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80岁老人的大脑中发生了什么?

BETH GREENFIELD
2024-07-06

年龄究竟会对大脑产生什么影响呢?

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2024年6月27日,美国总统乔·拜登(Joe Biden,时年81岁))和共和党总统候选人、美国前总统唐纳德·特朗普(Donald Trump,时年78岁)在佐治亚州亚特兰大参加美国有线电视新闻网(CNN)总统候选人辩论。图片来源:JUSTIN SULLIVAN/GETTY IMAGES

上周,时年78岁和81岁的候选人进行了总统辩论,辩论结束后,大多数美国人都在思考年龄问题。很多美国人都认为总统拜登看起来"年老体弱",至少有一次公开呼吁对其进行认知测试。

但是,年龄究竟会对大脑产生什么影响呢?《财富》杂志咨询了衰老问题专家,以更清楚地了解情况。

令人难以置信的大脑皮层萎缩

芝加哥大学(University of Chicago)神经学教授、健康衰老与阿尔茨海默病研究护理中心主任艾米丽·罗加尔斯基(Emily Rogalski)告诉《财富》杂志:“随着年龄的增长,大脑会发生许多变化,其中之一就是我们所说的大脑外层或皮层的萎缩。”

她解释说,大脑皮层就像树皮一样,是脑细胞赖以生存的地方。

她说:"大脑皮层对我们的思考和交流非常重要。"大脑皮层的萎缩往往发生在与记忆有关的区域,而且往往与记忆变化相关。不管你是否相信,当我们20多岁或30岁出头的时候,记忆力会达到巅峰。

同样容易受到影响的还有注意力和执行能力。罗加尔斯基说:"所有这些能力在某种程度上都是相互关联的,原因是你需要集中注意力才能记住事情。我们的认知功能并不是孤立存在的。并不是说大脑这片区域负责记忆,那片区域负责注意力,这些功能之间不进行相互作用。大脑是一个复杂的系统。”

与年龄相关的记忆力丧失是正常的

拉什大学(Rush University)精神病学和行为科学教授、拉什阿尔茨海默病中心神经心理学家帕特丽夏·博伊尔(Patricia Boyle)指出,麦克奈特大脑研究基金会(McKnight Brain Research Foundation)最近的一项调查发现,87%的美国人担心随着年龄的增长,他们会经历与年龄相关的记忆力丧失和大脑功能下降。

博伊尔告诉《财富》杂志:"但是,许多人不知道的是,与年龄相关的记忆力丧失并不总是严重认知问题的征兆。大多数人都不明白,与年龄相关的记忆力丧失通常与轻度健忘有关,是大脑衰老的正常现象,并不一定是严重记忆问题的征兆。"

她表示,正常衰老的迹象包括:

•偶尔做出错误的决定

•忘记偿还月供

•忘记时间

•找不到合适的措辞

•丢三落四

博伊尔说:“随着年龄的增长,出现认知衰老的迹象是正常的,就像身体衰老的迹象是正常的一样,比如行动迟缓或疼痛加剧。”

随着年龄的增长,大脑萎缩确实会加速

随着年龄的增长,脑容量会不断减少,包括负责认知功能的前额叶和海马体,到60岁左右,脑容量萎缩的速度会加快。

罗加尔斯基解释说:"随着年龄的增长,我们罹患多种疾病的风险也随之增加。”如果考虑到身体的磨损和脆弱性增加,而且事实上,不像臀部或膝盖,大脑没有替代品,就不难理解这一点了。

哥伦比亚大学梅尔曼公共卫生学院(Columbia University Mailman School of Public Health)健康政策与衰老方面的教授约翰·罗(John Rowe)博士指出,衰老可能会导致两种非典型认知功能丧失中的一种:痴呆症和轻度认知障碍(MCI)。他说:“与年龄相关的变化发生在12%到18%的65岁以上老年人身上。在日常生活中反映出来的是,人们变得更加健忘、丢三落四、失约,而且这可能会影响日常生活。”他补充说,每年约有10%的轻度认知障碍患者会发展为痴呆症。

