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Make the golden years golden

November 22, 2009 12:36 am

AS I RATTLE inexorably toward old age, my patients make me see the need for some kind of planning.

There are Mrs. A and her husband, who are effectively housebound by her stroke. There's Mrs. B., who is depressed from having to relocate in old age to a place where she knows no one. And there's Mr. C, with his Alzheimer's. Perhaps even more distressed is his wife, who frets over him incessantly.

The golden years can be pretty leaden without a little planning.

I'm not sure that in a single column I can give you a detailed prescription for managing old age. But I do want to share some pointers on how you can move more gracefully into your later years.

Much of the advice is the same old stuff: Eat right, exercise, don't indulge in unhealthy habits such as smoking, drinking too much, doing drugs, etc.

But probably most basic of all is the need to educate yourself--to make the effort to seek out the information you need to know.

You also need to implement all this advice you gather, and early. If you apply it only when you are already "golden," it may be too late.

PUTTING THINGS IN PLACE

Dr. Andrew Weil--that also aging, white-bearded guru of all things natural--has written a good book called "Healthy Aging: A Lifelong Guide to Your Well-Being."

In it, Weil notes: "Old people often torment themselves with three general concerns: (1) They don't want to suffer; (2) They don't want to be a burden to others; (3) They want the remainder of their lives to be meaningful."

Another point he makes is to forget all the nostrums and strategies to prolong life. Rather, accept the number of years you have been allocated, and do your best to stay healthy until it is time to fall off your perch.

Not everything you need to consider is strictly medical, though. Gearing up for old age means thinking about things such as estate planning, retirement and pension plans, life insurance, long-term-care insurance and health insurance.

Where you are going to live--and how you are going to cope with what comes your way--also are essential things to consider, though not strictly medical.

Estate planning and wealth management often get more attention from people looking to prepare for their old age than do the immediate health issues-- I guess because they are a marketable commodity.

The one item I would urge you to pay attention to is an advance directive/living will. This kind of document gives invaluable guidance to any caregiver and is most likely to help you achieve the first goal Weil mentions--of not suffering.

EAT THE RIGHT FATS

The general principle of diet for a healthy old age is the same as at any age. Avoid obesity and high cholesterol with an anti-inflammatory, Mediterranean-style diet, which emphasizes eating lots of fruits, vegetables and healthy fats.

It's the same kind of diet that is promoted for preventing heart disease and diabetes. Studies show insulin resistance (which is part of diabetes) correlates with a shorter, less-healthy life.

So, eat more omega-3 fats (found in things like fatty fish and walnuts) and fewer omega-6 fats (found in things like eggs and poultry). Eat more low-glycemic-index carbohydrates, things like brown rice and whole-grain bread. Also get lots of fiber, and eat protein more from vegetables than from animals.

Many experts recommend multivitamins and some dietary supplements to boost antioxidants and micronutrients--things like anthrocyanins and carotenoids. Calcium and vitamin D also are of particular importance for bone health in the elderly.

LEAD AN ACTIVE LIFE

Rather than pay gym fees and exercise only parts of your body with some repetitive workout, it's a lot smarter to lead a life where your activities of daily living give you a workout.

Abandon all those labor-saving devices. Push-mow the lawn, for example. Bike to the shops, take the stairs, split logs by hand.

"Walking is the overall best exercise," says Weil, director of the Program in Integrative Medicine at the University of Arizona

Studies have shown that muscle mass correlates with not ending up in a nursing home. And a study by the Institute of Pacific Health in Honolulu showed grip strength correlates with longevity, "suggesting the better-built organism lasts longer."

This same study--measuring the demographics of middle-aged men to see what correlated with extreme survival--noted that the most profound factor was education.

"Higher-educated people appear to fare better," the researchers reported.

They also noted that men who had a marital partner survived longer (or, dare I say it, maybe it just felt like it).

BODY, MIND AND SPIRIT

More than cancer and heart disease, the one thing people live in dread of is Alzheimer's disease, which "attacks the essence of an individual," wrote Weil.

It's the connections between neurons that seem crucial here--and education enhances those connections. You can foster this by using your brain.

Read, do crosswords or sudoku, go to plays or lectures. Learn a new computer program or a foreign language, says Weil. Maybe write articles for the local newspaper?

The Alzheimer's Society also emphasizes the importance of diet--of antioxidants and omega-3 oils in particular--and avoiding obesity.

Another factor relevant to your cognitive and emotional health is stress reduction. Learn breathing exercises, meditation, yoga or tai chi--which also are good for flexibility and balance.

Or try other cognitive behavioral maneuvers, such as re-framing the way you see things, to change your response to stress.

The golden years are meant to be a reward for busting your butt all your life. It is a dismal shame if you are too unhealthy to enjoy them.

Dr. Patrick Neustatter is a family practitioner in North Stafford. He can be reached at
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