Breaking the myths: Brain health and aging, By Margaret Uddin Ojeahere

Although the risk of dementia increases with age, advancing age does not automatically translate to the development of dementia.

Brain and mental health awareness is not simply a health issue, but it is a matter of dignity and human rights. Every older adult deserves care, understanding, and support. By breaking the silence around brain health problems like dementia, educating ourselves and others, and advocating for stronger services, we can build societies that values compassion over stigma. In doing so, we not only improve access to care and quality of life for older adults but also affirm the truth that mental health is a universal right, at every age.

This article is particularly unique as it turns a long-held dream into the reality of writing more regularly in PREMIUM TIMES, and because I will be exploring a topic of special interest, beginning with one of the populations I hold dear – older adults. A friend recently remarked that he had never seen me so insistent on expressing a point. I explained that I become especially vocal when the issue touches vulnerable populations such as children and older adults. Advocating for and supporting the needs of older adults remains a cause I am committed to. As the world sees more people living into older age, healthier habits and better healthcare are proving to be powerful drivers of longevity. Similarly, diseases once thought to affect only older adults in non-African countries are becoming increasingly common in places like Nigeria. Conditions such as depression and dementia, once considered alien to Nigerian older adults, are now emerging with greater frequency. But the real question is: “are they genuinely foreign or emergent, or merely under recognised within local contexts?” No doubt, their prevalence are increasing, but we must acknowledge that these conditions have long existed within our communities but were labelled with different names. Popular amongst these are “amụsu”, “àjë”, “máayèe”, “azẹn” “ohe”, “iffot” and it goes on and on, depending on what part of Nigeria you are from.

Ladi (not real name), used to be the women’s leader, a woman who drove economic activities in her community. A woman who once represented the very image of tenacity and fearless ambition in her agrarian community. Six years ago, following one of the many conflicts that plagued her community, she witnessed the gruesome killings of her husband and three children, and she progressively became a shadow of herself. Ladi, now 64 years, lives in a neighbouring village with a younger cousin and her family. She struggles with recurrent low feelings, reduced interest in things she once enjoyed doing, difficulty in concentration, forgetfulness, emotional detachment, sleep problems, and decline in self care. In some instances, she begs random people to forgive her for being the cause of her family’s death and, intermittently, she mutters to herself about deserving whatever comes her way. These behaviours have been interpreted by some of her surviving relatives as the supernatural repercussions of her past actions. Circulating rumours in her new community was that she practiced sorcery, and her plight is the consequences of her past. A few bold people have accused her of being responsible for the death of her relatives and the misfortunes faced by youths in the community. About three weeks to her presentation at the health facility, she narrowly missed being killed by irate youths, who had been informed that she had confessed to being responsible for the growing problems of substance use and the unemployment of youths in their community. It took the intervention of police officers to douse the agitations and refer her to the appropriate health services.

The scenario outlined reflects a worrisome number of reported experiences among older women in Nigerian communities. Unfortunately, many older adults, especially women, have tragically lost their lives because of misconceptions and misinformation perpetuated by poorly informed individuals or scapegoat seekers. While a greater number are neglected and left in terrible circumstances that are arguably worse than death. In the illustration above, Ladi manifests symptoms of mental disorder, which could be either depression, bipolar affliction, dementia, psychosis, or a trauma and stressor related disorder like post traumatic stress disorder (PTSD). While no mental health condition is explicitly identified in the account above, it draws attention to widespread misconceptions and the inadequate recognition of presentations of mental disorder in her context. This series on brain health and older adults begins by addressing common misconceptions and myths, whilst highlighting accompanying realities.

• Aging leads to unhappiness: On the contrary, increasing studies show that many older adults report higher levels of happiness and satisfaction with life than younger adults, often due to greater self-esteem, emotional resilience and social support.
• Depression and loneliness are normal in older adults: Depression is not a normal phenomenon of aging. It is a treatable but frequently overlooked mental health condition in older adults. Loneliness, on the other hand, may be experienced with age, but the stereotype of the lonely senior is quite misleading. Maintaining ties with family and friends, and participating in community activities, promotes social engagement, strengthens a sense of belonging, and helps to prevent loneliness.
• Dementia is inevitable with aging: Although the risk of dementia increases with age, advancing age does not automatically translate to the development of dementia. In fact, many older adults never develop dementia. However, the risk of dementia can be reduced by engaging in lifestyle modifications like exercise, healthy diets, avoidance of smoking, limitation of alcohol intake, social engagement, management of blood pressure and blood sugar.
• Once a family member has Alzheimer’s disease, other members will develop it: Although the chances of a person developing Alzheimer’s disease increases if there is a family history of dementia due to certain genes, having a parent, sibling or close relative with Alzheimer’s does not necessarily mean that one will develop the disease.
• Memory loss is a natural part of aging: While experiences like occasional forgetting of names and events are normal, significant progressive memory loss is not an inevitable process of aging. Engaging in exercises and adopting a healthy lifestyle can slow down cognitive decline.
• The mature brain cannot learn new things or grow: Research shows that the brain retains the ability to adapt, form new connections, and learn throughout life, which is a process known as neuroplasticity. Consequently, older adults can learn new skills, embrace technology, create new memories, and even pursue new careers or hobbies.
• Older adults are not interested in or able to use technology: Defying this outdated stereotype, growing numbers of older adults are embracing smartphones, tablets, social media, and online learning as tools to stay connected and thrive in later life.
• Anxiety is rare: Anxiety in older adults is fairly common but often underdiagnosed and underreported. Unlike younger people, older adults may show anxiety through physical complaints, sleep problems, or irritability, rather than overt worry.
• Older adults do not respond to therapy: Contrary to the belief that older adults do not respond to therapy, this can help with life transitions, grief, and chronic conditions, whether mental or physical illness, thereby ultimately improving their quality of life.
• Older adults are not productive or relevant in the broader social context: This assumption is misleading, as numerous older adults remain active, working, mentoring, and volunteering long after retirement, thereby sustaining valuable contributions to their communities.
• Sleep needs decline with age: Older adults require the same amount of sleep as younger adults; that is about seven to nine hours each night. What changes with age is not the need for sleep, but often its quality and consistency. Poor sleep can increase the risk of depression, dementia, and other health problems, thus making healthy sleep habits essential for brain and physical well-being.

Brain and mental health awareness is not simply a health issue, but it is a matter of dignity and human rights. Every older adult deserves care, understanding, and support. By breaking the silence around brain health problems like dementia, educating ourselves and others, and advocating for stronger services, we can build societies that values compassion over stigma. In doing so, we not only improve access to care and quality of life for older adults but also affirm the truth that mental health is a universal right, at every age.

Margaret Uddin Ojeahere is the Founder of Noetic Minders and a Consultant Psychiatrist with Jos University Teaching Hospital, Plateau State.