A new study has found that today’s older Americans can expect to live an average of two years longer in good health than previous generations. The gains suggest that older people are finding ways to add to the number of years they can live independently, a major goal of the aging population. By adopting a few simple strategies that maximize physical and mental health, most individuals can put off or avoid altogether many of the causes of decline that lead to disability and dependence, an MGH expert says.
The study, an analysis of government data published Sept. 12, 2013 in the American Journal of Public Health, found that today’s seniors also report fewer diseases and less difficulty with everyday ac-tivities such as standing and walking than earlier generations. The researchers theorized that the improvements, which were revealed in data collected over a 30-year period, are most likely associated with advances in the treatment of cardiovascular disease, vision problems, and other health conditions that were once major causes of disability in old age.
“Healthier lifestyle decisions based on greater knowledge about disease prevention may also be a reason for the improvement,” says Anthony P. Weiner, MD, Director of Outpatient Geriatric Psychiatry at Massachusetts General Hospital (MGH). “Of course, there are a number of factors that are outside an individual’s control—such as genetics, medical history, and life circumstances—that can lead to dependency in older age. However, research suggests that paying attention to physical, emotional, and social factors that can be controlled may help protect your health and well-being as you age so that you can re-main self-sufficient for as long as possible. It’s essential to plan for the journey ahead if you wish to pro-long your independence in older age.”
For most older adults, independence involves being able to care for daily needs, exercise control over personal decisions, and continue to engage in meaningful activities and relationships—all of which call for at least a moderate level of physical fitness and mental acuity.
With advancing years, a number of problems may arise that lead to functional decline and greater reliance on others. To avoid these problems, Dr. Weiner suggests six commonsense tactics that emphasize prevention and planning ahead. For details, see the What You Can Do section below.
WHAT YOU CAN DO TO MAINTAIN INDEPENDENCE AS YOU AGE
#1 PRESERVE MOBILITY: Physical decline is a major reason for loss of independence. Research shows that a sedentary lifestyle is often the cause of this decline. Physical inactivity can also lead to impaired cognition: A 2013 study published in the Journal of Alzheimer’s Disease found that a 12-week program of regular moderate exercise reversed memory decline and improved cognitive functioning in older individuals diagnosed with mild cognitive impairment. Suggestion: With your doctor’s approval, engage in a program of regular exercise—at least 30 minutes a day, five days a week—that focuses on strength, balance, endurance, agility and flexibility. Staying fit will help you preserve the ability to perform daily activities essential for independence, such as personal care, shopping, getting in and out of chairs and vehicles, climbing stairs, lifting and carrying objects, and doing simple housework. And since exercise is tied to better cognitive functioning, physical activity can also help keep you mentally sharp.
#2 EAT WELL: Vitamin deficiencies and poor diet are closely linked to mental and physical problems, which can interfere with independence. For example, research published in the April 2013 issue of the Journal of Nutrition, Health and Aging found a close association between frailty and poor nutritional status in older individuals. Study participants who met the criteria for frailty (showing signs of weight loss, low grip strength, slow walking speed, low physical activity, and exhaustion) were likely to be malnourished, and more than 90 percent of those who were malnourished were considered frail or pre-frail. Suggestion: Eat a nour-ishing low-calorie diet, such as the Mediterranean diet, that includes plenty of vitamin-rich fruits and vegetables, nuts, healthy fats such as olive oil, fish, whole grains, and legumes. Adequate nutrition not only helps maintain physical health, but also protects the brain. Research on diet and brain function suggests that people who adhere to a Mediterranean diet are not only physically healthy, but also have better cognitive function, reduced risk of Alzheimer’s disease (AD) and stroke, and lower rates of cognitive decline.
#3 STAY INVOLVED: Staying mentally challenged and socially connected is a prerequisite for good mental health and mental acuity in older age—both important prerequisites for independence. Working into older age may be one way to stay in touch with the world around you. A study presented at the 2013 Alz-heimer’s Association International Conference found that for each additional year that older adults put off retirement from their jobs their risk of developing dementia was reduced by 3.2 percent. Suggestion: Stay involved with rewarding activities and supportive social relationships. To avoid loneliness, that research suggests can double the risk for AD, consider continuing with employment or taking a part-time job, taking classes at a local university, volunteering to help out with family, community, or religious activities, or taking up a challenging new hobby.
#4 MANAGE YOUR MEDICAL CONDITIONS: Medical conditions such as cardiovascular disease, respir-atory problems, diabetes, and other ailments, if left to worsen, might eventually lead to disability. For example, addressing hypertension can reduce your risk for a stroke, and treating sleep disorders and sensory impairments such as vision and hearing loss can help preserve mental alertness. Suggestion: Work closely with your doctor to prevent and treat medical problems that might lead to functional disability. Remember to review your medications periodically with your doctor: Certain medications, such as anticholinergic medications used in sleep aids, allergy drugs, and over-the-counter cold and flu remedies, are associated with greater risk for falls, as well as cognitive decline.
#5 AVOID ACCIDENTS: Accidents of all types, and especially falls and vehicular accidents, are a major cause of dependency in older age. Preventing accidents is vital, especially in older age. Falls in older adults result in injuries that often put an end to independent living. An estimated 1.7 million Americans seek treatment for acute head injuries alone, and three-quarters of these individuals suffer traumatic brain injuries, many of which result in disability and functional decline. Suggestion: To lower your risk for falls and acci-dents, have your driving assessed and eliminate fall hazards such as area rugs and floor-lamp cords in the home. Wear seatbelts when traveling in vehicles, protect your head with a helmet while biking or skating, and seek medical assessment for dizziness or other issues that are affecting your balance.
$6 STAY POSITIVE: Older adults who live on their own often have characteristics that help them remain in-dependent. In addition to establishing a network of social support, maintaining their health, and watching their finances, these individuals often have personal attributes that include self-reliance, a positive attitude toward aging, and a sense of self-efficacy, research suggests. Suggestion: A positive attitude is basic to self-sufficiency. Instead of dwelling on negative issues that you cannot control, try to think about the positive aspects of your life, the things for which you are grateful. A positive attitude can help increase your self-confidence and resilience—the ability to adjust easily to challenges or changes—and reduce levels of stress, which can harm your physical and mental health. Finally, be willing to accept help occasionally. Accepting help from others when you need it allows you the greatest amount of independence over-all.