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Brain Health & Retirement: A Daughter’s Perspective

Posted by Cristina Filippo on 03/07/2017

Well, it’s happened.  The big life question that haunts every child growing up is…how will my parent leave this earth?  As I stood quietly in the emergency room approximately a year ago and heard the doctor say the words “vascular dementia” as the reason why my dad was having so many recent medical and behavioral issues, I realized how stark the future was.  My mom, as many caretakers do, tried to protect us from the truth for way too long.  It was at that moment I realized the gig was up.  Now was the time to step into that role of helping get things in order to take care of a dad that spent a lifetime taking care of me.  This is the man that grew up on a farm in Ohio, had a great Alaskan adventure with his college buddies, loved cowboy movies, taught me how to fish and raise cattle, and was passionate about his alma mater, OU and Barry Switzer-era college football.  He taught me how to hold a child's hair back when she is throwing up with the flu and how to be responsible and pay bills on time.  He was a brilliant engineer who completed his career retiring as Chief of the Civil Engineering Squadron on a local Air Force Base at the age of 58...spending the last 15+ years at the lake, working on tractors, traveling and enjoying his grandchildren.

Since that night, events have progressed rapidly.  Experts say the more intelligent the individual the longer they are able to compensate and then essentially have a steep drop off in cognitive abilities. That exact thing happened in our case.  As many of you may have noticed, I prefer not talk about it much.  A friend, whose mom had passed away from Alzheimer’s, recently said during lunch on a restaurant patio during a recent trip to Scottsdale, “Speaking of big life events, let’s talk about your dad”.  I said simply “Umm…Let’s not”.  It feels extremely private to me – even thinking about writing this blog made my heart skip a beat.  I want to preserve my dad’s dignity and I choose, for my own functioning, to remain at a more cognitive level instead of staying in my emotion.  I realize this is a very strange statement coming from a psychologist.

Over the last year, I have become intimately familiar with the term “ambiguous loss.” Ambiguous loss is different from the loss and grief of death because closure is not possible and grief cannot be fully resolved while the person with dementia is alive.  A small peek into the mixed feelings associated with this horrible disease is best illustrated by the feeling I get as I approach the memory care facility where my dad is living and wondering if I’ll see that look of recognition in his eyes or the blank stare of a stranger.  Elation when he does and crushing sadness when he doesn’t.

Why Talk About This Brain Disease?
So why would an organizational development psychologists, write about Alzheimer's disease and what does this have to do with the world of work?  The first reason is because this disease impacts the business world on several levels. In addition to the human suffering caused by the disease, Alzheimer’s is creating an enormous strain on the health care system, families (possibly your co-workers), the economy and the federal budget. Alzheimer’s is a progressive brain disorder (various types of dementia are the "symptoms") that damages and eventually destroys brain cells, leading to a loss of memory, thinking, personality and other brain functions. Ultimately, Alzheimer’s is fatal.

Currently, Alzheimer’s is the sixth-leading cause of death in the United States and the only one of the top ten without a means to prevent, cure or slow its progression. Over five million Americans are living with Alzheimer’s, with 200,000 under the age of 65. While deaths from other major diseases, including heart disease, stroke and HIV continue to experience significant declines, those from Alzheimer’s disease have increased 68 percent between 2000 and 2010. With the first of the baby boomer generation now turning 65, the U.S. population aged 65 and over is expected to double by 2030. Although Alzheimer’s is not normal aging, age is the biggest risk factor for the disease. Taken together, these factors will result in more and more Americans living with Alzheimer’s - as many as 16 million by 2050, when there will be nearly one million new cases each year. Due to these projected increases, the graying of America threatens the bankrupting of America.

In addition to these staggering statistics, the second reason I want to talk about dementia is that I’m worried about our aging baby boomer population.  They have so much to offer us Gen Xers and the Millennials as well.  They have a wonderful work ethic and are a wealth of information and experience.  As they consider retirement…I have one word – DON’T!  In the last 15 years, I have come across numerous individuals, both on a personal and professional basis, who have retired and ended up having multiple physical, emotional and mental health issues that were directly correlated to retirement.  Now, at first I thought this was my own opinion and that maybe I was just jaded by my own experience with my dad's early retirement and others.  However, after looking into this phenomenon, I wanted to expose you, our dear readers, to some significant research that you might want to consider.

