Sunday, July 9, 2017

Providing a Measurement for Aging Well

How are you Aging?

It's not often a question you hear, but at a certain age, you will begin to think about it if you haven't already.  I've often heard the quote, "You are as old as your joint's feel."  I've often joked my back feels 50, my elbows feels 80, my neck is 20 but my right ankle is 16, so I'm not to bad when you average it all out.  Joking aside, feelings are subjective.  At the clinic, I try to promote objective measures to know if we are doing better and making progress.  A poor question is how did your back feel this morning.  A good question is, were you able to sleep though the night without the back waking you up.  The first is subjective and the later is objective.  One gives clear information that can't be misinterpreted.  If the past week has been waking up twice a night with lower back pain and last night you were able to sleep through the night, progress is being made.

How do we measure Aging?

How do we go about answering the question, are you Aging well?  I think the best way is to scour the literature and put together some agreed upon measures that have shown a correlation with all cause mortality.  Essentially, researchers go over a bunch of studies and correlate stuff.  For example, this group ate 5 fruits and vegetables every day for 15 years and they had a 38% less chance of dying from heart disease.  So, in no particular order, here are a few things to start doing and tracking.

1.  Drink coffee.  Hooray.  2-5 cups of coffee have shown to be brain protective.  This means you are less likely to derive Alzheimers and Parkinsons if you drink caffeinated coffee every day.  It has shown to perhaps be a protector of stroke in women.  This is straight black caffeinated coffee.  Leave the spoonfuls of sugar.  In two very large meta-analysis studies Parkinsons was decreased by up to 31 %.  Coffee and Parkinsons.  There are also some strong correlations with drinking coffee and keeping Alzheimers at bay.  They believe the caffeine and the antioxidants in coffee play a protective roll of some kind.

2.  Get Up!  The simple get down and get back up test has some strong corrections with lifespan as it challenges a few important things, strength, balance and flexibility.  Simply sit down on the floor without your hands or knees and get back up without your hands or knees.  If you need to use an elbow or a hand you subtract a point.  Each point subtracted corresponds to less life span.  This article explains the point system.  Sitting Test.  I think it's a nice marker.  Everyday you do it and if for some reason it starts to get hard, you figure out why.  Every day, get on the floor and get up.  Practice different ways of getting up.

3.  Grip It.  Grip is a surprising thing that has a very strong correlation with health and life.  The loss of it has been shown to be even a better predictor of all cause mortality then even systolic blood pressure.  In these studies a hand dynamometer was used and for every 5KG loss, cardio vascular, Myocardial Infarction and non CV mortality went up.  Averaging 51kg per squeeze for men and 31 for females, both around 40 years old in this STUDY.  There was a corresponding decline as we age. This was one of the few studies I found that gave data.  Now this is great, but I'm the only one of my friends with a Dynamometer.  Two suggestions.  Hang from a pull up bar and time it.  That becomes your marker.  If every couple months you time it you will have a measurement of your grip.  2nd option is purchase a 20 dollar Iron Mind Captains of Crush gripper.  If you close the "trainer" that is 60lbs of pressure.  Count how many times you can close it.  If you can get 10.  There you go, you have your data to measure against.  (Cool thing, training your grip can lower your blood pressure as well)

(84 year old Canadian man deadlifted 440LB...more then me.)

4.  Be a Stork.  Can you stand on one leg?  When I first started looking into this I thought this would be more for the risk of falls.  Falling and fracturing a hip results in 1 out of 5 dying within one year.  But this study showed that the ability to stand on one leg with your eyes closed for less then two seconds to be more of a brain health marker.  Those that couldn't after repeated trying showed a correlation with small "Silent Strokes"  View eyes closed as more of brain marker and eyes open as balance and muscle coordination marker.  Shooting for 20 seconds eyes open and more then 5 with eyes closed.

