Who are you Calling “Old”? Living in Primetime
Healthy, vital, active, and thriving! These are not words commonly ascribed to aging and yet an entire generation of healthy, vital, active, and thriving people in their 40’s, 50’s, 60’s, and beyond are changing the very paradigm of aging in the United States.
A familiar adage says, “The future belongs to the young.” It is true. I content that for myself, a surgeon who specializes in the care of athletes and adult onset exercisers aged more than 40 years, as well as a member of this age group living in the prime of life, that the future belongs to the young, but the definition of “young” is changing.
Never in history have there been so many persons aged more than 40 years. As late as the 1930s, only 7% of the population was aged more than 40 years. Now, however, someone turns 50 years of age every 8 seconds. The 2010 census reports that the number of people living in prime time (aged . 40 years) is increasing faster than any other segment of our population, and the nation’s median age increased from 35.3 to 37.2 years in 2000. Seven states have a median age of more than 40 years.
This aging of our population is more than just a demographic phenomenon, but is changing the way we live, our economics, and business standards, as well. Leading this paradigm shift are, of course, the baby boomers. Since their conception after World War II, this wave of “America’s Youth” has demonstrated that by sheer number alone, they are capable of changing American economics. Now, by demanding quality of life throughout their entire life span, they are changing the way we age.
In the United States, we often look to sports to define our heroes and role models. When you look at the ranks of modern athletes, from pros to weekend warriors, those aged 40 years of age and older fill the roads and playing fields. They are redefining aging and making “40” the new “30”. Stories of athletes’ achievements at an older age fill the media every day. For example, swimmer Dara Torres, won an Olympic silver medal at 41, hockey player Mark Recchi, won a 3rd Stanley cup title 20 years after his first, pitching phenomenon Nolan Ryan was the first of a generation of Major League Baseball pitchers to throw fastballs well into his 40s or Tom Watson, who nearly claimed victory at the British Open less than one year after having total hip arthoplasty and less than three years away from qualifying for social security.
These amazing physical feats and performances are not reserved as a privilege of professional athletes alone. If you are a masters athlete or adult onset exerciser, look around the next time you race. No longer are you the “old loner” out on the course remembering the days before cell phones and having enough birthday candles to set a house on fire. Now, you are surrounded by thousands of recreational older-aged athletes just like you—a generation determined to remain fit and strong. According to John Hanc, colleague and sports writer, “Through a combination of scientific training, disciplined diet, and advanced sports medicine, they (masters-age athletes) are overturning immutable laws of biology, and they are reversing, or at least fighting to a draw, the aging process.”
A recent survey of active people in their 40s and 50s (Arthritis Foundation) demonstrated that:
- 64% feel an average of 11 years younger than their actual age
- 40% are living healthier and more physically fit than when they were in their 20s
- 57% are more physically active than their parents were at their age
- 33% boast they could beat their children in at least one sport
It is important to note that the above people are not the exception, but represent average people. All individuals have the chance to maintain this high quality of life and functional capacity throughout their lifespan if they choose to avoid sedentary living.
I have never held to the common belief that aging means an inevitable decline from vitality to frailty, and I have made it part of my research agenda to study masters athletes who continue to debunk the myth that turning 40 automatically means “slowing down.” Studies of athletic performance across the lifespan indicate that the slowing phenomenon of the aging process does not have a significant impact on performance until the seventh decade. Much of the “slowing down” we see in older athletes of all fitness levels relates more to changes in training intensity as opposed to absolute changes in biology.
HOW FAST DO WE AGE?
Scientific studies of the masters-aged athlete are important because they can help lead our new, more active, aging population to a stronger and more dynamic lifestyle. This can be done by identifying factors that slow us down because of disuse and sedentary living versus those that that are due to aging alone.
