It is necessary to maintain healthy and productive responses to the stresses and declines associated with aging. A key factor is the choice of attitude. It is critical to see opportunities for growth in aging – they are there to be had. Aging is accompanied by declines in the speed of learning, working memory, and memory capacity. These declines are not caused by disease and are nearly universal. Devoting memory resources to what is important, and ignoring things that are not important is an excellent strategy. The best way to avoid negative emotions caused by events and experiences in the past is to be actively involved in the present moment and planning for the future. Meditation is a valuable method to practice letting go and enhancing your awareness of the opportunities that are available now. Aging also presents an opportunity to demonstrate self-compassion. Frequently, persons express compassion to others throughout their lives with loving devotion and selfless actions, without realizing that that are worthy of compassion themselves. Psychological reserve can be enhanced by attention to the development of self-compassion and appreciation of what give your life meaning.

Sleep is incredibly important for the creation and maintenance of memories. It is an active process managed by the brain to allow for bodily rest and repair and maintenance of homeostasis. Good sleep is necessary for life and health and is essential for the encoding and storage or memories made during wakefulness. Poor sleep can interfere with all aspects of cognitive function, particularly attention and memory. Reduced sleep amount and quality has been linked to depression and impaired immune function. The length of sleep is not the only important factor; the quality of sleep is also vital. Animal studies have revealed that sleep deprivation damages gut bacteria and produces hazardous free radicals, called oxidative stress. Cognitive reserve is closely related to sleep. Too many people take sleep for granted or think getting a restful sleep is a luxury, not a necessity. But recent research shows the pattern on neuronal firing is replayed during sleep, which enhances the formation of memories. Older people frequently have sleeping problems that may impact the quality of life. This chapter reviews several things that you can do to improve the quality of your sleep.

In this last chapter I want to write about the clinical implications of the general neurotic syndrome as a central part of neurosis. Clearly, I am biased, but I will try to give opposite arguments a fair airing too.

As we age, we have a little bit less of everything: less energy, less physical flexibility, less learning capacity. That’s why the concept of multiple reserves is so important. Aging well isn’t just about avoiding death and disease. Aging healthy also means keeping the reserve capacity of our component systems high so that, as function declines with age, performance is less severely affected, and fitness is better maintained. The body’s organ systems are all interconnected and interdependent. And the brain is dependent upon the healthy functioning of all organ systems. It needs to be a goal of our aging to enhance the possibility that negative interactions do not take place. In order to pursue this goal, we need to manage our lifestyle activities so that our fitness levels can be enhanced. By this I mean fitness in the sense of interdependence—fitness of all the body parts, not only one of them. The good news is there are lots of things everyone can do to maximize healthful interactions inside our body and between ourselves and friends, family, and community.

We are not prepared by our genes for a sedentary lifestyle. Studies have shown that higher levels of physical activity throughout life are very good for you. Physical activity leads to good physical reserve and has beneficial effects on development of Alzheimer’s, as well as stroke, cardiovascular disease, and depression, in both humans and animals. It increases the production of new neurons in the brain that activates learning and also enhances the production of growth factors which can facilitate the communication among neurons and the maintenance of mental function. Exercise also enhances the immune system, producing more protective cells and antibodies and assists with skeletal, endocrine, and cardiac health. The function of blood vessels in the heart, brain, and everywhere in the body is enhanced with exercise. Research has shown that people who become less physically and mentally active in the years from midlife to later life have a higher risk of developing Alzheimer’s, compared to those whose participation stayed the same or became more active. Almost everyone is capable of some physical activity. Two rules of physical exercise must be followed: 1. Start; 2. Continue.

Our dietary choices affect our health and fitness in two ways: diet has a direct influence on the brain and other body parts and also influence the nature of our microbial populations in the gut. These two mechanisms frequently work together; a high salt diet can make high blood pressure worse and will influence the nature of our microbiota increasing inflammation – two issues which increase the risk of heart disease and stroke. Our dietary choices strongly affect our health through direct influence on all our organ systems, and the nature of our microbial communities has profound influence on our health and fitness. In order to have a diverse bacterial community we need a diverse diet with different good sources of nutritional support. Fiber-rich foods enhance the gut barrier and lower inflammation throughout the body. Good sources of fiber are reviewed in this chapter, along with recommendations for a plant-based diet with antioxidants, little meat, and low levels of saturated fat. High levels of sugar and salt intake, alcohol, and processed foods should be avoided. Fish consumption is advised and vitamin and mineral containing foods are also considered.