“If we are to believe the barrage of ‘good news’ dotting the press daily (about doubling our life expectancy, DNA, magic pills, and turtles that don’t age), we may all live to be 200—if we can just hang on a few more weeks. So what’s to worry?”
We’d better address this before we tackle present-day, flesh and bone reality!
We had also better focus on our own and our contemporaries’ current and coming physical and mental health, on the long shot that corporeal immortality arrives after we’ve caught the last train. Without either in full temper, getting old will really be a climb to reach that leave-taking terminal.
Once we see what and where we are physically and mentally, let’s implement a four-step process to gain some sense of control, in case some dreaded, adverse anomalies come knocking, uninvited and unwanted.
That is logically followed by a broader look at what physically awaits most seniors, at least in North America. There are physical ailments and conditions that appear with age. Other ailments and conditions, more opportunistic, may dash through the door the moment we open it. So we might begin a concerted campaign to hold them at bay, or remove the precursory conditions that increase the likelihood of their unwelcome entrance. Alas, some are totally out of our hands: they are gifted to us genetically. For all, this look will at least provide a pinch of understanding, to lessen the shock of seeing their new face.
A similar, broad look at our coming mental state, with its emotional and psychological components, will deal more with myths and truths than suggest steps by which we might somehow jack up our IQ another 50 points or remember our pharmacist’s phone number (or location).
Then we must put all of this knowledge and information to work so
we can fully use what we have to create our own very best Super Second
Life. That will include synchronizing the use of our abilities while we
have them to realize our dreams. Let’s wait until the next chapter to create
some understanding of the money and protective tools, like insurance and
assistance, that we will need to be safeguarded into old old age while
not being a burden on family or friends. Stress is indeed a killer; all
of this may help reduce that stress.
When we speak of a second life, aging, and health, we need a set of overriding ground rules. One, we are mortal. Two, it isn’t a sin to die, but it may be not to live.
So our purpose here is to both administer and enjoy our health as well and as fully as possible so we live the best life we can.
Let’s set aside two myths: old doesn’t equal sick, nor, by extension, does getting older mean getting sicker. In 1994, of Americans 75-84, 73% reported no disability. Even those over 85, 40% were fully functional. And the reduction in disability is accelerating, even among those over 95.
The second is that we are all headed for the nursing home. Hardly. Only 5.2% of the populace resides in nursing homes at any one time, and while over 40% will be there at some point in their lives, many of those spend only their last days or months there before dying.
Our focus in this chapter, then, is to take a good look at our present health, how that might change as we age, and how we factor those changes into our Super Second Life plans. While disability and nursing homes might be part of those last 30 years, so will decades of full, fun living with health very much in the background. Those years are our primary concern.
Of course, if our physical and mental health aren’t functioning well at any age, the rest of our life directly suffers—and it may be prematurely shortened. So most of what follows are things we can do now to get our body, our mind, and our attitude in as good a shape as possible, so that we can fully enjoy our bonus years.
But first we should also address the “why worry?” issue, that it doesn’t
matter what we do, scientists are about to unveil the life-stretcher, the
pill or system that will keep us all healthy and hopping until we’re 200—or
was that 500?—years old.
Live three times as long as our grandparents? A mixed blessing. Who wants to live two days longer if they are throbbing with uncontrollable, permanent pain or have the mind and future of a wrinkled potato? And who among us saved up enough survival money for two or three lifetimes?
On the other hand, with a much longer midlife and a long, enjoyable later life, given the resources and energy to do what we enjoy every day, hooray for those life-stretchers! Just think, if those 200 years were run in reverse, we’d still be able to speak with Thomas Jefferson.
But will you and I live to be 200? Fat chance. At best, we can watch with interest as science pulls forward both the fully functional length and the absolute length of life for those who follow—maybe for our grandchildren. It will be fun to watch, and if it touches us a bit, great! Right now most of us begin to suffer significant reduced function at about 70 while our absolute length is about 120.
Of course, we can already extend our lives by both paying attention
to our health and by courting daily the forces that support longer life—mostly
by cutting our vices and through adding a healthy diet, exercise, vigorous
mental activity, and less stress (with a few magic pills thrown in). We
can also hope that the forces that foster longer life appear quickly and
work fast enough so we can ride their coattails. Maybe some of them will
at least reverse our bodily damage—that tasted so good to inflict.
What are the changes to look for (and coattails to grab)?
* Some of the changes relate to stress, environment, and the body’s ability to repair itself. Some animals don’t deteriorate much at all, in safe, stressless settings. Rock fish live 150 years. We must adapt to humans what we can learn from them.
* Scientists can now double the life span of fruitflies by simply focusing on natural selection. The task is finding the genes involved, then applying pharmacology and gene replacement. When understood, reweaving the human genetic fiber will control the aging, which will allow us to stay healthier, younger, and able to fully function much longer.
