Ageing well

Attitude, diet and exercise are key if we are to age successfully, says Professor Susan Kurrle.

Frenchwoman Jeanne Louise Calment took up fencing when she was 85 and she bicycled until she was 100, when the local gendarme confiscated her bike because her deteriorating eyesight meant she kept running into people.

According to geriatric specialist Professor Susan Kurrle, Calment also drank port daily and she ate nearly one kilogram of chocolate each week until she died in 1997 at the age of 122. She also smoked two cigarettes a day, but because she lived in an upstairs apartment “she walked up and down three flights of stairs to smoke them”.

Speaking at the NSWNMA professional day, Professor Kurrle outlined the latest research on ageing, and what we can learn about “ageing successfully” by studying people such as Calment.  

Ageing well is an increasingly important issue as the life expectancy of Australians steadily increases. “We are currently adding a month to life expectancy every year that we live,” says Professor Kurrle, the Curran Professor in Health Care of Older People at the University of Sydney. “Every twelve years life expectancy goes up by a year.”

Australian women can now expect to live to at least 85, “but if we steer clear of chronic disease, that can be at least 90,” she says. “Kids being born today … can expect to live to 100.”

While in theory these numbers should be cause for optimism, much of the talk around ageing is negative, she notes. “The Productivity Commission, our managers, the Ministry of Health, all talk negatively about the ‘grey tsunami’, but I bet there is no-one … that doesn’t want to be part of that grey tsunami.”

What can we do then to age successfully and avoid age-related conditions such as dementia, frailty and sarcopenia (a decline in muscle mass)?

Unfortunately, Professor Kurrle says, one of the most important factors in ageing is one we can’t control. “Longevity is heredity so the first thing you have to have is the right genes.”

There are, however, three other key factors determining whether we age well that we can influence: our attitude, our diet and our approach to exercise.

“Having the right personality is the second thing: being positive, and Jean … was definitely positive. And you can actually change from being a very negative person to being a positive person, and certainly there are programs [to help you achieve that].”

Exercise has multiple benefits

Being physically active is crucial: exercise lowers your risk of a whole spectrum of age-related illness, including dementia, now 
the leading cause of death in Australian women. Exercise also lowers rates of “depression, breast cancer, bowel cancer and frailty,” Professor Kurrle says.

Exercise, both aerobic and resistance training, is also key, particularly in combating sarcopenia – the age-related loss of muscle mass.

“We lose about one per cent of our muscle mass from age 30,” says Professor Kurrle, who assesses elderly patients’ lower body strength with sit-to-stand tests, where she observes their ability to repeatedly stand from a seated position.

The 30-second exercise allows Kurrle to test your quadriceps and hamstrings, which she calls the “independence” muscles. “If they get weak you can’t get in and out of a car and, most importantly, on and off the toilet.”

When these muscles decline “you walk slowly, and you can’t get across the pedestrian light in time. You are much more likely to fall and more likely to end up in hospital. If you are in hospital you are more likely to stay longer and end up in residential care. You are also much less likely to recover well post-operatively”.

The third key factor in ageing well is nutrition, Professor Kurrle says, and she endorses the often-cited Mediterranean diet.

“Increasing fresh fruit and vegetables, increasing your avocados and olive oils and decreasing saturated fat is probably the diet to live longest.”

Contrary to what we might think, our need for protein increases as we age. While we need around 0.8 grams of protein per kilogram of our body weight per day when we are younger, our need for protein grows with age.

“Once you hit 75 you need 1.5 grams per day, nearly double,” says Professor Kurrle, noting that most hospital and aged care meals are often protein-poor.

It is never too late to adopt habits that will promote healthier ageing, says Professor Kurrle, and she recommends doing things that are easy to incorporate into your everyday life (see box).

“It doesn’t matter what you do as long as you are doing some exercise.”

Professor Kurrle’s seven tips for aging well

  1. Do 30 minutes of brisk walking five times a week (you can do it in two lots of 20 or 15 minutes each day)
  2. Go to the gym or buy yourself a set of 2kg or 3kg weights – about $10 from Target – leave them by your kettle and do a set every time you have a cup of coffee
  3. Do some balance training: stand on one leg while brushing your teeth every morning
  4. Stay curious and interested in others: staying mentally and socially active is important
  5. Care for grandchildren: minding grandchildren predicted significantly higher cognitive function in women (two or three days a week is ideal)
  6. Increase protein intake to 1.5 grams per day per kilo of body weight over the age of 75
  7. Decrease saturated fats and increase good oils such as omega -3