8 great ways to stay healthy and mentally sharp as you age

8 great ways to stay healthy and mentally sharp as you age

Dr. Rachel Pruchno can't tell you where you'll be 20 years from now. But she can tell you how to get there.

"Try walking," she says.

That simple step can start you on the path to successful aging, according to Pruchno, a developmental psychologist at Rowan University. She would know. For the past decade, she's studied more than 5,600 New Jersey residents to understand how they're faring as they age, and what has helped or hurt them along the way.

"The short answer to successful aging is exercise," Pruchno says. "So why don't people do it? It's hard. The challenge is motivation."

Motivation isn't my problem. I have plenty of that. It's been a little more than a year since I lost my mother to dementia. I miss her sorely and the pain of watching her mind wither away still feels raw. As I approach my 60th birthday, I worry about myself, too. I want to know what I can do to protect myself against dementia.

So I went to Rachel Pruchno looking not for inspiration, but for answers, because she has them in abundance. Her work over the past 10 years offers clear, scientifically sound guidance on how to fortify our minds and bodies now for the healthy, active life we hope to enjoy in later years.

Pruchno, director of research at Rowan's New Jersey Institute for Successful Aging, found most of us already have made choices that will bear on our future health. In some cases, we made them years ago. For instance, the participants in her study showed higher rates of healthy aging if they had a college degree. On the other hand, those who smoke, drink heavily or served time in prison at some point in their life were more likely to be in poor health.

But the unhealthy habits of our past don't have to haunt us. "What's more important," Pruchno says, "is the healthy behaviors you have now."

Her research showed that adopting good health habits in middle-age, or even later, can help overcome the negative effects of earlier choices in life. Pruchno says the great equalizer is exercise, but other health habits can make a difference too, including adopting a Mediterranean diet, keeping your weight down and drinking alcohol in moderation. The more health behaviors you engage in, the more likely you are to age successfully, Pruchno found.

Her long-term study, titled "Ongoing Research on Aging in New Jersey: Bettering Opportunities for Wellness in Life" and informally known as the ORANJ BOWL, launched in 2006. It gathered health data from 5,688 residents of New Jersey who were between the ages of 50 and 74 when the study began, and has continued to follow many of them since. "Some 3,500 people are still with us," Pruchno says.

The participants were surveyed in detail about their current well-being, and about their lifestyle and health habits. The study defined successful aging as having few chronic health conditions, being able to live a relatively normal life and experiencing little or no pain. It also had a subjective component, as participants were asked how successfully they think they've aged and how they'd rate their quality of life.

Pruchno found 73 percent of the original respondents to be "successful" agers based on both subjective and objective measures.

That might surprise those who still hold outdated notions that aging inevitably brings feebleness and infirmity. Recent research has exploded that myth. Many older adults continue to enjoy good health and mental sharpness well into their later years, a finding that the ORANJ BOWL study affirmed. "Our findings give credence to characterizations of mid- to late-life as a positive, productive time and help dispel the notion of successful aging as an oxymoron," Pruchno wrote in The Gerentologist.

Some of us are at higher risk for disease in our later years based on family history and genes. But genetic makeup is a minor factor, accounting for only about 25 percent of the individual differences in how we age.

That puts the onus on us. Pruchno says we largely decide what our lives will look like in old age based on the way we're treating our minds and bodies right now.

Her research found that those who aged most successfully were better educated, more likely to be married and more apt to be working or volunteering. They drank alcohol in moderation or not at all. They had a lower body mass index, exercised regularly and were more socially active.

"A sedentary lifestyle is the smoking of yesterday."

All of those factors are important, but I found it telling that as I talked to Pruchno and other experts at the NJ Institute for Successful Aging, every one of them brought up exercise as a crucial element in staying healthy and reducing your risk for dementia later in life.

"The single most important thing people can do for successful aging, short of quitting smoking, is exercise," says Dr. Thomas Cavalieri, dean of Rowan's School of Osteopathic Medicine.

