On Aging

Once again I find myself on the Inpatient service.  When patients are hospitalized for something, it's becoming more and more rare that their Primary Care doctor will follow them in there and take care of them.  That's where we step in.  It's always a busy month for me (70+ hours per week), but it's also given me an interesting view on people.

One lady I met was a 92 year old who was in for some leg pain following a lumbar spine fusion.  That's a pretty decent surgery for anyone, so it tells you something about her function prior to the surgery that they were even willing to do it.  She was just as pleasant as can be, and as sharp as a tack.  Funny, engaging, interesting, and very much with it.

I've also met some people on the other end of the spectrum.  There is a 42 year old with a heart that is only pumping about 1/3 as well as it should, who's had a couple of heart attacks, diabetes, smokes, requiring oxygen...you get the point.  It's amazing to see how people can age so differently.  

By far the saddest part for me isn't how they look, it's how they live their lives.  There is something about the "graceless agers" that is just slow all over.  They don't process as well, they don't understand as well, and when you ask them what they do, they have a hard time coming up with anything other than sitting around and doing nothing.  They often don't have many hobbies other than following something (football, Nascar, etc).  Their minds and bodies have simply gone with the status quo their whole lives. 

The people who are "graceful agers" have something that draws you in.  There is a light and intelligence behind their eyes.  They are engaged in the world around them.  They often volunteer or are plugged into the community somehow.  They often have a hobby or two, and have done interesting things in their lives.  This generation often stayed home with their kids and didn't have a career outside the home, but they found interesting things to keep their minds active.  Overall it's a pleasure to talk with them. 

With these experiences, and more like them, I've been giving a lot of thought to what makes people age well or poorly. Here's my list of what helps people age gracefully

1. Keep your mind active - This means more than doing the daily crossword, a word search, or reading a light novel .  It means doing something that challenges you mentally.  Learning a new language, learning a new skill, learning about a new subject in an in-depth manner, etc.
From a neurological and medical standpoint, if you don't use it you lose it.  Many people are actively learning when they are in college and start a new job, but after a while they get on cruise control with less and less requiring them to be mentally active.  Dust off that old noggin and do something different.

2. Keep physically active - The same lesson applies to muscles as it does to brains; use it or lose it.  Too many people don't push themselves physically.   Any exercise is better than none, and even a little makes a difference, but you should see the people who challenge themselves physically.  They hardly seem to age at all.  If you're going to work out, go for intensity and get your heart rate up to near your max (220 - age = Max heart rate), and lift some weights.  It's very hard to bulk up, so don't worry about that, but doing some dead lifts, squats, presses, and big lifts like these can keep you young for much longer than people have given credit to.

3. Be involved - For most of us that will often be church, but can be a lot more than that as well.  I've found that people are more well-rounded if they have some sort of community involvement and get outside themselves.  Helping others makes us realize what a great big world we live in and how great other people are.  This one is harder to measure in people, but they are just so much nicer if they are involved. 

That's it.  It sounds pretty simple, but humans are lazy.  If we have a chance to sit on the couch and not do something...that's exactly what we'll do.  We need to consciously develop these skills while we are young (or slightly older) and cultivate them throughout our lives. If you don't do this, one by one your current hobbies will drop off and you will do less and less each year.  This is the vision I try to show people.  It's not just that these people die earlier, it's that they lose out on so much in their lives that they could otherwise enjoy.  It sneaks up on them so slowly that they hardly feel it, until one day they realize they can't do thing they enjoy anymore.  I see it every single day in the hospital.