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Dr. Sanjay Gupta: It’s time to rethink what we call ‘old age’

Thought Leader: Sanjay Gupta
June 20, 2023
Source: CNN
Written by: Sanjay Gupta

I’ve been thinking a lot about aging lately. I’m turning 54 this year, so by all chronological measurements, I am middle-aged – the point when a person is, jokingly or not, considered “over the hill.” Yet that doesn’t fit my self-perception: If you were to ask me how old I feel, I would say mid-30s. I consider my 50s to be the best decade of my life so far.

The fact is, we all have this in common. No matter our location, culture, socioeconomic status or even political affiliation, we are all getting older, every minute of every day. And as my mom recently pointed out when I asked her about it, “aging is certainly better than the alternative.” So I have always been surprised there is such a societal stigma attached to it.

Maybe it’s because there are so many misperceptions around aging and about what getting older is supposed to look and feel like. (Think “The Golden Girls” and Archie Bunker from “All in the Family.”) Maybe it’s because everywhere you look, you see “anti-aging” products. (How can you be anti- or against something we all experience?) But the reality is that aging doesn’t have to be a sunsetting period we shy away from.

After all, there are countless people who have thrived and continued to improve throughout their lifetimes, such as Diana Nyad and the late Jack LaLanne.

So in this season of the “Chasing Life” podcast, we’re going to unpack what the passage of time means physically, emotionally and mentally – and how we can become the best versions of ourselves at any age. You’ll hear why friendships are vital at any stage in life and learn about the latest research on living longer and healthier, as well as what the science says about different methods of “biohacking.” We’ll also talk about the unique struggles women face as they get older – specifically all the pressure to keep up a youthful appearance – with actor, filmmaker and author Justine Bateman, who has made a conscious decision to age naturally.

What’s age got to do with it?

Why do we grow old? What’s happening to our bodies with the passage of time? And at what age does a person officially become old? Those are some of the many questions that came to my mind when we started working on this season. 

Historically speaking, old age was considered by scholars and writers to start around 60 – which seems a bit out of step with our contemporary times when, after all, 50 is the new 40 or maybe even 30. But even a 2009 Pew Research survey of Americans adults pegged that number at 68. (That was the average of all answers; tellingly, survey respondents between the ages of 18 and 29 put the number at 60, while those 65 and older said 74).

When I ask my teenage daughters, “when does old age begin?” they typically answer with something like, “Well, how old are you?”

All joking aside, as I have said, this is the best decade of my life so far, and despite being over 50, I have never felt more fit. Being a scientist, I have always been driven to measure things. So every year on my birthday, I time myself running a mile on the same route as fast as I can. And I have to say, I haven’t gotten slower throughout the 15 years I have been doing this – in fact, my time has actually gotten a bit better recently. And if you look at the world record running times for men and women, according to World Masters Rankings, there is only a slight slowing between ages 35 and 70, with real slowing not happening until 85.

This aligns with a paper I read recently about how biological age can be measured by analyzing blood samples for levels of a few hundred proteins. What was most fascinating to me is that the researchers found that we don’t age at a constant rate throughout our lives but rather in bursts, with the biggest changes coming around ages 34, 60 and 78, on average.

The question, to me, becomes how we can make those bursts smaller, less pronounced, in order to slow our eventual decline – because after all, aging is the biggest risk factor for many diseases, such as heart disease, Alzheimer’s and cancer.

We know that diet, physical activity, sleep and stress are all factors in the equation. But there are nuances here. For example, for one episode of the podcast, I interviewed Paul Holbrook, a certified strength and conditioning coach and the founder of a gym called Age Performance that caters specifically to older bodies. He argues that surges of intense activity are actually better than spending a long time on endurance exercises.

Holbrook’s point is that with these sudden surges of activity, you get the same heart and lung benefits that endurance exercises like jogging provide, but you also work out your fast-twitch muscle fibers. It’s these muscle fibers that keep us spry, strong and able to move quickly – and which we tend to lose more quickly as we age. Those muscles help prevent falls by increasing strength and balance, and if you do fall, your reflexes are faster, so you can react more quickly to reduce injury.

As soon as I spoke to Holbrook, I let my parents know what he said.

Falls are probably the biggest concern I have right now for my parents, who are in their 70s – almost 80s, in my dad’s case. According to the US Centers for Disease Control and Prevention, more than 1 out of every 4 people 65 and older has a fall each year. And of those falls, 1 in 5 results in a serious injury, like a hip fracture or a head injury. That kind of injury can take away a person’s independence in a heartbeat or erase decades of preventive efforts like keeping blood pressure, cholesterol and weight in check – things that my father and millions of others do. In fact, a few weeks back, I operated on an 80-something-year-old who fell and hit his head; even though he was in fairly good shape, he didn’t have enough muscle tone or fast-twitch fibers to stabilize himself and prevent the fall. Fortunately, he did very well in his recovery, in part because he was found quickly. But for too many seniors, a fall like that is associated with progressive and even terminal decline.

Is the midlife crisis real?

Another topic that we explore in the podcast is the idea of a midlife crisis. Now that I am, by most accounts, firmly entrenched in middle age, I want to know, is this crisis something I can expect? Because I haven’t felt the need to buy a fancy car or ditch my family to start a new life.

I spoke to a health psychologist and professor at the University of British Columbia, Nancy Sin, who explained that the traditional idea of a midlife crisis was rooted in existential anxiety about aging and mortality. But Sin reassured me it is mostly myth. To be clear, crises like divorce, disease or death do happen, but they are not relegated only to middle age.

But Sin also told me that the whole concept of “midlife crisis” has shifted since millennials, in particular, have started hitting middle age. Millennials are a generation long perceived as young, lazy and entitled, but they have also delayed acquiring the usual trappings of adulthood – a house, a family, a career – and the sometimes heavy financial and social responsibilities that go along with them. So what does midlife, and the midlife crisis, look like for them? For a gut check, I also speak to my brother who, at 10 years younger than me, is on the cusp of the millennial generation, to see how he is experiencing this stage of his life and whether it’s any different from my vantage point.

In keeping with the family theme, in our first episode of the season, which kicks off this week, I talk to my parents. I was surprised when they told me that they are living their best lives ever right now, in their 70s. Given how hard they had worked their entire lives, I sometimes worried they had lost the capacity for joy – but nothing could be further than the truth. What is particularly amazing is how they were able to stack the deck in their favor (despite setbacks in their early lives) in order to really make these their golden years.

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