CULTIVATING OUR INNER CHILD

Nanny Alda passed away just shy of her 102nd birthday. She was a happy elder, someone everyone enjoyed being around. She would laugh heartily at the jokes told to her and, with her radiant eyes and open spirit, listened intently to what others shared with her. I remember one particular moment I witnessed the brilliance of her personality when I took her to visit an old quarry that had been transformed into a park. She was so excited by the novelty that, in a moment of distraction, she dashed ahead along the slippery walkways, giving me quite the challenge to catch up with her. She was 96 at the time. Sadly, she passed away a few years later due to complications from surgery. But until the very end, she lived like that—ready to laugh, participate, learn, and engage with those who had the good fortune to be around her.

As we’ve discussed before, biological aging parallels the loss of functional reserves,  essential resources for maintaining physical or mental life. Cognitive reserve, another term for mental resilience, is drastically reduced with age unless, like my grandmother, it's been nurtured throughout life. Cognitive reserve refers to the mind’s ability to stay active, adaptive, and functional despite aging and the resulting changes in the brain. If we can keep this reserve intact or as unaffected as possible, it’s initially supported by factors largely out of our control—genetics, age, birth gender, and the molecular changes our bodies undergo.

However, the maintenance of cognitive reserve is also influenced by what we call acquired factors, like education, personal history, and the quality of emotional experiences throughout life. Unlike genetics and age, these are factors we can modify, either by ourselves or with the support of those around us.

So, if there are lifestyle choices that help people remain functional even in advanced age, how can we put them into practice? If you guessed that the title of this post is the answer, you’re spot on.

It’s fascinating that, to address something as serious as the degeneration of our nervous system, we’re invited to approach life with a lighthearted attitude: cultivating our inner child to keep our minds healthy and active over the years.

The concept of cognitive reserve encompasses factors that enhance the capacity of the neural networks involved, leading to greater efficiency in task execution and even compensating for the malfunctioning of areas already affected by aging. Neurologically speaking, investing in the expansion and quality of neural networks enhances what is called dendritic arborization, which increases neuronal and synaptic density and the myelination of a brain region known as the neocortex. This “new cortex,” the portion of the brain that expanded significantly in humans compared to other primates, is responsible for sensory perception, language, motor commands, consciousness, and logical reasoning.

We can’t ignore the association between nervous system decline and neurodegenerative diseases, particularly dementias, which have a close correlation with aging. In simple terms, dementias are diseases that accelerate or anticipate the depletion of the brain's functional reserves. Affecting millions worldwide, they are often linked to natural aging. However, as I hinted earlier, research shows that there are ways to reduce the risk of developing dementia, and one of the most effective ways is through a lifestyle that stimulates the brain and keeps our minds youthful.

There are various types of dementia, with Alzheimer’s being the most well-known and prevalent, followed by vascular dementia, Lewy body dementia, and frontotemporal dementia. These dementias share a set of symptoms associated with the decline in memory, thinking, and the ability to perform daily activities. Cognitive decline, memory impairment, behavioral changes, and loss of autonomy and functionality are common signs. From clinical experience, I would add that how individuals deal with emotions is also profoundly affected by the condition.

On a molecular level, proteins involved in brain function need to be “folded,” meaning amino acid sequences must be arranged into a three-dimensional structure crucial to their function. Misfolded proteins can lead to loss of function or, in some cases, the development of diseases. Another important process at play is “cleavage,” the cutting of polypeptide molecules (proteins) into smaller fragments. Cleavage is necessary to activate or deactivate proteins, process proenzymes (inactive enzyme forms) into active enzymes, or degrade defective or unnecessary proteins. These processes are critical for cellular and overall organism function, and research on them offers hope for people with dementia.

Misfolded proteins are observed in the major causes of dementia: beta-amyloid and TAU proteins in Alzheimer’s, TAU and TDP-43 proteins in frontotemporal dementia, and changes in alpha-synuclein in Lewy body dementia. The accumulation of these misfolded or cleaved proteins leads to reduced energy metabolism, production of reactive oxygen species, oxidative stress, inflammatory damage, synaptic dysfunction, and eventually, neuronal death.

Beyond detecting these protein deposits and applying neurological tests, factors like education level, literacy, IQ, cognitive flexibility, occupational complexity, participation in leisure activities, quality of life, and physical, cognitive, and social stimuli can influence the clinical presentation and progression of dementia.

