The poet Robert Browning once wrote “Grow old along with me! The best is yet to be,” but not many people believed him. Until recently, there was a widespread assumption that we lose brainpower as we get older.
That assumption was based not on research but on the absence of it, according to Dr. Gene Cohen. As life expectancy increased and scientists began to study older people, they found that aging was, in Cohen’s words, “not a wasteland but a frontier.” His research has shown that creativity can blossom with age.
Cohen, 63, is a graduate of Harvard and Georgetown University medical school, and he earned a doctorate in gerontology from the Union Institute. He was the first chief of the National Institute of Mental Health’s Center on Aging, then went on to serve as acting director of the National Institute on Aging and to coordinate Alzheimer’s-disease programs at the US Department of Health and Human Services.
Cohen is founding director of a think tank, the Washington, DC, Center on Aging, and is past president of the Gerontological Society of America. He now directs George Washington University’s Center on Aging, Health & Humanities. He is also a professor of behavioral sciences and psychiatry at GW.
His recent book, The Mature Mind: The Positive Power of the Aging Brain, reports new evidence that our brains may get better as we get older.
How do you explain the long-held belief that aging causes mental deterioration?
Prior to the 1970s, there was a wide gap between old and young—but it was an education gap, not an ability gap. In 1960, the typical education level of someone over 65 was 8.7 years. By 1990, it was 12.1.
In addition, many giants in psychiatry, such as Freud and Piaget, looked only at formal thought—purely scientific thinking. They concluded that we reached our peak intellectual development by the end of adolescence and early adulthood.
Those of us who’ve had teenagers realize that they do brilliant things but also absolutely stupid things. Piaget didn’t reconcile the lack of maturity of the frontal lobe and other parts of the brain.
When did this assumption change?
In 1975, the National Institute of Mental Health established a research center on mental health and aging. That same year, NIH created the National Institute on Aging, and the Veterans Administration launched a geriatric-research program. Studies began to disprove the hypothesis that negative changes were inevitable with aging.
We hear about “successful aging.” What does that mean?
By the end of the 20th century, geriatric medicine was focused on minimizing decline among older adults. But that view still focused on aging as a problem. New research has led to an understanding of the capacity for positive change and creative expression in the second half of life.
In my new book, I tell the story of Alex Haley, who enlisted in the Coast Guard at 17 and stayed there working as a writer in the public-relations department. He quit after 20 years to pursue his dream of writing more than press releases. At age 44, Haley stumbled upon the names of his maternal grandparents when going through post–Civil War records in the National Archives. This began a 12-year odyssey of research and writing about his ancestry, which culminated in the publication of Roots when Haley was 55.
What have we learned about the aging brain?
Certain aspects of brain function do decline with age—the speed with which complicated math problems are solved and the efficiency of short-term memory. However, we now know that older people are capable of producing new brain cells.
Genes operate somewhat like light bulbs. They’re capable of throwing off great energy and light—instructing the brain to create new cells and circuitry but nothing happens until they’re turned on. The biggest catalyst is a mentally stimulating environment.
Activities such as community-education courses, book and writing groups, arts programs, and challenging work—volunteer, paid, or part-time—boost development of the brain in the second half of life.
One study of the connection between leisure activities and the risk of dementia and cognitive decline found that dancing, board games, playing a musical instrument, crossword puzzles, and reading had the greatest impact in reducing the risk of mental disability.
How does the older brain function differently from that of a 20-year-old?
The brain is continuously changing, responding to experience and learning. We’ve just become aware that there are other positive changes. Young people tend to use one side of the brain or the other predominantly to solve mental problems. A researcher at Duke did functional MRI and PET scans of people over 50 while they were performing tasks. The researcher discovered that older people had less hemisphere asymmetry; they were using both sides of the brain together.
