Experts Offer Some Advice on How to Age Successfully

Published in Pawtucket Times, February 21, 2014

            As an aging baby boomer, the pains and aches of old age and my noticeable gray hair are obvious signs of getting closer to age 60.

            Amazing, being given a free donut with my large cup of coffee at Dunkin Donuts, an AARP member benefit, is a clear reminder to me of how people may perceive my chronological age.  When I pulled out my wallet to get my membership card, the employee said, “Don’t worry, your covered.”  Simply put, by having gray hair it was obvious to the young woman that I was eligible to get the free donut.

            The aches and pains of getting older happen more often, too.   After spraining my ankle from a fall on a sheet of ice, while taking out my garbage, it took much longer for this injury to heal.  Most recently, a sharp pain in my hip makes me wonder if hip replacement surgery could be in my future.

            Even like me, President Barack Obama has shown his age by his gray hair and is even beginning to publicly complain about his aches and pains, because of living over five decades.

            The 52- year- old President told retired National Basketball Association star Charles Barkley in a recent interview that he was limiting his trip to the basketball court to once a month because “things happen.”

             “One is, you just get a little older and creakier. The second thing is, you’ve got to start thinking about elbows and you break your nose right before a State of the Union address,” said the 52-year-old president in the interview on the TNT network before the NBA All-Star Game.

             Discussing the aging process during an exchange about his signature healthcare reform law, Obama said that being past 50, “you wake up and something hurts and you don’t know exactly what happened, right?”

 Taking Control of the Aging Process

             Of course, President Obama’s complaints about getting old went viral. Approaching two Rhode Island gerontologists and a geriatric physician, this columnist gives the middle aged President tips on easing into his old age.

            Phillip G. Clark, ScD,  Director, URI Program in Gerontology and Rhode Island Geriatric Education Center and Professor, Department of Human Development and Family Studies, notes that some research has indicated that the decade between 50 and 60 is when many people start getting “messages” that they are getting older. These can be physical, psychological, familial, and social.

             “A lot are based on the messages that they receive from those around them, including the media (“if you’re older than 50, you should be taking Centrum Silver, or you qualify for this special type of life insurance policy,” adds Clark. “These messages may not reflect an accurate picture of what normal aging really is, but rather a biased and stereotypical portrait,” he says, for example, supposed bodily reminders of aging, such as aches and pains, may be due more to lack of exercise rather than actual aging itself.

             To successfully age, “stay physically active” says Clark, suggesting that you get an assessment from your physician.  This helps both your body and your brain. A moderately brisk, 30-minute walk a day is all you need, he notes.  “It’s more important that you build physical activity into your daily routine and do something that you enjoy and can stick with, than spend a lot of money on a gym membership that you seldom use,” he says.  Eating a diet that is high in fruits and vegetables is also important as part of a healthy lifestyle at any age.

             Clark also recommends that aging baby boomers stay engaged with settings and activities that keep them involved in life through their faith community, family and friends. Even having a sense of purpose in life that gets you outside of yourself, through volunteering, can help you age more gracefully, he adds, stressing that having a social network and people who care about and support you are essential elements of successful aging at any age.

             But don’t forget to “have a positive attitude and keep a sense of humor,” warns Clark. According to the gerontologist, this can get you over the challenges and hurdles you may encounter.  “Being resilient in the face of the challenges of life and getting older demands that we see the positive side of situations and not get bogged down in focusing on what we no longer have. We need to emphasize what we can do to keep the enjoyment in our lives.”

             Successful aging may not be swimming the English Channel at age 80, noted Brown University Professor of Medicine and of Health Services, Richard Bresdine, Director of Brown’s Center for Gerontology and Healthcare Research and Director of the Division of Geriatrics in the Department of Medicine.  However, for the general population, successful aging, that is “optimum physical cognitive functioning, rests on your genes, education and life experiences,” he says, not accomplishing great feats like swimming the English Channel.

            While the Brown University geriatrician agrees with Clark about the impact of exercise and social networks on improving your health and longevity, he also sees other ways to increase the quality of your aging.

