Latest news with #geriatricmedicine
The Guardian
18-07-2025
- Health
- The Guardian
I'm an expert on ageing. Here's what I know about thriving in later life
Anyone who says 'age is just a number' has not reached the high numbers. Ageing is not easy, and 'forever young' is not a plan. Regardless of how many burpees you can do or protein smoothies you chug, the passing of time brings challenges. Roles that you relished change, words on menus seem to shrink, necks sag, diagnoses arise. On the other hand, ageing is not the downhill slide that people believe it is. A multibillion-dollar antiageing industry profits when you feel awful about yourself and fear ageing like the plague. The tragedy of ageing is not that we will all grow old and die, but that ageing has been made unnecessarily, and at times excruciatingly, painful and humiliating. Ageing does not have to be this way. I taught geriatric medicine and gerontology for 19 years at the University of California, Irvine school of medicine. At UCI's senior health center, I had a front-row seat to observe people, and their families, navigate old age. What struck me most was the radical differences in how people experienced their own ageing process. For some, it is a frustrating, degrading, painful trajectory of ever-increasing decline. For others, there is visible delight, spirituality, and joy in occupying their eighth, ninth, and 10th decades. When it comes to longevity, the primary focus has been lifespan, the length of life. More recently though, the scope has expanded beyond years of life to years of life in good health, or healthspan. This is a welcome shift, because we all want to live as healthy as possible for as long as possible. But there's a catch. A long life, even a long life in good health, doesn't mean much if you don't like your life. As geriatrician Dr Louise Aronson observes: 'We've added a couple of decades, essentially an entire generation, onto our lives, and we haven't figured out how to handle that.' To thrive in old age means to live a fulfilling, purposeful and satisfying life despite the challenges that accompany ageing. It involves maximizing physical health, cognitive function, emotional wellbeing, social connections, and a sense of meaning. Thriving doesn't mean being free of all health problems or challenges; rather, it emphasizes resilience, adaptability, and the ability to find joy and value in life. People don't thrive in longevity by mistake or luck. People who thrive in longevity actively maximize the quality of their lives. But how? I scoured the findings of 35 years of empirical testing on psychological wellbeing in longevity. The deeper I dug into the findings, the more I recognized a profound underlying pattern. The hundreds of predictors found in thousands of studies on what is necessary to thrive in longevity consistently group into four essential elements. Grow: They continue to expand and explore. Connect: They put time into new and existing relationships. Adapt: They adjust to changing and challenging situations. Give: They share themselves. Each of these elements is non-negotiable for wellbeing in longevity, and you can improve in each area. What we've been missing is a practical vocabulary and approach to maximizing the quality of our long lives. It's not enough to have a long lifespan and healthspan; we want what I call a long joyspan. Joyspan, or the experience of wellbeing and satisfaction in longevity, matters because without it, long life is a drag. The American Psychological Association defines joy as the feeling that arises from a sense of wellbeing or satisfaction. Experiencing joy is different from feeling happy. Happiness comes and goes and is often dependent on external circumstances. Joy can be experienced even in adverse situations. More akin to contentment than to ecstasy, joy may show up in the form of a smile, but many times it does not. You cannot always ascertain someone's joy by observing them. One older woman looking at the trees through her window may be lonely and miserable, while a different older woman looking at the same trees may be experiencing great joy. Regardless of your current age, you hold one of two mindsets: ageing as decline or ageing as continued growth. The decline mindset believes everything gets worse as you grow older and then you die. Sadly, this mindset is the most prevalent. The growth mindset sees ageing as a time of continued progress in becoming who you are. This mindset recognizes not only the challenges and losses of growing older but also the opportunities and strengths. Take my neighbor Dee, who is 81. A few days ago, I saw her on her front porch while I was walking the dogs, and she waved me over so she could tell me all about her sore hands, the 'absolute drivel' on TV, and how bad the hot weather makes her feel. Because Dee sees her life as a downward free fall, she's stopped showing up for it. She does not pursue her former interests, reach out to friends, or challenge herself. The long hours spent in her recliner have seriously weakened her legs, which she blames on the curse of being old. Our conversations never have room for topics beyond her discomfort. Despite our many conversations, Dee doesn't know anything about me other than the fact that I have two golden retrievers. There isn't any space for me to share my life, because her life, as miserable as she finds it, is the topic that dominates her mind. Dee definitely holds a decline mindset. I often run into another neighbor, Joan, who walks the same loop I do. I absolutely love it when I run into Joan. She is 82 and just radiant. Soon after our middle daughter was diagnosed with a brain tumor, I saw Joan and she noticed right away that something was off. She asked me what was going on in a way that felt safe for me to share. She listened intensely, then suggested ways to adjust to this 'new normal'. Joan has had so many new normals. Always very interested in something – a new plant she's potted, a new recipe, an interesting book, an upcoming art exhibit – Joan has a growth mindset. Growing older is about, well, growing, about becoming. Joan knows that interior strengths can continue to develop throughout life. I once told Joan how much I admire her attitude, and she laughed, saying: 'I find life fascinating. I'm still growing now, just as I have in every other phase of my life.' This is an adapted excerpt from Joyspan by Dr Kerry Burnight. For 18 years, she taught geriatric medicine and gerontology at the University of California, Irvine school of medicine. Used with permission from Worthy Books, a division of Hachette Book Group, Inc.
