How to live to be 100 and not regret it...

A longevity revolution is changing the concept of old age. And the superold are thriving. Their experiences teach us how to live long without regret.

PICTURE SPEAK

AGE BECOMES HER: Surrounded by great granddaughter and grand-daughter, Sushila Sahay looks forward to yet another day. It’s no big deal to be 99.

How does science explain someone like her? How can a woman about to start her second century be so full of life, while others decades younger fade away? A long life has always been shrugged off as a gift (or a curse) from the gods. “Who wants to live till 100? Not me,” Aditi Jha, a 20-something corporate lawyer with ITC, scoffs at the idea. But she may not have a choice. World demography has turned upside down and the super-old are thriving. “We are in the midst of a silent longevity revolution,” says P.V. Rama-murti, the father of Indian gerontology. “Never before in human history has this kind of explosion happened.” What’s more, the oldest-old forms the fastest-growing segment among the seniors, adds demographer Ashish Bose, Director of the Society for Applied Research on Humanities, Delhi. The number of centenarians is growing significantly for the first time in history. “And this will redefine the concept of old age.”

SCIENCE OF AGEING All that you ever needed to know about growing old and how to delay it 5 REASONS WHY YOU AGE CELL DEPLETION This happens in important tissues, including the heart and the brain UNWANTED CELLS Fat cells replace muscle, leading to diabetes and heart disease CHROMOSOME MUTATION Telomeres, which cap chromosomes, decrease in length and cause decay MITOCHONDRIA MUTATION Mitochondria, the tiny machines that power cells, can turn cancerous JUNK BUILD-UP Waste hoards in cells and hardens arteries 10 DO’S AND DON’TS TO LIVE LONG Don’t oversleep: More than eight hours is not healthy Be optimistic: It decreases the risk of early death by 50% Lose weight: Obesity is linked to diabetes and heart disease Get a pet: Pets reduce levels of the stress hormone, cortisol Be rich: Higher incomes make it easy to engage in health-promoting behaviours Quit smoking: It’s been linked to most common causes of death in the elderly Chill out: The anger-prone are six times more likely to have heart attacks by the age of 55 Pop antioxidants: Cinnamon to blueberries, they ward off cell damage and delay ageing Marry well: Pick a spouse whose family shows longevity and it may help your kids too Exercise a lot: Maintaining weight will give you energy and ward off stress LONGEVITY AND MOOD The Big Five personality traits that help people to live and thrive… Extroverted character Agreeable manner Conscientiousness Emotional stability Openness to experience

HELPING YOUR BODY COPE WITH THE CHANGES

MENTAL ACUITY: B vitamins and physical activity cut the risk of Alzheimer’s. VISION: Vitamin C, E and beta carotene with zinc may help cut degeneration in those at high risk of eye diseases. BONES: Peak bone mass occurs at the age of 35. Walking, jogging, weight training can preserve bones. MUSCLES: Weight training exercises may help slow age- related muscle loss. STOMACH: Eat fibre. Women should eat 25 g daily, men 38 g. BLOOD: Vitamin B12-fortified foods prevent anaemia, heart and nerve problems after 50. HEART: At least 30 minutes of brisk physical activity daily. Eat more fibre-rich foods such as oatmeal to help reduce blood cholesterol. Limit sodium to keep blood-pressure under check. Skip transfats. SKIN: Quit smoking. It causes premature wrinkles and ageing. Limit sun exposure, use sun-screen. JOINTS: Try to strengthen those quadriceps to help prevent osteoarthritis, specially in the knees. To relieve pain and symptoms, apply heat to joints. There is a range of motion exercises that are good for the joints. But don’t forget to warm up before beginning a work-out. Sources: World Health Organisation, ICMR, JAMA, IOTF, International Osteoporosis Foundation, Indian Heart Journal, Harvard Medical Jl.