Initially, other scientists disparaged this discovery as a desperate response of a brain that’s starting to fail. But we’ve learned that this “brain recruitment” is an asset. The convergence allows you to look at things in different ways. You have a new capacity. Any activity where the brain can optimally use both sides—that activity is like chocolate for the brain.
How does this show up on brain scans?
We studied autobiographical storytelling in 30-year-olds and 70-year-olds. In the 30-year-olds, the imaging lit up primarily the left hippocampus of the brain. In the 70-year-olds, both left and right lit up. The right side is more associated with intellectual curiosity and passion.
How does this “chocolate for the brain” affect the way we think?
In many different ways. What Piaget’s followers called “postformal thinking” enables older people to see not just the trees but the forest. For example, the historian Arnold Toynbee wrote that by his late seventies he had accumulated a degree of information that he’d never realized he was able to, and he had the ability to put it in perspective.
Postformal thought allows us to look at information we have had for a long time and to organize and synthesize it in new ways. We can make new connections and achieve new insights.
What about those “senior moments” when we struggle for a familiar word?
The tip-of-the-tongue phenomenon—there’s no overall consensus on what causes it. What’s important to recognize is that this phenomenon occurs throughout life. Misplacing one’s keys as a young adult registers as a nuisance rather than a diagnosis.
Some view our ever-increasing stores of memory as interfering with the efficiency of word retrieval, the same way that high use of Internet connections sometimes results in a delay before the information appears on the screen.
Meanwhile, despite the tip-of-the-tongue phenomenon experienced by many older adults, these same people are increasing their vocabulary. A major lesson in studying aging is that you can’t look at decrements in isolation because they’re accompanied by positive adaptations.
I think that after 50 there’s a new senior moment—a creative moment. There’s a liberation phase that begins to be very strong in the fifties. It’s characterized by metaphorical inner voices saying, “If not now, when?” and “What can they do to me?” These are powerful feelings based on accumulated experience that give you the courage to try something new.
Let me tell you a story about my in-laws. They got off the Metro in the middle of a snowstorm and couldn’t get a taxi to take them to our house. So they walked across the street to a pizza shop. My father-in-law ordered a pizza to be delivered to our house and then asked if he and his wife could be delivered along with it. They arrived, pizza in hand.
My father-in-law’s solution reflects not only the experience of years and agility of thought but also the feeling of inner freedom, self-confidence, and liberation from social constraints prevalent in younger people. He wasn’t afraid to make an unusual request of perfect strangers. You write about an “inner push” that motivates older people to express themselves in creative ways.
When I initially talked about late bloomers—Grandma Moses, Picasso, Georgia O’Keeffe—people said, “Get real. What are you, Ripley’s Believe It or Not?” But my research led me to a retrospective of folk art at the Corcoran in 1980. Of the 20 artists selected for the show, 16 had only begun their work or reached the mature stage of their art after age 65. Thirty percent had done so after the age of 80.
After the show, I did a much more in-depth study of folk art and found that regardless of racial and ethnic background, folk art is dominated by older people. This says something inherently powerful about creative expression.
But we aren’t all Picassos . . . .
Creativity can be expressed in different ways. There’s continuing creativity—somebody like the late cartoonist Herblock. There’s also changing creativity with aging—somebody like Bertrand Russell, who started as a mathematician and switched to philosophy in later life. There’s also creativity associated with loss. William Carlos Williams was a physician. He had a stroke in his late sixties. Fortunately, it didn’t affect his cognitive function. He could no longer practice medicine, but he turned to writing poetry full-time.
There’s nothing romantic about loss, but we can try to do things to transcend it—as Henri Matisse did with his cutouts. After he was diagnosed with cancer and had to use a wheelchair, he began doing massive cutouts and collages. He said it was as if he were cutting pure color.
How does creative expression affect overall health?
We studied older people in three cities to see the impact of cultural programs on their physical and mental health. The Washington group was divided—half participated in a choral-music program; the other half did other social activities. The singing group reported better health, fewer doctor visits, less medication use, not as many falls, better morale, and less loneliness.