5.  Chair Squats.  Stand up and sit down 35x in a minute.  This makes sense as it takes a lot of strength and endurance to do it.  The test was done on 53 years and older.  Those that could only do the test 22x or less in the minute were twice as likely to die in the next 13 years.  If you fail it, work on getting stronger.

6.  Walk On.  Walking may be the most underrated health and fitness activity you can do.  With the plethora of pedometers and fitness trackers available these days, there is no excuse to not know how many steps you get in.  If you need some extra motivation, adopt a dog, then you have to walk him 2x a day!  The research has almost shown a linear relationship to mortality,  The more you walk the less chance you have of dying.  But, when you get over 10,000 steps a day there is a jump and you have 40% decrease in mortality.  I read an article earlier this year that showed that 15,000 steps had an amazingly correlation with health.

7.  Know Your Numbers.  High blood pressure of 140/90 is considered high.  Dropping each by 5 points correlates to 7% less mortality.  Vitamin D levels below 20nG/ML  were associated with 2.37 increased mortality rate.  Resting heart rate is another easy measurement that has some correlation with increased mortality.  After 90 beats per minute, the risk for CVD is significant.  Shoot for 70 or less.

8.  Sleep Zone.  When it comes to sleep, Goldilocks had it right, not to little, and not to much.  Under 6 hours and over 9 hours were both predictors of death.  If either is in your life, get some help to figure out why.

9.  Make Some Friends In Your Community.  One of the best and healthy things a human can do is be involved in their community.  What that means to each individual will be highly different.  Whether it is church, a gym, a bike club, a book club or anything were you get involved and share some type of bond has proven to be a highly healthy trait that is ingrained in the human soul.  It has as much evidence for lifespan as quitting smoking.  I recently just finished Sebastion Jungers great book "Tribes," in it he describes why we gravitate towards things like Crossfit gyms and why we are the most content after natural disasters when we are forced to band together to endure hardships.  In fact, during wars, mental depression and suicide go down.

10.  Keep Your Joints Healthy.  Does your shoulder move in 360 degrees of motion?  Does your hip act like a hip?  Can you laterally bend your spine?  Joints are designed for motion.  If they can't, you tend to not move as much.  As you can see, a lot of these healthy aging markers will be improved if you can keep moving.  Functional Range Conditioning was designed to keep your joints acting like joints.  Every morning moving your joints and explore their motion, this is called your Daily CARS.  Controlled Articular Rotations.  Your asking each joint, hey can you move in a circle without much discomfort.  If not, figure out why.

All these ten steps give you markers to check in on.  Some daily, some weekly some every few months.  But, like any athlete, they give you guidelines on what to work on, what to put in maintenance and what to make a high priority.  

For those over 65, I wouldn't let anything go more then a month without getting actual help. Don't let a painful knee or hip stay painful 3-4 months.  That's a significant amount of time to lose conditioning  and lose valuable muscle mass and fitness.  In fact, it is worthwhile to check in with a quality Chiropractor, PT or Strength Coach to get what legendary track coach Dan Pfaff calls a Plan B.  If an athlete is injured they don't sit it out, they work just as hard on whats called Plan B to keep them in shape and ready to compete when they are ready to return to sport.  While you work on what is bothering you with your therapist, you work on Aging well with your plan B.

In a society that seems to fear aging, perhaps it's because we have looked around and seen so many older individuals struggling with any of the dementia's, the fragility of their bodies and the inability to care for themselves.  Perhaps it is because we have been told we have the "genetics" for certain ailments.  Perhaps it's because we have this fear we will become a burden for those we love.  At the end of the day our choices our some of the main factors we have that help with these fears.  I see it every day in the clinic, vibrant 80 year olds, hanging out with their grand kids and struggling 60 years old that fear what the future holds.

These 10 choices will give you an outline or map to help bring about measurable change.  So when someone asks how you are doing you can say, "I'm aging well my friend."

PS.  Please pass this along if you know someone you want to Age Well.  Thanks!