As a geriatrician (a doctor for older adults), my patients are those who have problems associated with aging, problems like memory impairment, falls, muscle loss and frailty. Although all my patients have aging associated conditions, the actual chronological age can vary from people in their sixties to centenarians. Two people of the same age can have a vastly different health status: one eighty year old is working and playing tennis, another is in a nursing home so they can be helped to the toilet. Although life ends the same way for us all, the duration and intervening years can differ vastly for any two people. So many age related conditions, like dementia and frailty can be prevented or at least significantly delayed with the right life strategies.
I have noticed some commonalities in my patients who are successfully navigating very old age. People are often kind enough to talk about how they have achieved not just a long, but active and healthy life. They do not live a joyless, ascetic existence avoiding every risk factor imaginable. Instead they talk about the things they do on a day-to-day basis that give their lives joy and meaning. These are people who are happy in the deeper way that comes from actively engaging with life.
This observation has lead me to actively undertaking research in positive health and I am currently doing a PhD exploring how protective factors translate to better health. Multiple studies have confirmed my observation of the power of positive health. These are my five favourite tips:
1. Be part of a social community – just having a strong network can help you live longer. People with stronger social relationships are more likely to live longer. In a meta-analysis this had an effect size comparable to stopping smoking 15 cigarettes a day. High levels of social support can even help you to survive a heart attack. Simple pleasures in life like stopping for a chat with your neighbour or catching up for coffee with a friend could actually prolong your life.
2. Cultivate positive emotion – we all want to feel joy, contentment and love. When we experience these emotions, our bodies release less cortisol, which means less inflammation and a healthier immune system. Another positive emotion, optimism has been shown to be protective against cardiovascular disease. We can all do this by including more things in our life that bring enjoyment and manage stress with strategies like mindfulness.
3. Self-care – it’s easy to dismiss self-care as selfish. It feels like there are so many important things, like housework and bills that should be done before we take time to care for ourselves. Some of my patients are tragically malnourished because they live alone and so they subsist on tea and toast because they don't feel they are worthy of the effort of cooking and eating. I often see people who have developed frailty related disability due to poor self-care. There is nothing selfish about eating a nutritious diet, staying active and being proactive about medical conditions to maintain an active life.
4. Cognitive challenge – it's easy to fall into habits that do not provide any challenge. Our brain is like a muscle, and we all know that to keep our muscles strong, we need to exercise. Around one in three cases of dementia is preventable and exercising your brain by learning something new is a highly enjoyable way to stay healthy. Some of my patients are still working well into late life, but there are many other ways to exercise the brain. Crosswords, computer skills and crafts are all challenges that can protect our cognition and keep our minds healthy and strong.
5. Purpose – having purpose in life can directly benefit physical health. Older adults with a higher sense of purpose have better general health and physical reserve to cope with illness. A higher sense of purpose is linked with lower levels of inflammation. Any thing that is gives meaning to your life like caring for loved ones or pets can give purpose. This is something that each of us can achieve.
It is impossible to know how long any of us will live. Maybe this is why we all have a hedonistic streak that drives us to make the choices that feel good in the moment. The great lesson I have learnt from my patients is that longevity and having fun today are not mutually exclusive. Aging is a cumulative process and it is never too early or too late to take control of your health.
The beauty of a positive health approach is that these positive factors are desirable in their own right. It is a rare person who can make all the small choices required each day based on an unspecified time in the future. Let’s talk about the decision to have a piece of cake, we all think of a treat like this in terms of denial. A positive health approach would be to invite a friend to share it, then go for a walk together and balance this meal by making yourself fish and salad for dinner.
I feel so privileged to work with older adults who have achieved something we all aspire to: longevity with good health. By learning from their wisdom, many more of us can enjoy a long life by making the most of each and every day.