The Guardian
18-07-2025
- Health
- The Guardian
I'm an expert on ageing. Here's what I know about thriving in later life
Anyone who says 'age is just a number' has not reached the high numbers. Ageing is not easy, and 'forever young' is not a plan. Regardless of how many burpees you can do or protein smoothies you chug, the passing of time brings challenges. Roles that you relished change, words on menus seem to shrink, necks sag, diagnoses arise. On the other hand, ageing is not the downhill slide that people believe it is. A multibillion-dollar antiageing industry profits when you feel awful about yourself and fear ageing like the plague. The tragedy of ageing is not that we will all grow old and die, but that ageing has been made unnecessarily, and at times excruciatingly, painful and humiliating. Ageing does not have to be this way. I taught geriatric medicine and gerontology for 19 years at the University of California, Irvine school of medicine. At UCI's senior health center, I had a front-row seat to observe people, and their families, navigate old age. What struck me most was the radical differences in how people experienced their own ageing process. For some, it is a frustrating, degrading, painful trajectory of ever-increasing decline. For others, there is visible delight, spirituality, and joy in occupying their eighth, ninth, and 10th decades. When it comes to longevity, the primary focus has been lifespan, the length of life. More recently though, the scope has expanded beyond years of life to years of life in good health, or healthspan. This is a welcome shift, because we all want to live as healthy as possible for as long as possible. But there's a catch. A long life, even a long life in good health, doesn't mean much if you don't like your life. As geriatrician Dr Louise Aronson observes: 'We've added a couple of decades, essentially an entire generation, onto our lives, and we haven't figured out how to handle that.' To thrive in old age means to live a fulfilling, purposeful and satisfying life despite the challenges that accompany ageing. It involves maximizing physical health, cognitive function, emotional wellbeing, social connections, and a sense of meaning. Thriving doesn't mean being free of all health problems or challenges; rather, it emphasizes resilience, adaptability, and the ability to find joy and value in life. People don't thrive in longevity by mistake or luck. People who thrive in longevity actively maximize the quality of their lives. But how? I scoured the findings of 35 years of empirical testing on psychological wellbeing in longevity. The deeper I dug into the findings, the more I recognized a profound underlying pattern. The hundreds of predictors found in thousands of studies on what is necessary to thrive in longevity consistently group into four essential elements. Grow: They continue to expand and explore. Connect: They put time into new and existing relationships. Adapt: They adjust to changing and challenging situations. Give: They share themselves. Each of these elements is non-negotiable for wellbeing in longevity, and you can improve in each area. What we've been missing is a practical vocabulary and approach to maximizing the quality of our long lives. It's not enough to have a long lifespan and healthspan; we want what I call a long joyspan. Joyspan, or the experience of wellbeing and satisfaction in longevity, matters because without it, long life is a drag. The American Psychological Association defines joy as the feeling that arises from a sense of wellbeing or satisfaction. Experiencing joy is different from feeling happy. Happiness comes and goes and is often dependent on external circumstances. Joy can be experienced even in adverse situations. More akin to contentment than to ecstasy, joy may show up in the form of a smile, but many times it does not. You cannot always ascertain someone's joy by observing them. One older woman looking at the trees through her window may be lonely and miserable, while a different older woman looking at the same trees may be experiencing great joy. Regardless of your current age, you hold one of two mindsets: ageing as decline or ageing as continued growth. The decline mindset believes everything gets worse as you grow older and then you die. Sadly, this mindset is the most prevalent. The growth mindset sees ageing as a time of continued progress in becoming who you are. This mindset recognizes not only the challenges and losses of growing older but also the opportunities and strengths. Take my neighbor Dee, who is 81. A few days ago, I saw her on her front porch while I was walking the dogs, and she waved me over so she could tell me all about her sore hands, the 'absolute drivel' on TV, and how bad the hot weather makes her feel. Because Dee sees her life as a downward free fall, she's stopped showing up for it. She does not pursue her former interests, reach out to friends, or challenge herself. The long hours spent in her recliner have seriously weakened her legs, which she blames on the curse of being old. Our conversations never have room for topics beyond her discomfort. Despite our many conversations, Dee doesn't know anything about me other than the fact that I have two golden retrievers. There isn't any space for me to share my life, because her life, as miserable as she finds it, is the topic that dominates her mind. Dee definitely holds a decline mindset. I often run into another neighbor, Joan, who walks the same loop I do. I absolutely love it when I run into Joan. She is 82 and just radiant. Soon after our middle daughter was diagnosed with a brain tumor, I saw Joan and she noticed right away that something was off. She asked me what was going on in a way that felt safe for me to share. She listened intensely, then suggested ways to adjust to this 'new normal'. Joan has had so many new normals. Always very interested in something – a new plant she's potted, a new recipe, an interesting book, an upcoming art exhibit – Joan has a growth mindset. Growing older is about, well, growing, about becoming. Joan knows that interior strengths can continue to develop throughout life. I once told Joan how much I admire her attitude, and she laughed, saying: 'I find life fascinating. I'm still growing now, just as I have in every other phase of my life.' This is an adapted excerpt from Joyspan by Dr Kerry Burnight. For 18 years, she taught geriatric medicine and gerontology at the University of California, Irvine school of medicine. Used with permission from Worthy Books, a division of Hachette Book Group, Inc.
