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LIFESTYLE DISEASES

The middle age mantra

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Living a healthy lifestyle when one is young can pay rich dividends later in life. But a recent Swedish study now suggests that adopting healthy habits during old age can also yield benefits. The study, published recently in the British Medical Journal, found that among 75-year-olds, staying physically active, having a social lifestyle and maintaining a healthy diet, as well as staying away from tobacco and alcohol, can add around five years to a woman's life and six years to a man's.
Even among those aged 85 or older, and people with chronic conditions, the average age at death was four years higher for those with a 'low risk profile' compared with those with a 'high risk profile'.

The study involved over 1, 800 individuals and was conducted over a period of 18 years (1987-2005 ). Those who survived longer were more likely to be women, highly educated, have healthy lifestyle behaviours, a better social network and were likely participate in more leisure activities than those whose life spans were shorter.

Smokers died a year earlier than nonsmokers. Former smokers had a similar pattern of survival to those never did, suggesting that quitting smoking in middle age reduces the effect on mortality.

Of the leisure activities, physical activity was most strongly associated with survival. The average age at death of participants who regularly exercised was two years greater than those who did not. Overall, the average survival of low-risk people was 5. 4 years longer than those with a high risk profile.

"In sum, the associations between leisure activity, not smoking and increased survival still existed in those aged 75 years or more, with women's lives prolonged by five years and men's by six, " said the authors.

"Results suggest that encouraging favourable lifestyles even at advanced ages may enhance life expectancy, probably by reducing morbidity, " they conclude.

The World Health Organisation (WHO) also seems to be paying more attention to promoting healthy lifestyles among the elderly. It recently came out with a first-of-itskind guideline on "Physical Activity and Older Adults", which laid down the appropriate levels of physical activity for adults aged 65 years and above. It said that for the elderly, physical activity should include leisure time activity (walking, dancing, gardening, hiking, swimming), transportation (walking or cycling), occupational (if the individual is still engaged in work), household chores, games or planned exercise.

The WHO said that in order to improve cardio-respiratory and muscular fitness, bone and functional health, and reduce the risk of non-communicable diseases, depression and cognitive decline, older adults should do at least 150 minutes "of moderate-intensity aerobic physical activity throughout the week or at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week. "

It said that aerobic activity should be performed in bouts of at least 10-minute durations. For additional health benefits, older adults should increase their moderate-intensity aerobic physical activity to 300 minutes per week, or engage in 150 minutes of vigorous-intensity aerobic physical activity per week.

"Older adults, with poor mobility, should perform physical activity to enhance balance and prevent falls on three or more days per week. Muscle-strengthening activities should be done on two or more days a week. When older adults cannot do the recommended amounts of physical activity due to health conditions, they should be as physically active as their abilities and conditions allow, " WHO says.

There are a number of ways older adults can accumulate the total of 150 minutes of physical per week. "The concept of accumulation refers to meeting the goal of 150 minutes per week by performing activities in multiple shorter bouts, of at least 10 minutes each, spread throughout the week then adding together the time spent during each of these bouts - like 30 minutes of moderate-intensity activity five times a week. These recommendations are applicable for all older adults irrespective of gender, race, ethnicity or income level, " WHO said.

Older adults who are inactive or who have limitations imposed in them by disease will have added health benefits if they move from the category of "no activity" to 'some levels" of activity. Experts say there is strong evidence to show that that compared to less active men and women, older adults who are physically active have lower rates of all-cause mortality, coronary heart disease, high blood pressure, stroke, Type 2 diabetes, colon and breast cancer, a higher level of cardio-respiratory and muscular fitness and a healthier body mass and composition. Their bodies are better geared to prevent cardiovascular disease, Type 2 diabetes and the enhancement of bone health. They exhibit higher levels of functional health, a lower risk of falling and better cognitive function.

The findings are especially relevant to India, whose elderly are not really in the pink of health. The Union health ministry estimates 1 in 4 four among India's elderly population are depressed, 1 in 3 suffer from arthritis, while 1 in 5 can't hear. While 1 in 3 suffer from hypertension in rural India and 1 in 2 in urban, almost half of the elderly have poor vision. Around 1 in 10 experience a fall that results in fracture while 2 in 5 are anaemic.

The WHO's recommendations are therefore vital for India which is also witnessing feminisation of its ageing population. According to WHO representative to India Dr Nata Menabde, by 2015, a quarter of the global elderly population will be in India and by 2026, the elderly population in India will be more than 12 per cent of the total population.

The Registrar General of India's latest data from the Sample Registration System 2010 had found that the percentage of women in the age group 60 years and above is higher in most large states.

According to the 2006 World Population Prospects, by 2050, the number of Indians aged above 80 will increase more than six times from the current number of 78 lakh to nearly 5. 14 crore. At present, 20 per cent of this category in India suffer from Alzheimer's disease.

The number of people over 65 years of age in the country is expected to quadruple from 6. 4 crore in 2005 to 23. 9 crore, while the number of Indians aged 60 and above will increase from 8. 4 crore to 33. 5 crore in the next 43 years.
Longevity too is increasing. According to the WHO's health statistics, while an average Indian lived for 57 years in 1990 and 61 years in 2000, he lived till the age of 65 in 2009.

According to the ministry's latest projections, the life expectancy at birth - the average number of years to be lived by a group of people born in the same year of an Indian male - will be 69. 8 years in 2021 compared to 65. 8 at present and 63. 8 years in 2001. In comparison, an average Indian woman can expect to live to 72. 3 years by 2021, compared to 68. 1 now and 66. 1 in 2001.

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