* Those eating foods lower in calories, much less fat, and high in nutrients may live 1/3 longer, if animal studies on rats and monkeys hold true in humans. We will be younger physiologically and have more stamina, better immune systems, and fewer diseases, according to Drs. Rick Weindruck from the University of Wisconsin, Madison, and UCLA’s Roy Walford.
* Less glucose also seems to be a longevity key, says Dr. Anthony Cerami (formerly from Rockefeller University), in part since it is also a protection against diabetes (which accelerates aging by a third). Since glucose causes harm when reacting with proteins, less glucose reduces the stiffening of joints, toughening of bones, and function loss in organs. A new compound breaks the damaging cross linking, which is one of the causes of aging.
* Oxygen free radicals are atoms or molecules with at least one unpaired electron, and thus are usually reactive and unstable. That’s bad news in humans since they are often linked to cancer. They also attack the mitochondria’s membranes and thus destroy us as we age. What can we do now? According to SMU’s Dr. Raj Sohal, eat fruits and vegetables and exercise!
* Dr. Miriam Nelson, from Tufts, speaks of a “magic pill,” a growth hormone for use in later life to stop the loss of body strength. It will bring more muscle, less fat, and more vitality, which in turn creates a sexier, stronger, more energized person. Beware, though: one side effect is cancer.
* Turn back the aging clock? Yes, says Dr. Judith Campesi from UC. Berkeley. “If we can reset the clock in each cell by lengthening the telemeres, they can divide without limit and we can abolish aging altogether!” What happens now when the cells stop dividing? We wrinkle, our skin ages, and we can’t fight disease. The solution is to restore the cells’ function(s) once they stop dividing.
Are we doomed to wait for the new bullet train while riding our old coal burner until the coal runs out? Hardly.
The smartest thing we can do is what we are doing now—planning, then living the best Super Second Life possible, without losing time standing by the tracks and pining about what may be at best a mixed blessing.
Remember that our kin just a century back, at the turn of the last century, lived an average of 48 years. Hard years, without antibiotics, cars, airplanes, radio, television, the computer, aspirin, or sanitary napkins. They too dreamed of a life when most people lived to 75 and some to 100. They wondered who would benefit from such wonders. Us, that’s who. Our train goes twice as far as theirs and much faster. We just have to live the journey fully.
But there’s more. We can actually extend our lives today by our personal
actions, by what we do, eat, and think. Let’s first look at where we are
now physically and mentally, then see where we can pick up some extra coal
to keep our old buggies chugging a bit longer.
The first thing we have to do is determine where we are physically and mentally. Little of this is a mystery—who knows us better than ourselves? Who else feels our pains? So some of this is simply establishing a baseline, part by part, for future comparison, much as a doctor does on an initial physical exam.
To that we must add some family history, to at least be aware of areas where future attention may be drawn.
And then we must get a second opinion, in this case from our physician, to begin a life maintenance program designed to keep us healthy, active, and fully involved all our days.
The idea is to be proactive physically and mentally now, with a four-step opening volley, then work our actions into an everyday routine that becomes part of our lifetime maintenance program.
The first three action steps are:
(1) If it hurts, pinches, oozes, swells, or smells, give it immediate
attention. Get it under control now; then, if possible, get it cured.
(2) If it’s been lingering around and is correctable, get it evaluated and under treatment.
(3) If it’s been around “forever” (and is chronic), get it under control and keep it there.
And (4), as each new health concern arises, treat it promptly.
The point is obvious: we should enter our Super Second Life armed with both health knowledge and a proactive plan to be able to enjoy every day fully and actively. We must get beyond the obsessive certainty that something will appear without warning and do us in. Or the worse mindset that “if I ignore it, it will go away.” Either can happen, but the best armor is information, professional input, and healthy living.
So that requires a personal checklist for us to complete, then share with our physician. It can be as informal as starting with our toes and moving up, noting anything of concern now or in the past at each way station: a knee that “pops out” when we walk, a sagging libido, a lip sore that has lingered for weeks or months. Then list the senses: sight, hearing, smell, taste, and touch. Anything unusual there? We take this list to our exam and discuss each item to see if it falls into the three action categories above or if it is at the initial, flag-waving stage where subsequent changes will merit attention or treatment.
To that list we add a dozen or so categories that must also be addressed, and should be checked annually, by our physician as we age: alcohol, drug, and tobacco use and abuse; breast cancer concerns; decline in function; deconditioning; hearing problems; dental problems; high blood pressure; malnutrition; vision problems; thyroid disease; prostate disease, and depression—plus any of the others discussed later in this chapter.
The list is also incomplete without factoring in our earlier health record and our family health pattern. As well, women who have not had regular exams must include a check for cervical cancer. Those of us with significant sunlight exposure now or in the past should have a skin cancer check. Heavy drinkers and smokers should check for oral cancer. And if there are indications or family history in colon cancer or diabetes mellitus, that should be checked too. Possible coronary heart disease should make everybody’s check list. And for the old old, so should obesity, dementing illness, and abuse or neglect.