一些老年人表现出很高的水平

罗加尔斯基强调,看待衰老的一个重要部分是,不要只纠结于那些出错的事情,还要关注新机会。“衰老带来的巨大挑战实际上是与衰老相关的污名,以及我们对老年人的期望(没有向上的发展轨迹,只有不断下降),我们不让老年人参与活动,剥夺他们应负的责任。”

她说,这也是一些新型豪华辅助生活设施存在的问题,这些设施提供从客房服务到洗衣折叠等服务。"事实证明,我们所做的许多日常活动,如洗碗或四处走动,实际上对保持肌肉强健相当有益。”同样,让大脑参与活动和保持大脑活跃也很重要,有多种形式可以实现这一目的。"比如,保持社交联系,学习新知识。但是,我们需要考虑如何锻炼大脑和使用身体,包括考虑如何练习精细运动技能......如果我们不进行这些活动,让别人代劳,我们不一定会给自己带来益处。"

不过,罗强调说:“变化巨大。我们所看到的是,越来越多的人表现出很高的水平,他们在某种程度上是超级长者。”

超级长者登场了……

作为正在进行的多学科“超级衰老研究计划”的一部分,罗加尔斯基正在从生物学、家族史和生活方式的角度进行研究,并寻找证据,以了解是什么让某些人看起来几乎不会衰老,至少是在认知水平上。

"我们发现,从生物学角度看,'超级长者'似乎与众不同。他们的大脑实际上看起来更像五六十岁的老人,而不像八十岁的老人。"她说,并补充说,他们大脑的萎缩速度比普通八十岁老人要慢。

她说:“因此,他们似乎在抵制大脑外层或皮层变薄,当我们使用极其精确的工具进行测量时发现,与50至60岁的老人相比,超级长者的大脑实际上并没有表现出任何萎缩。”事实上,大脑中有一个叫做前扣带回皮层(ACC)的区域(在动机、决策、情绪和情境线索方面发挥作用)。超级长者的前扣带回皮层比普通五六十岁老人的前扣带回皮层更厚。他们还发现了大量被称为冯·艾克诺默神经元的神经元,使得科学家们找到了理解超级长者的“生物学路径”。

罗告诉《财富》杂志,多年前,他在哈佛大学(Harvard University)管理着一个研究“成功衰老”的研究网络。在一项研究中,他对一群75岁的老人进行了长达六年的跟踪调查,在此期间对他们的身体和认知能力进行了测试。罗说:“研究结束时,25%的人没有变化,50%的人变得更糟糕,另一部分人则处于中间状态。”他指出,那些表现最好的人,也就是超级长者具有某些共同的生活方式特征,包括不独居、受教育程度高和享有经济保障。

这表明,如果你今天召集一群80岁的老人来评估他们的认知能力,你会得到好坏参半的结果:可能有一对夫妇患有痴呆症,一两个超级长者,其他人则介于两者之间。这不仅是由于人们的大脑变化速度不同,还与生活方式、遗传和其他因素有关。

罗指出,他自己也已经80岁了,他表示最重要的是,“我认为,当我们试图将平均值简化为对某个个体的决定时,谈论平均值是没有任何意义的。我认为我们不能把80岁老人的平均水平归结为某个人的水平。”(财富中文网)

译者:中慧言-王芳

上周,时年78岁和81岁的候选人进行了总统辩论,辩论结束后,大多数美国人都在思考年龄问题。很多美国人都认为总统拜登看起来"年老体弱",至少有一次公开呼吁对其进行认知测试。

但是,年龄究竟会对大脑产生什么影响呢?《财富》杂志咨询了衰老问题专家,以更清楚地了解情况。

令人难以置信的大脑皮层萎缩

芝加哥大学(University of Chicago)神经学教授、健康衰老与阿尔茨海默病研究护理中心主任艾米丽·罗加尔斯基(Emily Rogalski)告诉《财富》杂志:“随着年龄的增长,大脑会发生许多变化,其中之一就是我们所说的大脑外层或皮层的萎缩。”

