The Secret to Power Aging
What do an 86-year-old theologian, an 87-year-old marathon runner and a 103-year-old rheumatologist have in common? The key to longevity.
Dr. Ephraim P. Engleman is often asked for his advice. The American rheumatologist, who heads up a prestigious research centre at the University of California, San Francisco (UCSF), will turn 104 in the spring. A common query: “What’s the best way to stay as cheerfully, productively, healthily above ground as you?” “Choose your parents wisely,” he quips back.
Like many jokes, it contains a grain of truth. Genes matter. But they’re not the whole story, or even most of it. Scientists say longevity is around 30 per cent DNA and 70 per cent other factors, including lifestyle choices and psychological strategies.
We now have reams of data from longitudinal studies, twin studies and analyses of “super-seniors” who inhabit the world’s so-called “Blue Zones” (pockets where healthy centenarians thrive). To boil down all the wisdom found therein to one word seems folly, but here goes:
Humans need to be challenged. Continually. You could say “super-aging” is about finding ways to grow, even into our advanced years, to offset the forces of nature trying to diminish us.
The principle applies in all dimensions of our lives, even the ones not easily measured by heart tests or brain scans. Wisdom, character, spirit-whatever these qualities actually are, they anneal in the fire of “just-manageable difficulty,” no less than a marathoner’s cardiovascular system or a chess grandmaster’s frontal cortex. People who find ways to live on what the 12th-century mystic Hildegard of Bingen called the “green, growing edge,” in all they do, are youthful-no matter what their birth certificate says.
Betty Jean “BJ” McHugh is 87 years old. She is the fastest marathon runner on the planet in her age group by an astonishing margin: during the 2012 Honolulu Marathon, she crossed the line in five hours 14 minutes, smashing the old record by nearly half an hour. Since her first road race at age 51, the sprite-like mother of four from North Vancouver has set more than 30 world records.
Older runners are no rare sight in big-city marathons, but there comes an age point-around 80-where the numbers drop right off. Not coincidentally, it’s around the same point that human athletic performance craters. For reasons scientists can’t quite pinpoint, the body starts wearing down in double time. Muscle mass falls sharply. Lungs lose their elasticity. Mitochondria-those tiny power plants in our cells-degrade. Bones thin. Balance falters. Anyone who has found a way to stay youthful in the face of this formidable headwind-the McHughs of the world-seems mystical.
So what’s the secret?
For starters, the very exercise that becomes such a struggle when we age. The marathons McHugh runs now are far harder than the first one she ran three decades ago, even though she’s slowed the pace significantly. Round about Kilometre 24, “there’s a little war going on in my mind,” says McHugh, laughing. It takes a mighty will not to stop and walk.
The good news: for most of us, walking is more than fine. National health associations in both Canada and the United States recommend 150 minutes of brisk walking-or its equivalent-a week. While some studies maintain that working up a sweat delivers outsized benefits, the secret is finding an exercise you will actually continue to do, one that is pitched at a level that’s challenging but not overwhelming. Most sports-medicine experts also recommend adding resistance training as we grow older-to strengthen bones, help prevent falls and combat frailty.
After her morning run, McHugh will peel away from the tight company of her training group and pop into a yoga class. There is a level of productive restlessness about her-and that shark-like need for constant motion may be as important a key as the exercise training itself. What McHugh doesn’t do with her body is park it for long stretches. The television never comes on before the six o’clock news. She prefers walking to driving, even to her bridge games, which are up to five kilometres away.
Increasing evidence suggests we need to just move around as much as we need to exercise. Joan Vernikos, the former director of life sciences at NASA and godmother of “sedentary studies,” suggests the single best exercise we can do, bang for buck, is standing up frequently. Again, it’s about challenging the body-in this case, with gravity. And standing up repeatedly maintains circulation by keeping blood-pressure sensors in tune. With moving comes energy, and with energy comes-in McHugh’s case-the mojo to be a role model.
“One day out running, I saw a truck pull over,” she recalls. “This guy got out and said, ‘You’re BJ McHugh, aren’t you?'” She recognized him. Two decades prior, he’d stopped her as she was finishing a long run and asked her age. He’d looked rough then, but this time he was beaming. He said, “I’ve changed my whole life around, and I’ve qualified for Boston.”
Ephraim engleman rarely takes on new patients and has begun to feel obliged to suggest to his regulars, “Perhaps the time has come that you ought to think of getting another doctor.” No, thanks, they say: they’ll stick with him. Experience and wisdom are things you can’t just Google.
Likely the oldest practising physician in America, Engleman enjoys dispensing dry witticisms, eyes twinkling under stork’s nest brows. He recently renewed his driver’s licence (“So I’m good now until at least 105”), but in a nod to his family’s wishes, he sometimes lets a driver take him the 30 kilometres to work at the Rosalind Russell/Ephraim P. Engleman Rheumatology Research Center at UCSF, of which he is founding director. Once there, he answers correspondence, consults with colleagues, sees patients, and just generally bucks the odds surrounding aging and cognition.
The chance of an individual getting dementia doubles about every five years beyond age 65. Of those lucky enough to reach 100, only 15 to 25 per cent arrive with all their marbles. The brain of the average 90-year-old is about the same size as the brain of the average three-year-old: typically the shrinkage comes in the frontal cortex and the hippocampus, headquarters of planning and memory filing, respectively. Some very old folks whose wetware is still high-functioning owe much to what brain scientists call “cognitive reserve”-a backup system that keeps the brain humming even as senescence sets in.
