June 22, 2017

Healthy aging — building the PATH to resilience

Excerpt from Enlightened Aging: Building Resilience for a Long, Active Life, by Eric B. Larson, MD and Joan DeClaire

The year was 2006 and phones at our research center were ringing non-stop. Journalists from around the world were calling to confirm the news: We had identified a key factor in staving off some of the most feared conditions of aging — Alzheimer’s disease and related dementias.

Our solution: Regular exercise for at least fifteen minutes, three times a week.

“That’s it? Fifteen minutes? Three times a week?” The TV news producer sounded skeptical.

“More activity is better,” I told her. “But our study of seniors showed that even small amounts make a difference. And we found that the more frail a person is, the more he or she may benefit from exercise.”

“So can we interview one of your study participants on Monday?” she asked.

“No problem,” I said. “I’ll introduce you to Evangeline Shuler.”

“Van,” as her friends and family called her, was a delightful, 100-year-old who visited our research clinic every two years for check-ups. Always smiling and sociable with the study team, she was the perfect ambassador for our research. I asked one of our staff to give her a call.

But there was a problem. “That sounds like something I’d like to do,” said Van. “But I’ll be in Buenos Aires on Monday. I’m going to the annual tango festival!”

Intrigued, the news crew changed their schedule to meet Van at our clinic that afternoon. Once there, she was happy to answer all the reporters’ questions. Then she donned her dancing shoes and demonstrated her favorite moves for the television cameras.

Remarkably, Evangeline Shuler lived another seven years after that interview. How do some people achieve this level of vitality as they live into very old age? Is it genetics? Healthy habits? A great attitude? A combination of all these things?

It’s just the kind of question my colleagues at Kaiser Permanente Washington Health Research Institute and the University of Washington have been asking for more than 30 years. By 2016, we had enrolled more than 5,000 participants in the Adult Changes in Thought (ACT) study, documenting more than 40,000 person-years of data. As some participants develop dementia and others don’t, we explore the differences. The result is “a living laboratory” of aging — especially the aging brain.

The knowledge gained from this research gives us optimism and hope for the coming decades. We’re finding ways to help people use the science of healthy aging to have a better quality of life up until its very end.

The PATH to Resilience

If there’s one quality that’s consistent among those who age well and happily, I believe it’s this: Resilience — the capacity to adapt and grow stronger in the face of adversity or stress.

In observing my patients and research subjects, I see people follow three interrelated steps on a PATH to resilience:

  1. Pro-activity: This means taking charge of your own health and happiness by preventing illness and managing chronic conditions that may develop. It also means learning to be a partner with your health care providers, sharing important decisions, and getting care that’s just right for you — i.e., not too little and not too much.
  2. Acceptance: This means knowing change will come with age, which allows you to approach the future with equanimity and mindfulness — in large part by understanding your own values. Research has shown that we generally seek more meaning, fulfillment, and purpose in our lives as we grow older. We want stronger relationships with friends and family. Many of us want to keep contributing to the world through work, volunteerism, and hobbies. And most of us want to stay as independent as possible.
  3. THree reservoirs: Building reserves of well-being in three ways: mentally, physically, and socially. Mental reserves come from building, protecting, and enhancing brain function. Physical reserves are the result of maintaining heart health, bones, muscles, vision, and hearing. And social reserves are built by planning to have the relationships and financial resources needed as you grow older.

By taking this PATH to enlightened aging, perhaps you’ll come to a place where we can just relax and grow very old knowing we are safe, comfortable, and well cared for.

An earlier version of this excerpt was first published in Kaiser Foundation Health Plan of Washington’s blog, Northwest Health.

About Dr. Eric B. Larson and Enlightened Aging

Dr. Eric B. Larson is vice president for research and health care innovation at Kaiser Permanente Washington and executive director of Kaiser Permanente Washington Health Research Institute.

Learn more about Dr. Larson’s book and his approach to enlightened aging, or buy the book now on Amazon.

From Enlightened Aging: Building Resilience for Long, Active Life by Eric B. Larson and Joan DeClaire (Rowman & Littlefield, 2017). All Rights Reserved.