Living to see another day
The biggest cause of disability in older age in our society is inactivity.
Information on healthy ageing is a crowded space with a lot of non-medics weighing in on what’s best for us. What made you write this book?
I wanted to provide accurate information for my patients and their families, and as I wrote more and more, and got better at it, my writing started to reach a wider audience. I wanted to share the science of longevity and help people understand how to apply this to everyday life.
One of the aspects of the book I am most proud of is that I haven’t just explained what we know, I have explained why we know it, including some scientific methodology and research limitations. I hope that people will also be a little more skilled at reading health reporting after reading my book.
What does psychosocial health have to do with frailty?
When I am talking to people about looking after their health, I point out that having a cup of coffee with a good friend or hugging someone you love are also good for our health. Health is not just being in some sort of perfect physical form; the way we feel and our circumstances have a huge influence.
Frailty is a loss of physiological reserve that leaves an individual vulnerable to a significant decline from a seemingly minor insult. Lower socioeconomic status is associated with an earlier onset of frailty. For people who are already frail, having a higher level of social supports can be protective. While some of these are individual factors, this also highlights the importance of measures to end socioeconomic disadvantage and to combat isolation in our society.
What’s the most realistic but neglected advice you would give your readers?
The most important part of ageing is actually living well now. Nutrition, movement, sleep and emotional health are linked with longevity, but even more than that, they are valuable in their own right. If you want to live as long as possible for as well as possible, the best thing to do is start creating health today.
What’s the most unrealistic advice people tend to take?
The supplement aisle at the pharmacy and supermarket are the most unrealistic offers of health. There is very little regulation with the claims the supplement industry are able to make, and there is a lot of false hope that a simple supplement will fix complex problems. I recently saw an advertisement for a herbal stress supplement for women. Most women’s stress is the result of career, family, managing a household, money worries – it is condescending and unrealistic to suggest it will be solved with a pill and takes focus away from evidence-based approaches to buffering stress.
If you could bring about one single intervention that would significantly improve people’s ability to age well, what would it be?
This is like trying to choose my favourite child! Sleep, nutrition, emotional wellbeing are all integral, but if I have to choose one, it would be to get more people doing strength training. The biggest cause of disability in older age in our society is inactivity. As we get older, we have a decline in muscle strength, and the best way to offset this is resistance training. The challenge is that it’s not quite as simple as getting aerobic exercise by going for a walk, it is important to learn to do the exercises properly and to gradually work up to doing harder exercises. Since this is a particular issue for women, I run an online program with an exercise physiologist to help women get started with this kind of training to help people develop the strength that is so essential for enjoying life called Project Three Six Twelve.
What do you want GPs to know?
While women live longer than men, women are also more likely to have chronic health conditions and to need help with activities of daily living in older age. Having two x chromosomes does provide a biological advantage, and may explain why women are better able to fight off infections. Oestrogen also may play a protective role against heart disease. Women are also more likely than men to get dementia, so those extra years of life aren’t necessarily with the quality we would hope for.
Any lessons from the Coronavirus pandemic?
2020 has been a year like no other. This year has brought a new awareness of the social determinants of health and for those of us who are able, we all need to speak up for equality and look at what we are doing in our own lives, particularly for our Aboriginal and Torres Strait Islander communities to ensure that everyone has the opportunity to reach old age.
Dr Kate Gregorevic (Honorary, Department of Medicine, RMH) is the author of Staying Alive: the Science of Living Healthier, Happier, Longer (Pan MacMillan).