 Strategies to an Improved Life Style

             According to Besdine, a majority of people with high blood pressure don’t take medication to control it.  This chronic condition can cause strokes.  Smoking does not just cause lung cancer, “but every type of cancer and chronic lung disease, “one of the worst ways to die on this planet.”

             Driving safely can increase your lifespan and quality of aging.  As one ages your eyesight may change, glare becomes a problem, and you lose flexibility to turn.  Retraining programs, offered by AARP and AAA, can reduce the probability of having an accident, says Besdine.

             Don’t forget your pneumonia or influenza vaccination, warns Besdine.  Having repeated occurrences of the flu can lead to heart disease and other health issues, he says.

             A good nutritional diet is key to enhancing the quality of health in your later years, notes Besdine, but people living on fixed incomes may not be able to afford eating fruits, vegetables and lean meats.  Cooking for yourself may even lead to a decision to not make nutritional meals.  Besdine is also a big advocate of the Mediterranean diet, a heart-healthy eating plan that emphasizes fruits, vegetables, whole grains, beans, nuts and seeds, and healthy fats.  He notes that this diet reduces your chances of getting heart disease and diabetes.

             Besdine also notes that there are simple things that you can do at home to increase your longevity and quality of life.  Make sure your home is safe, equipped with fire and carbon monoxide detectors.  Rid your kitchen of toxic substances.  He urges a “gun free” home. “This is not a political statement. Research shows us that a person is much more likely of being shot by a gun that is kept at home,” he says.

             Screening for cancers (by scheduling a mammogram and/or colonoscopy) and depression, along with moderate drinking, good oral health care, and preventing osteoporosis by taking calcium and Vitamin D, even reducing adverse drug reactions and improving mobility, are simple ways to increase the chances of your successful aging, Besdine says.

 Unraveling Research Findings

             Rachel Filinson, Ph.D., Professor of Sociology/Gerontology Coordinator at Rhode Island College, says the “devil may well be in the details,” as older persons try to unravel research findings that might provide them with a clear road maps to achieve successful aging.

             For instance, Filinson notes that while some gerontologist have long regarded “under nutrition,” that is the consuming relatively few calories to sustain oneself,” as a way to increase one’s longevity, others disagree with the theory.

             Meanwhile, mental stimulation is believed by many to deter cognitive decline, Filinson says, but brain teasers and games have not been adequately proven by research findings, she adds, while reading and writing may be helpful.

             Although a large social network and recreational pursuits have been lauded as essential to enhance the quality of aging, some investigations have found that solitary activities like gardening are just as effective, observes Filinson.

             In that science can be a work in progress, Filinson believes that older adults can take charge of their lives by optimizing the positives and minimizing the negatives–how we age.  “It’s about the choices we make in life rather than the genes we were born with,” she quips.

             President Obama might well listen to Clarke, Besdine, and Filinson’s sage advice as to how he can cope with the aging process. Even small changes in his daily,  mundane routines, like using the stairs rather than taking an elevator in the White House or even taking Bo, the first family’s dog, for a brief walk around the grounds, can result in his living longer, even reduce his noticeable aches and pains.

              Herb Weiss, LRI ’12, is a Pawtucket-based writer covering aging, health care and medical issues.  He can be reached at hweissri@aol.com.

Loneliness Can Be Hazardous to Your Health, Even Lead to Untimely Death

            Published July 13, 2012, Pawtucket Times

“One is the loneliest number that you’ll ever do
Two can be as bad as one
It’s the loneliest number since the number one”

             Three Dog Night’s well-know lyrics on its first gold record may well mirror research findings of a study published last month in the Archives of Internal Medicine by University of California- San Francisco geriatricians.  That is, older persons can be lonely without really being alone because of lack of emotional connect, the feelings of emptiness or desolation being linked to serious health problems and even death.

             The UCSF geriatricians lead by Carla Perissinotto, MD, MHS, analyzed data in the Health and Retirement Study, a nationally representative study by the National Institute on Aging conducted on 1,604 older adults between 2002 and 2008. Researchers limited their analysis to participants 60 and older and the mean age being 71 years.