她解释说,大脑皮层就像树皮一样,是脑细胞赖以生存的地方。

她说:"大脑皮层对我们的思考和交流非常重要。"大脑皮层的萎缩往往发生在与记忆有关的区域,而且往往与记忆变化相关。不管你是否相信,当我们20多岁或30岁出头的时候,记忆力会达到巅峰。

同样容易受到影响的还有注意力和执行能力。罗加尔斯基说:"所有这些能力在某种程度上都是相互关联的,原因是你需要集中注意力才能记住事情。我们的认知功能并不是孤立存在的。并不是说大脑这片区域负责记忆,那片区域负责注意力,这些功能之间不进行相互作用。大脑是一个复杂的系统。”

与年龄相关的记忆力丧失是正常的

拉什大学(Rush University)精神病学和行为科学教授、拉什阿尔茨海默病中心神经心理学家帕特丽夏·博伊尔(Patricia Boyle)指出,麦克奈特大脑研究基金会(McKnight Brain Research Foundation)最近的一项调查发现,87%的美国人担心随着年龄的增长,他们会经历与年龄相关的记忆力丧失和大脑功能下降。

博伊尔告诉《财富》杂志:"但是,许多人不知道的是,与年龄相关的记忆力丧失并不总是严重认知问题的征兆。大多数人都不明白,与年龄相关的记忆力丧失通常与轻度健忘有关,是大脑衰老的正常现象,并不一定是严重记忆问题的征兆。"

她表示,正常衰老的迹象包括:

•偶尔做出错误的决定

•忘记偿还月供

•忘记时间

•找不到合适的措辞

•丢三落四

博伊尔说:“随着年龄的增长,出现认知衰老的迹象是正常的,就像身体衰老的迹象是正常的一样,比如行动迟缓或疼痛加剧。”

随着年龄的增长,大脑萎缩确实会加速

随着年龄的增长,脑容量会不断减少,包括负责认知功能的前额叶和海马体,到60岁左右,脑容量萎缩的速度会加快。

罗加尔斯基解释说:"随着年龄的增长,我们罹患多种疾病的风险也随之增加。”如果考虑到身体的磨损和脆弱性增加,而且事实上,不像臀部或膝盖,大脑没有替代品,就不难理解这一点了。

哥伦比亚大学梅尔曼公共卫生学院(Columbia University Mailman School of Public Health)健康政策与衰老方面的教授约翰·罗(John Rowe)博士指出,衰老可能会导致两种非典型认知功能丧失中的一种:痴呆症和轻度认知障碍(MCI)。他说:“与年龄相关的变化发生在12%到18%的65岁以上老年人身上。在日常生活中反映出来的是,人们变得更加健忘、丢三落四、失约,而且这可能会影响日常生活。”他补充说,每年约有10%的轻度认知障碍患者会发展为痴呆症。

一些老年人表现出很高的水平

罗加尔斯基强调,看待衰老的一个重要部分是,不要只纠结于那些出错的事情,还要关注新机会。“衰老带来的巨大挑战实际上是与衰老相关的污名,以及我们对老年人的期望(没有向上的发展轨迹,只有不断下降),我们不让老年人参与活动,剥夺他们应负的责任。”

她说,这也是一些新型豪华辅助生活设施存在的问题,这些设施提供从客房服务到洗衣折叠等服务。"事实证明,我们所做的许多日常活动,如洗碗或四处走动,实际上对保持肌肉强健相当有益。”同样,让大脑参与活动和保持大脑活跃也很重要,有多种形式可以实现这一目的。"比如,保持社交联系,学习新知识。但是,我们需要考虑如何锻炼大脑和使用身体,包括考虑如何练习精细运动技能......如果我们不进行这些活动,让别人代劳,我们不一定会给自己带来益处。"

不过,罗强调说:“变化巨大。我们所看到的是,越来越多的人表现出很高的水平,他们在某种程度上是超级长者。”

