Four-pronged approach can lead to healthy aging for older adults

Feb 13 2018

Want to live a long and healthy life? Of course.

Well, that's not going to just happen. It'll take some effort – especially if you're already 65 or older.

"It can be hard for older adults to make lifestyle changes," said Jo Cleveland, M.D., professor of gerontology and geriatric medicine at Wake Forest Baptist Medical Center in Winston-Salem. "Some things are easier to implement than others, and a lot depends on the individual and their particular situation. It'd be a lot easier to take a pill. But there's not a pill for this."

There are, however, four areas in which older men and women can take some non-drastic steps to improve their chances of what Cleveland calls "aging optimally." They are sleep, diet, exercise and social interaction.

Sleep

It's a common misconception that sleep needs decline with age, according to the National Sleep Foundation, so seniors need the same seven to eight hours of sleep as younger adults. But sleep patterns do change, and as people age they tend to have a harder time getting quality sleep.

"It's often disrupted sleep in older adults; they wake up because they have to go to the bathroom or because they roll over on a hip that's painful," said Cleveland, who is medical director of Wake Forest Baptist's geriatrics outpatient clinic and the Healthy Aging and Brain Wellness Clinic at the Sticht Center for Healthy Aging and Alzheimer's Prevention. "So it's really important to work with a primary care doctor to try to fix what is fixable. And that includes sleep apnea, which is rampant and under-diagnosed in the elderly population."

Adopting some basic sleep hygiene measures – such as establishing a regular sleep schedule, creating a quiet and comfortable sleeping environment and avoiding stimulants close to bedtime – also can help to reduce or eliminate sleeping difficulties.

Diet

The Mediterranean diet is widely considered the best way to eat for everybody, not just seniors.

More a pattern of food consumption than a "diet" in the usual sense of the word, the Mediterranean diet emphasizes fresh fruits and vegetables, nuts, grains, olive oil (as opposed to butter), herbs and spices (as opposed to salt), chicken and seafood (as opposed to red meat), plus a glass of wine. Research has shown that this type of diet reduces the risk of heart disease and is associated with reduced incidence of Parkinson's and Alzheimer's diseases and cancer.

"The areas of the world where people live the longest and have really good function late in life all follow the Mediterranean diet," Cleveland said. "But I think we have to paint it in broad brush strokes. Telling people to eat X number of ounces or X number of servings doesn't really work. Rather, it's to say to try to lean more toward fresh fruits and vegetables and so on as opposed to the more traditional American diet.

"Doing it gradually is a lot easier than trying to make a total change all at once."

Exercise

The federal Centers for Disease Control and Prevention recommends that people over 65 get at least 2 hours and 30 minutes of moderate-level physical activity each week to promote endurance, strength, balance and flexibility.

"That works out to about 30 minutes a day five days a week, and it can be walking, biking, swimming, dancing, gardening," Cleveland said. "It doesn't matter what it is as long it's something that gets your heart rate up."

She also endorses two 20-minute sessions of weight-strength training each week with exercise bands or hand weights.

But before beginning an exercise program, Cleveland said, older adults should "consult a physical therapist one time to make sure what you're doing is safe and right for you."

It should also be enjoyable.

"Seniors are no different than anybody else and keeping to an exercise program is challenging," Cleveland said. "So it's important to make sure you're doing something you like, and group classes are usually more fun than going to the gym and logging a mile on the treadmill by yourself."

Social interaction

"When we talk about staying healthy longer a lot of us think of that as meaning physically healthy, but the cognitive piece is just as important," Cleveland said.

Stimulating the brain plays a vital role in combating cognitive decline, but not all mental activity is of the same value, she said.

"If it's crossword puzzles or Sudoko or whatever, if you do it a lot you get good at that, but that doesn't really translate into preserving cognitive function," Cleveland said. "Learning something new is better, and learning something new in a social situation is even better."

While socialization is crucial to mental fitness, it's often left by the wayside as people age, because of lack of transportation, physical issues or other reasons.

"You have to be very creative sometimes to get seniors into a social function or group," Cleveland said. "Sometimes I tell my patients that their answer to any question about doing something should be yes. If your daughter asks if you want to go to your granddaughter's soccer game, say yes – even if you don't really want to.

"Getting out, being around people and doing what you can do is a big part of staying healthy."