Hektoen International

A Journal of Medical Humanities

Enhanced creativity in later life

Melissa Castora-Binkley
Elizabeth Handing
South Florida

Rembrandt self-portrait, 1669
National Gallery, London, UK

Painted the year of his death at age 63

The increased capacity for creativity in later life is not a new concept. Both professional and amateur artists alike have created some of their best works in later life. Galenson1 described some well-known lifetime artists such as, Michelangelo, Rembrandt, Virginia Woolf, and Robert Frost who were arguably past their “prime” when producing their best works. Similarly, as mentioned by Cohen,2 less well-known artists only began their artistic endeavors in older age. For example, William Edmondson, an African-American Nashville-native was 62 years old when he began working with limestone and 65 years old when he decided to begin carving. Just a few years later his work was featured in the first solo African-American exhibition in the Museum of Modern Art. Similarly, Irving Dominick, an American artist who began his artistry after retiring from a lifetime in heating and air conditioning began creating sculptures out of sheet metal. At the age of 66 Dominick created Marla, which is on display at the National Museum of American Art in Washington, D.C.. These examples illustrate that one does not need to be a professional, lifetime, or “primetime” artist to produce and inspire creativity. Moreover, changes in the aging brain may yield themselves naturally to enhanced creativity in later life. As Galenson states, “the assumption that each activity has a single typical life cycle of maximum creativity can lead to a basic misunderstanding of how creativity occurs.”1

Admittedly oversimplified, creativity can be described as the ability to generate original, novel, flexible, and useful ideas.3 Creativity is often related to artistic endeavors but is also used in problem solving, adaptation, and self-expression. Sternberg and Lubart4 defined creativity similarly, suggesting that creativity is the ability to think abstractly from convention. It can be the creation of a new concept by combining ideas that do not seem compatible or seeing beyond obvious representation. However, definitions of creativity based on divergent thinking have been challenged. In conceptualizing creativity, Baer5 discounts the ideas that: 1) creativity is always about wild (divergent) ideas, and 2) creativity is either present or absent in all areas (rather than the ability to be creative in only one or some areas). Nevertheless, creativity, as discussed here is not intended to be restricted to traditional artistic outlets but instead extends beyond music, poetry, literature, sculpture and the like.

Traditionally, creativity and originality have been thought of as the characteristics attributable to the right hemisphere of the brain6 whereas the left hemisphere has been thought of as responsible for logic and analytical thinking including higher-level reasoning, problem-solving, and language processing.7 While it is argued that persons who are characteristically logical rather than creative tend to engage the left hemisphere with greater frequency than the right, a simple reversed statement is not necessarily accurate. In other words, just because logically-minded individuals show left hemisphere activation at greater levels than those less-logically minded, it may be inaccurate to say that those who are creative use the right hemisphere of the brain more so than the left or with similar differences in hemispheric activation.

In fact, right-mindedness as critical to creativity was discounted as early as 1926. Bogen8 explains the creative process based on Wallas’9 phases of creativity: the first phase of creativity is described as preparation where an individual acquires a wide range of information through broad neural processing, albeit with a left hemisphere emphasis; next, the incubation stage occurs, often without the individual’s awareness, where information and ideas are rearranged with emphasized right hemispheric activation; then illumination follows which is characterized by the “light bulb” effect where inter-hemisphere communication occurs; finally, there is a stage of reorganization and refinement of the endeavor that favors the left hemisphere for expression of the idea. Therefore, the creative process from Bogen’s perspective (based on Wallas’ phases) is the outcome of the idea through bilateral activation. Underscoring this idea, a review of the neural basis of creativity concluded creativity should be considered a whole-brain process rather than a function attributed to right hemisphere activity and argued that interhemispheric interaction enhanced creativity.3

In old age, changes in brain physiology and functioning can be expected and may or may not be evident depending on the level of one’s decline. Examples of normal changes in cognition include a decline in fluid intelligence, memory retrieval, recall, and episodic memory.10 Mechanisms to compensate for neurophysiological and cortical activation changes that occur over the lifecourse include changes in frontal recruitment, neurogenesis, distributed processing, and bilateralization of hemispheric activation.11,12

Evidence suggests that older adults experience reduced hemispheric lateralization due to age-related cognitive decline.13 This idea is known as HAROLD, or hemisphere asymmetry reduction in older adults. There exists ample evidence which suggests that the emphasized right-brain or left-brain activity during specific neural functioning is reduced in older adults, and unlike younger adults, greater lateralized functioning between the hemispheres is initiated.

