Today was the 100th day that my son, Dylan, had been in school, so we dressed him up as if he were 100 years old. We sprinkled a little baby powder in his hair to make it gray, dressed him in a bowtie and high riding pants with suspenders, fashioned him in some lens free glasses. In his class, some parents went so far as to draw wrinkles and liver spots on their child’s face with a little make up. As I dropped of Dylan, dressed like an old man, he jumped out of the car full of energy and ran to his friends, without a care in the world. If only the actual reality of growing old were so simple.
These days, people are growing older, but they’re also living longer with illness. That means that the quality in our years is running shorter. In the United States, the life expectancy has actually gotten shorter despite the advancements in screening and in medications. There are a number of factors to consider as to why this might be the case, from increasing suicide rates to drug epidemics to increase in chronic disease, but the bottom line is truthfully, we are not taking care of ourselves. From fast food to smoking, people are choosing unwisely.
I had a patient come in, John, twenty-three, without any chronic illnesses, coming in for a check up. He was preoccupied about his heart, noting that he’d been having palpitations relating to anxiety. In reviewing his chart, his body mass index was 29 and his blood pressure was borderline at 133/86. I asked him about his diet and his exercise habits, to which he responded, “I do what I can.” At twenty-three, most people believe they’re immortal and that nothing will hurt them, but typically, this is when problems will start.
A number of health concerns arise as you age. First, muscle tone changes and debility sets in. Sarcopenia is the medical term for loss of muscle mass. After thirty, inactivity can lead to about a three percent loss of muscle mass with each decade. This can lead to mobility problems, low back and pain problems, and other injuries that can be related to loss of muscle tone as in falls and failure to guard oneself in an accident. Staying a healthy body weight gets more difficult to manage as you age, particularly if you are overweight, as it is also much more difficult to lose weight as you age. Metabolism will naturally begin to slow, and the five pound weight gain that people to tend to gain during the holidays over the years will add up. This can lead to medical conditions like hypertension and diabetes.
Falls become a reality as you get older, where balance becomes increasingly a problem, either from actual physical problems, as in from an inner ear issue or from stroke, or from medication issues, as some medications can present with dizziness as a side effect. Memory starts to fail, chronic illness sets in, and polypharmacy begins, leading to other potential problems like medication interactions and fatigue.
Aside from the physical pitfalls of growing older, there are the psychological ones, where depression and anxiety can impact life expectancy. Drug and alcohol abuse contribute to all sorts of physical problems, but the emotional ones are often overlooked. With continued abuse, substance abuse can take a toll on a person’s emotional health and actual will to live. Suicide, intentional or accidental, is one of the leading reasons as to why life expectancy has declined over the recent years.
I told John that time stops for no one and that at his age, his health priorities need to be inline with his daily agenda. The trajectory of your health starts in your twenties, when your metabolism is typically at its peak and there aren’t any ailments or chronic illnesses that you have to worry about. You don’t have back and knee pains to inhibit you. Your heart and lungs can keep up with whatever you choose to do. If that trajectory is less of a peak and more of a flat line, you’ll likely land short of where you’ll want to end up and the consequences of your decisions will accumulate much quicker. For example, the fifteen pounds that you’ve been trying to lose for the past year or two, will be thirty to forty in five to ten years and now we’re potentially talking about medications for diabetes or cholesterol. Growing old is never easy. It’s true that youth is wasted on the young, but with the proper maintenence, physically and mentally, you can hopefully make it all the way to 100 years.