A quick summary of our family’s health must accompany our personal checklist when given to the doctor. Of particular concern is the health of our parents, grandparents, and siblings. What major health problems do or did they have, when did they begin, and what was the result of each. Of obvious concern are genetic hand-downs, but also a shared environment can indicate possible future health concerns we shouldn’t overlook. This is not a list of impending doom but rather a peek at answers to future questions that might arise.
To our personal list and the family health record, we should add anything else of consequence in the health arena. This is the moment to clean the slate of all our preoccupations, then let our physician decide what deserves instant attention, what will be monitored, what we can do to improve our present state and keep it functioning well, and which other professionals or experts might be brought in to confront specific needs. This is also where we work with the doctor to create an ongoing, positive Super Second Life health maintenance plan. (Bring this book if your doctor has no idea what we’re talking about!)
The Appendix has a Medical Health History Questionnaire that can be completed and taken to the physician.)
Why bother with all of this? Why not just live it up and take our chances
later? Because by exploring our health future now, correcting the present
misfunctions before they grow and worsen, and adding in the record from
several generations past, we might well be able to improve our chances
of a long, pain-free, active future rather than reactively having to counter
whatever we are dealt.
It’s not enough just to get a baseline evaluation. We must also put ourselves on a life-enhancing and -extending health regimen, if we want to enter and enjoy a healthy and long second life. That doesn’t mean 30 years of sprouts, cold showers, and endless push-ups. But it does mean paying attention to simple, sensible acts that will make us more agile and able to do what we want longer.
One way to view this is to look backward. What are the seven habits of people who live 100+ years?
(1) sleep 7-8 hours a night
(2) eat breakfast
(3) don’t eat between meals
(4) keep their weight between 5% below and 10-20% above normal for their size
(5) get regular physical activity
(6) imbibe no more than two alcoholic drinks daily
(7) don’t smoke
And for us, who will gladly settle for most of those 100 years? We’ve already seen that eating food lower in calories and fat, plus favoring fruits and vegetables, are key components in programs that help eliminate free radicals and may extend our lives by a third. So one area where we can focus now and into the future is our diet.
Are there guidelines to determine what is a sensible diet? As many as there are nutritionists and diet-sellers. But a few have stood the tests and time. We can determine a healthy weight for ourselves (say 150 pounds), multiply that by ten, and keep our food intake within that many calories (1500), plus the number we expend in exercise (if, for example, we cycle 200 calories worth, to maintain our weight we get to ingest 1700 calories worth of food that day).
What kind of food? Keep the saturated fat a very small percentage of that total. Whole grains, fruits, and vegetables are low in calories and fat and are excellent components of any meal. We should limit the salt we add, and women may need more calcium and iron, before menopause. Beyond that, personal needs may require special dietary modifications. An example is the care that diabetics must take to maintain a proper insulin balance.
Alcohol can be a problem when used in excess. (In some, one drink is excessive.) Alcoholism in older people carries a toll, including proneness to injury (at a time when bodies mend slower and secondary complications appear), gastrointestinal illness, liver disease, malnutrition, and sometimes dementia.
Two-thirds of the chronic, excessive drinkers are longtime drinkers, but they are hardly a second life concern since most are dead by 65. At 40 we should be putting the brakes on our drinking with both feet. The other third are situational drunks; their addiction can be exacerbated by the things that age can bring, like retirement, money worries, health problems, and the death of loved ones.
There’s a direct link between alcoholism, depression, and impotence, which makes it harder for alcoholics to even want to live a healthy, exciting second life, much less adhere to a healthy life style to make it happen. Women aren’t excluded either; after 40, they are affected more quickly by alcohol. When should we seek help with our drinking? If the alcohol affects our relationships, influences how we schedule our days, alters our health, isolates us, or simply preoccupies us.
Exercise is very important in preventing health problems, including cardiovascular disease and depression, although less than 25% of Americans exercise at all. How beneficial? Walk an hour a day—it needn’t be all at one time—and you will live two more years. Women who exercise an hour daily will cut their risk of breast cancer by a third.
Building muscle, according to Dr. Nelson, may be the most important thing older folks can do to lengthen their lives and sharpen their mental acuity. As we age, we gain weight and lose muscle strength, but the latter can be reversed in as little as two months. Simple strength and endurance exercises can be done by either sex at any age; it stops free radicals as a bonus.
The minimum goal is some type of sustained activity for 30-40 minutes at least three times a week. We needn’t run marathons, scale peaks, or swim to the Azores, but the body continues to crave exercise, and it rewards us accordingly.
Dr. Mark E. Williams, in The Complete Guide to Aging and Health, says it best:
Regular exercise is the best antidote to many of the effects of aging. The major benefits from regular exercise include favorable effects on fats in the blood, better handling of blood sugar, increased maximal oxygen capacity, greater strength, denser bones, an improved sense of well-being, and better sleep.
