Healthy aging:
Americans living longer
In all the talk about health disparities among the races, there is finally a silver lining for African American men and women in Massachusetts.
For men who reach the age of 85, blacks are expected to live an additional nine years, two more than whites. For women, the number is eight more years for blacks and 7.6 years for whites.
Of course, the only problem is making it to 85.
But change is coming.
Dr. Monera B. Wong sees it everyday. A geriatrician at MGH Senior Health, Massachusetts General Hospital’s geriatric medicine unit. Wong attributes the longer life spans of all Americans to not just one thing, but a combination of everything from healthier diets and lifestyles to better medications and medical technologies.
Wong does not make predictions on how long people will live. “Suffice to say,” she quipped, “the numbers keep going up and up and women usually do better by about five years.”
Indeed, America is becoming a “mature” country.
According to Census 2006 Estimates, people aged 65 and above accounted for 36.8 million, or 12.4 percent, of the population, an increase of 9 percent since 1995. A fast-growing part of that group is the 85 and older population, which numbers more than 4 million.
Baby boomers are one reason for the large increase in the number of senior citizens. The number of Americans aged 45 to 64 who will reach 65 within the next 20 years increased by 40 percent this past decade.
African Americans are a growing part of the aged population. In 2006, 18 percent of persons 65 and over were minorities, and of this number, more than 8 percent were black.
There are several reasons for the increase in years — improvement in public health, better understanding of diseases and advances in medications and treatments — to name a few.
The results are very clear. In Massachusetts, for example, those born in 1900 were expected to live to the age of 45, while those born in 2005 had a life expectancy of almost 80.
Esther Williams is 74 years old, and she says, God willing, she will continue to “feel good” for a long time.
For Williams, living long is about “doing things sensibly” and heeding the words of the late comedian Richard Pryor, who once observed in one of his Mudbone routines that people don’t grow old being no fool.
Apocryphal or not, growing old does have its problems. Many of the illnesses and conditions that make up the leading causes of death in this country occur more frequently in the elderly. Heart disease, cancer, stroke, flu and pneumonia are more common in those over the age of 50, and increase in incidence with increasing years.
Time does take a toll.
Wong refers to the “geriatric syndromes” — conditions that commonly afflict older adults.
“Yes, people are living longer,” Wong cautioned, “but people have a lot of other conditions that go along with that.”
The eyes don’t focus and the hearing doesn’t work quite as well. Gray hairs are commonplace, and sexual dysfunction is a reality.
There are more troublesome changes as well. Kidneys lose efficiency in removing waste from the bloodstream. Some conditions common in African Americans, such as high blood pressure and diabetes, can damage kidneys even further. Medications can also be harmful.
Incontinence, or loss of control of the bladder, is fairly common. Older men often experience an enlarged prostate, which makes emptying the bladder difficult. Postmenopausal women can experience stress incontinence as the muscles controlling the bladder weaken.
Harder hit is the cardiovascular system — the heart and connecting blood vessels. An older heart becomes a less efficient pump, and the arteries, which carry oxygen-rich blood from the heart to the muscles and organs, become narrow and inelastic, leading to high blood pressure. According to the National Heart, Lung, and Blood Institute, there is a 90 percent chance of developing high blood pressure after the age of 55.
High blood pressure can lead to stroke, heart failure, heart attack and kidney failure — all common in the elderly and blacks as well.
Of principal concern are the brain and nervous system. Memory gets a bit fuzzier; reflexes a little slower. A major fear is Alzheimer’s disease, a chronic, debilitating condition that strikes the elderly.
The good news, however, is that poor health is not an inevitable consequence of aging. A healthy lifestyle can keep many of the changes at bay. Even better news is that it’s never too late to adopt the triad for healthy living — smoking cessation, healthy eating and weight control, and exercise.
The risk of heart disease drops almost immediately after smokers quit. Eating a variety of fruits, vegetables and whole grains can improve nutrition. Choosing foods low in trans and saturated fats, sugar and salt can minimize the dangers of cardiovascular disease and obesity.
According to recent studies, exercise not only helps the heart, muscles and bones by increasing blood flow throughout the body, it has also been found to keep the mind sharp and improve memory.
Although 30 minutes of exercise most days of the week are recommended, it is not necessary to fulfill the time requirement in one session. It can be broken up into 10-minute segments.
Old age is no excuse to stop getting regular screenings. Unless directed by a doctor, seniors should continue regular exams for breast, gynecological, prostate and colorectal cancers. Tests should also continue for chronic conditions like high blood pressure, high cholesterol and diabetes, which lead to cardiovascular diseases.
With one glaring exception, Williams is no stranger to leading a healthy lifestyle.
She walks four miles a day — two in the morning and two in the afternoon with her dog Coco — and is a member of a walking club called “Shangri-La” that was formed by the Colorado Street Citizens’ Group. She has also completed the 20-mile “Walk for Hunger,” sponsored by Project Bread. She likes yoga, and is part of a bowling league.
Williams said she cooks all her food from scratch. She does not eat frozen foods at all. She checks ingredients in the foods she buys for trans fat and salt.
For someone who rarely visited a doctor, Williams is remarkably healthy. A self-proclaimed naturalist, she never took drugs of any kind, including aspirin. All of that changed last August, when she was having trouble with her vision in her right eye.
When she went to the eye doctor, she told him that she hadn’t seen a primary care physician in years. The eye doctor made her find one and set up an appointment. She did, and was later diagnosed with high blood pressure and high cholesterol. She is on medication for those conditions.
She still remains cautious about medications. “I ask a lot of questions,” she said. “I always look at the medications for side effects. If something makes me dizzy, I’ll ask if there is an alternative drug that I can take.”
Her one unhealthy behavior, surprisingly, is smoking. Like most smokers, she wants to quit, and has taken significant steps in reducing the number of cigarettes she smokes from 15 a day to about five or six.
Because she doesn’t believe in taking what she considers to be unnecessary medicines, she is trying to quit on her own.
She has asked God for strength and set a quitting date: New Year’s Eve. “Hopefully, I’ll be able to say goodbye to smoking,” she said.
If she does, the chances are even greater that she might celebrate her 85th birthday.
And no telling how long after that. |
(top) Esther Williams (right) is a reading coach for Generations Incorporated, a nonprofit organization that connects Boston residents 55 and older with children who need help in reading and mathematics. Here, Williams is coaching Elise Santiago. Lera Shawver photo
(bottom) Esther Williams works with Fatima Sillah on her reading skills. Lera Shawver photo |
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Monera B. Wong, M.D., Geriatrician
MGH Senior Health
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