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Aging Successfully



Number: 00S05. Issue: Spring 2000

Author[s]:
Nahal Rose Lalefar and Janice Lin

Keywords:


Abstract:
INTERVIEWER: Well, old-timer, what would you say is the death rate around here?
RESPONDENT (after a long pause): I'd say about one per person.


            Defining successful aging is simple. According to Doctors Robert Kahn and John Rowe, authors of Successful Aging, it means to "grow old with good health, strength, and vitality."  However, to actually experience this archetypal state of being is quite a different story. Successful aging is the anti-aging potion of choice, possibly the closest that modern day society will ever come to finding the seemingly unattainable fountain of youth that was sought so fervently by Ponce de León. In today?s materialistic society, where commercials and advertisements try to market the idea of youth and rejuvenation, neither drugs nor cosmetics can come close to "clean living". Clean living, according to Kahn and Rowe, means exercising regularly, eating well, and refraining from smoking (although it is never too late to quit) and excessive alcohol consumption. Also, having a positive and optimistic outlook on life, thereby reducing stress, is one concept which is absolutely essential to successful aging. One should also stay in contact with family, friends, and community, and stay active through work and play. 

            The adjective "successful" is slowly becoming a common term to describe the aging process as a whole. With each passing decade, the death rate decreases and the quality of living increases. However, according to the National Center for Health Statistics, despite the decrease in death rate for both men and women, men have shorter life expectancies than women do by more than four years.  

            Death rates are now less than one half of what they were in 1900. In fact, the changes are so dramatic that it is currently estimated that of all human beings who have ever lived to 65 years or older, half of them are currently alive. Kahn and Rowe suggest that such advances are due to two important factors that take dualistic roles: people are taking better care of themselves, and science and medicine are taking better care of people. Technological advances have allowed for better control of chronic or fatal disorders such as heart disease, hypertension, diabetes, and kidney disease, thereby lowering the risk of death. Also, the fact that people are more educated, have more access to health care, and have better sanitary conditions, leads to a more natural course towards successful aging.

 

There is an optimistic theory among researchers, which envisions a longer, more active life with delayed disability for older people. This "Compression of Morbidity " theory predicts a reduction in the incidence of disorders such as hypertension, dementia, diabetes, and arthritis, all of which are typically non-fatal but very disabling. They fall within the parameters of usual aging (i.e. aging with some disease and functional decline). Healthy lifestyles can alter the rate of decline of physiological systems that have shown "age-related" patterns, such as vision and hearing impairments, reduction in muscle mass, strength, and breathing capacity, as well as a decrease in heart capacity and nerve function. Many of these disabilities have also been shown to be reversible, such as the reduction in the risk of heart disease years after smoking cessation.

            How can such disabilities be avoided? Although there is no clearly defined answer, two important considerations are diet and exercise. What many people do not realize is that doing one thing on a routine basis will have a positive cascade effect of reducing other disease risks. For instance, eating foods high in fiber, wheat bran, whole grain breads, and cereals, and reducing intake of animal fat and saturated fat found in dairy and meat products, will not only reduce the risk of heart disease, but may reduce the risk of getting colorectal cancer and prostate cancer as well.  Regular, active exercise will not only increase muscle mass and strength, but increase breathing capacity as well. This is critical because breathing capacity, if altered, is rarely recaptured. For instance, chronic obstructive pulmonary disease (COPD) is a long-term lung disease brought about by smoking, air pollution, and aging. With time, all the airways or tubes leading to the lungs become infected with bronchitis, and the airways become smaller as the tissue swells. There is no cure for COPD, so this serves as another reason to refrain from smoking.           

            Based on National Institute on Aging (NIA) findings, researchers have shown that staying physically active through aerobic exercise, strength training, and stretching is key to maintaining good health in later years. For instance, stretching improves flexibility, eases movement, and reduces the risk of injury and muscle strain. Aerobic exercises such as swimming, walking, and dancing increase the body?s ability to use oxygen, thereby strengthening the heart and lungs. These activities also lower the risk of heart disease and stroke in later years. Strength training, like lifting weights or exercising against resistance, builds muscle and bone, both of which decline with age. This type of physical activity allows for stronger bones, improved balance, and increase in muscle strength and mass. Strength training is very important, especially for women, because sedentary people suffer from bone loss (also called osteoporosis) at any age; it is not only reserved for the elderly. The risk of bone loss is especially great for post-menopausal women because of the low levels of naturally occurring estrogen in their blood.

