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Make your golden years rosy

It's never too late to reap the benefits of new lifestyle

Tuesday, September 22, 1998

By Sharon Voas, Post-Gazette Staff Writer

Helen Denham is aging well.

 
  Helen Denham of Highland Park is 70 and keeps fit through activities like gardening and mowing her lawn. (Robert J. Pavuchak, Post-Gazette)

At 70, the retired secretary mows her own lawn, gardens and climbs a step ladder to paint and wallpaper her six-room house in Highland Park. She attends low-impact aerobics classes religiously on Tuesdays and Thursdays, line dances on Fridays and volunteers at the Greater Pittsburgh Community Food Bank once a month with friends from her aerobics classes.

When she was diagnosed with osteoporosis last year, she started lifting light weights - and has the nicely defined biceps to show for it. When the level of triglycerides, a dietary fat, in her blood hit dangerously high levels, she cut the fat in her diet to 15 to 20 percent until it plummeted to a healthy level. After smoking off and on for 50 years, she quit last month.

Although we associate aging with frailty, dysfunction and illness, it doesn't have to be that way, as Denham shows. We hold a great deal of control over the quality of our older years.

The frailty of old age can largely be reversed. Many of the illnesses and problems we associate with aging are not the inevitable result of aging but of lifestyle - years of bad habits like smoking, eating fat-laden diets, being overweight and avoiding exercise.

In other words, it's never too late to shake off bad habits and reap the benefits of a healthy lifestyle.

"We are, in large part, responsible for our own old age," said Dr. John Rowe, president of Mount Sinai Hospital and School of Medicine in New York City and co-author of "Successful Aging." "We can make a very significant difference in our health status late in life - and it's never too late."

"Successful Aging" summarizes the results of the MacArthur Studies - dozens of studies led by 16 prestigious researchers into how people can age best. Rowe and co-author Robert Kahn, a University of Michigan professor of psychology and public health, who together led the decade of research, wrote a prescription for living good old days based on the research.

They found that remaining productive and engaged in activities, with an active social life, are essential to good health. Active involvement with life and people builds self-esteem, supplies support and understanding and wards off the loneliness and depression that devastate so many older people.

The key to aging well, in combination with those, is exercise.

Even older people who smoke or have high blood pressure are at lower risk of death than nonsmoking couch potatoes. And even people in their 80s and 90s who have never exercised before and have health problems can become more fit, and as a result, live longer and better, according to the MacArthur Studies and other research.

Consuming sufficient calcium and vitamin D cuts the risk of osteoporosis and crippling bone fractures regardless of age. B vitamins folate and B-6 can reduce the risk of heart disease and vitamin E supplements can protect against heart disease. A baby aspirin a day appears to cut the risk of heart attack and stroke, and post-menopausal hormone therapy reduces a woman's risk of osteoporosis and heart disease.

Exercise, a healthy diet, quitting smoking, losing weight, controlling high blood pressure and high blood sugar and taking the right medications significantly reduce the risk of heart disease and cancer. They also substantially decrease the risk of strokes, the most common cause of the loss of ability to care for one's self, osteoporosis, which can lead to crippling fractures, and falls, which can be life-threatening in the elderly. Regular physicals and screening for breast, colon and prostate cancer cut the risk of the most common causes of cancer death after lung cancer, research shows.


The predisposition myth

Although people often say they know they won't live past 60 because no one in their family does, we are not preset by our genes to live out a certain life span or die of certain diseases.

"People feel they're just playing out their deck of cards: I'm going to die at 65 because every male in my family has," Rowe said in a recent telephone interview. "People must be more proactive about their lifestyle."

The MacArthur Studies research on fraternal and identical twins in Sweden who were raised apart found that in all but the most strongly predetermined genetic diseases, such as Huntington's disease, lifestyle and environment have a more powerful impact than genes on the chance of developing the disorder. Diet, exercise and medications can delay or eliminate the onset of some cancers, heart disease, hypertension and many other conditions, even for people with strong family histories of those diseases.

