Informed Viewpoints On Human Aging: Can Aging be Modified?
I read the daily obituaries in NYT and see something interesting more and more frequently – more and more obituaries have number 100 attached to their names. Indeed, centenarians are the fastest growing segment of US population. I just recently lost one of my oldest patients to Covid; her age was 105. I had operated on her almost 40 years ago; after surgery we communicated over the phone a few times every year. She was always in good spirits, no complaints. I told her that I was grooming her to be the longest living person on our planet. I also told her that my wife and I visited the home of the longest documented lifespan of any human. We joked that since the longest documented lifespan of 122 years and 164 days had been recorded by Mme. Jeanne Calment of Arles, France, who died in 1997, my patient should live to at least to 123. My patient was Italian American, and mostly ate a Mediterranean diet and drank one glass of red wine a day with dinner.
In 2021 there were 573,000 centenarians in the world, 97,000 in the US. The highest percentage of centenarians are in Japan. Women live longer than men, and most centenarians are women. People in big cities live longer than people in rural areas. In the US the highest percentage of centenarians is in New York City. Why? Multiple reasons: people in big cities drive less and move more, they are exposed to less pesticides, and many other factors.
Now, when I speak to my patients, especially the older ones, I ask if they would like to live to be eighty, ninety, one hundred or even beyond. Most of them say yes, they would like to live to be very old but not as a burden to themselves or their family. Yes, they would like to have longevity be free of multiple age-related diseases like Alzheimer, Cancer, Diabetes, and Cardiovascular Disease. They would like compression of morbidity without multiple medications for chronic diseases and years spent in nursing homes. They are especially concerned about Alzheimer and general cognitive decline, mostly just waiting in a nursing home to pass away, no longer even recognizing their family members.
In the US we consume more pills than any other nation on our planet. Pharmaceutical companies are only too happy to provide a pill when simple good advice for healthy lifestyle could suffice. Many times, patients come to the office with the request for specific medications they heard about on TV or read about on some other news media. If the good doctor does not prescribe the specific meds, they go to see another doctor who might be more willing to prescribe it. Of course, for serious age-related illnesses, like cancer, cardiovascular or neurodegenerative diseases, and diabetes, patients should take medication. In doctors’ offices patients should not only get treatment for their disease but also solid advice on how a healthy lifestyle can prevent further medical problems in the future. We have to treat the disease, but prevention is smarter.
The fact is, we are getting chronologically older every day, but biology does not need to follow chronology. In our daily living we can see how some people age very fast and some others not so fast, some can preserve their youthful look into very old age. Are some people simply luckier than others? Biostatisticians would tell us this is not the case. People get luckier with a healthier lifestyle. What is this kind of lifestyle?
All these things are important: What we eat. How much we sleep. Do we exercise? How frequent is our social interaction with family and friends? Do we have a positive attitude– is our glass half full or half empty? For men especially, are they married or single– married men live longer. Do we have some bad habits like smoking or taking drugs? Are we religious– any religion prolongs lifespan; if not religious, then daily meditation can help. One’s educational level matters; the more educated the person is, the longer is his lifespan. The same goes for income level: the higher the income, the longer the lifespan.
But what matters most is our willingness for lifelong learning of new skills. If you don’t have a hobby, find one. It is never too early nor too late to learn new things, like playing a musical instrument, learning a new language. A bilingual brain has better cognition in general, maybe even prevents Alzheimer.
Nutrition, exercise and sleeping are probably among the most important parameters determining our healthy longevity.
Our eating habits matter–what we eat, how much we eat and how fast we eat. If we eat too fast we will eat more; it takes our stomach approximately 30 minutes to send the message to our brain that our stomach is full. If we eat fast, in that half hour we can eat a lot. We don’t need to be vegetarians; we can eat everything we like, only less and slowly. What we should be careful of is the sweets, the less the better. For chocolate lovers, dark chocolate is OK, just don’t overdo it.
Exercise matters as well, not only for physical health but also for augmenting your cognition and emotional well-being. Try to incorporate it into your day, ideally for thirty minutes every day. Any physical activity counts. You don’t need to go to gym, just go for a walk or even walk inside your place if it is too cold outdoors.
Sleeping enough, ideally 7 to 8 hours, is another important part of a healthy lifestyle. If you are older and retired, you can take a nap during the day, ideally after lunch for half an hour, as I do and I love it. Sleeping has numerous health benefits; it improves your immune system, can prevent obesity, stabilizes your blood sugar and blood pressure, and improves your cognition, especially executive functions, like planning and problem solving. Sleeping longer than eight hours can have negative effects, like diabetes and obesity.
The basic science on aging is progressing fast. Scientists have been able to double the life span of some lab animals with certain meds. In the TAME study at Einstein Medical School in the Bronx, Dr. Nir Barzilai is evaluating the effect of Metformin pills, normally used for diabetes treatment, in delaying aging. The final results will be published soon, but some early messages are encouraging that Metformin might prolong our healthy lifespan. Other substances are also being evaluated for prolongation of healthy lifespan. Stay tuned. In the meantime, a smart lifestyle is your best tool to prolong your healthy life.
Dr. Ciril Godec
Dr. Ciril Godec is Professor of Urology at Downstate Medical Center and was chairman of the Department of Urology at Long Island College Hospital for thirty years. He recently retired and is an honorary staff member at Maimonides Medical Center, where he served as Urology Residency Director and later Deputy Director of Urology since 2013.He is also a Board member at Cobble Hill Health Center.
Dr. Godec, who just celebrated his eighty-fifth birthday this past Valentine’s Day, is currently co-authoring his third book, “How to Declare Aging a Disease.”
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