Old Hearts, Old Brains

Generation ago, physicians spent most of their time rushing around to sick babies. Today, with scarlet fever, diphtheria, measles under control, most of their patients are oldsters. Although more than 30,000,000 persons in the U. S. are over 45, few doctors really know how the process of aging changes the human body. Last week in the New York Academy of Medicine, Cardiologist Ernst Philip Boas of Columbia, Neurologist Foster Kennedy of Cornell sounded off at a symposium on old hearts, old brains.

Pump and Tubes. Contrary to common medical opinion, said Dr. Boas, aging does not inevitably bring heart disease and arteriosclerosis (hardening of the arteries). There is a great difference, he continued, between natural withering and the "external insults" of disease. With age the human heart grows broader at the base, more pointed at the apex. Heart muscle fibres turn dark brown, heart valves stretch like old rubber tubes, lose their youthful elasticity. But all of these changes are normal, none spells doom. In healthy persons "the cardiac pump itself usually functions without faltering into advanced old age."

Arteriosclerosis is not "a simple wearing out of the arterial coats that comes with age," but the result of diseases as yet unknown. It is frequently found in victims of diabetes and high blood pressure, is more common in men than in women, in white persons than in Negroes.

Shriveled Sponge. "A narrative of the dilapidation of the master organ of life is lugubrious and depressing," said Dr. Kennedy. "All cells in the body can multiply and reproduce with the exception of those in the nervous system." These cells "are laid down in the embryonic life and grow with the individual until he reaches maturity." After that they never grow again, "never reproduce themselves."

An old brain of 60 or 70 years "is characterized by an amazing reduction in mass." It shrinks from its skull casing like a dry sponge in a wooden box. The membranes which enfold it, in youth tough as Cellophane, grow delicate as tissue paper. Often they are patterned with small plaques of bone. Brain convolutions shrivel, the valleys growing wider than the hills. Strangely enough, said Dr. Kennedy, only the cerebral cortex, seat of intelligence, grows wrinkled and old. Other more primitive brain structures remain "almost normal." The cells of the cortex, usually some 14 billion, "are reduced in number . . . many have vanished utterly."

An old man, continued Dr. Kennedy, is forgetful because his memory tract, the corpus callosum (a belt of fibres connecting the two brain hemispheres), shrinks to one-third its size. And he loses interest in his environment because he is plagued by "sensations from his gut," which his brain is not strong enough to control.

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