Healthy aging

Issue: BCMJ, vol. 61 , No. 8 , October 2019 , Pages 310 President's Comment
Dr Kathleen Ross
Dr Kathleen Ross

“Aging is an extraordinary process where you become the person you always should have been.”
—David Bowie

Aging is an inevitable part of life. Each of us deals with the changes brought on by life differently—some embrace them, while others fight them, seeing them as a herald of physical or cognitive limitations and challenges. No matter your view, we can all agree that aging is unavoidable.

The experience of aging is an individual journey. How we achieve healthy aging is of popular interest, particularly as it relates to “aging in place” initiatives across the country aimed at supporting seniors who wish to remain in their homes.

There are definitely a number of factors out of our control that contribute to aging, such as genetics and the presence of multiple medical conditions. However, diet and exercise also play important roles in the experience of aging well, and we do have control over these factors. Maintaining our mental health and limiting our substance use are increasingly being explored as contributors to overall body health and wellness.[1]

The most graciously aging person I know is my dance teacher who at 83 years of age is still dancing the hula on stage with her aging dance group. Her smile is bright and welcoming. Her arthritic hands are gracious and evoke emotion and meaning with each motion. Her knee range isn’t the same as it was 8 years ago before she was hit by a car, and her back doesn’t move as well as it did before she fell and broke three vertebrae last winter, but there she is on stage, in her flowing dress, smiling and entertaining us all. It would never occur to her to stop dancing; it has been her life. Compare this with a patient of the same age with diabetes, hypertension, chronic renal disease, and arthritis. His idea of exercise is walking from his chair to the fridge and back, his best friends are his TV remote and reclining chair, and he continues to make poor food choices. These individuals have different expectations and attitudes on aging.

So what can we as individual practitioners do to encourage active healthy aging in our patients? I would argue that making time to begin the conversation is a first step. A healthy diet really does make a difference to disease development, but also to weight and muscle mass maintenance. Regular exercise, as little as 4400 steps a day, can help increase life expectancy.[2] Exercise in general improves our mental health and contributes to control of or even elimination of a variety of chronic diseases and improves frailty.[3] If we, as trusted advisors, consistently incorporated diet and exercise questions into each patient encounter, and consistently shared the message that these vitals are as important as heart rate and blood pressure, we could shift patient expectations and motivate even the most at-risk patients to effect meaningful change one step at a time.

As our population demographic ages we should highlight the benefits of healthy aging. Society is beginning to recognize the limiting effects of agism. We need to shift the dialogue on aging from a vision of fading into the sunset to an active maintenance program akin to properly maintaining a vintage car. It is just too easy to park the body out back, enjoy the easy life, and let the grass grow over the tires.
—Kathleen Ross, MD
Doctors of BC President


References

1.    Centers for Disease Control and Prevention. The state of mental health and aging in America. Accessed 23 August 2019. www.cdc.gov/aging/agingdata/data-portal/mental-health.html.

2.    Lee I-M, Shiroma EJ, Kamada M. Association of step volume and intensity with all-cause mortality in older women. JAMA Intern Med 2019;179:1105-1112.

3.    BC Guidelines. Resource guide for older adults and caregivers (2017). Accessed 23 August 2019. www2.gov.bc.ca/assets/gov/health/practitioner-pro/bc-guidelines/frailty-patientguide.pdf.

Kathleen Ross, MD. Healthy aging. BCMJ, Vol. 61, No. 8, October, 2019, Page(s) 310 - President's Comment.



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