Heathy aging and Health-Related Quality of Life Flashcards
Life Expectancy of gender and age
@ birth = 83 y [85 y (F), 81 y (M)]
1990: 81 F, 77 M
10 y increase from 5 decades ago
Among highest in developed world (#19)
@ age 65: 21.6 y (F), 18.5 y (M) [6y ↑ since 60s]
Current 20 y acceleration period: “Baby-boomers”
If you make it to age 65 your life expectancy goes?
down
@ age 65: 21.6 y (F), 18.5 y (M) [6y ↑ since 60s]
Current 20 y acceleration period: “Baby-boomers”
ratio of old people to kids
2015: 1st time in Cdn history, ≥ 65 y surpassed 0-14 y
2036: 1/4 (25%) Canadians ≥ 65 y (>10M), vs. 14% in 2009
people are likely to live the longest in___
People are likely to live longest in developed countries with state-funded healthcare systems like Japan, Canada, UK, Australia all with average life expectancies > 80 years.
Tiny tax haven of Monaco – notoriously wealthy inhabitants + compulsory state-funded health service – highest life expectancy 89.5 years (93.5 F/85.6 M), 5 years higher than anywhere else on earth. Lowest life expectancies: several African countries 50-55 years.
Percentage of canadian semiors health
6% poor
16% fair
38% good
28% very good
12% excellent
What is Healthy Aging?
Age @ death = 25% genetics/heredity
Non-genetic factors (e.g. lifestyle behaviours) affect development of age-related diseases
“Successful aging”: Within normal aging, extrinsic lifestyle & psychosocial factors can either have a compounding effect on the aging process, or play a neutral or positive role.
Absence of disease & related disability + high cognitive & physical functional capacity + active engagement in life.
“Successful aging”:
implies the inclusion of physical, mental & social health, & the potential for improvement in all of these realms.
“Compression of Morbidity”
Previously: Increased life expectancy viewed as pre-cursor to certain pandemic of disability & ill health
Now: Possibility of good health until very end of life
= Dominant paradigm for healthy aging.
Average life expectancy continues to rise, but
maximum lifespan has not increased – however, onset of morbidity & disability can be postponed, extending adult vitality further into that fixed lifespan & compressing the period of disability to just a brief time before death.
“Compression of Morbidity”
increasing life expectancy, can it be compressed?
With increasing life expectancy, the ideal is that the increase in onset age of morbidity outpaces increases in total life expectancy this creates compression of morbidity at the end of life.
Morbidity cannot be compressed indefinitely – but the possibility exists for a long healthy life, followed by a relatively rapid terminal decline.
Evidence for compressing morbidity
20-year follow-up of Penn University alumni: Among those who were physically active non-smokers with recommended body weight (low risk group), onset of disability was delayed by 10 y, vs. inactive overweight smokers (high risk group)
Age 50+ running club vs. non-running healthy community controls followed for 21 years: Runners developed disability at only 1/4 the rate of non-runners, & onset of disability delayed by 14-16 y in runners group vs. non-runners.
Studies also compared postponement of morbidity (10-16 y) vs. mortality (3-7 y) in these groups proof-of-concept for “compression of morbidity”.
How will you spend your last 10 years? (video)
https://www.youtube.com/watch?v=qNkzVz5Aljk
Summary of healthy aging and compression of morbidity
Healthy aging implies maintenance of physical, mental & social health
The compression of morbidity hypothesis suggests that positive lifestyle factors can help delay morbidity to a greater extent than the increases in life expectancy we have witnessed over many decades
What Changes Occur with Aging?
Decreases in Fitness (VO2max)
Changes in Body Comp (Increased Fat Mass)
Osteoporosis (Decreased Bone Density)
Sarcopenia (Decreased Muscle Mass)
Changes in Brain
(** Many characteristics associated with aging are not due to aging at all, but rather result from the neglect & abuse of our bodies & minds! **)
60 year old Swede commercial (1973):
http://www.youtube.com/watch?v=PMD35tUh-Ek
Changes in Maximal Oxygen Uptake over the Lifespan
8% loss per decade 24-56
12% loss per decade 46-68.5
5.8% loss per decade 41-75
Changes in Body Composition with Aging
age 67 -> age 79 (fatmass increased, skeleral muscle decreased)
Osteoporosis
Abnormal decalcification of bones causing loss of bone density.
Bones are porous & fragile: Break with smaller stress than would occur in healthy (dense) bones.
2 million Canadians: 1 in 4 F, 1 in 8 M > age 50
Common sites of fracture: Hip, vertebrae, wrist
Lowering Your Risk of Osteoporosis
Get adequate calcium
Exercise regularly
Drink alcohol only moderately
Don’t smoke
Let the sunshine in
Benefits of Regular Physical Activity
Greater ability to live independently
Sustained/increased lung capacity
Maintain strength, flexibility, posture, balance
Reduced blood pressure & healthier blood lipids
Protection against osteoporosis, sarcopenia, arthritis, T2D
Better physical & mental health
Increased immune system effectiveness
Better protection from MI, & greater chance of survival
Fewer symptoms of anxiety, depression, dementia
Lower risk of dying from variety of diseases
Maintenance of mental agility & flexibility, response time, memory, hand-eye coordination ** Fluid intelligence **
The Aging Brain
grey matter mass loss
Alzheimer’s Disease:
Progressive neurological disease, not normal aging; begins like normal dementia, can die when lose capacity to regulate elementary body functions: malnutrition, dehydration, infection or heart failure. More common in women: 30% by 85 y.
Issues in Aging: Nutritional Needs
Nutrients Often Lacking:
Folate Magnesium
Vitamins: D, E, B6, B12, C Zinc
Calcium
Issues in Aging: Nutritional Needs reason?
physically not being able to make the food,
not enough momney for supplments
