Aging Well

I think that when most people think of aging well, they think of what adults do to become healthy older people. Another line of thinking, which I happen to like, is that successful aging starts  in childhood (may be even in utero) as many things that occur in childhood can affect health as adults. Think of people whose mothers had rubella while pregnant with them. For those of us old enough to have gotten chicken pox rather than the vaccine, we’re at risk for shingles as adults. Severe iodine deficiency can lead to hypothyroidism and developmental delay (a more politically correct term for mental retardation). Growing up bilingual seems to protect against developing dementia, as well as having other beneficial effects on growing brains. The list goes on.

Though many people associate older age with disability and frailty, it doesn’t necessarily have to be that way. One thing I was taught throughout my training is that the older old (people in their 80’s and 90’s) are healthier than those in their 60s. At first this might sound counter intuitive. However, if one considers that those who are sickest die sooner, then it makes sense. The person whose only health issue is well controlled diabetes or well controlled hypertension is much more likely to reach his or her 80s than one who is overweight, diabetic with a glyco-hemoglobin of, for example, 9.5%, high cholesterol and has poorly controlled hypertension.

However, as I am assuming most if not all people reading this are adults, and as a time machine that would let people go back and vaccinate themselves against chicken pox, or somehow convince their parents to make them grow up bilingually (unless they did already)does not exist, I will limit myself to what an adult can do to age successfully. Nothing is guaranteed to prevent illness or frailty but what I suggest below does seem to help protect from or delay such things.

1. Stay Active. Our ancestors did not sit in cubicles all day earning enough money to buy food. They had to do any one of the following to get food: hunt animals, gather food, tend/harvest crops in the field or herd cattle/sheep etc. Only in the past few millennia was it possible for farmers to support a population where everyone didn’t need to be involved with procuring food/housing/etc. Not that getting food was a 24/7 job, but took more physical effort than driving to a supermarket. Even then people walked or rode horses to get places on land. Now it seems like to go more than 50 feet people drive their cars. Our bodies were made to be used. We should all be taking at least 10,000 steps a day (this comes out to walking approximately 5 miles/day).

2) Avoid bad behaviors. By this I mean, don’t do things that can shorten your life. Avoid smoking (not only is it bad for your lungs and increased your risk of lung cancer and of COPD, it raises your risk of bladder cancer, kidney cancer, esophageal cancer, raises your blood pressure and risk of heart disease). Drink in moderation (no more than 1 drink/day). Avoid any street drugs and sharing needles.  If you are sexually active and not in a monogamous relationship, use condoms. Having a discussion about your partners(‘) HIV status isn’t a bad idea either.

Don’t forget to embrace good behaviors. By this I mean not just those things I mention above and below, but also keeping any chronic diseases you have under control as best you can.

3) Be part of a community. Whether it’s a church (or synagogue or mosque), club for a hobby you enjoy, volunteering or any other activity that regularly gets you out with people, do something where you interact with people. The more positively the activity affects your community, the better. Humans are a social species. It helps keep your mind active if you remain part of a community.

4) Watch your diet. Eat healthy. What constitutes a healthy diet could (and likely will) take up a whole other blog post or two. Eat more vegetables. Cut back on meat – processed and otherwise. Eat more fish. Don’t drink to excess.

5) Be curious and educate yourself throughout your lifetime. Whether it’s people with more neural connections that end up in college and graduate school (and that is what makes people with college degrees less likely to develop dementia) or whether the education helps the neural connections stay healthy isn’t known. It could also be that the more educated someone is the more likely it is they will maintain doing healthy behaviors. In any case,  your brain is like a muscle, use it or loose it. If you have the time and inclination, learn another language. Take up a new hobby. Take a course in something you don’t know anything about. Take a refresher course in Italian (or spanish, or multivariable calculus, whatever floats your boat). If it’s another language, try and get good enough you can go to a foreign country where that is the official language and use that without having to speak English.

6) I realize not everyone has as much money as Warren Buffet or Donald Trump, but watch your financial health as best you can. If you retire, you don’t want to have to choose between a co-pay for medication or rent +/- food. If you can afford it, consider getting long term care insurance. If you need long term care, it can mean the difference between being at home with help or needed to go into a nursing home (policies are different, some might pay for nursing home stays as well).

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