CNN
24-06-2025
- Health
- CNN
Losing weight in middle age could reduce chronic diseases later, study shows
Sign up for CNN's Fitness, But Better newsletter series. Our seven-part guide will help you ease into a healthy routine, backed by experts. All the work that goes into losing weight in middle age could set you up for a longer, healthier life later, according to a new study. A sustained weight loss of about 6.5% of body weight without medications or surgery in middle-aged people is linked to substantial long-term health benefits, said lead study author Dr. Timo Strandberg, professor of geriatric medicine at the University of Helsinki in Finland. Those benefits included a reduction of risk for both chronic diseases and death from all causes. The study, published Tuesday in the journal JAMA Network Open, analyzed data of about 23,000 people from three different groups across different time periods: one group from 1985 to 1988, another from 1964 to 1973, and a third between 2000 and 2013. Researchers grouped the people in the studies based on their starting body mass index (BMI) and whether they gained, lost or maintained weight and compared the patterns with hospitalizations and death records. People who lost weight in midlife were less likely to experience heart attacks, strokes, cancer, asthma or chronic obstructive pulmonary disease in their older years, according to the study. Those who lost weight were also less likely to have died of any cause over the next 35 years, the study found. It's important to note that much of the data was collected before weight loss medications or surgeries were widely available, meaning that the benefits largely came from body changes driven by alterations in diet and exercise, Strandberg said. The study is important because it provides evidence of the relationship between weight loss and both cardiovascular disease and mortality, which hasn't been studied enough, said Dr. Aayush Visaria, a clinical researcher and incoming instructor of medicine at Rutgers Robert Wood Johnson Medical School in New Jersey. He was not involved in the research. Although the study is strong in that it utilizes a large sample, there are some limitations when applying the results, Visaria said. The study was conducted on White Europeans, meaning that it's difficult to generalize the results to different populations, Strandberg said. 'BMI is very different across different racial ethnic groups,' Visaria said. And BMI, which looks at weight in proportion to height, isn't always the most accurate way to gauge body composition, he added. BMI is still used widely because it is easy to calculate, but it doesn't differentiate based on a person's proportion of bone or muscle, Visaria said. 'There's so many variables that might play into how someone's body composition changes, even though maybe their weight might not change as much,' Visaria said. Other studies suggest that the fat distribution makes a big difference –– the fat around a person's organs may be what really drives a lot of disease risk, he said. Lifestyle changes –– such as a healthy diet and more exercise –– were important factors in the risk reduction. The study was observational, meaning that the data can show a relationship between weight loss and a reduction in chronic disease and mortality risk, but researchers can't say for sure that the weight loss was the factor that lowered the risk, Visaria said. Although the researchers adjusted for other factors that could influence the risk, such as age, they did not adjust for lifestyle behaviors such as diet and physical activity, he added. Those changes could be behind the lowered risk of chronic diseases just as the weight loss itself could be, Visaria said. Both weight loss and the behavioral changes behind it are often tied together in improving health, Strandberg noted. Weight loss relieves conditions such as osteoarthritis, obstructive sleep apnea and fatty liver, while changes to diet and exercise have been shown to decrease cardiovascular risks, he added. Lifestyle is always important when it comes to good health, meaning that you should continue to strive for a healthy diet and good physical activity –– even if you are using weight loss medications, Visaria said. The Mediterranean diet –– which prioritizes fruits, vegetables, grains, olive oil, and nuts and seeds –– has consistently been ranked the best diet for wellness and disease prevention. Studies suggest this way of eating may improve bone density in older years, prevent some cancers and lower risk of heart disease. For physical activity, the World Health Organization recommends that adults engage in at least 150 minutes per week of moderate-intensity or 75 minutes of vigorous-intensity aerobic activity, along with muscle-strengthening activities at least twice a week. However, obesity is not just a problem individuals need to tackle –– it is a structural issue as well, Strandberg said. Healthy foods and opportunities for physical activity need to be more accessible in modern societies to help curb the health impacts associated with obesity, he added.