In 2001, I began studying masters athletes who participated in the National Senior Games (i.e., the Senior Olympics), as these recreational athletes exhibit high levels of functional capacity throughout their lifespan and may represent the purest measure of aging without the confounding variable of disuse and sedentary living. In a study of performance times in track athletes racing at distances from 100 to 10,000 m, I found that running times across all distances declined with age. Although this trend was expected, the surprising find was the small degree of performance decline that occurred with age. Until aged 75 years, the observed decline was slow and linear, with decreases of less than 2% per year. This decline was not found to be statistically significant. At age 75 years, however, the rate of decline increased to approximately 8%. These results suggest that if disuse and disease are eliminated, individuals should be able to maintain high levels of functional independence until 75 years of age. What does this look like in real race times? During the 2001 National Senior Games, the 50 year-old man who won the mile clocked in at 4 minutes, 34 seconds and the 70 year-old winner won in 7 minutes. The same year, the male winner of the Pennsylvania state high school race won in 4 minutes, 17 seconds. It is amazing to witness approximately 30 years of aging from 18 years to 50 years adding only 17 seconds onto these recreational mile times. As an example to demonstrate this higher performance level that can be achieved in an older athlete, 24-year-old Sydney Maree set the men’s amateur collegiate record for the mile at 3:52.44 in 1981, and 52-year-old Steve Scott set the men’s masters record for the mile at 4:26.75, more than a 25 year difference in age accounting for less than 30 seconds of time.
Running records like these are great examples of the fact that only 30% of how we age is determined by genetics, while the remaining 70% is determined by the lifestyle choices we make, including the choice to be active. At present, our genetic code cannot be altered, but training and lifestyle can.
The study of records of older athletes is not limited to track and field or running events. Weightlifting records, analyzed over time, demonstrate an approximately 1 to 1.5% decline per year, with accelerated declines occurring only after age 70 years. Long-term weightlifting infers a 20-year muscle strength advantage such that 85-year-old weightlifters can be as powerful as the 65-year-old non-weightlifter.
The same small declines in performance with aging are witnessed in swimming. Hirofumi Tanaka and Douglas Seals, leaders in the field of aging physiology, studied the performance of masters swimmers, and found peak performance in the 35- to 40-year-old age group, with modest declines occurring until approximately age 70 years. After this age, performance declined exponentially.
These studies of running, weightlifting, and swimming indicate that when the variables of disuse, atrophy, and sedentary living are removed from the aging picture, individuals are capable of high-level performance until their mid-70s. Does this mean that as an aging population we expect too little of ourselves, and that we are satisfied to settle into the myth of growing older the way our parents did? My contention, as a surgeon and researcher out to change the way we age in this country, is that much of the disease and frailty we witness before our mid-70s is due to sedentary living, and not aging alone.
THE BIOLOGY OF AGING
Even though we are physically capable of more than we expect of ourselves as we age, there are real age-related factors that change the game. What really does happen as we age? At the cellular level, rapid cell division provides the human body with a remarkable regeneration capacity. It enables us to rapidly recover from injury throughout childhood and our early adult years. As we continue to age, our bodies become less efficient at these regeneration activities, resulting in stiffer tissues and a decline in overall performance. These changes lead to a decline in heart rate by 10 beats per minute per decade (unless we work at it); lean muscle mass declines; intramuscular fat increases, leading to decreased strength and power; lung function gets stiffer; and anabolic hormone production declines as does the quality of neuronal pathways between the brain and muscles. All these factors attribute to loss of exercise economy, endurance capacity, and lean muscle mass.
However, many of these age-related declines are amplified by sedentary living and the impact of disease(s) that can accompany it. It is well documented that people who engage in persistent physical activity decrease their risk of developing type 2 Diabetes by 40%, mortality due to heart disease by 40 to 50%, their risk of colorectal cancer by 40%, mortality due to prostate cancer by 50% and developing ovarian and breast cancer by 60%. Healthy active individuals are 1.5 times less likely to have depression compared with sedentary individuals, and men who keep active have a 41% less rate of erectile dysfunction compared with sedentary men.
F.A.C.E.-ING OUR FUTURE
Whether you are an athlete seeking to maximize your performance and minimize injury, a “once upon a time” athlete who is getting off the couch for the first time in 20 years or if you are an adult onset exerciser, there is never an age or activity level that prevents you from taking control of your future. Some of the earliest studies of the benefits of physical activity were performed on 90-year-old men doing resistance training while living in nursing homes. Even these men were able to increase their strength and functional capacity by investing in a daily activity regimen.
The question is how do you start? Despite the plethora of information on every news stand urging us to get ripped abs or a bikini body, I find many of my patients of all activity levels are overwhelmed and are not sure what to do. I remind them to F.A.C.E. (Flexibility, Aerobic Exercise, Carry a Load, and Equilibrium and Balance) their future. Your maturing body is unique and not simply a bad sequel to your 20-year-old self. Living in prime time means a well rounded exercise program with four components.