The FINANCIAL — Many factors influence healthy aging. Some of these, such as genetics, are not in our control. Others — like exercise, a healthy diet, going to the doctor regularly, and taking care of our mental health — are within our reach. Research supported by National Institute of Ageing (NIA) and others has identified actions you can take to help manage your health, live as independently as possible, and maintain your quality of life as you age
The brain controls many aspects of thinking — remembering, planning and organizing, making decisions, and much more. These cognitive abilities affect how well we do everyday tasks and whether we can live independently.
Some changes in thinking are common as people get older. For example, older adults may:
Be slower to find words and recall names
Have problems with multitasking
Experience mild decreases in the ability to pay attention
Aging may also bring positive cognitive changes. For example, many studies have shown that older adults have larger vocabularies and greater knowledge of the depth of meaning of words than younger adults. Older adults may also have learned from their many years of accumulated knowledge and experiences. Whether and how older adults apply this knowledge, and how the brain changes as a result, is an area that researchers are actively exploring.
Despite the changes in cognition that may come with age, older adults can still do many of the things they have enjoyed their whole lives. Research shows that older adults can still:
How the brain changes as people age
As a person gets older, changes occur in all parts of the body, including the brain.
Certain parts of the brain shrink, including those important to learning and other complex mental activities.
In certain brain regions, communication between neurons may be less effective.
Blood flow in the brain may decrease.
Inflammation, which occurs when the body responds to an injury or disease, may increase.
These changes in the brain can affect mental function, even in healthy older people. For example, some older adults may find that they don’t do as well as younger individuals on complex memory or learning tests. However, if given enough time to learn a new task, they usually perform just as well. Needing that extra time is normal as people age. There is growing evidence that the brain maintains the ability to change and adapt so that people can manage new challenges and tasks as they age.
The secrets of cognitive super agers
Some people in their 80s, 90s, and beyond defy the common assumption that cognitive decline goes hand in hand with aging. These people, called cognitive super agers, have memory performance comparable to people 20 to 30 years younger. NIA supports research to study cognitive super agers, including the “Resilience and Resistance to Alzheimer’s Disease in Centenarians and Offspring” study at Boston University Medical Campus and the “Study to Uncover Pathways to Exceptional Cognitive Resilience in Aging” at Northwestern University. Research is ongoing to understand what sets these people apart to help others prevent (or even reverse) age-related cognitive decline.
The brain-body connection
There is growing scientific evidence of the brain-body connection. Not only can changes in our brain affect our thinking, but also changes in our physical health may affect our brains.
For example, an NIA-funded study of almost 3,000 older adults showed that healthy lifestyle factors — physical activity, not smoking, not drinking heavily, following the Mediterranean-style diet, and engaging in mentally stimulating activities — can have important benefits. People who engaged in four or five of these behaviors had a 60% lower risk of developing Alzheimer’s compared to those who only followed one or none. People who followed two or three of the activities had a 37% lower risk.
In another study, older adults with higher levels of physical activity showed slower rates of cognitive decline than peers who were less active. Another example of how physical health can affect brain health has to do with the heart. Observational studies have found that high blood pressure in middle age, along with other cerebrovascular risk factors, such as diabetes and smoking, increase the risk of developing dementia.
Taking care of your physical health
While scientists continue to actively research how to slow or prevent age-related declines in physical health, they’ve already discovered multiple ways to improve the chances of maintaining optimal health later in life. Taking care of your physical health involves staying active, making healthy food choices, getting enough sleep, limiting your alcohol intake, and proactively managing your health care. Small changes in each of these areas can go a long way to support healthy aging.
Get moving: Exercise and physical activity
Whether you love it or hate it, physical activity is a cornerstone of healthy aging. Scientific evidence suggests that people who exercise regularly not only live longer, but also may live better — meaning they enjoy more years of life without pain or disability.Older adult, in a park, doing yoga on a mat
A study of adults 40 and older found that taking 8,000 steps or more per day, compared to only taking 4,000 steps, was associated with a 51% lower risk of death from all causes. You can increase the number of steps you get each day by doing activities that keep your body moving, such as gardening, walking the dog, and taking the stairs instead of the elevator.