超级长者登场了……

作为正在进行的多学科“超级衰老研究计划”的一部分,罗加尔斯基正在从生物学、家族史和生活方式的角度进行研究,并寻找证据,以了解是什么让某些人看起来几乎不会衰老,至少是在认知水平上。

"我们发现,从生物学角度看,'超级长者'似乎与众不同。他们的大脑实际上看起来更像五六十岁的老人,而不像八十岁的老人。"她说,并补充说,他们大脑的萎缩速度比普通八十岁老人要慢。

她说:“因此,他们似乎在抵制大脑外层或皮层变薄,当我们使用极其精确的工具进行测量时发现,与50至60岁的老人相比,超级长者的大脑实际上并没有表现出任何萎缩。”事实上,大脑中有一个叫做前扣带回皮层(ACC)的区域(在动机、决策、情绪和情境线索方面发挥作用)。超级长者的前扣带回皮层比普通五六十岁老人的前扣带回皮层更厚。他们还发现了大量被称为冯·艾克诺默神经元的神经元,使得科学家们找到了理解超级长者的“生物学路径”。

罗告诉《财富》杂志,多年前,他在哈佛大学(Harvard University)管理着一个研究“成功衰老”的研究网络。在一项研究中,他对一群75岁的老人进行了长达六年的跟踪调查,在此期间对他们的身体和认知能力进行了测试。罗说:“研究结束时,25%的人没有变化,50%的人变得更糟糕,另一部分人则处于中间状态。”他指出,那些表现最好的人,也就是超级长者具有某些共同的生活方式特征,包括不独居、受教育程度高和享有经济保障。

这表明,如果你今天召集一群80岁的老人来评估他们的认知能力,你会得到好坏参半的结果:可能有一对夫妇患有痴呆症,一两个超级长者,其他人则介于两者之间。这不仅是由于人们的大脑变化速度不同,还与生活方式、遗传和其他因素有关。

罗指出,他自己也已经80岁了,他表示最重要的是,“我认为,当我们试图将平均值简化为对某个个体的决定时,谈论平均值是没有任何意义的。我认为我们不能把80岁老人的平均水平归结为某个人的水平。”(财富中文网)

译者:中慧言-王芳

In the wake of last week’s presidential debate between the 78- and 81-year-old candidates—and the impression among some that President Joe Biden looked “old and frail,” with at least one public call for cognitive testing—much of America has had age on the brain.

But what does age actually do to the brain? Fortune consulted with experts on aging to get a clearer picture.

The incredible shrinking cortex

“The brain undergoes many changes associated with aging, and one of them is the shrinkage of what we call the outer layer of the brain, or the cortex,” Emily Rogalski, professor of neurology at the University of Chicago and director of its Healthy Aging & Alzheimer’s Research Care Center, tells Fortune.

The cortex, she explains, is like the bark on a tree, and is the layer where brain cells live.

“It’s really important to our thinking and our communication,” she says, and its shrinking tends to occur in areas related to memory, and tends to be correlated with changes in memory—which is at its peak performance, believe it or not, when we are just in our 20s or early 30s.

Also vulnerable as a result are skills of attention and executive functioning. “And all of these things are interrelated in a way, because you need to have good attention in order to remember something,” Rogalski says. “Our cognitive functions don’t just sit on little islands of, here’s memory and here’s attention, and there’s no interaction. It’s a complex system.”

Age-related memory loss is normal

A recent McKnight Brain Research Foundation survey, points out Patricia Boyle, professor of psychiatry and behavioral sciences at Rush University and a neuropsychologist with the Rush Alzheimer’s Disease Center, found that 87% of Americans are concerned about experiencing age-related memory loss and a decline in brain function as they grow older.

“But, what many don’t know is that age-related memory loss is not always a sign of a serious cognitive problem,” Boyle tells Fortune. “Most people do not understand that age-related memory loss is usually associated with mild forgetfulness and is a normal part of brain aging and not necessarily a sign of a serious memory problem.”

