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A friend of mine in his early 60s recently fell off a shed he was building. The shattered bone and the lengthy rehab would be hard on anyone. Should he expect, though, to return to optimal mental and physical functioning, despite his age? There’s some good news (at least for some of us) from a large national study of over 8,000 adults age 45-85. For this study, researchers Mable Ho and Esme Fuller-Thomson of the University of Toronto focused on those who were over 60 after participating in the three-year study. Their analysis of the data shows that we can put aside our ‘gerascophobia’ (fear of aging) and look forward to many years of optimal health even if we experience a setback related to disease or injury. The secret is how healthy we were before the illness, and our lifestyle choices afterwards.
Their study focused on those whose health improved over the duration of the study, finding plenty of evidence that “old age does not necessarily result in poor physical health, nor is a decline in well-being inevitable.” Instead, what Ho and Fuller-Thomson concluded is that modifiable lifestyle factors like being physically active, maintaining a reasonable body weight, not smoking, getting enough sleep, and being social were actually hedges against decline after illness strikes. In other words, illnesses happen, but decline is not a foregone conclusion.
There are some interesting ideas here. First, our resilience to disease and disorder as we age depends on many different systems (parts of our lives) working well together. Think of these as dominoes standing on end, ready to tumble into each other. Staying fit means we have more energy; a larger network of peer and family relationships keeps us more active and mentally stimulated; and proper weight, diet, and sleep means our body has the resources to recover. Put these together and even if you only manage to secure one or two of these factors in your life, chances are that the others may follow.
The second takeaway is that just because we’re getting older doesn’t mean that a health setback is a fatal blow to our capacity to flourish. With the right effort and a little help from health care providers, family and community, we can still look forward to many years of healthy functioning.
There are a few things to remember, though, if one desires a long and happy life. First, being relatively healthy before an illness makes it much more likely you’ll recover from an illness and do as well or better than you did before. Being depressed or having limitations to participating in daily activities like shopping, or being outdoors are big disadvantages against regaining health after an illness. Likewise, lower income and lower education levels are also associated with poorer health outcomes as we age, perhaps reminding us that with education and income comes access to better health care (like physiotherapy for my friend) and fewer daily hassles that put a burden on our functioning.
Of course, even if money is a problem but we tick the boxes for a solid social network, a positive attitude toward life, and are not overweight or sleeping poorly, we may do just fine after all. That doesn’t mean public health officials should ignore income-related barriers to health care. It just means that the odds are stacked against those with less money achieving optimal health.
