Aging Gracefully

Aging GracefullyConnie Marsh MD

Department of Psychiatry and Behavioral Sciences

To get back my youth, I would do anything in the world, except take exercise, get up early, or be

respectable.

Oscar Wilde 1891

Typical American in 2012 Over past 100 years

Stronger Healthier Taller Living 30 years longer

And in the end, it's not the years in your life that counts, but the life in your years.

Abraham Lincoln

Successful Aging

Freedom from disability and disease High cognitive and physical functioning Social engagement

Social and productive activities

Centenarians

Personalities are highly resilient or robust Extraversion Emotional stability Conscientious

“I see the positive side of a situation.”“I keep busy.”

Centenarians

More likely to Not worry or be anxious Rely on religious beliefs and acceptance Take things a day at a time Accept health problems Be open Be less sensitive

In spite of illness, in spite even of the archenemy sorrow, one can remain alive long past the usual

days of disintegration if one is unafraid of change,

insatiable in intellectual curiosity, interested in big things,

happy in small ways.

Edith Wharton

Aging Gracefully

Emotionally Physically Mentally Spiritually

Aging Gracefully Emotionally

The bad news / good news

Personality stays the same over time.


Emotional well being tends to improve in late adulthood

People develop better emotional regulation as a result of life experiences

People choose to be involved in more meaningful goals and activities

Awareness that “life is short”


Ageism

Ageism

“To be over sixty-five in an age like ours is to feel bad even when we feel good.” Useless Unwanted Incompetent Frail

Joan Chittister, The Gift of Years

“It is a pathetic moment in the history of the human condition when the outside world tells us who and what we are—and we start to believe it

ourselves.”

“Ageism is a lie.”

“The only way to counter it, however, is to refuse to allow it to taint our lives.”

Maya Angelou


To name a few Letting goSadnessLimitations

SolitudeLonelinessForgiveness

RegretFearAdjustmentRelationships


Life circumstances that threaten well-beingLoss of social self

Small group of people who provide sense of belonging

Closest, most meaningful relationships


Life circumstances that threaten well-being Constant, unrelenting stress Negative situations that don't allow time for

recovery Ex: chronic disability, caregiving Neurologic pathology


Improve by Increasing social support

Transportation, telephone, computer Maintain control

Shape your environment to achieve your goal Make time for positive experiences

Experience positive emotions every day


Minimize stress and anxiety Set realistic expectations Exercise regularly Prepare ahead Take breaks throughout the day/change your routine Learn to relax and do it regularly Cut back on caffeine Get enough sleep Let yourself laugh Talk about feelings

Gary Small The Memory Bible


Be part of a social organization Spend time with other people every day Maintain ratio of three pleasant activities to one

negative activity Adapt, or adopt a new activity, if enjoyable activity

can no longer be performed at same level Seek help for depressive symptoms Enhance the role of spirituality in your life

Gary Small The Memory Bible


Protective pathway of volunteering Reduces depression, anxiety, stress Increases feelings of usefulness, growth, fulfillment,

self-respect Protects against role loss and social isolation

With passage of time, people are likely to encounter hardships and obstacles. Growth in

wisdom does not depend on what we experience in life, but how we deal with difficult times.

Wise persons see life crises and happiness as two sides of the same coin: living a full life

Depp and Jeste, editors, Successful Cognitive and Emotional Aging

Aging Gracefully Physically

Oldest Marathon Runner?


Fauja Singh age 103 Born in India, lives in Great Britain Completed marathon in Hong Kong February 2013 Started running age 89 Has completed eight 26-mile marathons


Physical activityRelated to decreased morbidity and mortalityPrevents/treats many health conditionsDecreases fall risk, improves recovery of

physical limitationsDecreased risk of dementia


Physical activity Decreased depression and anxiety Higher rates of quality of life Long term physical activity is related to Post-poned disability Longer independent living


Barriers?


American College of Sports Medicine and American Heart Association Guidelines 30 minutes of moderate-intensity aerobic activity 5

days weekly or vigorous 3 days weekly Strength training exercises twice a week 10 minutes of flexibilty work twice weekly Balance training 3 days weekly


Walking Yoga Tai Chi

Gentle mind body exercise appropriate for persons with impairments and physical limitations

Balance, strength, flexibility


Aging Gracefully Cognitively


Michelangelo– Pieta Firenze (The Deposition) age 75– Died age 88, sculpting 3 days before death

Monet– Water Lilies age mid 70s

Picasso– Chicago Picasso age 83– Died age 91


The good news / bad news

Normal aging brain Decreased free recall memory Decreased processing speed Vocabulary and general knowledge unchanged or

improves

forgetfulness


Dementia is NOT normal aging

Dementia risk increases with age


Risk factor for Alzheimer's Dementia which may contribute to up to half the cases Diabetes High blood pressure Obesity Depression Being sedentary Smoking Low education and lack of mental stimulation

The Lancet Neurology

Remember that cognitive changes can sometimes be mitigated by

taking one's time using memory aids having a healthy life style


Engage in cognitively stimulating work

Work or volunteer in something meaningful

Consider yourself a lifelong learner and utilize community resources for continuing education


Take part in intergenerational programsEngage in cognitively stimulation leisure

activities that are novel and challengingcomputer games, Wiiautobiographical writing“brain training” programs

Meditation

Aging Gracefully Spiritually

Joan Chittister The Gift of Years

Age is no impediment to the magnet of life in us.

Life is about becoming more than we are, about being all that we can be.


The spiritual dimension of life gives us the resources to make a long-term evaluation of the nature and meaning of life itself.

As the physical dimension of life diminishes, the spiritual commonly increases.

The last stage of life in not non-life, it is a new stage of life

Spiritual tasks of later lifeEmbracing the blessings of this timeOvercoming the burdens of it



Let go of our fantasies of eternal youth and fears of growing old

Find beauty of what it means to age well

Meaning Joy Transformation Newness Possibility Fulfillment Mystery Freedom Time Wisdom


Deepak Chopra Ageless Body, Timeless Mind

Keys to active mastery


Keys to Active Mastery

Live in the presentTake time to be silent/meditateRelinquish your need for external approvalRelinquish your anger from old hurtsWork on self-knowledgeShed the burden of judgmentReplace fear-motivated behavior with love-

motivated behavior

Share your wisdom


Aging Gracefully

Emotionally Physically Mentally Spiritually

Youth is the gift of nature but age is a

work of art.Stanislaw J. Lee

Readings

Highly recommended Joan Chittister, The Gift of Years, 2008

Might consider Gary Small, The Memory Bible, 2002

“An innovative strategy for keeping your brain young” Heavy stuff

Collin Depp and Dilip Jeste, editors, Successful Cognitive and Emotional Aging, 2010

Aging Gracefully

Documents

social organizationspend

goalmake time

emotionallylife circumstances

late adulthood people

years longerand

emotionallyminimize

chronic disability

small ways