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Level Up Notes 2.0: Brain Rules for Aging Well by John Medina

I hate it when people say “It’s just a part of aging.”

Of course there are inherent biological changes with time but it seems like an easy out. Truth is many of the changes that occur as we get older can be managed and minimized.

John Medina's follow up book to his original Brain Rules focuses on the aging mind. Brain Rules for Aging Well explains the brain changes we see with age and 10 principles we can employ to stay vital, happy and sharp.

Here are my notes

Be a friend to others, and let others be a friend to you

Socializing, Medina says, is like vitamins for your brain. Relationships are critical for brain health. This includes marriage, long-term partnerships and friends.


  • Cognitive decline is inversely proportional to increased social interactivity> Socialize more!

  • The cognition boost of social interactions is not dependent on the number of friends you have or the length of those friendships

  • You benefit from having friends of all ages

  • Socialization helps to reduce stress & boost your immune system which becomes more compromised as you age

  • Relationships take work to maintain and therefore act as a workout for your brain, “cognitive calisthenics”

  • Web-based social interactions are beneficial too, but in flesh interactions cause changes in the gray matter of several regions of our brain while only amygdalar changes are seen in online relationships

  • Isolation and loneliness are the biggest risk factors for depression and mortality as we age.

Cultivate an attitude of gratitude

It's not surprising to read that mindset matters as we age. Despite what you might think about older folks getting grumpy, they actually “develop more emotional stability, become more agreeable and more conscientious”


  • As we age we become more selective with our attention, paying more attention to positive stimuli vs. negative stimuli

  • Aging promotes the process of prioritization: “what matters most?”

  • You become more trusting as you get older: positive and negative consequences

  • Depression is an issue as we age. It is influenced by several factors.

  • Hearing and vision loss are correlated to depression in the elderly

  • Dopamine circuits decline as we age so we see changes in risk-reward behaviors, motivation and optimism

  • To maintain optimism as you get older practicing gratitude has the most profound effect

Mindfulness not only soothes but improves

Aging can be stressful. Despite the negative changes in stress regulation as we age, overall older people report being less stressed


  • The hippocampus region of your brain gets worse at regulating the stress hormone cortisol release as you age

  • Baseline cortisol levels start to rise around age 40

  • This adjustment in part makes it more difficult to respond to threats and once you do, you don’t calm down as easily.

  • Mindfulness-based stress reduction techniques are very effective at decreasing stress in older folks.

  • Mindfulness helps you focus on the present moment without judgment. This facilitates brain tasks such as emotional regulation and cognition, helping with stress management

  • Age identity helps with stress: the younger you think you are despite your real chronological age the better you deal with the stress of aging.

Remember it’s never too late to learn – or to teach

Lapses in memory are one of the most common changes attributed to aging. My parents are in their 70s and I am constantly impressed by how much knowledge they have and how much they remember.


  • We have multiple memory systems and they don’t age at the same rate

  • Semantic memory, our ability to remember facts, is not that affected by aging It actually improves comparatively because your database is larger

  • Procedural memory gains are seen with improved vocabulary

  • Working (or short-term) memory does tend to decline as we age, this is partially related to your genes and the most common result is forgetfulness (those damn keys....)

  • Learning something new will boost your memory as you age (neuroplasticity)

  • Teaching helps you retain memory

  • Playing music, reading books, exercise, meditating, eating healthy and positive social relationships are all memory boosting activities.

  • “Every day you exercise your brain, above what you do typically, delays that deterioration by 0.18 years.”

Train your brain with video games

The consequence of this particular brain rule is that my kids are going to try and convince my parents to game with them or possibly vice versa (win-win)


  • You don’t get better at focusing as you age. You get better at ignoring distractions.

  • Decrease in neural insulation slows down processing speed as you age and this affects cognition

  • Gray matter within your cerebellum shrinks which in turns affects balance, coordination, attention, and mood.

  • Brain training programs such as Beepseeker and NeuroRaces have shown to increase processing speed which led to memory gains

Look for 10 signs before asking “Do I have Alzheimer’s?”

Some form of memory decline associated with aging is normal. Alzheimer’s is not.


The most important info to pass along from this chapter are the 10 warning signs:

  1. Memory loss that disrupts daily life

  2. Difficulty completing familiar tasks

  3. New problems with words in speaking or writing

  4. Misplacing things and losing the ability to retrace steps

  5. Challenges in planning and problem solving

  6. Decreased or poor judgment

  7. Withdrawal from work or social activities

  8. Changes in mood and personality

  9. Trouble understanding visual images and spatial relationships

  10. Confusion with time or place for more info

MIND your meals and get moving

You already know intuitively that exercise and diet affect how you age but it’s more important than most think.


  • Executive function which includes emotional regulation and cognitive control (attention, planning, adapt) are all affected by aging because the connections between the pre-frontal cortex (PFC) and other brains areas like the amygdala and hippocampus start to deteriorate.

  • To counteract this effect on your brain you want to exercise as this stimulates a process called angiogenesis (blood vessel creation) as well as neurogenesis (the growth of neurons) #bdnf

  • “The effect of exercise is dose dependent – the more you exercise the better your brain functions- tough there is a limit.” This includes aerobic and strengthening

  • Nutrition is a complex topic not to be covered in one chapter of a book. Medina discusses the benefits of the Mediterranean and MIND diets and briefly highlights the benefits of caloric restriction and plant based diets.

For clear thinking, get enough (not too much) sleep

Rightly so, sleep has been getting a lot of attention in the health, wellness and performance worlds the past few years.


  • Yes, sleep quality is affected by aging but this is highly variable.

  • What happens? Sleep becomes fragmented as we get older, affecting sleep quality

  • Slow wave sleep decreases from an average of 20% of your sleep cycle to 9%

  • This impacts many things but mainly Memory and Executive function via the glymphatic system

  • “If you want to diminish cognitive decline in old age, you must start accruing good sleep habits in middle age” – (I’m on it! - how about you?)

  • Lack of sleep is a risk factor for Alzheimer’s

  • To learn more about sleep health check out my sleep posts: here(1), here(2), here(3), here(4), here(5), here(6) and here(7)

You can’t live forever, at least not yet

“Aging is not a disease any more than puberty is. It’s a natural process, one that usually leads to a whopping misunderstanding. People don’t die of old age. People die of discrete biological processes that break down because they’ve spent too much time on the planet.”


  • Your genetic makeup is largely (25%-33%) responsible for your life expectancy

  • Longevity science on telomeres and such is new. There’s a lot we don’t know.

  • Instead of focusing on not dying we should focus on living well

Never retire, and be sure to reminisce

This is the one rule I just can’t buy into. I’ll be retiring one day. But it might apply to many folks out there.


  • Retirement is very stressful for many older adults

  • So much so that those that do not retire lower their mortality risk by 11%

  • Supposedly the folks living it up in the Blue Zones don’t retire

  • You can retire but still stay active, eat well, manage stress and have an active social life

Favorite Quote

“You really do get wiser with age, depending on how you define wiser (and age)”

Level Up your Brain, Age, & Hat game !


Photos by: Cristian Newman, Vlad Sargu, Tiago Muraro, Angels Vicente, Eberhard Grossgasteiger, Hardik Sharma, Alex Harvey, John Moeses Bauan, Fancycrave on Unsplash


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