CNN
27-05-2025
- Health
- CNN
Losing weight in middle age could reduce chronic diseases later, study shows
Sign up for CNN's Fitness, But Better newsletter series. Our seven-part guide will help you ease into a healthy routine, backed by experts. All the work that goes into losing weight in middle age could set you up for a longer, healthier life later, according to a new study. A sustained weight loss of about 6.5% of body weight without medications or surgery in middle-aged people is linked to substantial long-term health benefits, said lead study author Dr. Timo Strandberg, professor of geriatric medicine at the University of Helsinki in Finland. Those benefits included a reduction of risk for both chronic diseases and death from all causes. The study, published Tuesday in the journal JAMA Network Open, analyzed data of about 23,000 people from three different groups across different time periods: one group from 1985 to 1988, another from 1964 to 1973, and a third between 2000 and 2013. Researchers grouped the people in the studies based on their starting body mass index (BMI) and whether they gained, lost or maintained weight and compared the patterns with hospitalizations and death records. People who lost weight in midlife were less likely to experience heart attacks, strokes, cancer, asthma or chronic obstructive pulmonary disease in their older years, according to the study. Those who lost weight were also less likely to have died of any cause over the next 35 years, the study found. It's important to note that much of the data was collected before weight loss medications or surgeries were widely available, meaning that the benefits largely came from body changes driven by alterations in diet and exercise, Strandberg said. The study is important because it provides evidence of the relationship between weight loss and both cardiovascular disease and mortality, which hasn't been studied enough, said Dr. Aayush Visaria, a clinical researcher and incoming instructor of medicine at Rutgers Robert Wood Johnson Medical School in New Jersey. He was not involved in the research. Although the study is strong in that it utilizes a large sample, there are some limitations when applying the results, Visaria said. The study was conducted on White Europeans, meaning that it's difficult to generalize the results to different populations, Strandberg said. 'BMI is very different across different racial ethnic groups,' Visaria said. And BMI, which looks at weight in proportion to height, isn't always the most accurate way to gauge body composition, he added. BMI is still used widely because it is easy to calculate, but it doesn't differentiate based on a person's proportion of bone or muscle, Visaria said. 'There's so many variables that might play into how someone's body composition changes, even though maybe their weight might not change as much,' Visaria said. Other studies suggest that the fat distribution makes a big difference –– the fat around a person's organs may be what really drives a lot of disease risk, he said. Lifestyle changes –– such as a healthy diet and more exercise –– were important factors in the risk reduction. The study was observational, meaning that the data can show a relationship between weight loss and a reduction in chronic disease and mortality risk, but researchers can't say for sure that the weight loss was the factor that lowered the risk, Visaria said. Although the researchers adjusted for other factors that could influence the risk, such as age, they did not adjust for lifestyle behaviors such as diet and physical activity, he added. Those changes could be behind the lowered risk of chronic diseases just as the weight loss itself could be, Visaria said. Both weight loss and the behavioral changes behind it are often tied together in improving health, Strandberg noted. Weight loss relieves conditions such as osteoarthritis, obstructive sleep apnea and fatty liver, while changes to diet and exercise have been shown to decrease cardiovascular risks, he added. Lifestyle is always important when it comes to good health, meaning that you should continue to strive for a healthy diet and good physical activity –– even if you are using weight loss medications, Visaria said. The Mediterranean diet –– which prioritizes fruits, vegetables, grains, olive oil, and nuts and seeds –– has consistently been ranked the best diet for wellness and disease prevention. Studies suggest this way of eating may improve bone density in older years, prevent some cancers and lower risk of heart disease. For physical activity, the World Health Organization recommends that adults engage in at least 150 minutes per week of moderate-intensity or 75 minutes of vigorous-intensity aerobic activity, along with muscle-strengthening activities at least twice a week. However, obesity is not just a problem individuals need to tackle –– it is a structural issue as well, Strandberg said. Healthy foods and opportunities for physical activity need to be more accessible in modern societies to help curb the health impacts associated with obesity, he added.
