There is a progressive slowing of cognitive, sensory and motor processing that begins in the fourth decade of life. The change is so subtle at first that it is obvious only at the highest levels of performance. By midlife, most people are experiencing frustrating delays in retrieving information from memory, especially nouns and names.

New learning requires more repetition and practice. Sophisticated imaging studies demonstrate that the brain has to work harder in older adults to achieve the same learning performance of young adults. Memorization tasks cause the brain of middle- and old-age adults to recruit more help from the frontal lobes, bringing greater awareness and focus to learning efforts.

This and other adaptations allow older adults to maintain high function into old age, unless disease-related decline, say from stroke or Alzheimer’s disease, intercedes. But in the absence of such diseases, cognitive function (except new learning and word recall) is not much affected by age. Even more hopeful is the discovery in recent years that new experiences and intellectual challenges stimulate neuronal growth in old people as in the young.

Personality also changes with age

A sense of urgency can develop as men strive to finish their work, leave a legacy for their family or finally do things they have put off for years. The sense of mortality may come as a sudden shock in the form of an unexpected injury, illness or being laid off from a job a guy expected to have the rest of his life.

Sometimes it comes on gradually as we begin to recognize the aging of our bodies and the new limits in strength and endurance we experience. Men are competitive by nature and accepting the physical limitations of aging can be hard. The challenges of aging can, however, stimulate emotional growth. Men can become secure enough to acknowledge their shortcomings and wise enough to depend on others to help compensate for them. They can become more accepting of flaws in others.They may feel a little more vulnerable and have a keen awareness that they cannot always control events. As a result, they may develop better communication skills and actually become better leaders, husbands and fathers.

Adaptation to aging

Successful adaptation to aging means different things to different people, but it generally refers to the ability to stay active, engaged and productive despite changes in health and function. Social isolation, irritability and increased alcohol use are very common in men who are not adapting well. When this happens, there are often several causes.

A complete medical exam along with laboratory tests to look for medical disorders, mood disorders, sleep disorders or neurologic problems is recommended. Advice to adopt health practices such as a vegetable-rich diet, exercise, meditation and improved sleep is easy to ignore and needs to be reinforced, perhaps through peer pressure on a daily schedule.

Elevating pleasant events and play to high-priority status in the schedule is another helpful strategy, particularly as a shared effort to restore joy to marriage and friendships. If a person becomes demoralized or depressed, professional help should be sought. Severe anxiety, hopelessness, decreased food or fluid intake, self-neglect or suicidal thoughts should prompt urgent intervention.

The transition from middle age to old age can be tough for men. The inevitable changes in brain and body function, social roles, loss of friends and family and reduced independence demand flexibility and willingness to let go of preconceived notions of what retirement and old age would be like. Fortunately, we have within us the capacity to grow, change and adapt throughout our lives. It is important to remember this fact. It is the key to thriving in old age despite its many challenges.

Dr. Clifford Singer is the medical director of geriatric mental health and neuropsychiatry at The Acadia Hospital in Bangor.