Creative endeavors are self-sustaining. One DC woman was 94 when she joined the chorale. She was amazed she could sing and keep up with the group. She made new friends. She took pride in her accomplishment. Why do some older people seem depressed and negative?
That typically happens when somebody is experiencing a tremendous amount of loss and feeling they’re no longer in control of their situation. On the other hand, when you do morale studies, study after study shows that older people—even frail older people and those dealing with adversity—have morale comparable to that of younger adults.
How do you explain that?
After studying recent brain research, I’ve concluded that changes in the part of the brain that processes emotions—called the amygdala—may be contributory.
In brain-imaging studies, young adults and older adults were exposed to positive and negative emotions to see how the amygdala lit up and how long it stayed lit. Positive emotions caused the amygdala to light up the same way and stay lit for the same amount of time in both groups. But with negative emotions—fear, rage, envy—the amygdala lit up less intensely and for a shorter interval in the older group.
I suggest this helps explain the counterintuitive high morale in older people. They deal better with the consequences of adversity. Fear is less of an issue. Social phobias dissipate. Somebody who couldn’t speak in front of a group in their twenties may take the community stage 45 years later.
It’s not just the amygdala. Recently there was a study showing that as we age, the frontal lobe of the brain—the part that enables us to manage our behavior—may also increase in capacity to deal with negative emotions.
Do you plan to retire?
I’ve actually retired, but I’ve never been able to cut back to full-time.
Have you felt that “inner push”?
In my late forties, I became a board-game inventor. I teamed up with an artist, Gretchen Raber, and the game was a finalist in an international show on games as works of art.
My game designs draw on lessons from gerontology and promote intergenerational play. One of them is called W-W III: A Game of Word Wars. It’s a cross between chess and word games, though easier to play than either. Several equalizers permit people of different ages and skill levels to play together. Children can use a dictionary to form words, or teams of adults and children can play against each other.
I’ve also designed a board game to be played by Alzheimer’s patients and their families called Making Memories Together. It’s built around four squares representing people, animals, special occasions, and favorite objects from a patient’s life. At each turn, the patient is shown a photograph from his or her past. When I played with my parents, I showed my father pictures of his years in the Navy aboard the USS Indianapolis. On the back of each card is a description to be read aloud. Once the deck of cards is created by the family, anyone can play.
W-W III is available from genco-games.com. Making Memories Together will be available there later this year.
What are you working on now?
I’m excited about working with children. Kids often have a positive attitude about older people in their family but a negative view of aging. In fairy tales, older people are wicked, weird, or weak. I’m working with the American Library Association, looking for books that portray aging in a positive way. I’m also thinking about an educational game about the positive impact of aging.
What do you say to your contemporaries who are terrified of growing old?
We are the beyond-bingo generation. We can, if we want to, learn, grow, love, and experience profound happiness in our later years.
What have you learned about life?
Life is so much about the choices you make. Philosopher Albert Camus once said, “Life is a sum of all your choices.” In Harry Potter and the Chamber of Secrets, the Hogwarts headmaster, Albus Dumbledore—one of the best depictions of positive aging in modern children’s literature—advises Harry: “It is our choices that show what we truly are, far more than our abilities.”
In my book The Mature Mind, I point out that with aging, maturing social intelligence contributes to better choices in every sphere of one’s life. This enables the second half of life to be every bit as interesting as the first.
What have you learned about Washington?
Let me focus on one aspect apart from its rich history. There are many places and situations in which each of us has an opportunity to make a difference—no matter how big or small. But Washington is unique in terms of the number and diversity of offices in which important decision-makers sit and deliberate.
This is perhaps the major reason I’ve remained here after “retiring.” The focus of my work on aging is primarily a people focus, a public focus. Washington has provided me an unparalleled opportunity to share what I’ve learned face to face with many of these decision-makers, with the goal that this knowledge will translate into new programs for the public good. This has been one of my better choices.