Aging Successfully, 3 Things You Can Do ? Men's Health

Watch a rerun of the sitcom Everybody Loves Raymond and you?ll see what a battering older adults take in the entertainment media, especially television. In one episode, the dysfunctional Barone family is startled when a car crashes into their living room, driven by none other than Raymond?s father, Frank. Fortunately, no one is hurt. The crash is attributed to Frank?s poor vision and lack of judgment. Marie, his wife of many decades, helps play out the television version of older marital life as a hateful coexistence, caustically reveling in her husband?s forgetfulness when it is discovered that he has failed to renew their auto insurance. Adding insult to injury, Frank asks his son Raymond to falsify the insurance claim to avoid liability. In the sitcom world, this is supposed to be funny ? a string of tired stereotypes that cast older adults as physically fragile, cognitively impaired, socially bankrupt, difficult to deal with ? and venal.

In welcome contrast, the term ?successful aging? is frequently turning up in newspapers, magazines and books. For example, one edition of the Wall St. Journal included an entire section titled ?The Secrets of Successful Aging.? Out of curiosity, we Googled ?successful aging? and immediately found nearly five million citations.

About a decade ago, geriatrician John W. Rowe, M.D., and social psychologist Robert L. Kahn, Ph.D., published a landmark book titled Successful Aging, which described the results of a nationwide study of older adults. The book presented conclusions from a comprehensive study aimed at characterizing the positive features of aging. The authors defined successful aging as the ability to maintain three key characteristics:

• Low risk of disease and disease-related disability
• High mental and physical function
• Active engagement with life

Each characteristic is important and the three are somewhat hierarchical. Good health and less disability make it easier to maintain high physical and cognitive function, which in turn facilitate engagement with life. However, Rowe and Kahn emphasized that the combination of these three components in the same person most fully encompasses ?successful aging.? We would add a major component of good luck to the definition. Indeed, luck affects the absence or presence of many diseases, such as Parkinson?s disease or rheumatoid arthritis. The major contribution of Rowe and Kahn was to emphasize the factors that we can influence through the personal choices we make now and in the future, the ones that do not depend on luck. Recognizing these factors helps understand the responsibility we can each take to achieve successful aging.

One traditional place to start studying successful aging has been with those who have achieved exceptional longevity. There is a sizeable medical literature dealing with the ?oldest old,? those individuals 100 years of age or older, the centenarians. That Methuselah-like achievement is not as rare as you might think ? the fastest-growing segment of our population is those 85 years of age or older. The U.S. currently has more than 55,000 centenarians, and conservative predictions suggest that there may be as many as 600,000 by the year 2050.

Studies of the factors responsible for exceptional longevity have focused on unraveling the complex genetic factors that might predict longer life. At present, identifiable genetic factors may contribute to longevity, particularly genes that protect against many of the diseases seen more commonly in older age. Intense scientific interest is centering on how some of these genes might be manipulated, even in older people. While breakthroughs are occurring, it will be many years before the full potential of gene therapy can be realized.

Another approach has been to define the environmental factors responsible for perhaps two-thirds of the variations in longevity. For decades, researchers have carried out epidemiologic studies of groups of people who have demonstrated exceptional longevity. Some of the earlier studies have been discredited due to imperfect birth records and even fabrication of ages. However, later population studies seem to validate the factors identified by Rowe and Kahn.

Not long ago, The National Geographic Society completed surveys of populations who seem to attain remarkably long life and remain relatively healthy and robust in their communities. Dan Buettner summarizes these in his book The Blue Zones.? Interestingly, these communities are found in multiple areas of the world and in a variety of ethnic groups that do not necessarily share the same genetic traits. Four places have been studied: Okinawa, Japan; Sardinia, Italy; Loma Linda, California; and the Nicoya Peninsula, in Costa Rica. While the extent and nature of medical care vary among these sites, there are strong commonalities in the characteristics of successful aging. Specifically, these populations are similar in that there is little obesity, and diets high in fiber and low in saturated fat are preferred. These populations also engage in much more physical activity than other groups. They walk more and rely less on motorized transportation. Finally, these oldest old have substantial social involvement in family and communal activities.

When older people in the U.S. are studied for decades, researchers find many of the same factors at play. For example, a recent report summarized a 25-year study of U.S. male physicians who were followed to age 90. In the men who survived to at least 90 years, the actions they took to prolong their lives included avoiding smoking, maintaining recommended body weight, and exercising daily. Happily, these risk factors are all ones that individuals, even those 70 or older, have some control over.

William J. Hall, M.D., is currently the Paul Fine Professor of Medicine and Director of the Center for Healthy Aging at the University of Rochester School of Medicine. Dr. Hall is an internist-geriatrician with research interests in the impact of viral respiratory tract illness in older adults and more recently, in preventive strategies to promote healthy aging. He founded the Center for Lifetime Wellness, a fitness center dedicated to adults over 50 years of age. He is a member of the American Geriatrics Society where he received the Jahnigen Award for his contributions to education. He has been active in the leadership of the American College of Physicians, including serving as president from 2001 to 2002.? He currently serves on the Board of Directors of AARP.

This story has been excerpted from Dr. Hall?s 2010 book, Taking Charge of Your Health (The Johns Hopkins University Press).

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