Although it has many other benefits, exercise is an essential tool for maintaining a healthy weight. Adults with obesity have an increased risk of death, disability, and many diseases such as type 2 diabetes and high blood pressure. However, thinner is not always healthier either. Being or becoming too thin as an older adult can weaken your immune system, increase the risk of bone fracture, and in some cases may be a symptom of disease. Both obesity and underweight conditions can lead to loss of muscle mass, which may cause a person to feel weak and easily worn out.
As people age, muscle function often declines. Older adults may not have the energy to do everyday activities and can lose their independence. However, exercise can help older adults maintain muscle mass as they age. In a 2019 investigation of data from NIA’s Baltimore Longitudinal Study of Aging, researchers found that moderate to vigorous physical activity is strongly associated with muscle function, regardless of age. This suggests that exercise may be able to prevent age-related decline in muscle function.
In addition to helping older adults live better, maintaining muscle mass can help them live longer. In another study, researchers found that in adults older than 55, muscle mass was a better predictor of longevity than was weight or body mass index (BMI).
What can you do?
Although many studies focus on the effects of physical activity on weight and BMI, research has found that even if you’re not losing weight, exercise can still help you live longer and better. There are many ways to get started. Try being physically active in short spurts throughout the day or setting aside specific times each week to exercise. Many activities, such as brisk walking or yoga, are free or low cost and do not require special equipment. As you become more active, you will start feeling energized and refreshed after exercising instead of exhausted. The key is to find ways to get motivated and get moving.
Healthy eating: Make smart food choices
Making smart food choices can help protect you from certain health problems as you age and may even help improve brain function. As with exercise, eating well is not just about your weight. With so many different diets out there, choosing what to eat can be confusing. The 2020-2025 Dietary Guidelines for Americans provide healthy eating recommendations for each stage of life. The Dietary Guidelines suggest an eating pattern with lots of fresh fruits and vegetables, whole grains, healthy fats, and lean proteins.dinner plate on a table with salmon and veggies
Much of the research shows that the Mediterranean-style eating pattern, which includes fresh produce, whole grains, and healthy fats, but less dairy and more fish than a traditional American diet, may have a positive impact on health. A 2021 study analyzing the eating patterns of more than 21,000 participants found that people closely following the Mediterranean-style pattern had a significantly lower risk of sudden cardiac death.
A low-salt diet called Dietary Approaches to Stop Hypertension (DASH) has also been shown to deliver significant health benefits. Studies testing the DASH diet found that it lowers blood pressure, helps people lose weight, and reduces the risk of type 2 diabetes and heart disease.
Yet another eating pattern that may support healthy aging is the MIND diet, which combines a Mediterranean-style eating pattern with DASH. Researchers have found that people who closely follow the MIND diet have better overall cognition — the ability to clearly think, learn, and remember — compared to those with other eating styles.
Try starting with small changes by adopting one or two aspects of the Mediterranean-style eating pattern or MIND diet. Several studies have shown that incorporating even a part of these eating patterns, such as more fish or more leafy greens, into your daily eating habits can improve health outcomes. One study of 182 older adults with frequent migraines found that a diet lower in vegetable oil and higher in fatty fish could reduce migraine headaches. Another study that followed almost 1,000 older adults over five years found that consumption of green leafy vegetables was significantly associated with slower cognitive decline.
Even if you haven’t thought much about healthy eating until recently, changing your diet now can still improve your well-being as an older adult. If you are concerned about what you eat, talk with your doctor about ways you can make better food choices.
Getting a good night’s sleep
Getting enough sleep helps you stay healthy and alert. Even though older adults need the same seven to nine hours of sleep as all adults, they often don’t get enough. Feeling sick or being in pain can make it harder to sleep, and some medicines can keep you awake. Not getting enough quality sleep can make a person irritable, depressed, forgetful, and more likely to have falls or other accidents.older adult sleeping in a bed
Sleep quality matters for memory and mood. In one study of adults older than 65, researchers found that those who had poor sleep quality had a harder time problem-solving and concentrating than those who got good quality sleep. Another study, which looked at data from nearly 8,000 people, showed that those in their 50s and 60s who got six hours of sleep or less a night were at a higher risk of developing dementia later in life. This may be because inadequate sleep is associated with the buildup of beta-amyloid, a protein involved in Alzheimer’s disease. Poor sleep may also worsen depression symptoms in older adults. Emerging evidence suggests that older adults who were diagnosed with depression in the past, and do not get quality sleep, may be more likely to experience their depression symptoms again.
