Successful Aging

What is successful aging?

What can you do to achieve it?

Drs. John Rowe and Robert Kahn defined successful aging as the ability to maintain 1) low risk of disease and disease-related disability, 2) high mental and physical function, and 3) active engagement with life. Martha Crowther and colleagues proposed expanding the term to include “maximize positive spirituality” to reflect the fact that a sizeable body of research links religion / spirituality to health and well-being. Stowe and Cooney  argued that Rowe and Kahn neglect early-life experiences, social relationships, and societal structure, all of which affect the life course and lead to wide differences in individuals’ aging process. In their defense, Rowe and Kahn noted that their successful aging model intentionally emphasized healthy lifestyle choices that individuals can make to improve their prospects later in life.

Does evidence support the idea that embracing healthy lifestyle choices matters for the long run? More specifically, does embracing healthy lifestyle choices in midlife increase your Quality of Life Span? Researchers used data from the Honolulu Heart Program and the Honolulu Asia Aging Study to find out. A total of 5,820 men of Japanese American ancestry free of illness and functional impairments at baseline and with an average age of 54 years were followed for up to 40 years (1965 to 2005).

Researchers evaluated risk factors for each participant including overweight, high blood glucose, high triglycerides, hypertension, low grip strength, ever a smoker, high alcohol consumption, low education, and unmarried. All these factors can be modified by healthy lifestyle choices. Researchers defined exceptional survival as living to age 85 with no chronic illness and without cognitive or physical impairment. Fifty-five percent of men with no risk factors were exceptional survivors compared to 9 percent for men with six or more risk factors. Healthy lifestyle choices can increase Quality of Life Span – live better, live longer.

Given the surge of baby boomers in the US, understanding behaviors that promote successful aging should be a public and personal health priority. European researchers used data from the Whitehall II study to address this need. Participants included British civil servants aged 42-53 at the beginning of the study in 1991-1994. For this study, successful aging included good mental, cognitive, and physical health, and lack of disability and chronic diseases. Healthy behaviors included never smoking, moderate alcohol consumption, being physically active, and eating fruits and vegetables daily.

After a median follow-up of 16.3 years, 953 of 5,100 participants (18.7 percent) qualified as aging successfully.  Each of the four healthy behaviors individually predicted significantly higher chance of successful aging, ranging from 29-45 percent. Participants who engaged in all four health behaviors (11.8 percent of 5,100) had 3.3 times greater odds of aging successfully compared to participants with no health behaviors. Thus, the payoff for making these four healthy lifestyle choices can be huge for middle-aged people.

Norwegian researchers investigated lifestyle factors, singly and as a unified concept, as midlife predictors of aging 20 years later. The Nord-Trondelag Health Study (HUNT) provided data for 4,497 participants with a mean age of 52.7 years at baseline and 75.3 years at follow-up an average of 22.6 years later. Successful aging criteria included absence of disease (including depression), high physical and cognitive functioning, and active engagement with life. Lifestyle factors included physical activity, smoking, alcohol consumption, obesity, and social support.

At follow-up, 15.6 percent of the participants met the successful aging criteria. After adjusting for confounders, the characteristics of never or former smoker, moderate to high physical activity, low alcohol consumption, and good social support individually predicted greater odds of successful aging. Individual lifestyle factors predicted different components of successful living. Never smoking and good social support in midlife most powerfully predicted the highest odds of successful aging (74 and 54 percent, respectively) after more than two decades when considering successful aging as a unified concept. Participants who adopted all five positive lifestyle factors at midlife had 3.27 times the chance of achieving successful aging compared to participants who had zero or one healthy lifestyle factor. Wouldn’t it make sense for you to start making healthy lifestyle choices now so you can age successfully?

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