Aging Gracefully Connie 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. Aging Gracefully Emotionally 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” Aging Gracefully Emotionally 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 Aging Gracefully Emotionally To name a few Letting go Sadness Limitations Regret Solitude Fear Loneliness Adjustment Forgiveness Relationships Aging Gracefully Emotionally Life circumstances that threaten well-being Loss of social self Small group of people who provide sense of belonging Closest, most meaningful relationships Aging Gracefully Emotionally Life circumstances that threaten well-being Constant, unrelenting stress Negative situations that don't allow time for recovery Ex: chronic disability, caregiving Neurologic pathology Aging Gracefully Emotionally Improve by Increasing social support Maintain control Transportation, telephone, computer Shape your environment to achieve your goal Make time for positive experiences Experience positive emotions every day Aging Gracefully Emotionally 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 Aging Gracefully Emotionally 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 Aging Gracefully Emotionally 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? Aging Gracefully Physically 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 Aging Gracefully Physically Physical activity Related to decreased morbidity and mortality Prevents/treats many health conditions Decreases fall risk, improves recovery of physical limitations Decreased risk of dementia Aging Gracefully Physically 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 Aging Gracefully Physically Barriers? Aging Gracefully Physically 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 Aging Gracefully Physically Walking Yoga Tai Chi Gentle mind body exercise appropriate for persons with impairments and physical limitations Balance, strength, flexibility Aging Gracefully Physically Aging Gracefully Cognitively 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 Aging Gracefully Cognitively The good news / bad news Normal aging brain Decreased free recall memory Decreased processing speed Vocabulary and general knowledge unchanged or improves forgetfulness Aging Gracefully Cognitively Dementia is NOT normal aging Dementia risk increases with age Aging Gracefully Cognitively 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 Aging Gracefully Cognitively Engage in cognitively stimulating work Work or volunteer in something meaningful Consider yourself a lifelong learner and utilize community resources for continuing education Aging Gracefully Cognitively Take part in intergenerational programs Engage in cognitively stimulation leisure activities that are novel and challenging computer games, Wii autobiographical 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. Aging Gracefully Spiritually 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. Aging Gracefully Spiritually The last stage of life in not non-life, it is a new stage of life Spiritual tasks of later life Embracing the blessings of this time Overcoming the burdens of it Aging Gracefully Spiritually Let go of our fantasies of eternal youth and fears of growing old Find beauty of what it means to age well Aging Gracefully Spiritually Meaning Joy Transformation Newness Possibility Fulfillment Mystery Freedom Time Wisdom Aging Gracefully Spiritually Deepak Chopra Ageless Body, Timeless Mind Keys to active mastery Keys to Active Mastery Live in the present Take time to be silent/meditate Relinquish your need for external approval Relinquish your anger from old hurts Work on self-knowledge Shed the burden of judgment Replace fear-motivated behavior with lovemotivated behavior Aging Gracefully Spiritually 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