Smoking has deservedly received a bum health rap these past years, and anybody who doesn’t know that it is harmful to their health probably is one of those aliens we see in movies living in human bodies. So if we’re resisting with all of our might, puffing into our second life is a luxury we can ill afford. In a nutshell: it’s far more likely to painfully shorten than extend those extra years.
Alas, the body is more forgiving than society. Quit now and in two to five years our elevated risk of heart disease is about equal to a non-smoker. The risks of cancer and emphysema also drop markedly. Circulation improves. Friends return. Insurance rates drop. And we aren’t reminded daily that cigarette smoking remains the single most preventable cause of death in the United States for men and women and that we can cure 85% of all cancer if people (like us) stopped smoking.
The last thing we can do to extend our life and make it more enjoyable is to reduce our stress. Stress is the body’s response to a demand, and too much stress has physical and psychological consequences, including insomnia, headaches, and ulcers. It wears the body down and reduces the amount of repair the body makes to itself, which induces aging.
There are solutions—and good news: we experience less stress as we age! We can simply stop worrying so often, at least about things over which we have no control. Earthquakes, conspiracies, the falling ruble, even bad jokes happen but beyond taking prudent precautions and remaining attentive, the stress we develop about them and other uncontrollable actions serve no useful purpose. Healthy coping mechanisms to stress include exercise, meditation, biofeedback, or self-hypnosis; unhealthy ones include overeating and substance abuse.
What you are doing now—planning a full, active, enjoyable Super Second Life—may be the very best way to reduce stress. You are taking control and creating your own future reality. Since you are the creator, if things don’t work out, no stress—just change the reality!
Living long enough to enjoy a Super Second Life does have health consequences beyond those just mentioned. Everyday things change because of age. These are the most common examples that we must consider now and factor into our future plans:
* The third addiction (after tobacco and alcohol) is drugs. Not many dedicated cocaine or heroin users reach middlessence. A bigger concern are the old-fashioned, doctor-prescribed legal drugs. Not every user is addicted and some simply must use them to live those extra years with any pleasure, but the guess is that about 60% of the 50+ users are needlessly addicted to painkillers, tranquilizers, sedatives, sleeping pills, or muscle relaxants.
* Let’s look at depression again because it is so common in seniors and is an organic illness with biochemical changes in the body. It’s estimated that 25% of the seniors dip into depression at some point, and that 1/3 of those with dementia probably are depressed and are treatable. The treatment for depression is specific drugs and psychotherapy, one or both. Sometimes it passes on its own in six months—but what a lousy, hopeless six months. Dangerous too, because the depressed can turn to suicide. Particularly vexing to seniors is the depression created by mixing alcohol with specific allergy medicines, antidepressants, barbiturates, motion sickness medication, painkillers, sleeping pills, and some blood pressure prescriptions.
* Let’s talk sex, again. It can be a vital element of a Super Second Life, or so thought 97% of 800 folks 60-91 years old in a study that said they liked sex. Eighty percent thought it was good for their health. But impotence can soften that enthusiasm real fast! Yet 50-60% of the 10 million men thus afflicted have a physical cause that can be treated. Prescription drugs can be one of those possible causes. There are 41 that can be implicated, including Tagamet, Desyrel, Prozac, and Valium—plus, of course, alcohol and tobacco.
* Prostate enlargement starts appearing in the 40s and will be present in virtually all men by about 65. Three things to consider: (1) get a PSA blood test often to make sure it doesn’t become cancerous; (2) exercise and sex help in the short run (“Head for the bed, Mabel. My prostate’s acting up!”), and (3) there are effective drugs now to use before or instead of surgery.
* If we can keep our heart in shape, bingo—that’s the #1 killer in folks over 50. So we need to get our blood pressure checked and treated if it’s too high, watch our cholesterol levels, pay attention to our diet (or start one) if we’re more than 20% over our ideal body weight, and exercise regularly.
* Menopause used to be a hint to get coffin insurance. Now women live a third of a great life with and after menopause. Some see it as the gateway to an exciting new beginning, but the passing can be unpleasant: 75% of the women have symptoms. Most are immediately treatable. Menopause can also create a new, positive, dynamic in a marriage. It’s also a time to see your physician—to see if hormone replacement therapy is for you and learn more about preventing osteoporosis.
* Women jump into the fore for heart disease after menopause, so weight is an issue. Attention to eating matched with exercise can usually remove this concern.
* What fun is a second life if we’re as blind as Magoo? By 45, most of us need corrective lenses; almost all do by 60. So we need to get our eyes checked, in part for macular degeneration. (While there, have a glaucoma check. Two million people have it and half don’t know.) If cataracts are found, 95% of those with them had improved vision after surgery. And forget tinted lenses or sunglasses at night after we’re 60: we need seven times the light that a 20 year-old requires. There are also amazing laser eye surgeries that quickly correct near- and far-sightedness.