More generally, a 2021 study found that older adults who did not sleep well and napped often were at greater risk of dying within the next five years. Conversely, getting good sleep is associated with lower rates of insulin resistance, heart disease, and obesity. Sleep can also improve your creativity and decision-making skills, and even your blood sugar levels.
There are many things you can do to help you sleep better, such as following a regular sleep schedule. Try to fall asleep and get up at the same time each day. Avoid napping late in the day, as this may keep you awake at night. Exercise can help you sleep better, too, if it isn’t too close to bedtime. Research suggests that behavioral interventions, such as mindfulness meditation, can also improve sleep quality.
Quit smoking
It doesn’t matter how old you are or how long you’ve been smoking, research confirms that even if you’re 60 or older and have been smoking for decades, quitting will improve your health. Quitting smoking at any age will:
Lower your risk of cancer, heart attack, stroke, and lung disease
Improve your blood circulation
Improve your sense of taste and smell
Increase your ability to exercise
Set a healthy example for others
One study found that among men 55 to 74 years old and women 60 to 74 years old, current smokers were three times more likely to die within the six-year follow-up period than those who had never smoked.
If you smoke, quit.
If you smoke, quit. Quitting smoking is good for your health and may add years to your life. One study of nearly 200,000 people demonstrated that older adults who quit smoking between the ages of 45 and 54 lived about six years longer compared to those who continued to smoke. Adults who quit between the ages of 55 to 64 lived about four years longer. It is never too late to stop smoking and reap the benefits of breathing easier, having more energy, saving money, and improving your health.
Read more about how to quit smoking as an older adult.
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Alcohol and other substances
Like all adults, older adults should avoid or limit alcohol consumption. In fact, aging can lead to social and physical changes that make older adults more susceptible to alcohol misuse and abuse and more vulnerable to the consequences of alcohol. Alcohol dependence or heavy drinking affects every organ in the body, including the brain.
A comprehensive study from the National Institute on Alcohol Abuse and Alcoholism shows that alcohol consumption among older adults, especially women, is on the rise. The researchers also found evidence that certain brain regions show signs of premature aging in alcohol-dependent men and women. In addition, heavy drinking for extended periods of time in older adults may contribute to poor heart health, as shown in this 2016 study. These studies suggest that stopping or limiting the use of alcohol could improve heart health and prevent the accelerated aging seen with heavy alcohol use.
In addition to being cautious with alcohol, older adults and their caregivers should be aware of other substances that can be misused or abused. Because older adults are commonly prescribed opioids for pain and benzodiazepines for anxiety or trouble sleeping, they may be at risk for misuse and dependence on these substances. One study of adults age 50 and older showed that misuse of prescription opioids or benzodiazepines is associated with thoughts of suicide.
Go to the doctor regularly
Going to the doctor for regular health screenings is essential for healthy aging. A 2021 study found that getting regular check-ups helps doctors catch chronic diseases early and can help patients reduce risk factors for disease, such as high blood pressure and cholesterol levels. People who went to the doctor regularly also reported improved quality of life and feelings of wellness.Older adult reviewing information with his doctor
Visit the doctor at least yearly and possibly more depending on your health. You cannot reap the benefits of medical advancements without regular trips to the doctor for physical exams and other tests. Regular screenings can uncover diseases and conditions you may not yet be aware of, such as diabetes, cancer, and cardiovascular disease. If you only seek medical attention when you’re experiencing symptoms, you may lose the chance of having your doctor catch a disease in its earliest stages, when it would be most treatable. Regular check-ups can help ensure you could start treatment months or years earlier than would have been possible otherwise.
Taking care of your mental health
Mental health, or mental wellness, is essential to your overall health and quality of life. It affects how we think, feel, act, make choices, and relate to others. Managing social isolation, loneliness, stress, depression, and mood through medical and self-care is key to healthy aging.
