DEAR DOCTOR K:
I recently read that aging affects something called “executive function.” Could you please explain what this is?
Executive function is an umbrella term for the complex thinking required to make choices, plan, initiate action and inhibit impulses. You can think of executive function as your “inner CEO.”
Executive function is more complicated than it might seem at first glance. Let’s look at planning, for example. What do you need to do when you plan? You need to set a goal. Then you need to focus on the task at hand and ignore other tasks. You need to ask yourself if you have any behaviors that you need to curb to get the task done — and change those behaviors if the answer is “yes.”
For instance, do you tend to get distracted? Do you shy away from asking others for help? Can you improve how you explain your vision or plans to others? That’s just a partial list.
Not surprisingly, executive function can be more important than many kinds of memory for managing the day-to-day tasks of independent living.
The good news is that you can help preserve executive function by doing many of the same things you should already be doing to stay healthy. Older people who exercise, for example, have better executive function than those who remain idle. Aerobic exercise may be especially beneficial.
Lack of sleep scrambles executive function, so there’s another reason to get enough sleep. High blood pressure seems to have a harmful effect on executive function. So if you have it, make the lifestyle changes required and take the medicines prescribed.
Researchers are looking into whether certain drugs might help older people with executive function deficits. So far, the results have been mixed.
In the meantime, try the following to improve (or compensate for) your executive function:
- Pay attention to paying attention. In other words, work on maintaining focus. If you’re easily distracted, do what you can to remove distractions. Does your smartphone always need to be on? Callers can leave messages, and you can pick up your emails and text messages later. I had one patient who found himself so easily distracted that he created a small enclosed work area in his basement where he had only a chair, desk and computer — no books, no phone, no radio, music player or TV. He also had an alarm clock and developed the discipline to get up and leave the room only once every two hours, when the alarm clock went off. Seem excessive? It worked for him.
- Say it out loud. This is a standard memory tip. For example, “I am now putting my keys in my pocket.”
- Make it a habit. Always put keys and other personal items in the same place so you don’t have to remember where you put them.
- Write it down. Lists and plans of action are a way of “outsourcing” executive function from the brain to a piece of paper or a computer file.
Follow these tips, and your “inner CEO” may stay in good shape.