* If our hearing is getting worse, guess what, it happens with age, mostly to men. (A quick cure: move to the African Sudan, where there is no hearing loss.) Unfortunately, the range most affected includes the human voice. The single greatest cause? Excessive earwax! Some need surgery or earwax irrigation; most use hearing aids. We could also learn lip reading if we weren’t so blind!
* Most of us grew up on the edge of the fluoride revolution in dentistry, so we’re still likely candidates for cavities as well as periodontal disease. Ninety percent of us will be affected by the latter, giving true meaning to “long in the tooth!” The best advice: brush twice daily, floss, and visit the dental hygienist at least once a year. The goal is to keep all of the teeth we can and stay pain free.
* Arthritis is what most people think of when they think of aging. Gnarled paws, inflamed knees, and massive aspirin-popping! For 17% of us, that’s about it. Most people get it when they’re younger and it gets progressively worse and chronic, which needn’t be. Some arthritis can be stopped in its tracks if found early enough; most can be managed and permanent disabilities prevented. The form most commonly seen is rheumatoid arthritis, which appears in our 30s and 40s. Aspirin is still the wonder drug. But osteoarthritis comes from the gradual disintegration of cartilage. We get it early but feel it in our 50s. Keeping our weight down, exercising, and regular stretching are helpful. Keeping in contact with our physician makes sense here to stay current with the wonders taking place in pharmacology and genetic treatment.
* Diabetes is a major concern as we age. It’s an endocrine disorder that requires strict attention to diet and lifestyle. There are two kinds. The one that is new to seniors is the maturity-onset diabetes, affecting 14 million Americans. It usually appears after 40 and is controllable, mostly by diet and exercise. The affected do not need insulin but must pay strict attention to a treatment regimen to reduce disability that generally affects the eyes and limbs. Over 80% are overweight when diagnosed. We should always get tested for diabetes at our regular exam.
* If diabetes isn’t the greatest fear of seniors, then surely Alzheimer’s disease is. While it’s not as prevalent as we think (at the most, four million have it or a similar form of dementia), it is devastating in the loss of memory and function to the person and the violent disruption it makes in the lives of their families. It usually appears in the 60s, is psychologically devastating in its early stages, and survival is generally less than five years. There is no known cure at present.
These are the factors to consider when we establish a Super Second Life
baseline with our doctor. What problems or conditions we have now, what
might we expect in the future based on our family history, and what our
lifestyle might inflict upon us. This proactive knowledge, with a program
to confront each need as it arises, puts more control of our future in
Taking control of our lives may also be the single most important thing we can do to develop and maintain our own mental well-being. Being in control silences helplessness and despair, the true foes of age.
It’s important to know that while we will slow down, functionally we won’t be much different mentally in 30 years than we are now. We have no more reason to fear instant insanity or sudden senility than we do to expect our hands to suddenly turn green.
Senior mental health isn’t an oxymoron nor do all consider aging as synonymous with mental decrepitude. In China, where age is honored, the elderly perform much higher on tests than their American counterparts.
Granted, some seniors are dithering, bewildered, and uncertain who or where they are, but most of those are very old and or very sick—and some aren’t seniors at all! A third of us will function as well as ever at least into our 80s, and almost all of the rest will follow a slow, predictable path of sanity at a slower pace through our second lives.
As we saw earlier in Chapter 1, we will lose the ability to perform some mental exercises quickly. We will perform simple tasks slower, and worse if they are complex or we are surprised. (Some of that has nothing to do with the mind. We are stiffer and more afraid to do them wrong.) Our short-term memory will get poorer and we won’t be able to skunk the young in such things as typing and list memorization. And in times of severe stress or major loss, we might mentally freeze up for a while. It sounds awful but we will persevere.
We’ll do so because the tests that measure those dwindling capacities don’t test all of the experiential knowledge and skills we gathered, including the pesky ability of older people to improvise, compensate, and unconsciously create tricks to be able to think and function just as fast (or nearly so) as our younger counterparts. Other tests show that other kinds of memory, like the procedural memory of how to play golf or swim, aren’t touched by age at all.
It wasn’t a total surprise, then, when a test group in Seattle, completing
the same complete battery of tests every seven years, didn’t steadily decline
in their cognitive abilities after they passed 20. In fact, in skills that
counted, they stayed about the same until they were in their 60s. Only
by their 80s were there some areas of significant loss.
Who held up the best? Well educated, middle class, healthy, flexible people. The most important trait? Flexibility. In fact, Dr. K. Warner Schaie, from Penn State, who designed the Seattle Longitudinal Study, found mental flexibility—the willingness to improvise and to try unorthodox ways of doing things—a prime predictor of mental vivacity in the later years. Conversely, the more mentally rigid the person became as they aged and the lower their satisfaction with life, the quicker the deterioration of their intellect.
Schaie identified the three factors most often associated with strong mental function in older age groups to be an above-average level of education, a complex and stimulating lifestyle, and being married to a smart spouse.
