Aging Well

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A few months ago, Dr. William Frishman, the Dean of Medicine at my former medical school, NY Medical College, wrote a column about aging that I would like to share with you. More and more people are living to their predicted life spans and achieving advanced old age. This is especially true in the U.S. and Japan. Dr. Frishman listed 10 factors that accounted for people living to their genetically determined life-span. The first factor is genetics. A genetic basis for old age has always been present and, throughout history, people have had a maximal life span of about 120 years. Certain markers may predict old age such as elevations in HDL (“good” cholesterol) and family histories of longevity.

Factor #2 is advances in antibiotics, public health, and vaccines. Efforts to improve water and air quality, vaccines, and antibiotics have gone a long way toward reducing infectious diseases as a cause of death, especially in children. Next is advances in the treatment and prevention of cardiovascular disease. This includes better treatment for hypertension, lipid disorders, and smoking, all of which, if untreated, can lead to early heart disease and death. Factor #4 is advances in surgery including better treatment of appendicitis, long bone fractures, coronary artery disease, and cardiac arrhythmias. Dr. Frishman’s fifth factor is eliminating or moderating high-risk behaviors. This is an individual factor and includes modification or elimination of high-risk factors such as cigarette smoking, drug addiction, excessive alcohol consumption, riding a motorcycle, and reckless or impaired driving. Addressing these factors reduces the incidence of premature death, allowing more people to reach their true life-span.

The next factor is family and social support. One doesn’t make it to old age without support from friends and family. As families move apart from each other, more older parents require custodial care in specialized facilities, where outcomes are not always favorable and where older people placed in these facilities may not achieve their true old age. The next factor is eliminating war and poverty. Too many young people have been killed early in life in wars. Sustained peace is a secret to long life. Factor #8 is luck, or if you prefer, divine intervention. Doctors know that a patient’s belief in God will make a difference in their recovery. Over the years I have personally witnessed events in medicine that cannot be explained save for the existence of divine intervention. The next factor is developing healthy habits such as regular exercise, healthy nutrition, flossing your teeth, and maintaining a proper weight. Finally, cultivating optimism in life is important. An optimistic attitude provides a survival advantage over pessimism. Helping depressed patients become more optimistic may prevent hopelessness, which may lead to drug addiction and suicide.

Dr. Frishman is quick to point out that he is not promising immortality, as every living thing eventually dies. But he is pointing out ways to help people find out how to achieve their natural life span.

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