Cognitive reserve is the key to aging well from the neck up. There are a few ways to build it.
You exercise, preferably vigorously. Which Engleman doesn’t. (“I don’t even do the walking I used to do,” he says, because of increasing back trouble.)
You keep the brain continually challenged with reading, writing, blogging, puzzling, bridge playing, travelling, language learning, storytelling. The more interventions you pile on, the better, as the benefits seem to compound. “The principle of synergy-you know, one plus one equals three-has been shown time and time again to forestall dementia,” says Richard S. Isaacson, director of the Alzheimer’s Prevention Clinic at New York-Presbyterian/Weill Cornell Medical Center. “Having more brain activities is good for the backup system.” When the brain encounters novelty, it’s forced to adapt. Neurogenesis, the hatching of new grey-matter cells, has no known age limit. So not only can you teach an old dog new tricks, it’s essential if you want that dog to stay sharp. (Engleman, among other non-work-related diversions, emcees at a local social club-and writes his own material.)
You go to school: education levels correlate with cognitive performance. Then you keep going to school, even when you’re out of school. Lifetime intellectual enrichment seems to delay the onset of cognitive impairment by three to eight years, notes Prashanthi Vemuri, the lead researcher of a new study out of the Mayo Clinic in Rochester, Minn., published in the journal JAMA Neurology.
So far, so good for Engleman. But he may have a secret weapon on his side, as well: music.
Engleman is a former violin prodigy. He put himself through school partly by playing in a vaudeville orchestra. He still jams with a chamber quartet once a week in his San Mateo, Calif., home, where he lives with his 99-year-old wife, Jean. “Playing music,” he says, “is a real stimulus-and very, very good for the soul.”
The science bears out his statement-the first part, at least. Isaacson rattles off six studies that have helped build the case. In one of them, four weeks of music therapy increased the level of neurotransmitters in the bloodstream of Alzheimer’s patients. He was so persuaded by the data that he picked up his guitar again-and now plays bass in a band of neuroscientists. They’re called The Regenerates.
In the French village of Trosly-Breuil, just north of Paris, 86-year-old Jean Vanier lives a simple life. Each day, he walks from his house to the group home he established 50 years ago, where he eats, laughs and prays with his adopted family. This is the first L’Arche community. Founded on Vanier’s vision, the organization is built around the idea that if adults with mental disabilities were settled in private homes alongside non-disabled people, the result would be a boon to both sides.
The son of former Canadian governor general Georges Vanier, he had once seemed destined for a different kind of life. Having written his PhD dissertation on Aristotle, he briefly taught philosophy at the University of Toronto. But there was a spiritual curiosity in Vanier that academia couldn’t satisfy, and he followed
his mentor, a Dominican priest named Father Thomas Philippe, to France, taking on a life of voluntary poverty and daily challenge. It irks Vanier when people call him, as many are inclined to, a living saint. The sacrifice he made is no sacrifice at all, he insists, since the disabled offer us a great gift: they teach us how to become human. More generally, having to accommodate the wishes and quirks and demands of others tests our patience and, in the bargain, strengthens it. Would he be the person he is now had he remained on that earlier trajectory? “God knows,” Vanier says. “All I know is I’m here now. I have grown. I still have things to grow into-to have fewer barriers, to be more open to people. The story’s not finished. I’m 86, but the story goes on.”
Unlike physical and cognitive aging, there is no identifiable point where people start to break down spiritually-and no reliable prescription if it happens. Studies have found that those who attend religious ceremonies live longer, although who can say if the active ingredient is the spiritual part and not, say, the routine or the power of social networks.
We tend to think of spirituality in terms of meditation or perhaps prayer, a private inward journey. To Vanier, that is only half the story. A second current nudges us in the opposite direction, out of ourselves and into meaningful contact with others. In effect, at a phase of life when many people start closing themselves off, Vanier counsels opening up. Instead of spending our later years cementing our own comfort within tiny tribes, we should be reaching out. In what one could call an adaptation response of the soul, empathy begets empathy.
In his Grant Study, which began in 1938 and followed a group of male undergraduates from Harvard for the rest of their lives, psychiatrist George Vaillant found that the ones who thrived into old age were the ones who, among other things, figured out how to love and be loved.
If there is a reliable prescription for aging well cordially-from the heart-it’s this: keep the company of people you care about and who care about you. “It was the capacity for intimate relationships that predicted flourishing,” Vaillant noted.
It’s tempting to prop up BJ McHugh, Ephraim Engleman and Jean Vanier in their respective shop windows as models of brilliant aging of the body, brain and soul. But the ways in which people age brilliantly aren’t mutually exclusive. Indeed, these three-as with spectacularly robust old men and women of all stripes-have a fair bit in common.
All have a strong sense of purpose that propels them out of bed every morning. And the drive is directed outward: all three were drawn to helping professions (McHugh is a retired nurse). When Howard S. Friedman, a professor of psychology at the University of California, Riverside, was crunching the data for the Longevity Project-a study that was published in book form in 2011 and followed more than 1,500 American children to their dotage or their grave-he discovered a pattern: the hardest workers had the longest lives.
And so we return to the old formula: strive, adapt, live on. The kites that remain in the sky the longest are pinned there by resistance.
Bruce Grierson is the author of What Makes Olga Run? The Mystery of the 90-Something Track Star and What She Can Teach Us About Living Longer, Happier Lives.