Healthy aging: Living longer and living better

Howard Manly | 1/15/2014, 6:05 a.m.
Improvements in public health and medical treatment have significantly increased life expectancy in the past 60 years. People more frequently ...

Monera  B. Wong, M.D., M.P.H.
Associate Chief, Geriatric Medicine
Massachusetts General Hospital

Monera B. Wong, M.D., M.P.H. Associate Chief, Geriatric Medicine Massachusetts General Hospital

By 2030 — just 16 years away — one-fifth of the U.S. population will be 65 years or older, says the U.S. Census Bureau. This group will look very different from the elders of today; they will be fitter and more ethnically and racially diverse.

Blame it on the baby boomers, the large group of post-war babies born between 1946 and 1964. Also to blame are vast improvements in public health and medical treatment that enable people to live well into their 80s and 90s. Some even top the century mark.

Though there’s no magic pill to slow the aging process, Dr. Monera Wong, associate chief of Geriatric Medicine at Massachusetts General Hospital, makes a good point. “You can’t slow down the process of aging,” she said, “but you can age better.”

There is a big difference in elders of long ago and today. “People are not only living longer, they are living well for longer,” she said. “Disability in the elderly is much less now.”

In 1900 the life expectancy in Massachusetts was 45 years according to Massachusetts Deaths 2010, a publication of the Massachusetts Department of Public Health. Those born in 2010 are expected to live until the age of 81, almost double the number of years.

Unfortunately, what often accompanies extended years is a hike in chronic disease. And it usually comes in pairs or more. As noted by the Centers for Disease Control and Prevention (CDC), two-thirds of older Americans have multiple chronic diseases.

Cataracts may cloud the vision and the hearing doesn’t work quite as well. Gray hairs are commonplace, bones lose density and muscles their strength and flexibility.

There are more troublesome changes as well. Kidneys lose efficiency in removing waste from the bloodstream. Some conditions common in African Americans, such as high blood pressure and diabetes, can damage kidneys even further. Medications can also be harmful.

Incontinence, or loss of control of the bladder, is fairly common. Older men often experience an enlarged prostate, which makes emptying the bladder difficult. Postmenopausal women can experience stress incontinence as the muscles controlling the bladder weaken.

Harder hit is the cardiovascular system — the heart and connecting blood vessels. An older heart becomes a less efficient pump, and the arteries, which carry oxygen-rich blood from the heart to the muscles and organs, become narrow and inelastic, leading to high blood pressure. According to the National Heart, Lung, and Blood Institute, there is a 90 percent chance of developing high blood pressure after the age of 55.

High blood pressure can lead to stroke, heart failure, heart attack and kidney failure — all common in the elderly and blacks as well.

Of principal concern are the brain and nervous system. Memory gets a bit fuzzier; reflexes a little slower. A major fear is Alzheimer’s disease, a chronic, debilitating condition that robs the elderly of not only their memory, but the ability to reason and understand.

The picture may look bleak, but actually, many elders are faring quite well. The State of Aging and Health in America 2013, published by the CDC, has developed report cards on health indicators in four areas: health status, health behavior, preventive care and screening and injuries. The scores range from one to four, one being the best.