Presented by: Yusra Hussain, MD
Medical Director, Stanford Aging Adult Services
Stanford University Medical Center
- Many health concerns are not a natural part of aging and can be avoided or controlled by smart lifestyle changes
- A healthy lifestyle is one that is rich in social activities, emotional relationships, physical activity, intelligent behavior choices and mental stimulation
- Diet and exercise are the most important tools for maintaining health
- Depression is not a normal part of aging and can be held at bay through social connections and by managing disabilities that induce isolation
The search for longevity goes back millennia-but is the quest a question of mortality or of quality of life? With today’s medical advances, adults are living longer and longer, many of them celebrating good health along with longevity. It’s important to be aware of the many components of aging, including physical health, mental agility and emotional well-being.
There are specific steps that can be taken to prolong good health and delay the onset of illness, said geriatrician Yusra Hussain, MD, medical director of Stanford Aging Adult Services, at a presentation sponsored by the Stanford Health Library. With positive lifestyle habits, plenty of exercise and activities, and strong social support, seniors can look forward to personal fulfillment and a long, healthy life.
“Many of what we consider geriatric conditions-such as incontinence, falls, cognitive decline-are not necessarily a natural part of aging,” she said. “There’s a huge difference between a 70-year-old who is independent and active, and one who is ill.”
Many of the ailments of old age are avoidable-or at least controllable-by making lifestyle changes. About one-half of deaths in the United States are attributable to adaptable risk factors, particularly physical activity. Fewer than half of Americans exercise enough, and 26 percent do no physical activity at all. More than two-thirds of the adult U.S. population is overweight or obese.
So what is a healthy lifestyle? Hussain defined it as one that was rich in social activities, emotional relationships, physical activity, intelligent behavior choices and mental stimulation. “Stay busy, eat well and control risk factors,” she said. She cited several specific areas that affect how we age:
“As we age, our metabolism changes, leading to less muscle mass and more fat,” Hussain said. “We have reduced liver and kidney function. And while we have less brain mass, we actually have more synaptic connections. New research shows there is great malleability in the brain, and new functions can be learned even later in life. I’m very optimistic about this and truly believe we do get wiser as we age.”
These physical changes cause us to eat lesser quantities and also affect how our bodies metabolize medication. Since older people are more likely to be on several prescriptions, it’s important to keep your physician up-to-date on your medications to avoid negative drug interactions.
Even adding a small amount of exercise to your routine shows immense benefit, said Hussain: It lowers the risk of heart disease; delays onset of diabetes; improves blood pressure, functional status and performance; reduces risk of falls and osteoporosis; and enhances mental health and cognitive function.
Choose an aerobic, resistance or balance routine that you can follow for a total of 60 minutes four or five days a week. Use light weights to improve muscle strength, and try to get up to your target heart rate (220 minus your age).
“Exercise is of paramount importance,” she said. “Find something you enjoy, and listen to your body. I see patients all the time who push themselves too hard. Make your body the judge of how much exercise is enough.”
Your diet should be rich in vegetables and fruits, low in simple carbohydrates, fats and cholesterol, and moderate in protein and dairy.
“I have a strong belief against artificial sweeteners, soda and processed food,” Hussain said. If you are eating a healthy diet, you don’t really need supplements.”
The exceptions, she added, include calcium and Vitamin D, since even in California, with its adequate sunshine, many people have a deficiency. Studies have not shown proven benefit to taking folic acid, Vitamin E, antioxidants or co-enzyme Q-10.
“If you do feel the need to take supplements, read the label, use standardized products made in the U.S. or in Europe, and review it with your doctor,” she said. “Be aware of your medications, including herbal supplements. My feeling is, unless your life or well-being depends on it, don’t take it.”
“In general, as we get older we gain weight,” Hussain said. “A little extra weight is actually a good thing because it acts as a reserve when we get ill. That said, there are myriad problems associated with excess weight. I’ve had patients who lost weight, and I literally crossed medical problems off their list.”
Mental exercises have been proven to improve brain health, she said. Data on the potential benefits of medications such as NSAIDs, statins and ginkgo biloba is inconclusive and still being studied.
Frailty is not really a disease but rather a combination of the aging process and a variety of medical problems, including heart conditions, osteoporosis and cognitive decline. Though common, it remains poorly understood: Part of the problem is that it defies exact definition.
Frailty can strongly affect how an elderly person will respond to medical treatment, as well as how long and how well they will live.
“Do not equate frailty with aging,” said Hussain. “Frailty is a syndrome by itself. I believe if we are diligent about screening and overall health, we can avoid this condition. It is not a normal part of aging.”
Depression is associated with reduced levels of the neurotransmitter serotonin, impairing the body’s ability to respond quickly to external situations. Good emotional health involves finding ways to reduce stress and anxiety.
“Depression is not more common in the elderly. The only thing that remains steady in life is your personality,” said Hussain. “You have the same personality at age 86 as you did at age 26. Aging does not cause a change in personality.”
Hearing or vision problems are especially problematic in the elderly because they can affect social interactions and quality of life, leading to depression or isolation. Hussain described a patient who was being screened for dementia because he refused to interact with others; after his hearing was tested, she found his mental abilities were fine-he simply could not hear what was going on.
Other screenings, including tests for cancer, need to be done with a perspective toward quality of life rather than mere survival.
“Personal values affect both the need and the benefit,” she said.
“Make use of home health assessment agencies and LifeLine to keep your home safe,” she said.
About the Speaker
Yusra Hussain, MD, is a clinical instructor of geriatrics and the medical director of Stanford Hospital’s Aging Adult Services, a program designed to meet the unique demands of older adults by providing specialized care and access to resources. The program’s extensive network offers consultations and assessments, assistance with appointments, physician referrals, advocacy, coordination of services, access to community resources, and educational workshops. Hussain received her MD from Hahnemann University in Pennsylvania and has been at Stanford since 2005.
For More Information:
Stanford Aging Adult Services
Stanford Medicine Magazine: Special Issue on Aging
Stanford Center on Longevity