Memory is the glue of life. Without it, our focus softens, our experience of the world blurs, and our identities melt away. But as people age, their memory declines. Many billions of dollars have been spent to understand the biological basis of dementia and to devise a cure. In most cases, they have failed spectacularly.
But what if, rather than study the brains of people with advanced memory loss, we instead studied the brains of people with the opposite condition: extraordinary memory and brain health in old age?
For the past few decades, Sandra Weintraub, a scientist at Northwestern University, has been part of a team studying the brains of “super-agers,” people 80 and older who have the memory ability of people in their 50s. In a new paper published this year to considerable fanfare, she found that super-agers didn’t have much in common. They didn’t share a diet, or an exercise regimen, or a set of maladies or medications. One thing, however, united them: their social relationships.
Today’s guest is Sandra Weintraub. We talk about the science of memory and the brain and the protective benefit of social connection for our minds and ourselves.
If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com.
In the following excerpt, Sandra Weintraub explains to Derek how she got into the field of memory and aging research and defines some of the terms essential to that field.
Derek Thompson: Your research spans memory, aging, Alzheimer’s, dementia. What got you into this space?
Sandra Weintraub: What got me into this? Well, OK, so if you really want to go way back to my undergraduate years at McGill University, McGill was kind of the first place in North America to really be interested in the brain and behavior. How does your brain do all the things that you do: think and talk and behave and sing and all of that? So I was incredibly interested in that, but there was no real field that was a clinical field for people who were interested in brain and behavior unless you wanted to be a neurosurgeon or a neurologist, which I didn’t want to do that. So over the years, this specialty developed of neuropsychology, and I decided that’s what I wanted to do because neuropsychology is the clinical psychology specialty devoted to working with the results of brain injury. Not kind of therapy or your feelings, but really somebody who has been developing normally has a brain injury: What happens, and why does it happen, and what are the different parts of the brain that cause it to happen? That’s where I really started.
My interest in aging, I then went to work at the Boston Aphasia Research Center and was very interested in people who had had strokes, who lost their language. And I worked there for a very long time. And then when I was ready, finished my degree and ready to get a job, I had my first job at a hospital that had a lot of older patients, and a lot of the older patients that I was seeing—and in those days, of course, people just never got the medical attention until things were really advanced. So I was seeing people who were in pretty late stages of dementia, and as I worked more and more in this field, and as we made more progress, we began to realize that you don’t wake up with dementia.
It starts 10, 20 years earlier, and we started seeing people earlier and earlier and earlier. So then I became really interested in: What is the earliest sign of a dementia? We always think of memory loss, but in our case, we’ve discovered that you can have an aphasia as the first sign of a progressive dementia, or you can have visuospatial deficits, or you can have behavioral changes. So I really got interested in: What can these neurodegenerative diseases tell me about the human brain and how it works? Then there was this thing called “normal aging,” and I started seeing people who were worried about their memory, but they didn’t have any problems when they were tested. And so I saw people who seemed to be kind of normal for their age, and then I saw people who were incredible that had memories like a 20-year-old, and I got really interested in: Why do those people, well, how can they preserve their memory?
Thompson: Let me just stop you right there before you finish your story. I would love to make sure that we retrace some of the vocabulary here. Tell me what aphasia is.
Weintraub: Sure.
Thompson: And then also, could you slow down and distinguish between what one might call “normal memory loss” and what is diagnosed as dementia or Alzheimer’s?
Weintraub: Those are very excellent questions. So the first thing you asked was: What is aphasia? Aphasia is a term—I mean, if you want to break it down from the Latin, it means “without language or without speech”—and it is the term that’s applied to a loss of the ability to communicate using words, understanding words, reading words, anything that has to do with your brain making words. Usually, it’s due to a stroke, but it can also be due to neurodegeneration in the part of the brain that controls your language function.
Thompson: And when we’re defining dementia and Alzheimer’s, what are we talking about here?
Weintraub: How long do you have, because … So normal aging is if you take 1,000 people between 65 and 85, and you give them a test, and you get a total score on the test, and then you average the score on that test: That’s what’s considered average for that age range. However, if you look at who’s at the bottom and who’s at the top, you have a huge spread across that average. I don’t know if you know what the standard deviation is, but it’s kind of variation around a mean. So when you take 30-year-olds and you do that test, their standard deviation is much, much smaller. If you take 80-year-olds, it’s huge. So it means that there are people at the top of that standard deviation that are performing like 30-year-olds, and that’s … So I don’t believe in normal aging. For me, there’s no such thing as normal aging.
Now, how do you tell if somebody is really having problems? And when you use the word dementia, we don’t talk about dementia; we talk about cognitive impairment, because there are stages. So you can start off with what’s called mild cognitive impairment, and if this is a neurodegenerative, it keeps going over time, and it eventually turns into a dementia, which means that you have cognitive impairment so severe that you can no longer function in your daily life. A lot of people have mild cognitive impairment, and they’re fine daily. They can drive. They can do finances. They’re just a little annoyed by their memory loss. But when it gets to the point where you’re not remembering things, you miss paying bills, you’re forgetting where you’re going when you’re driving, that’s what we call dementia.
This excerpt has been edited and condensed.
Host: Derek Thompson
Guest: Dr. Sandra Weintraub
Producer: Devon Baroldi
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