A New View of Healthy Aging


Keep a healthy weight, watch your diet, and make sure your blood pressure, blood sugar, cholesterol, and other crucial numbers are in a normal range. That’s what we’ve been told for years are the essentials for good health.

But now a new study published in the Proceedings of the National Academy of Sciences is proposing a new model of health. Under this model, some people who are traditionally considered unhealthy are actually the healthiest people; conversely, many people who would be considered healthy actually have significant underlying issues that increase the chances that they die or become incapacitated within five years.

The study conducted by The University of Chicago took a sample of 3,000 people aged 57 to 85 and posed a list of 54 questions that included mental health, vision, and mobility as well as physical health. The researchers then applied a statistical method called finite mixture modeling to identify six health categories among the population.

The results show the healthiest people, comprising 22 percent of older Americans, actually have obesity and high blood pressure. These people had fewer organ diseases, better mobility, sensory function, and psychological health than others. Other recent studies have suggested that obesity may not be the health problem it is made out to be, and could even protect against some diseases.

The unhealthiest people had uncontrolled diabetes and high blood pressure, who often have difficulty moving and performing daily tasks of living. The study also identified new classes of people who had twice the risk of death or incapacitation within five years. These included people of normal weight who had just one major health problem such as thyroid disease, anemia or ulcers, those who had a broken bone since age 45, and those with psychological issues such as depression or loneliness.

Those with poor mental health, and those who had broken bones after age 45, made up a quarter of the population. Between 14 and 19 percent of people in those classes would likely be dead within five years, compared to 6 to 16 percent of people in generally good health.

The traditional model of healthy aging views illness in terms of failures of specific organs and systems in the body. One problem, according to the researchers, is that multiple systems fail at once when people, especially seniors, get sick. Another problem is that the traditional model doesn’t consider other factors that have a huge impact on physical health such as clear vision and hearing, mobility, and psychological health.

The current, century-old medical model maintains that people stay healthy by avoiding heart disease, high blood pressure, high cholesterol, and high blood sugar. However, the comprehensive model of health and healthy aging includes other factors such as psychological well-being, sensory function, and mobility as essential factors of overall health.

Two-thirds of the population in this age group are considered healthy overall in the current medial model. But under the new view, about half of these people actually have “significant vulnerabilities that affect the chances that they die or become incapacitated within five years,” according to the study.

“At the same time, some people with chronic disease are revealed as having many strengths that lead to their reclassification as quite healthy, with low risks of death and incapacity.”

Cancer caused 24 percent of deaths among people over 55, but “seemed to develop randomly with respect to other organ system diseases,” the researchers said.

According to the researchers, conditions like cancer and high blood pressure, and behaviors like smoking, might not always pose as big a risk of death or incapacitation as certain mental health and sensory issues. Although these are important, other factors like loneliness and poor hearing were better predictors of being dead or incapacitated within five years.

The researchers write, “Health has long been conceived as not just the absence of disease but also the presence of physical, psychological, and social well-being … from a health system perspective, a shift of attention is needed from disease-focused management, such as medications for hypertension or high cholesterol, to overall well-being across many areas.”

“Instead of policies focused on reducing obesity as a much lamented health condition, greater support for reducing loneliness among isolated older adults or restoring sensory functions would be more effective in enhancing health and well-being in the older population,” according to study coauthor Edward Laumann.

The lead author of the study, Martha McClintock, said the findings question the idea that everyone progresses through a series of health states as we age. Instead, she likens aging to a river system: “When we’re young adults or middle aged, we’re pretty much in the same boat, but then with aging the stream splits up (and) we start zigging and zagging on different pathways.”

She suggests older people can use this information to find a healthcare team trained to take a more holistic view of health. They should consider vision, hearing, mobility, and mental health in the context of their overall health. They can also avoid loneliness by becoming more socially active.

This speaker eloquently describes how our mental state affects our well-being.


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