             Perissinotto notes in her study that it was one of the first studies to examine the relationship between loneliness and functional decline and death.

             “In our typical medical model, we don’t think of subjective feelings as affecting health,” said Dr. Perissinotto, an assistant professor in the UCSF Division of Geriatrics. “It’s intriguing to find that loneliness is independently associated with an increased rate of death and functional decline.”

 Lonely in Relationships

             UCSF researchers say that one of the more surprising findings of the team’s analysis is that loneliness does not necessarily correlate with living alone. The study found 43 percent of surveyed older adults felt lonely, yet only 18 percent lived alone.  

             “We are interested in identifying the different factors that cause adults to become functionally impaired and ultimately at risk for nursing home admission,” Dr. Perissinotto. “The aging of our population and the greater odds of institutionalization make it important for us to think about all the factors that are putting elders in danger, including social and environmental risks,” she noted.

             Researchers at UCSF focused on death and a decrease in the ability to perform daily activities such as upper extremity tasks, climbing stairs, and walking. People who identified themselves as lonely had a statistically significant 59 percent greater risk of decline. For death, 45 percent were at greater risk of death.

             “This is one of those outcomes you don’t want to see because it was terrible to find out it was actually true,” Dr. Perissinotto said. “We went into the analysis thinking that there was a risk we could find nothing, but there actually was a strong correlation.”

            The UCSF Research team believes the impact of loneliness on an elderly patient is different from the effects of depression. While depression is linked with a lack enjoyment, energy and motivation, loneliness can be felt in people who are fully functional but feel empty or desolate.

             The “baby boomer” generation – those born between 1946 and 1964 – represents the largest population growth inU.S.history. Some of them now are part of the 39.6 million population of people older than 65. That number is expected to more than double to 88.5 million by 2050.  As that population continues to expand, Dr. Perissinotto said she hopes to be able to start to integrate social and medical services for elderly patients more comprehensively, and be more mindful of what kinds of social interventions they require.

             Physicians “asking about chronic diseases is not enough,” she said. “There’s much more going on in people’s homes and their communities that is affecting their health. If we don’t ask about it, we are missing a very important and independent risk factor, she says. “We don’t think we can change genetics, but we can intervene when someone is lonely and help prevent some functional decline.” 

             That’s what 85-year-old jazz singer Barbara Dane is trying to avoid as she continues to entertain in theEastBaywell into her 80s.  “When your spouse dies, there’s a missing space in your heart,” says the widow. “You still want to know that someone cares about you. Connection to other people becomes even more important at this point in your life.”

               Dane, who has performed for over 70 years, credits her active social life to her positive outlook on life. She adds, “A lot of people around me are aging, and some are not doing so well,” she said. “Some who never developed social skills are having the hardest time and those are the ones we need to watch out for.”

 Everything is Interconnected

            Phillip Clark, ScD, Professor and Director, Program in Gerontology and Rhode Island Geriatric Education Center, says that these findings are consistent with what gerontologists have been saying for years; namely, that the experience of aging can only be understood by taking into account its physical, social, and psychological dimensions, because they are all interconnected with each other. “When we get older, we find that different parts of our lives and our health are increasingly related to each other,” he says.

             Dr. Clark states, “Although this recent study does distinguish between the research literature on social support and its specific results on loneliness, certainly the two areas share a common insight: that the psychosocial context of aging can either enhance or undermine our health as we get older.”  For instance, having one close friend—a confidante—as we get older can help buffer us from some of the negative effects of the losses often associated with aging. Just one person with whom we can share our joys and sorrows can make all the difference, he adds.

             The implications of this study are clear to Dr. Clark.  Professionals [including physicians] who work with older adults must be attuned to the psychosocial contexts of older adults and ask questions about how they are feeling, not just physically but also mentally.

             Dr. Clark believes it is not normal that we become depressed or lonely as we get older, and things can be done to address these problems so that older adults have a rewarding and healthy later life.

             Herb Weiss is a Pawtucket-based freelance writer who covers aging, health care and medical issues.  He can be reached at hweissri@aol.com.  This Commentary appeared in July 13, 2012 issue of the Pawtuckt Times.