Aging with a Sharp Mind: What Neuropsychology Teaches Us

Episode 53 · Laurie Groh, MS LPC SAS with Victoria Hagan, therapist, Shoreside Therapies · 2025-06-03

You walk into a room and can't remember why. You reach for a word and it isn't there. At some point most of us start quietly wondering: is this normal?

Show notes

This episode is a recorded webinar with Victoria Hagan, a therapist at Shoreside Therapies who previously worked in a neuropsychology department and helped develop a brain health clinic there. She's the person I'd want explaining this.

Normal, MCI or dementia?

Victoria laid out four categories. Super-agers, about 10 percent of people over 80, have brains functioning 20 to 30 years younger than their age. Mild cognitive impairment, roughly 10 to 20 percent at age 65, means the brain is declining a little faster than we'd like but it isn't dementia. The dementias (Alzheimer's, Lewy body, vascular) affect about 5 to 8 percent at 65, rising every five years.

And then there's normal brain aging, which is most of us. At 50 our brains don't work quite as fast. Multitasking is harder. The word takes longer to arrive. You walk into the room, walk out, and then remember. That is all normal.

The middle category is where lifestyle has the most leverage. About half of people with MCI go on to develop dementia and half don't. Her goal is to give people every tool to stay in the healthier half. She also noted that research shows dementia risk can be reduced by up to 40 percent through lifestyle changes.

The nuns who never showed it

The study that stuck with both of us is the Nun Study, which has followed hundreds of School Sisters of Notre Dame since 1986. Victoria described several sisters whose brains, at autopsy, showed Alzheimer's-related changes, including one with a genetic risk, who never showed memory loss during their lives. One had strong memory testing until she died at 102.

Her takeaway: we may not be able to change what's happening at the cellular level, but we can change how much it affects our lives.

Five pillars of brain health

Nutrition. Victoria walked through the MIND diet, which pulls the brain-relevant pieces from the Mediterranean and DASH diets: whole grains, leafy greens, vegetables, nuts, beans, berries, poultry and fish, olive oil as the main fat. No red meat, and most protein from plants. On supplements she was direct: the research isn't showing a benefit from Prevagen or similar products.

Exercise. Her phrase was "the secret sauce." If it's good for your heart it's good for your brain. The target is 150 minutes a week, which can be 30 minutes five days, in ten-minute pieces if you need to. When someone asked for one habit to start today, this was her answer.

Sleep. Seven to nine hours. Victoria described sleep as the cleaning crew clearing out the gunk and filing the day's papers so you can find them later. It may also reduce the plaques associated with Alzheimer's. Her basics: screens off 30 minutes before bed, no alcohol or caffeine close to bedtime, same bedtime every night, and if you're awake for 20 minutes, get up and do something relaxing. On "is scrolling really that bad," her honest answer: if you sleep fine, maybe not. If you don't, try a magazine.

Social engagement and learning. Use it or lose it applies to the brain too. Her rule of thumb is 11 or more activities a week across three buckets: leisure (reading, walking), social in real life (cards, mahjong), and intellectual (a new hobby, an instrument, a language). Once you've mastered the crossword or the phone game, the brain stops getting extra benefit from it.

Stress reduction. Chronic stress contributes to Alzheimer's, cardiovascular disease and depression. She led the group through box breathing (in for four, hold four, out four, hold four) and also named CBT and spirituality.

The part I didn't expect

Victoria said that in neuropsychology she was surprised by how many people came in worried about memory and word-finding, tested with no cognitive decline, and turned out to have significant stress, anxiety or depression. Addressing that often eased the memory complaints.

Her image: when you're young, stress takes up maybe 5 percent of a big healthy brain. As capacity shrinks with age, that same 5 percent takes up a bigger share and starts to crowd things out. Reducing stress frees up cognition.

She also flagged newer research linking hearing loss and dementia. If you have hearing aids and don't wear them, this might be the motivation.

Get it checked

If you're concerned, talk to your doctor and ask about a neuropsychological evaluation. If it's MCI, catching it early is when these tools matter most. We screen our bodies with mammograms and colonoscopies. I'd put this on the same list.

Key takeaways

1. Slower recall and lost words after 50 are usually normal aging, not dementia.
2. Lifestyle changes may reduce dementia risk by up to 40 percent, and matter most in the MCI window.
3. Exercise is the single habit with the biggest payoff for brain, body and mood.
4. Aim for 11 new or social activities a week. Passive repetition doesn't build reserve.
5. Memory complaints are sometimes stress, anxiety or depression in disguise.
6. Sleep is when the brain cleans and files. Protect it.

If this one hit close to home

If you're worried about your memory, or you suspect stress is taking up more of your brain than it should, Victoria Hagan offers a free phone consult through Shoreside Therapies in Wisconsin and online in several other states. Our intake coordinator will help you find the right fit, even if it isn't us.

More on this topic: Midlife Identity hub · Brain Health and Cognitive Aging Tips · Manage Anxiety in Midlife and Build Emotional Resilience · Holistic Sleep Strategies for Midlife Women

This episode is for education and entertainment. It is not therapy and does not create a therapeutic relationship. Hosted by Laurie Groh, MS, LPC, SAS.