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Neurologist gives board a rapid primer on the aging brain and late‑life cognition
Summary
Dr. Richard Riemer (Touro University) presented an overview of structural and cognitive changes in normal and healthy brain aging, highlighting variability among individuals and evidence that lifestyle, cardiovascular risk reduction and ongoing cognitive engagement can help preserve function.
The board heard a 30‑minute educational presentation Feb. 13 on normal brain aging from Richard Riemer, DO, professor of clinical neurology at Touro University and director of a neurology residency program.
Riemer summarized imaging and cognitive research describing age‑related structural changes — cortical thinning, white‑matter decline and ventricular enlargement — and their variable relationships to cognition. He emphasized that population studies show considerable individual heterogeneity: many people retain high cognitive function at advanced ages while others show an inflection point leading to progressive impairment. Riemer described common cognitive domains (attention, working memory, declarative memory, visuospatial skills and executive function) and how they are differentially affected by normal aging. He noted that procedural and nondeclarative memory (skills such as surgical technique or driving) are relatively preserved with practice, while working memory and processing speed typically decline.
Riemer said longitudinal cohorts and in‑vivo imaging (MRI, functional MRI, PET) have improved understanding of the aging brain compared with postmortem studies and stressed the concept of cognitive reserve — higher education, ongoing learning and physical activity correlate with slower decline. He pointed to evidence that the hippocampus can show structural change associated with activity and learning (e.g., London taxi drivers’ hippocampal size) and that exercise may promote hippocampal neurogenesis. Audience members, including several board physicians, asked about clinical recognition of age‑related decline among aging clinicians, personality changes and whether lifestyle or personality traits influence trajectories; Riemer said research is ongoing and that compensatory brain mechanisms can mask decline but that self‑monitoring and peer oversight remain important in clinical practice.
The presentation was educational and not a policy action; board members thanked Dr. Riemer for the overview.