Other studies show that we gain in wisdom as we accumulate life experiences
and we also improve in our ability to manage our daily affairs. In fact,
when tested in offering advice about fundamental matters of life, older
people consistently knocked the socks off of their younger counterparts.
Our mental slippage is not due to loss of brain cells, which myth suggests die out 100,000 at a time. Rather, they remain in the brain but become senescent, or dormant, according to Harvard’s Dr. Gerald Fischbach. What’s more important is that there is very little loss in the cortex, where elaborate thinking takes place.
Our best hope now is two-pronged. First, we can stop this loss by helping the neurons survive. Free radicals are part of the problem, but so are stress hormones, which will do damage if elevated for too long. All of us, then, can reduce our stress. And women after menopause can take estrogen, since that helps increase dendrites and regrow cells. The benefit? It will help restore their verbal memory and cognitive performance.
And we can train our brain to learn again. Older brains have an astonishing
ability to rejuvenate themselves, but they do it by rewiring the neurons.
Studies find tutoring can recover all that was lost in the past—it was
still there when retested seven years later! Even the memorization of random
numbers and names. Even to prevent dementia, brain exercise and vigorous
use is recommended.
Our greatest fear is that at some point we will totally lose our mental function. How would we care for ourselves or make life-sustaining decisions? Again, Dr. Mark Williams addresses this:
For most of us this fear of becoming mentally incompetent is groundless. Much harm results from the assumption that all mental functions decline with age. We begin to believe the stereotype, which en-courages us to withdraw and lose our self-esteem. Mental function does not have to decline; the capacity to learn continues through life.
Current studies of the mind and aging show four things we can do to maintain and even increase our brain power almost as long as we live:
(1) Maintain good health and a strong cardiovascular system
(2) Seek intellectual enrichment
(4) Control our lives
Let’s look at each of these to see how they might help us restructure
our activities in our Super Second Life.
There’s no absolute correlation between a sound body and a sound mind although sickness clearly saps energy from and redirects a mind. There is a link, though, between those with heart disease, diabetes, and high blood pressure and mental decline. It’s as likely to be the lifestyles that lead to both the physical and mental im-pairments as the diseases themselves: overeating, inactivity, and stress.
Memory loss is neither inevitable nor untreatable. Harvard neurologists are finding that later in life the brain stops producing a hormone involved in memory. So memory boosters are on the horizon: a dozen other substances are also candidates, including psychoactive drugs that could mimic the missing chemical and reinvigorate the memory.
Keeping us mentally sharp seems as simple as undertaking a variety of
new, enjoyable, challenging activities. That seems to force the brain to
Old rats provided the clue to how this happens. UC. Berkeley’s Dr. Marian Diamond gave toys to some rats, none to others. The neurons of the rats with the new challenge quickly sprouted new connections that enlarged the blood flow to their brains. Brains with more connections have a higher cognitive capacity. They may also resist Alzheimer’s.
There were two more conclusions for humans, since the effect on rats diminished when the novelty wore off and they grew bored. So we too must vary our mental stimuli. And it won’t continue if we don’t “enjoy” the activity.
What might we read here? If we don’t do something at least as exciting after retirement as before, we will lose ground. If we don’t consciously seek something relatively new and agreeable or gratifying, we won’t be keeping our mind refreshed. And if we don’t plan for new and challenging activities, they probably won’t happen.
We saw earlier the benefits of exercise for the body, young or old. It logically follows that the brain, being a bodily organ, would also benefit.
Science has now proven the point. In tests, humans who exercised did better in cognition and mental performance. The exercise increased the blood supply to their brains, elevated the brain’s own chemicals, and brought oxygen and antioxidants. Tests in rats showed the same result: the brains of rats that exercised increased in cognition, learning, and motor skills. Their brains were more active and in better health.
Alas, more is not better. Thirty minutes a day of walking is far better
than no exercise at all. But hours of exercise in older test subjects shows
Why would liking life and being emotionally balanced be just as influential on the aging mind as mental activity? We know that those who suffer from negative emotions like depression, anxiety, and anger score lower than those who find life satisfying.
Dr. Robert Sapolsky, from Stanford, may have the answer. His theory
is that the stress-related release of adrenal hormones bathes neurons in
a dangerous chemical wash that can eventually damage the brain.
An important study published in 1972 by James H. Barrett lets us see how our mental and emotional health is challenged during our second life, and what we can do to preserve our stability and confront the changes. He sees six major regressive tasks confronting the elderly.
(1) accepting and adjusting to a decline in physical health, the onset
of which can be delayed by a good balanced diet, regular check-ups, and
(2) adjusting to a reduction in sexuality, in part related to changes in sex drive and the physical debilitation of their spouse.
(3) readjustment to their dependent-independent pattern of living.
(4) acceptance of a different role in the family.
(5) learning to accept more than they can give.
(6) reorientation to their primary social group.
Are we all subject to these six major changes? If we live long enough, probably. But an independent, well planned life and a supportive family can delay most of them, and make the emotional transition natural and gradual.