Some signs of normal aging, she says, include:

• Making a bad decision occasionally

• Missing a monthly payment

• Losing track of time

• Not being able to find the right words

• Losing things around the house

“As we get older, it is normal to see signs of cognitive aging just like it’s normal to see the physical signs of your body aging, like moving slower or more aches and pains,” Boyle says.

Brain shrinkage does accelerate when you’re older

Brain volume continues to decrease as we age—including the frontal lobe and hippocampus, the areas responsible for cognitive functions—with the rate of shrinkage increasing by around age 60.

“With aging, we increase our risk for many diseases just by getting older,” which makes sense, Rogalski explains, if you think about wear and tear and the increasing vulnerabilities of our body—and the fact that, unlike with hips or knees, there are no brain replacements.

Aging brings the possibility of one of two types of atypical loss of cognitive function, notes Dr. John Rowe, a Columbia University Mailman School of Public Health professor of health policy and aging: dementia and mild cognitive impairment (MCI), “an age-related change that occurs in between 12% and 18% of older people, over 65,” he says. “And what is reflected in day-to-day living is that people become more forgetful, they lose things, they miss appointments, and this can have an impact on your day-to-day function.” MCI, he adds, progresses to dementia in about 10% of people per year.

Some older adults are performing at high levels

Rogalski stresses that an important part of looking at aging is to not just dwell on the things that go wrong, but new opportunities. “A huge challenge with aging is actually the stigma associated with aging and the expectations that we put on individuals as they age—that there is no trajectory but down—and that we take away activities and responsibilities that people can do.”

And that’s a problem in some new, luxury assisted-living facilities, she says, which provide services from room service to laundry folding. “It turns out that many of these daily activities that we do, such as washing our dishes or just moving around, are actually really good for keeping those muscles strong.” Similarly, it’s important to keep our brain engaged and active, which can come in many forms. “It can come from staying socially connected. It can come from learning something new. But we want to think about exercising our brain and using our body, including thinking about ways to practice our fine motor skills … and if we have those things taken away and done for us, we’re not necessarily doing ourselves a service.”

Still, stresses Rowe, “There’s tremendous variability. And what we’re seeing is an increasing proportion of the older population that’s performing at very high levels who are kind of superagers.”

Enter the superagers…

Rogalski, through her research as part of the ongoing, multidisciplinary SuperAging Research Initiative, is looking at evidence from biologic, family history and lifestyle perspectives in order to learn what makes certain people seem to barely age, at least cognitively.

“What we’ve seen is that superagers, biologically, seem to look different. Their brains actually look more like 50 to 60 year olds than they do like 80 year olds,” she says, adding that their rate of shrinkage is slower than that of average 80-year-olds.

“So they seem to be resisting that thinning of the outer layer of the brain, or the cortex, and when we measure it using really precise tools, we see that the superager brains actually don’t show any shrinkage relative to the 50- to 60-year-olds,” she says. In fact, there’s a region of the brain called the anterior cingulate cortex (ACC)—which has a role in motivation, decision-making, and emotional and situational cues—that’s thicker in the superagers than it is in the 50- to 60-year-olds. They’ve also discovered an abundance of a neuron called von Economo neurons, helping scientists to have a “biologic pathway” for understanding superagers.

Years ago, Rowe tells Fortune, he ran a research network that studied “successful aging” at Harvard University. In one study, he followed a group of 75-year-olds for six years, testing them physically and cognitively over that period. “At the end, 25% had not changed, 50% had gotten much worse and the other kind of stayed in the middle,” says Rowe, noting that those who did the best, the superagers, shared certain lifestyle characteristics, including not living alone, educational attainment, and financial security.

It underscores how, were you to gather a bunch of 80-year-olds today to assess their cognitively abilities, you’d get mixed results: Probably a couple with dementia, a superager or two, and others who are in between. That’s not only due to people’s brains changing at different rates, but also the difference in lifestyles, genetics, and other factors.

Bottom line, says Rowe, who points out that he himself is 80, “I don’t think we can talk about an average with any meaningful validity when we are trying to reduce that to a decision about a person. I don’t think we can ascribe an average of an 80-year-old to an individual.”

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