MedCity Influencers

Aging Gracefully – Part 1 The Normal Aging Process

It is possible to slow the aging process. No there is no Fountain of Youth and no, there is no pill that’s been discovered. It’s all about lifestyle and this means starting at an early age and sticking with it through the years. I was recently invited to give a talk to a group of […]

It is possible to slow the aging process. No there is no Fountain of Youth and no, there is no pill that’s been discovered. It’s all about lifestyle and this means starting at an early age and sticking with it through the years.

I was recently invited to give a talk to a group of about 100 individuals contemplating moving to a continuing care retirement community. The topic – is it possible to slow the aging process? I titled it “Aging Gracefully.” Here are my thoughts divided into three major categories: the normal aging process, (in posts to follow) slowing the aging process, and  obtaining the very best comprehensive health care. The talk was picked up by the Howard Times of the Baltimore Sun; the reporter’s article is available at this link: http://bsun.md/1AtQW7E

“Old parts wear out.” That’s normal aging. It’s universal, it’s progressive and, at least as we know it today, it is irreversible. Most organ functions decline by about 1% per year. Fortunately our organs have a huge redundancy and so we can afford the declines without illness. But eventually if we live long enough and the process continues at the usual rate a point is reached at which functional impairment or actual disease presents.

Let’s use bone mineral density and cognitive function as examples. During our childhood and teenage years our bone mineral density increases and with it our bone strength. It reaches a peak at about age 20 and plateaus and then by age 35 starts a slow but inexorable decline of about 1% per year. Should we live long enough we will reach a point which we can call the “fracture threshold” meaning that if we fall it’s possible to break a leg or a bone in our back. Of course that 1% decline per year is an average. Some people decline faster and some people decline more slowly. We’ll come back to that point. The same goes for cognitive function. We’re at a peak at about age 20 and then there is a long plateau with a slow decline such that by the time we’re in our 80’s or 90’s most people have some noticeable decline in cognition.
There are certain impairments that come with aging such as reduced vision, reduced hearing and reduced mobility. We might not consider these as true diseases. However there is also an increased prevalence of chronic illnesses such as heart failure, cancer, chronic lung and kidney disease and diabetes. They often manifest in older ages but they actually originated many years ago. For example coronary artery plaque buildup begins in childhood but may not manifest itself as a heart attack until the late 60’s. Similarly lung cancer is on average diagnosed at age 72 but the cause began way back as a teenager when the person first went back behind the garage for a smoke. (BTW, not all lung cancers are due to smoking but for those that are, it was a long slow process over time.)
These chronic illnesses are largely due to our adverse behaviors, our lifestyles. The four big behaviors that need to be addressed are nutrition, exercise, chronic stress and tobacco. We could add other factors but especially inadequate dental hygiene and excessive alcohol. All too many of us have poor nutrition (e.g. packaged and processed foods, lack of fresh fruits and vegetables, etc.) and at the same time we eat too much of it. Most Americans don’t get an adequate amount of exercise. It seems that everyone has some level of chronic stress and 20% of Americans smoke.
To summarize, there is a normal aging process wherein organs reduce their function by about 1% per year. This rate of decline is related, in part, to our lifestyles beginning when we are quite young. There are also age-prevalent chronic diseases that are also life style driven. Our personal agendas need to include attention to healthy living so that we can preserve wellness.
Next time – Slowing the Aging Process
Stephen C Schimpff, MD is  former CEO of the University of Maryland Medical Center, senior advisor to Sage Growth Partners and is the author of The Future of Health Care Delivery- Why It Must Change and How It Will Affect You