Barrett suggests seven compensatory tasks that should help us meet these changes and make a better adjustment in old age.
The first is what this book is all about: develop new leisure time activities to meet changing abilities and financial limitations. We go farther on these pages by helping us identify those financial limitations, abilities, and dreams. We then try to optimally match them so that we can live the best life possible when the expenditure of that energy, ability, and funds makes the most sense.
Learn new work skills. This is particularly important to those who must or want to continue working.
The third, readjust dietary needs, acknowledges that we need a healthy but different diet as we age.
Adjust to changing environments recognizes that aging usually
requires differing housing accommodations, often in new locales.
A hard change is to adjust to the changing mores of society. Every new generation has a new set of rules, music, and standards. Live and let live seems to work best here. We needn’t hum rap music any more than the new set must dance the bunny hop or do the twist.
The sixth says that we must adjust to a new status or role in society. We’re no longer top dogs; others are running the companies, community, and clubs. But we can still be vital participants and even acquire a new, different status through our new activities, if that’s what we want.
The most important may be the seventh: change your individual self-concept. We must find a comfortable new us that will withstand the buffeting winds of a new world. We must be pleased with who we are and which of our values we want to project into our second lives. Again, by defining a Super Second Life and what is important to us, we are defining that self-concept, plus creating the ways we will live it in the years to come.
Joanne M. Schrof’s article in the U.S. News & World Report (Nov. 28, 1994) provides excellent suggestions of what we might do at various stages of our life to stay mentally vital as we age.
* In childhood, eat properly (to avoid nutritional deficits that can permanently impair mental functions), get lots of stimulation (which can increase brain cell connections by as much as 25%), and stay in school.
* In young adulthood, make many friends, find a mentor (to get older adults’ advice), marry someone smarter than you, and take adult courses (but don’t cram).
* In middle age, develop expertise, save money (so you can afford mind-nourishing experiences), achieve your major goals then (so you don’t enter retirement unfulfilled), and avoid burnout.
* After 65, seek new horizons, resist the temptation to settle into a comfy routine, engage the world (do things you believe make a difference in life), take a daily walk, and keep control (helplessness leads to mental apathy and deterioration).
Our biggest danger isn’t loss of mental function but of just giving up, of saying “it’s too late” or “why try?” This is called “disengagement,” and it strikes too often shortly after retirement, when we have fewer interactions with colleagues and they are less rewarding. We’re the odd person out, and the eventual result is withdrawal and isolation. It marches in hand with depression.
Its prevention and cure seem to be the same: finding and maintaining a sense of well-being, a kind of ongoing purposefulness. An examination at our lives, finding them different but acceptable. Good health also helps—plus a positive outlook and a satisfaction with life in general.
Did you ever notice that those seniors who flat-out enjoy life are having most of the fun? And there’s a lot more of them around? And they live to a ripe old age? We might look for a clue there.
Planning our Super Second Life can help too. By forming a future where
we build on those elements we want to share with others, we not only keep
actively involved in continuously creating our own fate, it allows us to
define our future role in work, our family, and our chosen social group.
It’s the antithesis of withdrawal.
Why do we bother to do all of this? Granted, we can slow things down a bit by capping the booze and exercising—even switching from Big Macs to Little Macs. But isn’t the idea to have fun in the second life, not to be forced to count calories and see if Aunt Tess had a bum ticker?
You got it! To have fun; contribute again; contribute differently; find
joy, then spread it to others.
Getting a handle on our health now and taking simple, straightforward steps to retain our vigor and abilities as long as possible is why we need both a baseline and a set of guidelines for future healthy living.
It also helps us better fill in our time pegs so that we realize our dreams when we have the capacity to fully enjoy and accomplish them.
What does that mean?
That if we want to hike 500 miles on the Appalachian Trail and we have an ankle tendon that’s been acting up, we do three things: get the tendon tended to, train up on several shorter weekend treks, and schedule our major hike when we are young and vigorous enough to enjoy it.
Common sense? You’d think so until you talk to every other senior with plans a decade too late to perform.
It means first creating that Super Second Life health maintenance program with our physician. Determining what we must attend to immediately, what must be evaluated, how and when those treatments will take place, which chronic problems we must get under control, and how that affects our activities.
To that we add the changes we are making in our daily lives to make them healthier. And we factor in those things from our family history that may or will require attention in the future, with as many details as we and our doctor can conjure.
All of these factors are projected on a 30-year map to see in which 5-year or 10-year time pegs we will best be able to do the things we want. Some of it is absolute: we can’t hike until the ankle is healed. Some is approximate: we’d like to lose ten pounds before we take part in an Elderhostel dig. Some is indeed common sense: getting our pilot’s license is a sooner rather than later thing, in part because of the family’s propensity to go bat blind as they age. And some is situational: we don’t want to plan much for the next year because of the progressively worsening health of a terminal parent.
So we need this information for our Action Plans explained in Chapter 14.
