You’re only as old as your brain
We are psychiatrists specializing in geriatrics. One of us saw a report of a brain MRI which read, “These images are completely normal, which is not compatible with the patient’s age.” The patient was in her late 80s. The lady had evidently confused the radiologist by flouting his stereotype of what her brain was supposed to look like.
Pre-judging people based on their sex, or race, or where they went to school, is called sexism, or racism or elitism and is wrong. Pre- judging someone based on their age is called ageism, and it is just as wrong.
In fact, newborn babies are all remarkably alike when compared to all 80-year-olds or 50year-olds. We grow more and more different as we grow older. Our age in years, or “chronological age,” is not the best measure of our biological age. That is why doctors take note of whether patients “appear their stated age.”
Biological age reflects how much our bodies — including our brains — show the physical effects of aging, for which there are high-tech measures like telomere length and DNA methylation. But it is more practically reflected in how well an older person functions. We vary greatly in the rate at which we experience the effects of biological aging; the process is influenced both by our genes and by our environments.
With aging, everybody experiences some decline in muscle strength and speed and reaction time, but not at the same rate that everyone else does. There are 80-year-olds who run marathons and compete in pickleball tournaments, which many who are decades younger cannot do. Similarly, everyone experiences some cognitive slowing but not at the same rate as everyone else.
Most people slow down at a pace between two extremes. At one extreme, 5% to 10% of people 65 and older decline a lot and do so rapidly because they have diseases that cause dementia.
At the other extreme, some decline very little. They are not as quick as they once were but still more than hold their own with younger peers. Consider Ruth Bader Ginsburg, David Attenborough, Maya Angelou, Warren Buffett, Anthony Fauci.
These luminaries were — or are — not what we consider average octogenarians, but there lies our mistake: There is no meaningful definition of an average octogenarian. They are all exceptional older adults, sometimes referred to as “super-agers.” Older people who remain at the tops of their professions and organizations are usually superagers.
When we ask whether someone is too old to drive, or to manage their own affairs, or to do a certain job, it is really not their age that concerns us but rather their competence at the particular task.
If the job requires superior muscle strength or reaction time, we might select someone still in their physical prime. However, if the job is primarily cognitive, we would not rule someone out because of their age.
In fact, an older person’s accumulated experience and wisdom might be assets in a given job. Remember when Ronald Reagan was asked, during a presidential debate, whether age should be a factor in the election? He shot back that he would not exploit the “youth and inexperience” of his much younger opponent Walter Mondale.
Those who lament that we are being ruled by a “gerontocracy” are not actually concerned about our leaders’ chronological or biological ages. What they are really focused on are the leaders’ policies and priorities with which they disagree.
But it’s kind of cool to characterize our differences as generational rather than personal, like Pepsi branding itself as the “choice of a new generation” almost 40 years ago.
In the 1960s, Bob Dylan sang: Come, mothers and fathers throughout the land,
And don’t criticize what you can’t understand,
Your sons and your daughters are beyond your command, Your old road is rapidly agin’, Please get out of the new one if you can’t lend your hand,
For the times, they are achangin.
As the young revolutionaries grow older, those who become successful leaders typically take the long view and become more strategic and measured in their approaches. This in turn infuriates the next generation, and the cycle continues.
Those in positions of authority surely remember the days when they themselves were the young and the restless. The wise among them are paying attention to the perspectives and concerns of the next generation of leaders, who will take their place before long.
But is age really the issue? What we are really arguing about is the leaders’ goals and values. Or their strategies to accomplish their goals and values.
It is legitimate to vociferously debate policies and priorities, without invoking the dreadedand misguided- specter of “senility.”
Dylan is 81. Aging is in everyone’s future. Ageism does not need to be.