Interestingly, these psychosocial indicators can sometimes mask traces of dementia even if neurobiological markers are present. Does this sound too abstract? Here’s a practical example. For the diagnosis of some types of dementia, the presence of vascular changes (microbleeds and vascular gaps), protein deposits, temporal atrophy, and ventricular dilation is required, while intracranial volume, brain circumference, and cortical thickness are markers of cognitive reserve. Depending on the study, between 25% and 67% of clinically “normal” individuals could be diagnosed with some form of dementia if only anatomical and neurobiological criteria were used. In other words, even with a deteriorated biological base, people with a preserved mental life manage to stay off the radar of neurodegenerative diseases associated with natural aging. Science has shown that we can adopt strategies to delay the onset of these diseases or even prevent them. And this is where the concept of "cultivating the inner child" comes in.

When we talk about this ability, we’re referring to maintaining a youthful spirit, open to new experiences and knowledge. Children are naturally creative and curious; by nurturing these qualities, we can help our brains stay healthy and functional for longer.

But how do we cultivate this inner child? Children are always learning, and so can we. Continuous learning is one of the most effective ways to keep the brain active. It doesn’t necessarily mean going back to school but rather developing new skills, hobbies, or knowledge that feed our curiosity. Learning to play an instrument, studying a new language, delving into fields like history, botany, philosophy, or astronomy, or engaging in manual activities like painting and crafts are all great ways to challenge the mind.

Playing is not just for children. As adults, we should continue exploring the world and nourishing our playful side through interactions with others, moments of leisure, and structured games like crosswords, board games, puzzles, and video games, which are valuable tools for keeping the brain entertained. Creativity, whether through writing, art, music, or storytelling, also plays a crucial role in maintaining brain health. When we create, we activate various areas of the brain, keeping them in constant operation.

Healthy children have an incredible ability to make friends and socialize, something that often becomes more difficult as we age. However, staying socially active and investing quality time in relationships is essential. Joining groups, clubs, or simply gathering with friends and family can help keep the brain active and reduce the risk of neurodegenerative diseases.

Moreover, constant movement and physical exercise are inherent characteristics of childhood and remain essential for brain health. Regular exercise can improve memory, and thinking, and reduce the risk of neurodegenerative diseases. Therefore, finding ways to exercise, such as dancing, walking, doing household chores, or practicing a sport, can be an excellent way to keep both body and mind healthy.

Finally, one of the most striking characteristics of children is their ability to live in the present moment, without excessive worries about the future or the past. Practices like meditation and mindfulness help us cultivate this mindset, reducing stress. Being present allows us to enjoy life more fully and keep our minds calmer and more focused. I vividly remember that after reaching old age, Grandma no longer despaired excessively in the face of difficulties nor took herself too seriously. Instead, she preferred to laugh at her occasional blunders and confusions, which gave her life a unique lightness.

Cultivating the inner child also involves adopting a positive mindset. Children are resilient and have an incredible ability to marvel at the simple things in life. Maintaining a positive attitude, practicing gratitude and forgiveness, and finding joy in small things are powerful ways to protect our mental health. When we are happy and emotionally healthy, our brain also benefits.

In conclusion, preventing dementia isn’t just about taking medication or sticking to strict diets. It’s about how we live our lives, how we keep our spirits youthful, active, and curious. Cultivating our inner child is more than just a way to keep the brain healthy—it’s a way to live a fuller, richer, and happier life.

When I think about my grandmother and how she lived until the end of her life, I’m reminded that for her, old age was never an obstacle to living joyfully. She continued to connect deeply with everyone lucky enough to be in her company. One last note about her is that life did not privilege her more than any of us— from the social periphery where immigrants lived and still live, she lost a sister at a young age, endured war, worked hard, struggled financial difficulties that nearly led to hunger, survived a dictatorship, battled melancholy for much of her adult life, and confronted a brain tumor that almost took her from us in her late 60s— but she never lost her resilient inner child. She nurtured it through every hardship, wrote poems and ultimately blossomed with the wisdom she had gathered over the years.

I encourage you to explore the post Aging and Olding as a complement to today’s discussion. It dives into the idea of healthy aging through the lens of interacting and exchanging with others. And if you’re more inclined towards science, you might want to delve into the book that inspired this text: Neurobiologia dos Transtornos Psiquiátricos, edited by João Quevedo and Ivan Izquierdo (Porto Alegre: Artmed, 2019). For those who don’t read Portuguese, the three volumes of Cambridge Medical Reviews: Neurobiology and Psychiatry, edited by Robert Kerwin (Cambridge University Press, 2011), are also excellent resources.

I hope this inspires you to rediscover the joy of learning, playing, and connecting with others. By doing so, we’re not only promoting healthy aging but also crafting a life that retains the sweetness and spontaneity of childhood.

Image source: Jeremy Poland / iStock