And we need this information to lead a sensible life at any age. Since
we are mortal and mortals die, we simply need it to live the best we can.
* Barrett, James H., Gerontological Psychology (Thomas,
* Ettinger, Walter H., M.D., and Brenda S. Mitchell, Ph.D., and Steven N. Blair, PED, Fitness After 50 (Cracom Publications, 1996). Sensible.
* Rosenfeld, Isadore, M.D., Live Now Age Later (Warner Books, 1999).
* Rowe, John. W., M.D., and Robert L. Kahn, Ph.D., Successful Aging: The MacArthur Foundation Study (Dell, 1998).
* Williams, Mark E., M.D., The American Geriatrics Society’s Complete Guide to Aging and Health (Harmony Books, 1995). An excellent, no-nonsense guide.
For a list of aging-related health organizations (with address, phone,
and website), please look here.
Your doctor will have his/her own medical chart, but to see the kinds of items usually included, the following sample chart will serve. Please excuse the poor formatting due to HTML limitations.
MEDICAL HEALTH HISTORY QUESTIONNAIRE
NAME __________________________ Age ________ Today’s Date _______________
CURRENT MEDICAL PROBLEMS __________________________________________
OTHER CONCERNS you would like to discuss with the doctor ____________________________________________________________________________
List PRESCRIPTION MEDICINE you now take (include dosage, reason you take it, who prescribed it):________
List OVER-THE-COUNTER MEDICINES, vitamins, and food supplements you take _______________________
ALLERGIES: _______________________________ SENSITIVITIES __________________________________
Do/did you EXERCISE? _______ How much? _______ hrs/wk, # of years? _______ Year you QUIT ___________
Do/did you SMOKE? ______ How much? ______ packs/day ______ # of years ______ Year you QUIT _________
Do/did you DRINK alcohol? _________ How much? _________ drinks/week _________ # of years ____________
Year you QUIT _________ Previous or current problem with alcohol? __________________ AA? ____________
Do/did you use (circle): caffeine Nutrasweet marijuana cocaine chewing tobacco diet pills
Do you wear seat belts? ______ Do you wear sunscreen? __________ Ride a motorcycle/bicycle? ______________
List SURGERIES you have had (include year, surgeon, hospital): _______________________________________
Describe HOSPITALIZATIONS/ILLNESSES not included above (include year, hospital): ____________________________________________________________________________________________
Have you had (circle): migraines hepatitis mono ulcer
bleeding problem blood clots head injury drug addiction gallstones
tuberculosis STDs seizures memory trouble arthritis
psoriasis heart murmur rheumatic fever polio shingles
alcoholism depression mental illness gout hemorrhoids
hearing trouble vision trouble other ________________ ______________
Age at first period _______________ Date of last normal period ___________ # of pregnancies ______________
# of live births __________ # of children living with you ________ birth control method ____________________
Date of last PAP __________________ Done where _________________________________________________
Date of last mammogram ___________ Done where _________________________________________________
Do you have (circle):
irregular periods bad menstrual cramps heavy periods pelvic pain infertility
female trouble hot flashes vaginal dryness vaginal discharge vaginal odor
vaginal itching PMS breast problems abnormal mammogram abnormal PAP smear
List diseases that run in your family _______________________________________________________________
Who in your FAMILY has/had (circle if cause of death and write age of death)
heart disease _________________________________ genetic disorder _________________________________
diabetes _____________________________________ cancer ________________________________________
thyroid disease ________________________________ alcoholism _____________________________________
mental illness _________________________________ arthritis _______________________________________
glaucoma _____________________________________ asthma ________________________________________
allergies ______________________________________ stomach problems _______________________________
tuberculosis ___________________________________ high blood pressure ______________________________
Who lives in your household? ____________________________________________________________________
Where do/did you work? ________________________________________________________________________
Describe your education/upbringing, etc. ___________________________________________________________
How much do you weigh? ______ How much would you like to weigh? _______ Heaviest weight _____________
When was your last:
tetanus shot ________________ flu shot ___________________ EKG _____________________
TB test ____________________ HIV test ___________________ sigmoidoscopy _____________
chest X-ray ________________ pneumonia shot _____________ hepatitis vaccine ____________
rectal exam _______________ blood test _________________
Describe your diet: ____________________________________________________________________________
Describe your skin problems: ___________________________________________________________________
Describe lung and breathing problems: ___________________________________________________________
Describe problems with your stomach, intestines, colon, digestion, bowel movements: ______________________
Describe any urinary trouble: ___________________________________________________________________
Describe sexual concerns: ______________________________________________________________________
Describe any bone, muscle, or joint problems: ______________________________________________________
Describe any hormone problem: _________________________________________________________________
Describe any problems with your thinking, concentration, moods, energy level, interest in life, etc.: __________
Describe problems with strength, sensation, coordination, neurologic function: ____________________________
Anything else? _______________________________________________________________________________
the book: How to Create Your Own Super Second Life:
What Are You Going to Do With Your 30 Extra Years?