Transcript Notes - KU School of Medicine–Wichita

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
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Typical American in 2012
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Over past 100 years
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Stronger
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Healthier
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Taller
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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
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Freedom from disability and disease
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High cognitive and physical functioning
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Social engagement
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Social and productive activities
Centenarians
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Personalities are highly resilient or robust
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Extraversion
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Emotional stability
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Conscientious
“I see the positive side of a situation.”
“I keep busy.”
Centenarians
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More likely to
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Not worry or be anxious
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Rely on religious beliefs and acceptance
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Take things a day at a time
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Accept health problems
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Be open
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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
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Emotionally
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Physically
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Mentally
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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
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Ageism
Ageism
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“To be over sixty-five in an age like ours is to
feel bad even when we feel good.”
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Useless
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Unwanted
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Incompetent
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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
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Improve by
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Increasing social support
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Maintain control
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Transportation, telephone, computer
Shape your environment to achieve your goal
Make time for positive experiences
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Experience positive emotions every day
Aging Gracefully Emotionally
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Minimize stress and anxiety
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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
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Be part of a social organization
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Spend time with other people every day
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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
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Seek help for depressive symptoms
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Enhance the role of spirituality in your life
Gary Small
The Memory Bible
Aging Gracefully Emotionally
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Protective pathway of volunteering
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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
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Oldest Marathon Runner?
Aging Gracefully Physically
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Fauja Singh age 103
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Born in India, lives in Great Britain
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Completed marathon in Hong Kong February 2013
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Started running age 89
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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
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Barriers?
Aging Gracefully Physically
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American College of Sports Medicine and
American Heart Association Guidelines
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30 minutes of moderate-intensity aerobic activity 5
days weekly or vigorous 3 days weekly
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Strength training exercises twice a week
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10 minutes of flexibilty work twice weekly
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Balance training 3 days weekly
Aging Gracefully Physically
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Walking
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Yoga
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Tai Chi
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Gentle mind body exercise appropriate for persons
with impairments and physical limitations
Balance, strength, flexibility
Aging Gracefully Physically
Aging Gracefully Cognitively
Aging Gracefully Cognitively
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Michelangelo
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Pieta Firenze (The Deposition) age 75
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Died age 88, sculpting 3 days before death
Monet
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Water Lilies age mid 70s
Picasso
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Chicago Picasso age 83
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Died age 91
Aging Gracefully Cognitively
The good news / bad news
Normal aging brain
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Decreased free recall memory
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Decreased processing speed
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Vocabulary and general knowledge unchanged or
improves
forgetfulness
Aging Gracefully Cognitively
Dementia is NOT normal
aging
Dementia risk increases
with age
Aging Gracefully Cognitively
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Risk factor for Alzheimer's Dementia which may
contribute to up to half the cases
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Diabetes
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High blood pressure
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Obesity
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Depression
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Being sedentary
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Smoking
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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
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Meaning
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Joy
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Transformation
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Newness
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Possibility
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Fulfillment
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Mystery
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Freedom
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Time
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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
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Emotionally
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Physically
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Mentally
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Spiritually
Youth is the gift of nature
but age is a work of art.
Stanislaw J. Lee
Readings
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Highly recommended
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Joan Chittister, The Gift of Years, 2008
Might consider
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Gary Small, The Memory Bible, 2002
“An innovative strategy for keeping your brain young”
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Heavy stuff
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Collin Depp and Dilip Jeste, editors, Successful
Cognitive and Emotional Aging, 2010