With my 70th birthday rapidly approaching, my eyes have begun to gravitate towards articles with headlines like “Can I afford to retire?”, “Living on a pension income”, “Housing crisis for senior women,” and the like.
One January morning, my interest was piqued by an article in The New York Times entitled “The 7 Keys to Longevity.” I was feeling particularly healthy and fit, having just returned from my daily 6:00 a.m. two-kilometre walk at a nearby community centre, so I decided I’d read the piece. (On days when miscellaneous aches and pains make me less than enthusiastic about the possibility of a long life, I quickly move past any such articles.)
The seven keys to longevity provided by author Dana Smith will not likely surprise you:
- Stay active by engaging in at least 20 minutes of physical activity each day.
- Eat lots of fruits and vegetables.
- Get enough sleep; between 7 and 9 hours a night.
- Don’t smoke, and drink in moderation.
- Manage chronic conditions.
- Avoid loneliness and isolation in favour of relationships with others.
- Have a positive mind-set.
I evaluated myself on each of the seven and, other than failing miserably with a score of 0 in the staying active category (a number of work and personal crises meant those early morning walks fell by the wayside a few months ago), I did reasonably well. But I also had some questions:
What’s the role of family history in determining longevity? Economic security? Are these seven keys simply to living longer or to having a longer high-quality life? And, how can any thinking, feeling person have a positive mind-set right now?
Athletes of life
More recently, I read an article in The New Yorker entitled “No Time to Die: When does the quest for a healthy life become unhealthy?” It leads with the depressing subtitle that the average American enjoys just one healthy birthday after the age of 65.
Dhruv Khullar writes:
“Many of us have come to expect that our bodies and minds will deteriorate in our final years – that we may die feeble, either dependent or alone. Paradoxically, this outcome is a kind of success. For most of history, humans didn’t live long enough to confront the ailments of old age.”
Khullar goes on to explore the work of Peter Attia, who he describes as “perhaps the most prominent longevity evangelist.” Attia believes that “science, technology and targeted work” can address the “marginal decade at the end of our lives when medicine keeps us alive but our independence and capacities bleed away.” He encourages many of the same approaches as set out in the seven keys to longevity, but he also has a laser focus on the importance of becoming “athletes of life:” goblet squatting 55 pounds when you’re 40 (I guess it doesn’t matter that I don’t know what goblet squatting is, since I should have started doing it 30 years ago), practising “toe yoga,” (another mysterious-to-me activity); in short, becoming what he calls “athletes of life.”
His critics warn that “by incessantly preparing for the future we mistake a long life for a worthwhile one.”
As Khullar puts it:
“One day, we’re going to die. What should that mean for how we live today?”
I like Ezekial Emmanuel’s approach. He’s an oncologist and health policy professor, who was a special advisor to the Obama administration, and he told Khullar:
“Living a long time is not an end in itself. If it becomes the focus of your life . . . that is one of the worst mistakes you can make.”
Emmanuel’s position is that doctors should focus less on “getting rich people from ninety to a hundred” and more on improving health in communities where people die young.
Those are often, not surprisingly, poor communities, where people cannot afford healthy diets and have limited or no access to health care, poor or no housing and likely face higher risks of violence in their lives. Folks in poor communities are often under- or un-employed and are less likely to have jobs that provide them with health care benefits or pension plans.
Shifting priorities
Khullar talks about research showing that we tend to grow more content as we age, even when we lose some of our capacities, quoting a friend of his family in his 80s:
“I can’t do everything I used to. But I wouldn’t say I’m any less happy than I was before.”
I regularly bemoan the things I can no longer do: put on my socks without sitting down; stay up late; enjoy eating in a loud restaurant; sit on the floor (well, I can sit on the floor as long as I never have to get back up), and so on. While my 20-year-old self may have grimaced at the thought of such incapacity, my almost-70-year-old self no longer sees these losses as worth more than a passing complaint.
Dying With Dignity Canada has released a revised Advance Care Planning Kit, which I highly recommend. I worked through it last weekend, comparing my responses to various medical scenarios to those when I completed the same exercise a few years ago. To my surprise, my answers had moderated slightly: a few questions now contain “I am uncertain” answers, breaking up the wall of “no” responses when asked whether I would want treatment in a variety of catastrophic situations.
Despite this modest shift, I still see myself as a quality over quantity kind of person. What I am beginning to understand as that damned 70th birthday gets closer is that what I understand to be quality is not a hard and fast thing; it changes with time and experience, and is likely to undergo a few more shifts before I get to the point where I – or those I have entrusted with this task – have to make any final decisions.