Mental Retirement
Retiring at 55 and spending the rest of your life relaxing on the beach or at the golf course may sound appealing, but if you want your brain to keep working at full capacity, it’s probably not a good idea. As reported recently in the Washington Post, mounting evidence shows that staying in the workforce into old age is good not only for our bank accounts, but also for our health and mental acuity. That’s great news for Americans, who keep working further into old age on average later than Europeans, and who will be retiring even later than previously, thanks to changes built into Social Security benefits.
As medical advances extend the length of the human lifespan — and the number of healthy, active years — scientists, economists and policymakers are delving into the question of what the optimial time to stop working is. One message is becoming clear: don’t stop too soon.
“Retiring too early can hurt you,” said Esteban Calvo, a sociologist with the Columbia Aging Center and the Institute of Public Policy at Diego Portales University in Chile. He is currently conducting a longitudinal study looking at over 100,000 people in 21 countries to determine the physical and mental effects of retirement.  So far, the study, “Should I Stay or Should I Go?” shows negative effects for those who retire earlier than the mean age - and the outcomes are worse the earlier you stop working. “At 50 it will be very, very bad for your health,” Calvo said. “At 60 it will be bad but not as bad as at age 50.”
So when is the sweet spot for retirement? The optimal age is around the late 60s/early 70s, but depends on factors from an individual’s financial security to the culture he or she lives in. “It’s not that you have to work forever,” Calvo said. But those who retire too early feel more sad and lonely and disconnected. “You’ll be calling your friends to see if they want to play golf or see a movie and they will be at work, and five years later your friends will be calling you and you’ll say ‘I don’t want to play golf anymore.’ You’re living your life at a different pace from your peer group.”
Though not all in agreement, several studies comparing people across industrialized nations have shown a strong correlation between early retirement age and diminished cognitive function. In countries such as France and Austria, where labor force participation among men in their early 60s is lower compared to younger men, cognitive performance was found to be significantly lower than in places like the U.S. and Denmark where older men’s labor force participation was higher, according to a 2010 study published in the Journal of Economic Perspectives.
A 2013 longitudinal analysis by researchers at the University of Padova that controlled for age, physical health, income, education, and early life conditions confirmed the “mental retirement” hypothesis and found that early retirement may also be associated with the onset of dementia. And a study the same year by a French research agency showed that for each additional year they worked, people reduced their risk of dementia by 3.2%.
It’s not just whether you’re retired, but for how long: the more years spent in retirement, the higher the risk of cognitive decline, the Italian study found. There were also other factors; for example, if you did well in math at age 10 your brain was less likely to slow down in old age. But if you lived in a rural area during childhood, it was more likely.

The fact that a person is working may not in itself be as important as the kind of work one does, cautions Ursula Staudinger, director of the Columbia Aging Center and the lead author of a 2014 study of assembly line workers in Germany showing that those who changed tasks more often over 16 years had better brain function and cognitive performance than those who did not. That is true whether or not you are highly skilled. “At every level of education there are types of work that are more complex than other jobs,” Staudinger said. “You don’t have to despair if you have a low-level job, but you have to make sure that at your level you have enough complexity.”
No matter when you retire, be mindful of how you do it, experts advise; retirement can in itself cause psychological stress that increases risk for dementia.  While some people gleefully embrace the end of their working days, others experience anxiety and depression when they lose the mental stimulation and social networks that go along with employment. Volunteering can help counteract that, though studies show those benefits come only if people are genuinely engaged in their volunteer activities.
“We have found that work stimulates cognitive development to the extent that work is engaging and also challenging,” said Jacquelyn James, co-director of the Sloan Center on Aging and Work at Boston College. “I think we used to think that doing crossword puzzles was the best way to keep our cognitive ability alive and developing and I think we’re seeing that it takes more than that. It’s much more important to do things that challenge the mind, like learning a new language, or learning a new technology.”
Final Thoughts
All that being said, I will disclose now that I thought my dad was active enough at the time.  However, looking back and really understanding the research more, I realize that he probably wasn't. That is where this blog comes in to "sound the horn" and give you some facts to make good, informed decisions as your career progresses. It also might help you be more aware of this growing problem as people in your organization and community are impacted by dementia. 

I'm hoping that all of this was not too personal, was not too depressing and/or was not offensive to those of you considering retiring soon.  I wouldn’t have written it if I didn’t care about those with whom I spend my time working and living with.  This disease is such a punch in the gut and, honestly, based on these predictions, none of us will escape without knowing someone with Alzheimer’s disease. 

There are two things I ask of you. One is to approach the planning of your retirement with these statistics in mind…we need you in the workforce and your brain needs to stay active!  The second request may be selfish as well…If you do know the caregivers (friends, employees, neighbors) of a dementia patient, be sure to slow down and ask how they are, if you can sit down with them for a chat and cup of coffee and, lastly, give them a big hug.  They need it.

We are taking next week off for Spring Break, but will return soon after.  Have a great rest of the week and, as always, please let us know if we can help you in your journey!

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