The extremely pleasant upsides to getting older
<p><strong><em>Dr Kate Gregorevic is a geriatrician with a research interest in health and lifestyle factors that are associated with healthy ageing and recovery from illness.</em></strong></p>
<p>I wonder if Pete Townshend still agrees with his famous line “I hope I die before I get old.”</p>
<p>There are so many wonderful things about reaching older age, from the joys of grandchildren, to the freedom of retirement, and friendships with a depth that comes only from a lifetime of connection, yet so often media commentators seem to find only negative things to say about ageing. While there’s definitely difficulties and challenges, recent studies have shown that there has never been a better time to achieve advanced age.</p>
<p><strong>Dementia is decreasing</strong></p>
<p>Older adults now are less likely to get dementia than in times gone by. There is a very famous study that has been conducted over many decades in the town of Framingham in the USA. The study has been running continuously since 1948, and the current participants are the descendants of the original cohort. This means that the study investigators have been able to look really carefully at health outcomes for this group of people and relate them back to risk factors. Through rigorous testing, people who developed dementia have been identified, and <strong><span style="text-decoration: underline;"><a href="http://www.nejm.org/doi/full/10.1056/NEJMoa1504327#t=article" target="_blank">on average, since 1977, there has been a decline in the incidence of dementia of 20 per cent per decade</a></span></strong>, while the average age of dementia onset also increased from 80 to 85. These results have been largely due to a decline in vascular dementia, which is dementia related to small and large strokes. There are two important factors that are likely to be responsible for this decline. The first is that people in the later cohorts had a higher level of education (known to be associated with improved health outcomes). The second is better management of cardiovascular risk factors, like high cholesterol and blood pressure. This study is consistent with others conducted in the <span style="text-decoration: underline;"><strong><a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61570-6/abstract" target="_blank">UK</a></strong></span> and <strong><span style="text-decoration: underline;"><a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3818336/" target="_blank">Denmark</a></span></strong>, and it shows that some cases of dementia can be prevented, and so less people will have to face this debilitating disease, reinforcing the long term benefits of taking positive steps towards good health.</p>
<p><strong>People are staying stronger for longer</strong></p>
<p>One of the fears for many people as they age is the fear of losing independence. It is an unavoidable truth that some people will face some loss of the ability to do day-to-day tasks in old age. The good news is that with the increase in life expectancy, most of these years are years in good health. <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61690-0/abstract" target="_blank"><strong><span style="text-decoration: underline;">Data from the Global Burden of Disease 2010 study</span></strong></a> show that from 1990 to 2010, most of the increased years in life expectancy were disability free. Other studies have looked at the ability of older adults to perform activities of daily living. These are the simple, day-to-day things like toileting, bathing, going to the shops and managing money. Most studies have found that older adults now, compared to in past years, are more able to continue doing these tasks that are so vital for independence. Although many people do develop health conditions associated with ageing, medical management is improving and helping enable people to retain physical function. Staying physically active and eating well are key to continuing this trend of longer vitality.</p>
<p><strong>Older adults are happier</strong></p>
<p><span style="text-decoration: underline;"><strong><a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61489-0/abstract" target="_blank">There is a u-shaped relationship between happiness and age.</a></strong></span> Happiness is high in childhood, dips in middle age and rises again in older age.<a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61489-0/abstract" target="_blank"></a> In fact, one study found that the happiest group were people in their 90s. When we refer to one’s “wellbeing”, we are talking about their happiness, life satisfaction and a sense of purpose. Wellbeing is an independent predictor of life expectancy, even when physical health is accounted for. It might be that as people have the wisdom of many years, people don’t waste time on activities that do not bring them joy. Another thought is that in very old age, there is no longer the stress to earn money. There is often an awareness that material things and social status do not bring happiness, a good reminder that there is no sense wasting precious time on people and activities that do not make life better today.</p>
<p>Mick Jagger once said, “I’d rather be dead than still singing ‘Satisfaction’ at age 45”, yet in his 70s he and the Rolling Stones are still selling out stadium tours. Getting older is a great achievement, and with the improvements in health and wellbeing, many older adults are today able to continue living healthy and productive lives for far longer than before, whether it’s continuing to work or travelling the world. By making choices to remain physically active and seek out experiences that challenge and engage, you too can be like Mick and find that “satisfaction”.</p>
<p><em>To find out more information about ageing well, visit <span style="text-decoration: underline;"><strong><a href="http://elderhealthaustralia.com/" target="_blank">Elder Health Australia here.</a></strong></span></em></p>
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