            In addition to diet and exercise, there are other precautions that can be taken in order to age successfully. Simple tasks such as applying sunscreen (minimum of Sun Protection Factor 15) twenty minutes to two hours before sun exposure may not only reduce the risk of skin cancer, but also protect the skin from UV rays, keeping the skin looking younger and fresher for a longer period of time. One must try to avoid excessive exposure to sun and cold.

            Perhaps the most conspicuous aspect of successful aging is the concept of avoiding disease. However, successful aging extends further than that. Low probability of disease refers not only to the presence or absence of disease but also to the presence or absence of risk factors for disease.  One disease factor is stress, which can negatively affect a person?s health and mind.  In a study relating psychoneuroimmunology and aging, aging was considered to be a condition associated with many social changes that are likely to induce psychological stress. Successful aging brings into play the idea of "resilience" to describe the rapidity and completeness with which people recover from stressful episodes and return to meeting the criteria of success.  It comes as no surprise that limiting stress can significantly reduce the process of aging successfully. How does it do this? With stress comes a multitude of various conditions including high blood pressure, elevated blood-glucose levels, increased levels of the stress hormones cortisol and adrenaline, and high cholesterol levels.  These conditions subsequently lead to the development of hypertension, cardiovascular disease, diabetes,  and declined physical and mental functioning, including memory loss. 

            There are many ways handle stress. For example, in moments of high anxiety, deep breathing helps, as does sitting quietly and relaxing each set of muscles in your body. Also, exercise is very important because it breaks down the body's resistance to insulin, helps end stress-eating, and alleviates the cravings for alcohol and tobacco. Furthermore, having a social support system is essential, particularly in situations dealing with the loss of a loved one.

            Social contact is very useful in keeping stress levels from endangering the body.  In addition, positive thinking can offset the negative consequences of stress. Enduring personality dispositions provide a dependable basis for adaptation to a changing world, and it is suggested that the stability of the personality itself contributes to successful aging by allowing the individual to plan for the future and by contributing to a sense of identity.  If one uses such resources properly, stress will not significantly taint the process of successful aging.

     In the end, one must remember that aging is a path, not a destination. Successful aging is not the imitation of youth, nor is it just simply aging gracefully. Nobody can reverse or slow the effects of time. However, by aging successfully, the quality of life will be better in its latter stages.  If one is active, whether it be through volunteer work or interpersonal contact, he or she is also being productive. If tomorrow?s individual can balance this active lifestyle with freshness, vigor, and an accumulation of experience, then he or she will have truly succeeded in aging successfully.

 

REFERENCES:

Costa PT, Jr., Metter EJ, McCrae RR. Personality stability and its contribution to successful aging. Journal of Geriatric Psychiatry 1994;27(1):41-59.

Guidi, Luisa. Psychoneuroimmunology and Aging. Gerontology. 1998;44: 247-261

Kahn, Robert L. and Rowe, John Wallis. Successful Aging. Pantheon Books, New York: 1998.

Kahn, Robert L. and Rowe, John Wallis. Successful Aging. The Geronotlogist. Vol 37, No. 4, 433-440.

Logan, Gary. "Strung out on Stress." July-August, 1998. World Wide Web: http://www.successfulaging.com/article3.html

Ludwig, Frederic. Editor. Life Span Extension: Consequences and Open Questions. Springer Publishing Co. New York: 1991.

The National Institute on Aging Information Center, 1999. World Wide Web: http://www.nih.gov/nia/health/pubpub/lifeext.htm

National Center for Health Statitics, 1999. World Wide Web: http://www.cdc.gov/nchs/releases/99facts/99sheets/97mortal.htm

Paola Timiras, MD, PhD, Professor Emeritus, Molecular & Cellular Biology, UC Berkeley

Trudi Cole, PhD, School of Public Health, UC Berkeley