Social isolation and loneliness
As people age, changes such as hearing and vision loss, memory loss, disability, trouble getting around, and the loss of family and friends can make it difficult to maintain social connections. This makes older adults more likely to be socially isolated or to feel lonely. Although they sound similar, social isolation and loneliness are different. Loneliness is the distressing feeling of being alone or separated, while social isolation is the lack of social contacts and having few people to interact with regularly.Older woman, appearing sad, looking out a window
Several recent studies show that older adults who are socially isolated or feel lonely are at higher risk for heart disease, depression, and cognitive decline. A 2021 study of more than 11,000 adults older than age 70 found that loneliness was associated with a greater risk of heart disease. Another recent study found that socially isolated older adults experienced more chronic lung conditions and depressive symptoms compared to older adults with social support.
Feeling lonely can also impact memory. A study of more than 8,000 adults older than 65 found that loneliness was linked to faster cognitive decline.
Research also shows that being socially active can benefit older adults. A study of more than 3,000 older adults found that making new social contacts was associated with improved self-reported physical and psychological well-being. Being social may also help you reach your exercise goals. A 2019 study found that older adults who had regular contact with friends and family were more physically active than those who did not.
Stress
Stress is a natural part of life and comes in many forms. Sometimes stress arises from difficult events or circumstances. Positive changes, like the birth of a grandchild or a promotion, can cause stress too. Research shows that constant stress can change the brain, affect memory, and increase the risk of developing Alzheimer’s or related dementias.
Older adults are at particular risk for stress and stress-related problems. A recent study examined how levels of the stress hormone cortisol change over time. Researchers have found that cortisol levels in a person’s body increase steadily after middle-age, and that this age-related increase in stress may drive changes in the brain. A meta-analysis funded by the National Institute of Mental Health supports the notion that stress and anxiety rewire the brain in ways that can impact memory, decision-making, and mood.
Finding ways to lower stress and increase emotional stability may support healthy aging. In an analysis of data from the Baltimore Longitudinal Study of Aging, scientists followed 2,000 participants for more than five decades, monitoring their mood and health. The data reveal that individuals who were emotionally stable lived on average three years longer than those who had a tendency toward being in a negative or anxious emotional state. Long-term stress also may contribute to or worsen a range of health problems, including digestive disorders, headaches, and sleep disorders.
Depression and overall mood
Although depression is common in older adults, it can be difficult to recognize. For some older adults with depression, sadness is not their main symptom. Instead, they might feel numb or uninterested in activities and may not be as willing to talk about their feelings. Depression not only affects mental health, but also physical health. A review article funded by the National Heart, Lung, and Blood Institute summarizes hundreds of studies from around the world showing that depression increases risk of heart disease and metabolic disorders. Research has also shown that recurrent depression is a risk factor for dementia. In a study of more than 1,000 older adults, scientists found a relationship between the number of depressive episodes and increased risk of developing Alzheimer’s.Older adult holding his head in his hands, looking sad.
Although different than depression, which is a serious medical disorder, mood changes can also influence aging. A 2020 longitudinal study demonstrated a link between positive mood and better cognitive control. Further studies are necessary to determine whether changes that improve mood could improve cognition. The way you think about aging can also make a difference. Research shows that whether you hold negative or positive views about aging may impact health as you age. Negative beliefs about aging may increase undesirable health outcomes, Alzheimer’s disease biomarkers, and cellular aging. Meanwhile, positive beliefs about aging may decrease the risk of developing dementia and obesity.
Leisure activities and hobbies
Your favorite activities are not only fun — they may also be good for your health. Research shows that people who participate in hobbies and social and leisure activities may be at lower risk for some health problems. For example, one study found that participation in a community choir program for older adults reduced loneliness and increased interest in life. Another study showed that older adults who spent at least an hour reading or engaged in other hobbies had a decreased risk of dementia compared to those who spent less than 30 minutes a day on hobbies.Grandmother playing a game with her granddaughter
Research on music, theater, dance, creative writing, and other participatory arts shows promise for improving older adults’ quality of life and well-being, from better cognitive function, memory, and self-esteem to reduced stress and increased social interaction. Even hobbies as simple as taking care of a pet can improve your health. According to a 2020 study, pet ownership (or regular contact with pets) was associated with better cognitive function, and in some cases, better physical function.
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