Cavalieri says smoking was an overarching health threat for decades, but with aggressive anti-smoking campaigns, that has gradually changed. In the ORANJ BOWL study, 84 percent of respondents said they didn't smoke. But only 29 percent said they exercise regularly, which Cavalieri finds troubling.

"A sedentary lifestyle is the smoking of yesterday," he says. "It has an impact on heart disease, but also on cognition. What's good for the heart is good for the brain."

Cavalieri says the case for exercise is so compelling that it's changed his own behavior. "Based on more and more data pointing to the tremendous beneficial effects of exercise, I have become more diligent about that," he says. "I take a brisk 30-minute walk with my wife every day. There are not only health benefits to that, it's good for your marriage."

Pruchno is devoted to exercise as well. She wears a Fitbit and monitors it faithfully. "I don't go to sleep until I get my 10,000 steps in," she says.

There's been discussion of late about the best forms of exercise. One recent studysuggests that sustained aerobic exercise, such as jogging, is more beneficial to brain health than interval training or weight-lifting. For her part, Pruchno is exercise agnostic.

"Based on my reading of the literature, it doesn't matter what you do," she says. "Find an exercise that works for you and do it. Try walking. Just do it. Put one foot in front of the other."

If you're already exercising regularly, good for you. But according to the ORANJ BOWL results, here's what's even better for you: combining several healthy habits.

Most studies focus on a single behavior. But Pruchno and colleague Maureen Wilson-Genderson of Virginia Commonwealth University wanted to know how much additional benefit we gain by combining health behaviors. To determine that, they looked at what happened to people who incorporated any of the following, all of which have been linked to successful aging:

  • Exercise
  • Adherence to a Mediterranean diet
  • Maintaining a healthy body mass index (or BMI)
  • Not smoking
  • Drinking in moderation

When people combine health habits, researchers call that "clustering." Most people, it appears, are clusterphobic. Some may combine a couple of health habits, but few cluster three or more. In the ORANJ BOWL study, only 22 percent adhered to at least three of the key health behaviors Pruchno was looking for, and a scant 3 percent adhered to all them.

Still, the more people combined those behaviors, the better they fared. Those who combined two healthy behaviors had slightly better odds of aging successfully. When three behaviors were combined, the odds were noticeably better, and for those who combined four or five factors, the odds improved dramatically.

And even though these particular behaviors are important in preventing dementia, so are other factors that Pruchno identified in her study, including education, volunteering and being socially active. The goal is to incorporate a variety of them into your life.

Looking at my own behavior, I'd say I'm doing so-so. I exercise, I don't smoke and I don't drink. That's good, but now that I fully understand Pruchno's research, it feels inadequate. Especially when I consider what's at stake.

I wouldn't say I'm terrified of dementia. But after living through the hell of what it did to my mother, I have a healthy fear of it. Whatever is in store for me over the next 20 years, I want to face it with a healthy body and an able mind. To improve my chances of that, I need to up my game.

First, while the meals I eat are reasonably healthy, I snack incessantly throughout the day and most of what I shove into my mouth between meals is a nutritionist's nightmare.

And then there's the matter of my weight. Numerous studies have found that obesity in mid-life creates a significant risk for dementia and other chronic diseases. The National Heart, Lung and Blood Institute recommends a BMI in the range of 18.5 to 24.9. According to the institute's BMI calculator, I would need to weigh 188 pounds to be within the normal weight range. That was an eye-opener for me. I haven't weighed under 190 pounds since I was in my 30s, and it's a struggle to keep my weight under 200.

If I'm paying attention to what Pruchno's research shows, I need to get my BMI down, and I need to lay off the junk food and that nightly bowl of ice cream that I crave so much. Those will be hard habits to change, but I'm going to work on it.

At the very least, I have a sense of urgency that eluded me when I was younger. I used to wonder what 60 would look like. I don't have to anymore. It stares back at me every day in the mirror. What I fret about now is what 80 will look like.

Largely, that's up to me, and what I do between now and then. I'm determined to  improve my odds of aging well. If anything I learn and share along the way is beneficial to you, perhaps we can both arrive at 80 more successfully.

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Date Published: Monday, June 13, 2016 - 17:45