Last updated on 6th November 2015
Catero, my wife, and I are just back from four days in the South visiting friends. We're blessed with some lovely friendships but, partly because most of us live pretty busy lives, it's easy not to see people who live quite far away for months or even years. A while ago we decided to at least partly remedy this, so we booked four days off our work and contacted old friends who lived along the South Coast of England, from Dorset through Hampshire to Sussex, to set up reunions. We got back last night. Over the four days away we saw seven sets of friends. It was lovely ... really heart-warming, poignant, fun, fascinating. And that's what I'm writing about here ... the fascinating bit. We saw seven sets of friends aging and we shared how we ourselves are getting older. We range from our mid-50's to late 70's (Catero & I are in the second half of our 60s). Several of our friends are retired, several are gradually bringing careers to a close. What did I learn talking with them, hearing how they're balancing their lives, how they look after their health, support their families, travel, engage in their communities, and step back from their jobs? It was really interesting ... as well as heart-warming and a lot of fun.
It links with the general question "How are our lives going?". One useful way to think about this is looking at three overlapping questions "How well are we physically?", "How distressed are we psychologically?" and "How much are we flourishing?" Cutting to the chase with "How well are we physically?", try visiting the rather wonderful "UbbLE - UK longevity explorer website" which will give you a pretty accurate estimate of your chance of dying in the next five years. Going to my own website's "tag cloud" and clicking on "mortality" will also bring up a series of blog posts mostly underlining the importance of very physical behaviours for improving life expectancy - see, for example, "Does healthy lifestyle really make a difference?", "Eat 5 to 9 portions of fruit & veg daily", "How much should I weigh if I don't want to die early?", "15 minutes of exercise daily reduces mortality by 14%" and "The recommendation to do strengthening exercises".
Something I wondered about with some of my more conscientiously healthy Southern friends is "What is an optimum amount of physical exercise for improving mortality?" A pretty good place to go to answer this question is Moore & colleagues' 2012 paper "Leisure Time Physical Activity of Moderate to Vigorous Intensity and Mortality: A Large Pooled Cohort Analysis". They write "A high level of moderate to vigorous leisure time physical activity was associated with a lower risk of mortality during follow-up and a longer life expectancy after age 40. Compared to no leisure time physical activity (0 MET-h/wk), (MET stands for "Metabolic Equivalent of Task" and approximately measures energy used during an activity compared with energy used at rest) low levels of leisure time physical activity, i.e., 0.1–3.74 MET-h/wk and 3.75–7.4 MET-h/wk, had multivariable-adjusted HRs of 0.81 (95% CI: 0.79–0.83) and 0.76 (0.74–0.78), and life expectancies that were higher by 1.8 (1.6–2.0) and 2.5 (2.2–2.7) y, respectively. Levels at or just above the minimum level recommended by guidelines (7.5–14.9 MET-h/wk) were associated with even lower risks of mortality (HR = 0.68; 95% CI: 0.66–0.69) and higher life expectancies (3.4 y higher; 95% CI: 3.2–3.6). Finally, levels at two times (15.0–22.4 MET-h/wk) and three or more times (22.5+ MET-h/wk) the minimum recommended level were associated with further, albeit diminishing, reductions in risk of mortality. The respective HRs were 0.61 (0.59–0.63) and 0.59 (0.57–0.61), and life expectancies were higher by 4.2 (4.0–4.5) and 4.5 (4.3–4.7) y. Similar results were obtained in models excluding deaths during the first 5 y of follow-up (27,804 deaths excluded; HR for 22.5+ versus 0 MET-h/wk = 0.67; 0.65–0.70). Our spline curves showed that the dose–response relationship was curvilinear (pnonlinear,0.01), with the greatest gains in years of life expectancy occurring at approximately 15+ MET-h/ wk (Figure S1), equivalent to approximately 300 min of brisk walking per week."
More to follow ...
At a straightforward level, how do we get a sense of how our lives are going? Arguably there's value in thinking separately about physical and psychological wellbeing. Of course they are strongly intertwined, but as George Vaillant pointed out (p.370) in his fine book Triumphs of experience" (which follows 268 Harvard undergraduates for 75 years from university up into their 90's) "Mature defenses (Vaillant is using psychodynamic terminology here) remain the sine qua non of warm relationships. Alas, however, they do not appear to be essential for sustained good health and successful physical aging - yet another favourite hypothesis washed up as I followed the men into old age." Of course there's plenty of evidence suggesting that good relationships are important for physical as well as psychological health - see the post "Strong relationships improve survival as much as quitting smoking" - but it's noteworthy that on the rather wonderful "UbbLE - UK longevity explorer website" (which will give you a pretty accurate estimate of your chance of dying in the next five years), many of the questions are decidedly physically orientated (although note the power of the simple subjective "In general how would you rate your overall health?" as a key mortality predictor).
... George Vaillant reports on a remarkable 75 year long study tracking 268 Harvard undergraduates right through their lives into old age. A description of the book states "At a time when people are living into their tenth decade, the longest longitudinal study of human development ever undertaken offers welcome news for old age: our lives evolve in our later years and often become more fulfilling. Among the surprising findings: people who do well in old age did not necessarily do so well in midlife, and vice versa."
More to follow ...