Statistics prove the point. More than half the world’s oldest-old live in six countries: China, US, India, Japan, Germany, and Russia. In 2000, 69 million people in the world formed the oldest-old. Among them, 7.8 million were 90-plus, and about 167,000 estimated to be 100 and beyond. According to the UN Global Action on Ageing 2007, they are growing at 4.4. per cent in India and China, compared to the world average of 2.6 per cent. In 1998, there were 1.3 million centenarians in the world, today there are 1.5 million in India alone, points out a HelpAge report. By 2050, the world’s share of centenarians is projected to reach 3.3 million, led by China, US, Japan, and India.

The number of the oldest-old in India is around 8m They are growing at double the world average, 4.4% every year In 60 years, life expectancy has shot up by nearly 20 yrs The number of centenarians in India stood at 1.5 m in year 2000

Scientists are all fired up. And researchers—in stem cells, choromosomal telomeres, nanotechnology and more—are throwing up an alphabet soup of theories to explain longevity. Can organs be replaced the way we replace worn brakes on a car? Can genetic therapies rejuvenate the ‘junk’ we build up in our cells? Can microscopic nanobots be made to flow through the body, warning us of future health problems? Do stem cells hold the key? Dr Salim Yusuf, Director of Cardiology and Population Health Research Institute at McMaster University in Canada, compared the quest in a recent presentation at the All India Institute of Medical Sciences (AIIMS), Delhi, to the timeless questions raised by Paul Gaugauin in his famous painting, D'où Venons-Nous: “Where did we come from? What are we? Where are we going?”. But beyond that philosophical big picture, some simple rules work. “How long you live depends partly on the genes you are born with and partly on lifestyle— how you live and eat, what types of stress and trauma you experience and what sort of a person you are,” he asserts.

PICTURE SPEAK

LOVE AND LONGEVITY: Family ties keep Satyavati Suri (middle) ticking over. A key to long life, holds new research. “It’s not just what you eat. The key to long life is also how much you eat.” DR K.S. REDDY CARDIOLOGIST, PUBLIC HEALTH FOUNDATION OF INDIA AND AIIMS

While the super-old are happy to offer homespun explanations for their longevity— “I never took a drink,” “I never smoked,” “I lived on oranges”—experts are trying to unravel the biological factors that allow some people to reach 100. Low fat and low protein diet also boost longevity, holds a study in the May 2005 issue of New Scientist. Lowering the amount of protein and fat in the diet helps increase lifespan by nearly 65 per cent, it says. Yet another new study, published in the International Journal of Epidemiology, found diet rich in fruits, vegetables, fish, beans and whole grains as the foundation of longevity. Dr D. Prabhakaran of the Department of Cardiology at AIIMS, agrees: “Green leafy vegetables and fruits lower the risk of cardiovascular diseases.”

It’s not just what you eat; it’s how much you eat,” says Dr K.S. Reddy, Director of the Public Health Foundation Of India. For, scientists now believe the sure-fire way to live long is calorie restriction—reducing a body’s energy intake below its energy expenditure. “It extends lifespan and delays the onset of age-related diseases.” Last year the first systematic study showed that those on restricted diets had lower insulin resistance (high resistance is a risk factor for type 2 diabetes) and lower levels of low-density lipoprotein cholesterol (high levels are a risk factor for heart disease). Reddy mentions the Japanese island of Okinawa, home to the world’s largest population of centenarians. “They follow a dietary philosophy known as hara hachi but—literally, eight parts out of 10 full.”

Diet is not the only key. People who are active on a regular basis and consume fewer calories live longer, says a new study from the University of Florida: “Those who exercise can add three years to their life, and their hearts reap benefits from something as simple as a brisk walk for 30 minutes a day.” In a study, The Old-Old and Oldest Old for the ministry of Social Justice and Empowerment in 1999, P.K.B. Nayar of the Center of Gerontology, Kerala, found that those who did moderately strenuous work in youth lived long. “That’s because your body does a better job of circulating blood and oxygen—improving muscle endurance and strengthening the vital organs,” says Dr Anoop Misra, head of diabetes and metabolic disorders at Fortis Hospital, Delhi.