"The bottom line is very clear: with rare exceptions, only about 30 percent of physical aging can be blamed on genes," the authors wrote.

Often, older people believe that after decades of bad habits, what they've lost is gone forever.

"I've had older people say to me: Tell my son. I've already smoked millions of cigarettes," Rowe said.

Smoking raises the risk of coronary heart disease, stroke, lung cancer and other potentially fatal illnesses. A pack-a-day smoker is four times more likely than a nonsmoker to have coronary heart disease. But the risk of heart disease and stroke begin to drop rapidly soon after you quit smoking. And, within five years, an ex-smoker isn't any more likely to have heart disease than a person who never smoked.

"... the good effects of quitting smoking hold regardless of age, the number of years one has smoked or how heavy the habit," the authors wrote.

Unfortunately, the risk of developing lung cancer doesn't drop to that of someone who has never smoked until 15 years after quitting. Although lung cancer is what smokers fear most, smoking raises the risk for a plague of other ailments, including emphysema, and quitting reduces those risks.

"Forget about cancer, when I'm 70, I don't want to be attached to an oxygen tank," said Dr. Cynthia Rosenberg, chief of the geriatrics division at the Western Pennsylvania Hospital and medical director of the West Penn-Vintage Community Care Center for Seniors.

"If you smoke, you're not breathing well, so you don't feel as good, and it affects the circulation to your legs," she said. "Most people begin to start feeling better when they quit."


Restoring fitness

Rowe says his patients often say: "Doc, I've been a couch potato for so many years, I can't possibly get back in shape."

But research has proven even people in their 90s can get in better shape after years of sloth.

Light weight-lifting builds muscle mass that is lost as people age, building strength and setting the base for doing cardiovascular exercises. Weight-bearing exercises, such as walking and low-impact aerobics increase cardiovascular fitness. Both help prevent and reverse osteoporosis.

"The facts are that exercise dramatically increases physical fitness, muscle size and strength in older individuals," the authors say. "Besides rejuvenating muscles, resistance exercises (pumping iron) also enhance bone strength, limiting the risk of osteoporosis and fractures of the hip, spine and wrist.

"Exercise also improves balance, thereby decreasing the risk of falling, a common and life-threatening problem in older persons."

"Moderate exercise provides almost as many benefits, if not as many, as strenuous exercise," Rowe said. "You need about 100 minutes a week and you can budget it anyway you want - 15 minutes now, 20 minutes tomorrow."

For all the good exercise can do, it can do more harm than good if older people try to start pumping iron or even doing something so seemingly harmless as walking, without the help of a trainer or exercise class, said Steven Zelicoff, exercise physiologist and director of the Center for Health Promotion in Shadyside. Older people often have bad feet and balance problems that could cause a fall if they start walking for exercise.

"The sheer repetitive nature of walking can be dangerous to joints that are 70 years old. So pick a couple of exercises and rotate - walk and ride a stationary bike, walk and swim," Zelicoff said.

"An older adult exerciser needs to be much, much more cautious about his training and nutrition and hydration patterns than an elite younger athlete," he said.

Senior citizen centers, community centers, private health clubs and YMCAs and YWCAs offer fitness classes specifically designed for older people.

Although diseases such as heart disease, high blood pressure and arthritis are common among older people, they don't have to get in the way of a full life. Regardless of your age or how long your list of diseases, what's important is how well you take care of yourself to function at your highest level possible.

After all, if you were told someone is a 75-year-old man, who has had a heart attack and has hypertension and diabetes, you wouldn't be able to say whether he's sitting on the U.S. Supreme Court or in a nursing home.

"As far as aging, you've got to stay active," said Denham, the active Highland Park woman. Nobody's going to come to your house and ask you to come out. You've got to go out on your own.

"I feel good."



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