HEALTHY AGING: What It Is and How to Attain It

1. HEALTHY AGING:What It Is and How to Attain It PAS 645 Masters’ Project Louise R. Kelly Advisor: David Fahringer, M.S.P.H., PA-C

2. What is a Normal Lifespan? • Oldest documented lifespan is 122 y., 5 mos., 14 days • What was the secret of this longevity? • Living a relatively disease-free life • This is the reason most of us can expect to outlive our grandparents • In 1900 the average projected lifespan was 47 • By 1999 the average life expectancy had risen to 73 for men and 79 for women • Factors which contribute to longevity are: (1) heredity, (2) environment, (3) lifestyle

3. What is Healthy Aging? • There are as many definitions for ‘healthy aging’ as there are people to give them • Basically people don't want to just live long lives, they want to live long healthy lives • Longevity is qualitative not just quantitative and successful or ‘healthy’ aging is more than just the absence of disease and infirmity

4. Why Should We Care About This? • Nobody escapes the effects of aging and even if you are now in your 20s and 30s, the sooner you begin to take pro-active steps to prevent the deleterious effects of aging, the better off you will be as you proceed along the age continuum • Another answer to the above question is that “you willbe seeing these people.” As the Baby Boom generation comes into the healthcare system it will become increasingly important to know the normal vs. the abnormal effects of aging on the human body and how to deal with them

5. What Determines How We Age? • There are several different levels upon which aging is calculated: • *Chronological Age – The actual number of years you have been alive • *Biological Age - A general term which encompasses physiological processes associated with aging such as loss of muscle strength and endurance, loss of ability to resist disease, wrinkling of the skin due to loss of collagen and elastin and other deficits associated with the aging process • *Psychological Age - How old you feel and think you are • *Social Age - How you are treated and categorized by society

6. Of the above components, Biological and Psychological Age are the ones over which we can exert the most control • We can exert some control over the acceleration or retardation of aging by what we eat and drink, whether or not we exercise and keep in shape and the inclusion or exclusion of other unhealthy activities such as smoking and excessive food and alcohol intake

7. Designer Genes • There is a significant genetic component to longevity. Scientists now suspect that lifespan is determined by a combination of environmental and genetic factors with genetics accounting for up to 35% of this interaction (NIA Aging Report, 2007) • Another way in which our genetic inheritance can prove to be useful is to help us be aware of familial genetic traits and tendencies toward specific disease processes

8. Normal Physical Changes with Aging • Aging causes functional changes in certain cells. The rate at which they multiply slows down and the numbers of certain cells necessary for our immune system to function properly decreases with age • Age also causes changes in our responses to environmental stressors such as ultraviolet light, excessive heat, low oxygen levels, toxins and poor nutrition • Another very important change is in the rate of cell apoptosis which programs cells to self-destruct or die at appropriate times

9. Mental Changes With Aging • Many people experience mild cognitive impairment (MCI) which can be a transitional stage between the cognitive changes of normal aging and the more serious changes brought about by Alzheimer’s Disease • While it is true that many people with mild cognitive impairment go on to develop Alzheimer’s Disease it is also true that many more do not • The two greatest risk factors for Alzheimer’s Disease are age and family history (Snowdon, 2003)

10. 7 Behaviors of a Healthy Lifestyle: • Exercising • Eating a diet high in fruits and vegetables • Not smoking • Drinking alcohol in moderation • Getting adequate rest • Coping with stress • Having a positive outlook

11. The Role of Exercise in Healthy Aging • Many of the changes in our musculoskeletal system result more from disuse than from simple aging. Fewer than 10% of Americans participate in regular exercise and the most sedentary group is 50 years of age or older • There are 4 major ways to improve physical fitness: aerobic exercise (walking, swimming, water aerobics), resistance training, flexibility training and lifestyle modification (McDermott, 2006)

12. The benefits of getting and staying physically fit cannot be overemphasized. In addition to the immediate benefits to the body as a whole, there is evidence which suggests a positive correlation between physical fitness and mental fitness • Maintaining physical fitness is beneficial to cognitive function (Hartman-Stein, et al., 2003)

13. Nutrition or -A Waist is a Terrible Thing to Mind • Caloric restriction appears to delay normal age-related degeneration of almost all physiological systems. (NIA, 2007). In animal studies it was found that calorie restricted diets are more important to an extended life span than maintaining a healthy weight and exercising (Mayo Clinic, 2007) • Exactly why this happens is not known but it is hypothesized that cutting down on calories slows metabolism. Since free radicals are a byproduct of metabolism, fewer free radicals are generated and oxidative damage to cells is lessened

14. Calorically restricted animals also have somewhat lower body temperatures which may lower genetic damage to cells • There is also less free glucose circulating in the systems of calorically restricted animals which may reduce the potential for protein crosslinking, a biochemical process implicated in cellular aging • As we age, our basal metabolic rate decreases so that we need fewer calories each day to maintain normal weight. (Madsden, et al., 2004; Mayo Clinic, 2006). As metabolism slows, calories which were hitherto used to fuel your body’s energy needs are now stored as fat (Medline Plus, 2006)

15. Limit Your Vices • Cigarette smoking is one of the single most damaging factors to the body overall. Cigarette smoking causes 90% of lung cancers and people who stop - no matter how long they have been smoking - immediately lower their risk of getting lung cancer • Cigarette smoking has been shown to be a factor in the increased risk for cartilage loss and knee pain in men with knee osteoarthritis (Amin, et al., 2007) • Cigarette smoking also results in lowered immunity to infections and it suppresses normal healing processes

16. It is recommended that alcoholic drinks be limited to no more than 2 drinks per day for men and 1 drink per day for women. Excessive alcohol intake causes many adverse effects if it is taken in large amounts over time. Among other things, it can increase blood pressure, decrease immunity and cause memory loss • Research has shown a direct link between sleep deprivation and memory loss. Sleep needs change little throughout adulthood. At least 6 hours of sleep each night are required for memory to perform at its peak and regular sleep habits also make you less forgetful

17. Depression has been shown to mimic the signs of memory loss including an individual’s becoming forgetful and less organized • Depression can also interfere with sleep habits which gives it a two pronged attack against proper memory function • If depression is a factor, then by and large memory function should return to normal as depression lifts (AGS, 2005)

18. Prevention • It is easier (and MUCH less expensive) to prevent an illness than it is to treat it. In that regard, everyone should see their primary care provider on a regular basis to monitor for conditions that are associated with aging such as diabetes mellitus, hypertension, hyperlipidemia, weight gain and cardiovascular disease • By taking action early to prevent or treat a condition, we stand a much greater chance of minimizing the long-term deleterious effects of many conditions which can have the cumulative effect of shortening our life span and/or interfering with our quality of life

19. And In Conclusion . . . • A famous science fiction character once said “Live long and prosper.” I believe that this is the end result to which we all aspire and I also believe it can be achieved • Research has proven that it’s never too late to adopt a healthy lifestyle and if for instance, you are a smoker and quit smoking now, your risk of heart disease begins to fall almost immediately

20. Eating a variety of fruits and vegetables, getting out for a daily walk and engaging in some other form of regular physical exercise are just a few ways in which you can begin preparation for both a physically and intellectually healthy later life no matter what your is age now • The take home message here is that living a healthy lifestyle – no matter when you start – can and does improve when and how you age

21. The End

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