We live in a wonderful era in human history where not only is life expectancy increasing, but also the number of years of life in good health (Soloway, Lancet 2015). Since there are now so many more elders in our community, we finally have a chance to learn about what promotes vitality in old age. I am a geriatrician, which is a specialist doctor for older people. I am also doing a PhD looking at health assets, which are factors that are associated with longevity and good health status, even in the setting of frailty. In this blog, I hope to share with you latest developments in ageing research, and particularly in positive ageing to help you not only to age well, but to live well today.
Live Well to Age Well
In my work as a geriatrician, I have the privilege of looking after many people at the end of their time. This is a constant reminder to me to make every day meaningful. It is never too soon to start living the best life you can today, to get the most out of the years ahead. The positive health movement identifies individual and community resources that promote health and well-being. Living well today and living to age well are one and the same. Successful ageing doesn't just mean living as long as possible, but living as well as possible. The pillars of successful ageing are social engagement, nutrition, physical activity and cognitive challenges. By finding meaning and enjoyment in every day, we can lead the longest, healthiest life possible.
“What's critical is allowing yourself to love others, and being able to take people in --as in, 'I've got you under my skin.” (George Vaillant).
People with higher levels of social engagement have decreased mortality and maintain their higher health status for longer. And it is not just about the number of friends someone has, it is the quality of these relationships that are important; supportive and rewarding relationships must be cultivated. A higher level of social engagement can even help recovery from illness and can decrease the chance of leaving hospital with a new disability. Social engagement can only happen if you are an active and giving participant in your relationships with friends and family.
Life lesson: Finding ways to spend time with close family and friends every day is joyful and proven to be good for your health.
Food is one of the central pleasures of life, and as people age their nutritional needs change too. In this age group obesity is still associated with increased disability and dementia, but while many people spend their entire lives trying to lose weight, in old age priorities need to change. Losing weight usually means also losing precious muscle mass, therefore unless weight loss is accompanied by an exercise program and adequate protein intake, there is a risk of muscle loss leading to a decrease in strength, and unlike younger people, older adults do not easily regain muscle when it is lost.
So what does this all mean? To maintain muscle mass to maintain the ability to be independent, it is really important to ensure that all meals have protein and a variety of fruit and vegetables to provide all the required nutrition. Also some older people are at particular risk of malnutrition, especially if they have a small appetite. In this group frequent small meals and snacks can help to stave off weight loss.
Life lesson: focus on preparing delicious meals with as much nutritional goodness as you can fit on your plate.
The research is not really clear how much physical activity is the optimal amount, but almost everyone can find a form of physical activity that is fun, so really the the best form of physical activity is the one that you enjoy and that you can fit into daily life.
As people age, there is a loss of muscle mass. If this reaches a critical level, it can stop people doing their activities of day-to-day living, like hanging out washing. It can also contribute to a loss of balance. Ideally physical activity should be something that also promotes balance and strength. Activities like Tai Chi and yoga can improve balance and decrease the risk of falls. The other great benefit of physical activity is that healthy body promotes healthy mind. Exercise at age 60 is associated with a decreased risk of dementia at age 90 (Vaillant, 2014). So a brisk walk today may help your brain stay healthy for many years to come.
Life lesson: Find an activity you enjoy, so it can be something you look forward to every day.
The old adage of ‘use it or lose it’ is very true for our brains. Our brains retain the ability to learn and change well into old age. It is not enough to keep doing the same routine, to protect our brains against decline, we need to keep challenging ourselves. In a study of older adults who were given brain training in memory, reasoning and speed of processing, this actually improved their level of functioning in activities of daily living (Rebok, 2014). Like physical activity, the right cognitive activity is one that you are interested in.
Life lesson: Learning anything new is going to use memory, reasoning and speed of processing, so the right activity is anything you want it to be!
It is rare that someone lives their life making everyday decisions based on future health.It is hard to say no to the piece of cake in your hand, because of how your health might be in ten years. The Live Well-Age Well philosophy is about making positive changes to make today a better day. The pillars of successful ageing (social engagement, nutrition, physical activity and cognitive challenges) work best when they are combined, so starting a yoga class will challenge you physically, but you’ll also have to exercise your mind to learn the poses. Ask a friend to teach you something new on the computer, visit a friend for a game of chess, or cook a meal with a grandchild (eating a nutritious meal always tastes better with loved ones!). The choices to live well & age well are only limited to your imagination, the important part is making it happen.
So, what does living well mean to you?