AGE TEST Start with 70 years, average life expectancy in India. Depending on your answers to these questions, add or subtract appropriate number of years.

An example Attitude: Are you an optimist? Do you approach life with good humour? Are you able to let go of stressful things? If no, subtract 5 years. 70-5=65 Genes: Do you have at least some family members who have lived past the age of 90? Exceptional longevity runs strongly in families. If yes, then add 10 years. +10=75 Exercise: Do you set aside at least half an hour, three days a week, to exercise? Muscle-building exercises are particularly important. If no, subtract five years. -5=70 Interests: Do you do things that challenge your brain, regularly? It’s important to take on activities that are novel and complex. If yes, add five years. +5=75 Nutrition: Do you have a diet which keeps you lean? If no, then subtract seven years. -7=68 Smoking: Do you smoke? If yes, subtract five years. -5=63 Total 63 years

But isn’t frailty as inevitable as white hair and wrinkles? Researchers are questioning this assumption. The November 2001 issue of Archives of Internal Medicine reported a fresh approach. Frailty—muscle weakness, fatigue, a slow or unsteady gait, weight loss and lack of memory—is no longer seen as just part and parcel of growing old. Instead, it is newly recognised as a real condition in its own right. And cardiovascular disease is central to it. “In many cases, undetected cardiovascular disease is a major reason why people become frail,” says Dr Ashok Seth, Chairman and Chief Cardiologist, Max Devki Devi Heart and Vascular Institute, Delhi. “You may not have classic symptoms like chest pain or a stroke. But you may have partly blocked blood vessels in the brain, legs, kidneys or the heart.”

With so much evidence that lifestyle is the key to healthy ageing, it might be tempting to ignore the role of genes altogether. That would be a mistake. Swedish scientists tackled the problem in 1998 by looking at the only set of people who share genes but not lifestyle: identical twins separated at birth and reared apart. If genes were most important, you would expect the twins to die at about the same age. In fact, they don’t, and the difference convinced the scientists that only about 20 to 30 per cent of how long we live is genetically determined. “The dominant factor is lifestyle,” says Dr Nikhil Tandon, professor of endocrinology at AIIMS. “Of course, those who have healthier genes and live healthier lives—really survive for a long time.”

Sahay doesn’t believe in spending her leisure hours in benign reflections. During her quiet hours, she relaxes with her knitting. Or she reads her favourite book, the Ramayana. Or she’s on the phone with family and friends (she keeps track of all birthdays and anniversaries). There’s more. Every morning, she sets aside time to check out the balance sheets of her ancestral farmland near Bijnor in Uttar Pradesh. In fact, she does it so well that the kheti yields a neat profit. Doesn’t she get tired? Her eyes light up: “I’ve always been a cheerful person. Not a complainer.”

That’s the biggest clue to longevity. The National Institute on Aging in the US reported this year that there’s a positive correlation between optimistic disposition and death-age. “Centenarians are invariably strong, flexible characters, emotionally resilient, rooted in family and community,” says S.D. Gokhale of Pune, who heads the International Longevity Centre in India. Consider Satyavati Suri, 86, who lives with her daughter’s family in Mumbai. “I am surrounded with love and care and I am healthier than people half my age,” she says. But there’s more. The oldest-old often reflect strong passion for learning. Researchers from the universities of Michigan report that those with long careers live longer and healthier. Why is work and learning associated with better health and greater longevity? “Work requires you to have social contact, use your mind, get some exercise, and all these promote longevity,” asserts Gokhale.

If centenarians are navigators who successfullycomplete the long, perilous voyage—of maladies, mishaps, and conflicts that commonly lead to death—their experiences have much to teach us. And here science converges with common sense. Eat sensibly. Keep walking. Keep knitting.

If you can’t keep friends, make new ones. Plan so much invigorating work that there’s just no time to die. And no regrets when you do. At dusk, surrounded by innumerable portraits of the loved ones she has beaten at the game of life, Sushila Sahay looks forward to yet another day. It’s no big deal to be 99.

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