CNN
27-05-2025
- Health
- CNN
Losing weight in middle age could reduce chronic diseases later, study shows
Sign up for CNN's Fitness, But Better newsletter series. Our seven-part guide will help you ease into a healthy routine, backed by experts. All the work that goes into losing weight in middle age could set you up for a longer, healthier life later, according to a new study. A sustained weight loss of about 6.5% of body weight without medications or surgery in middle-aged people is linked to substantial long-term health benefits, said lead study author Dr. Timo Strandberg, professor of geriatric medicine at the University of Helsinki in Finland. Those benefits included a reduction of risk for both chronic diseases and death from all causes. The study, published Tuesday in the journal JAMA Network Open, analyzed data of about 23,000 people from three different groups across different time periods: one group from 1985 to 1988, another from 1964 to 1973, and a third between 2000 and 2013. Researchers grouped the people in the studies based on their starting body mass index (BMI) and whether they gained, lost or maintained weight and compared the patterns with hospitalizations and death records. People who lost weight in midlife were less likely to experience heart attacks, strokes, cancer, asthma or chronic obstructive pulmonary disease in their older years, according to the study. Those who lost weight were also less likely to have died of any cause over the next 35 years, the study found. It's important to note that much of the data was collected before weight loss medications or surgeries were widely available, meaning that the benefits largely came from body changes driven by alterations in diet and exercise, Strandberg said. The study is important because it provides evidence of the relationship between weight loss and both cardiovascular disease and mortality, which hasn't been studied enough, said Dr. Aayush Visaria, a clinical researcher and incoming instructor of medicine at Rutgers Robert Wood Johnson Medical School in New Jersey. He was not involved in the research. Although the study is strong in that it utilizes a large sample, there are some limitations when applying the results, Visaria said. The study was conducted on White Europeans, meaning that it's difficult to generalize the results to different populations, Strandberg said. 'BMI is very different across different racial ethnic groups,' Visaria said. And BMI, which looks at weight in proportion to height, isn't always the most accurate way to gauge body composition, he added. BMI is still used widely because it is easy to calculate, but it doesn't differentiate based on a person's proportion of bone or muscle, Visaria said. 'There's so many variables that might play into how someone's body composition changes, even though maybe their weight might not change as much,' Visaria said. Other studies suggest that the fat distribution makes a big difference –– the fat around a person's organs may be what really drives a lot of disease risk, he said. Lifestyle changes –– such as a healthy diet and more exercise –– were important factors in the risk reduction. The study was observational, meaning that the data can show a relationship between weight loss and a reduction in chronic disease and mortality risk, but researchers can't say for sure that the weight loss was the factor that lowered the risk, Visaria said. Although the researchers adjusted for other factors that could influence the risk, such as age, they did not adjust for lifestyle behaviors such as diet and physical activity, he added. Those changes could be behind the lowered risk of chronic diseases just as the weight loss itself could be, Visaria said. Both weight loss and the behavioral changes behind it are often tied together in improving health, Strandberg noted. Weight loss relieves conditions such as osteoarthritis, obstructive sleep apnea and fatty liver, while changes to diet and exercise have been shown to decrease cardiovascular risks, he added. Lifestyle is always important when it comes to good health, meaning that you should continue to strive for a healthy diet and good physical activity –– even if you are using weight loss medications, Visaria said. The Mediterranean diet –– which prioritizes fruits, vegetables, grains, olive oil, and nuts and seeds –– has consistently been ranked the best diet for wellness and disease prevention. Studies suggest this way of eating may improve bone density in older years, prevent some cancers and lower risk of heart disease. For physical activity, the World Health Organization recommends that adults engage in at least 150 minutes per week of moderate-intensity or 75 minutes of vigorous-intensity aerobic activity, along with muscle-strengthening activities at least twice a week. However, obesity is not just a problem individuals need to tackle –– it is a structural issue as well, Strandberg said. Healthy foods and opportunities for physical activity need to be more accessible in modern societies to help curb the health impacts associated with obesity, he added.
