Coming back to the question of what is normal in terms of brain function and how to identify pathology, the answer is never simple. While there are objective tests of cognitive function, performance can depend a lot on arbitrary factors like how anxious the person is when taking the test, how well they slept, and whether they have ever done this kind of testing before.
How do we even know
Of course only we can experience our own brain function from the inside, and while we tend to assume that these experiences are the same, we don’t actually know if that’s true.
Back in high school my art teacher would set up a still-life display for the class to draw, and I was always struck by how different the drawings would look. Was it because we saw things differently, or because our brains and hands rendered the images differently on the page, or both?
What we do know is that we share enough similarities that we can recognize our experiences in others and communicate about them. So when I hear music that makes me want to dance, I will begin to move my body and invite others around me to do the same.
What’s working for you?
When I’m assessing my own brain function I tend to value alertness, focus and attention for executive function work like analysis and spreadsheets. And for creative work I prefer a more drifty zone that is still focused, but I almost have to take a big step away from my logical brain to allow more flow.
Sometimes I’ll notice that my energy level or attention is flagging, or that I’m super distractible on the internet. And I’ll know that I need to move my body, drink water or that my brain needs a break. At other times I’m just taking one appointment after another and when I look up three hours have passed in a blink.
Only we can judge for ourselves how our brains are functioning, compared to what our past experiences. And just as our bodies may have more stiffness or move more slowly over the years, we will begin to see changes in the brain.
It takes time
It’s important to recognize that clinical dementia involves not only memory, but also language, spatial, and executive functions. And it takes time for us to see the big picture of what is happening to the brain. Early dementia is called Mild Cognitive Impairment (MCI), with memory symptoms as listed above, looking pretty innocuous and even frankly indistinguishable from normal “brain farts” or memory slips.
Loving what is
I have also learned that it doesn’t serve me to worry about what will come. I know that I might be living with dementia some day. I know that I may never get dementia. I know that my other friends and family face the same uncertainty, as we all do with age. We each choose how best to cope with that uncertainty, whether through planning or just waiting.
I know that I can help myself by proactively looking for ways to improve my brain health, by prioritizing exercise, nutrition and sleep, and by continuing to learn more as new science emerges on how to prevent dementia. I can manage my stress by coaching through thoughts and feelings to lessen my own suffering, and by taking care of myself by setting healthy boundaries.
I choose to focus on my work in helping people gain agency over their own aging and to accept what is normal for their own brain. Whatever is happening is normal for them and only they can do the work to further optimize their own brain performance.
We can each choose to count our many blessings each day. To be grateful for the gifts that we have been given, for our loved ones and most of all for the present moment.
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