Optimal Aging is a concept that is fairly new.  It is a set of ideas about how we age and is a bit more optimistic than some ideas that have been put forward in the past.  I like it because it is very practical and actually places some control in the hands of the individual and in our approach as a society to how we manage the aging process.  You will find that some of the suggestions on how to achieve Optimal Aging are repeated or seem similar as you explore the sections below.  Part of the appeal of these ideas are that they are simple, they are supported by research studies and they just plain make sense.  They are not necessarily easy to carry out but they provide great guideposts.  They are goals to strive for and they help do away with the notion that "good genes" are the main ingredient in aging well.  Genetic influence is always present but only one of many elements responsible for how we age.

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What most of us hope for as we age is a balanced, contented life with the ability to carry out our normal daily activities.  We hope to be able to maintain our dignity and age gracefully.  In reality most of us are able to do this until late old age or until we develop some kind of disease process that accelerates the aging process.  These would include conditions such as diabetes mellitus or heart and blood vessel disease.  Sometimes we prematurely age ourselves by smoking cigarettes, being obese or becoming sedentary.  One of the factors that contributes to the aging process is the loss of what is known as reserve capacity.  We are born with abundant reserve capacity and have the ability to undergo a lot of physical and emotional challenges.  Then, we get back up, brush ourselves off and move on.  As time goes by we seem to be less and less able to bounce back from adversity. Our body organs don't want to cooperate with us and we become discouraged and weakened until finally we succumb to disability and death.

Optimal Aging
is the capacity to function across many domains - physical, functional, cognitive, emotional, social and spiritual - to one's satisfaction and in spite of one's medical conditions.  Plasticity or the characteristic of remaining flexible or "moldable" is the key. 

Most people want a life that is meaningful, fulfilling and relatively independent no matter how old they get.

Optimal Aging takes into account an ecological model for health promotion that recognizes the importance of  individual, social and environmental factors

How we relate to each  other, to our community and to the medical care system may be as big a factor in aging well as the actual diagnoses we live with.

Your doctor can only guide and encourage you to stay healthy.  Your own behaviors are far more important than anything the doctors or nurses say or do.

Public Policy seems to encourage sickness care over preventive and wellness care, causing some of us to wonder if unhealthy behaviors really matter.

As much as 95% of healthcare spending goes to medical care and biomedical research, but lifestyle, health behaviors and the environment are responsible for more than 70% of avoidable mortality. The Institute of Medicine reports that this includes:

• Exercise (strength, flexibility and balance)
• Nutrition (eating a balanced diet, maintaining normal body weight and taking a multivitamin daily)
• Sleep (important in memory consolidation)
• Avoidance of Disease Causing Agents (tobacco, excess alcohol, chronic low level stress such as depression and anxiety)
• Practicing Preventive Medicine (immunizations, good oral care, recommended screenings and diagnostic tests)
• Early treatment of diseases and medical conditions (hypertension, diabetes, etc.)
• Avoidance of physician caused complications (being informed, questioning and advocating for yourself or having someone who can advocate for you)

Determinants of Health

Health Professionals tend to focus on the small but expensive component of disease but traditional medical care plays only a small role in the overall health of a population.

1. Function
2. Disease
3. Social Environment and Support System
4. Physical Environment
5. Genetic Endowment
6. Individual Responses - behavior and biology
7. Health Care System
8. Well-being

More on this later....

Exercises to Promote
Optimal Aging

• Do some form of exercise for 30 minutes a day.
• Never use an elevator or escalator when stairs are available.
• Walk or bike on errands that would take less than 10 minutes to drive.
• Don't use remote control devices.
• Use manual devices when possible (lawn mower, broom).
• Park a long distance from the main door when shopping.

Exercises to Improve Balance

• Engage in exercise that requires balance such as tai chi or dancing.
• While standing in line or cooking, stand on one leg or with your feet in tandem.
• Try heel or toe walking for short distances (10 - 20 feet).
• Stand up and sit down on chairs using one leg with hand support if needed.

Promotion of Optimal
Nutrition

1. Replace saturated and trans fats with unsaturated fats.
2. Substitute whole-grain carbohydrates for refined-grain carbohydrates.
3. Substitute nuts, beans, chicken and fish for red meats.
4. Eat 9 servings per day of fruits and vegetables.
5. Use alcohol in moderation.
6. Take a multivitamin

Promotion of Optimal Cognitive Function

1. Take a multivitamin.
2. Engage in mentally stimulating activities.
3. Remain socially engaged.
4. Exercise regularly.
5. Develop methods to detect and reduce stress (relaxation techniques, soothing music, yoga, meditation).
6. Get adequate sleep.

So what, you may be asking, is the importance of the flexibility that I mentioned earlier.  Even if we do everything we are supposed to, most of us are going to develop some disease processes and acquire some type of disability as we age.  Or, in the past if we have not been diligent about maintaining our health, we can still have a good life by adapting to our circumstances.  Attitude, interactions with those around us and our willingness to forge ahead even in the face of adversity mark the lives of those who are aging optimally.  I will explore these, and other ideas by monthly additions via my free newsletter the LateBloomersGazette.  Get on my mailing list by using the box below.  Past editions of the LateBloomersGazette can be found by clicking here.

My thanks to Dr. Kenneth Brummel-Smith, a long time and well respected Geriatrician, for his articles in The Annals of Long Term Care in 2008 on Optimal Aging.  He has brought the concept to the forefront of other models of aging and I hope I have been able to do justice to his work. - Jean Root, D.O.