneliness is associated with early mortality .. implicated in just about every medical problem you can think of, and a feeling of purposeless is damaging too. So counter-intuitively, having everything done for you in a nursing home may actually increase feelings of stress and frustration. Any responsibility – even choosing to have and look after a plant pot in a nursing home – helps reduce stress, increases alertness, sociability – and then health outcomes. But, in contrast, in terms of what gets better, Levitin has this to say: Older adults in general (I know you can probably think of exceptions) are better at emotional regulation; they are better able to control their feelings, are less reactive to insults, and pay more attention to the positive things in their lives”.
One final thing – sleep. Age brings with it changes to our sleeping patterns and to how well we sleep. The idea that older adults need less sleep is a myth. They tend to get less sleep, but they still need the eight hours the rest of us need. Levitin is clear that improving your sleep hygiene – duration, timing and quality of sleep – is hugely beneficial in many areas of your life – and that it can be done. There are lots of techniques – avoiding blue light, reducing caffeine, sleeping in the dark and so on, but one is paramount – go to bed and get up at the same time every day.
So there you are, a really great read, interesting, informative, and practical as well. Ageing is far from being the continual decline we hear about on all sides, and some things get better. And there’s a lot we can do to improve our enjoyment of our later years, and our physical, mental and cognitive health as well. As I’m coming up to my mid-60s, that’s really great news!
Daniel Levitin, The Changing Mind: A Neuroscientist’s Guide to Ageing Well (Penguin Life, 2020). 978-0241379387 400pp, hardback.
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