HAROLD has been evidenced in many studies on cognitive functioning. For example, Cabeza, et al.14 found that younger adults encoded word pairs using the left lateralized prefrontal cortex and during retrieval used the right lateralized prefrontal cortex; however, in the same exercise, older adults displayed little prefrontal cortex activity during encoding and a more bilateralized pattern during retrieval. Another study by Backman et al.15 demonstrated greater lateral activation (left cerebellum and Wernicke’s area) in younger adults compared to bilateral activation of the medial-temporal cortex in older adults.

The effects of HAROLD have also been evidenced in studies on verbal working memory.16-19 Reuter-Lorenz et al.19,20 documented that older adults demonstrated greater bilateral activation in anterior regions of interest compared to younger adults. Specifically, verbal working memory showed greater left hemisphere activation among younger adults and bilateral hemispheric activation among older adults. Moreover, older adults who displayed bilateral activation of the dorsolateral prefrontal cortex exhibited faster response speeds compared to older adults who maintained right lateralized dorsolateral prefrontal cortex activation.19 

Similarly, spatial working memory demonstrated right hemisphere activation among younger adults and more bilateral activation among older adults. In a study that tested inhibition, a go/no-go task was utilized and found similar results.21 That is, older adults exhibited hemispheric asymmetric reduction by demonstrating more extensive activation bilaterally and prefrontally compared to younger adults. This reduction in hemispheric asymmetry has been confirmed by other studies that have used both verbal stimuli15,18 and emotional-verbal stimuli22 as well as intentional and incidental learning.23

From the evidence presented, HAROLD can be generalized beyond a single domain of measure or process, but encompasses a variety of cognitive tasks showing differences in neural recruitment networks between younger and older adults. More importantly to note is the fact that the literature on HAROLD fails to encompass measures of creativity. Although we cannot yet determine a direct connection, one can hypothesize, based on these bodies of evidence, that HAROLD may lead to increased creative capacity in old age given that creativity may be a function of lateralized brain activity.

Combined with reduced inhibition, which has also been linked to the biological basis of creativity in older age,24,25 perhaps the lateralization of hemispheric brain functioning assists older adults in reaching creative initiation or their creative peak. Whether professional or novice, creative activity can be a useful tool for engagement, productivity, personal expression, and a means to promote healthy aging. The idea presented here should be used to guide the design of studies that seek to enhance the evidence-base of creative and performing arts programs for older adults. This idea of changes in hemispheric activation in old age in relation to creativity needs to be tested and should be used to help older adults understand that they need not be a professional to engage in creativity for the first time in later life. It is necessary to continue research in this area and develop theoretical models which guide participatory arts programming. This development is critical to the field to provide the foundation needed for inclusion with other accepted evidenced-based health promotion programs.

Several limitations should be noted. First, causality cannot be determined nor can the determination be made of how much creative capacity can be explained by lateralized brain function. Additionally, the reviewed studies are cross-sectional, thus limited in the ability to state that HAROLD is truly an age-related change; the evidence suggests differences between age groups but until longitudinal studies evidence HAROLD, we can only assume that these changes are due to aging. It is also important to note that HAROLD focuses mostly on prefrontal cortex (PFC) activation. Other brain regions involved in creative processes have not been researched thoroughly, and should be considered for future studies.

The evidence suggesting that creativity is a right hemispheric function should not be discounted. A meta-analysis investigating brain specialization and creativity concluded that creativity is predominately a right-brain function.26 However, the idea presented in this paper is not focused on dominance of the hemispheres. Instead, the idea presented acknowledges that while one hemisphere may still be dominant, it is the activation of both hemispheres that lends itself to increased capacity for creative expression.

Creativity should be described as bilateralized activation of brain functioning, and adults generally experience more bilateralization in older age. Evidence for HAROLD remains strong, and studies are currently ongoing to analyze age-related recruitment mechanisms and compensatory strategies. Neuroimaging methods would provide direct evidence of neural pathways complimented by behavior task performance and provide researchers with a multi-modal perspective regarding age-related changes and creativity. Perhaps this compensatory cognitive mechanism is the mechanism which provides enhanced, or in some cases initial, creative capacity at a time when many other attributes decline.



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MELISSA CASTORA-BINKLEY, MA, has been researching creativity and aging since 2008 with a focus on health promotion and benefits of participatory arts programming. In 2012, she served on an expert panel for the National Academy of Sciences discerning the science of aging and the arts. Currently finishing her PhD in Aging Studies at the University of South Florida, she promotes quality of care in healthcare through the Quality Improvement Organization for Florida.

ELIZABETH P. HANDING, BA, is currently a Doctoral Candidate in Aging Studies at the University of South Florida. Her research interests include neuroscience and cognitive aging among older adults emphasizing lifestyle interventions to promote optimal aging.

Highlighted in Frontispiece Winter 2015 – Volume 7, Issue 1

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