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<http://online.barrons.com/this_week>Features
MONDAY, JUNE 23, 2008
FEATURES MAIN  


  Healthy Returns ? How to Live Longer

By *MARY PINKOWISH*  | MORE ARTICLES BY AUTHOR
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    Special Report: Retirement -- Eight things to do to live longer and
    minimize the aches and pains of aging.

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*MY AUNT AND GREAT-AUNT* were both pushing 102 when they died. I figure
I stand a decent chance of getting there, too -- and when I do, I'll try
not to gloat. As Thomas Perls, director of the New England Centenarian
Study, told me, living to 102 simply "won't be as great an
accomplishment for you." That is, compared with my aunts I've lived a
privileged life health-wise. In addition to my presumably good longevity
genes, I'm enjoying the benefits of childhood vaccinations, anti-smoking
campaigns throughout my school years, antibiotics and, of course,
Lipitor. So are you.

The longer you live, the longer your life expectancy. At his birth in
1950, a white male had a life expectancy of 66. 3 years. When that man
turns 65 in 2015, his life expectancy will have stretched to 77.8
(nearly the same as a baby born in the United States in 2006). And if he
makes it to 85, his life expectancy will be 89.4 years. A white woman
born in 1950 may do even better and can expect to live to age 80 if she
reaches 65 and nearly 90 if she reaches 85.

[healthboarder]
Corbis
Boomers are hoping to keep their bodies and minds agile as they age. New
tests, treatments and exercises can help.

Numbers like that have left baby boomers hoping to far outdistance their
original life expectancies -- and to minimize the chronic diseases of
aging. Living to 90 or 95 with an agile mind and only a brief illness
before death -- that's the ticket. It can make for either a glorious
retirement or a fulfilling professional life after 65, as many are planning

So, you've quit smoking and had a colonoscopy. What's next? Below,
you'll find the latest thinking on everything from diagnostic tests to
exercise to life-extending chemicals. The story "The Hidden Costs of the
Golden Years
<http://online.barrons.com/article/SB121401034714593887.html?mod=article-outset-box>,"
meanwhile, shows how to handle the spiraling costs of health care.
Here's to a long and financially savvy life.

*Get a Coronary Scan*

"We can pick up coronary artery disease 20 years before you need bypass
surgery or have a heart attack," says David A. Fein, medical director at
the Princeton Longevity Center in Princeton, N.J. While cholesterol
levels can be telling, a coronary CT scan to determine your calcium
score, or how much calcium is in the plaque that lines blood vessels in
your heart, is a better predictor of heart disease and stroke risk, says
Fein. By a certain age most of us have some plaque, and calcium specks
in plaque suggest that a person is at higher risk for a coronary "event"
than someone whose plaque contains no calcium.

The predictive value of coronary calcium scoring was demonstrated in a
study of more than 6,700 men and women published in the New England
Journal of Medicine in March. Compared with people who had the lowest
(best) calcium scores, those with the highest scores had 10 times the
risk of angina, a heart attack, or death from coronary heart disease. A
coronary-calcium scan, runs between $300 and $600; insurance coverage
varies. You'll be exposed to X-ray radiation equivalent to the
background radiation you'd normally get during the course of a year just
walking around.

*Exit the Road to Diabetes*

Diabetes, which affects more than 20% of people over age 60, is the
antithesis of healthy aging and reduces life expectancy by up to 15
years. Diabetes greatly increases the risk of heart disease, stroke, eye
and kidney disease, and limb amputations. A study of more than 5,100
people published in an early, online edition of the July 1 Annals of
Internal Medicine demonstrated a link between diabetes and hearing loss,
with 21% of diabetics experiencing at least mild hearing loss, compared
with just 9% of non-diabetics of the same age.

Your doctor can tell if you're at risk by determining whether you have
metabolic syndrome -- a cluster of problems including excess abdominal
fat, high cholesterol, high blood pressure, insulin resistance or
glucose intolerance, a tendency to make blood clots, and high blood
levels of C-reactive protein, or CRP. Early medication and lifestyle
changes can delay the onset of diabetes, or prevent it.

*Find Your Inner Fat*

Body fat comes up frequently in health discussions, but not all body fat
is created equal. There is subcutaneous fat, which lies just under the
skin and is harmful mainly because of the extra pounds it represents,
and there is visceral fat, which packs the spaces around abdominal
organs and has been linked to increased risk of heart disease, diabetes
and some cancers.

People with lots of visceral fat often have high levels of CRP, which is
associated with heart disease. Visceral fat is very strongly associated
with metabolic syndrome, according to results from the widely respected
Framingham Heart Study that were published last year in the journal
Circulation.

It's impossible to tell the difference between visceral fat and
subcutaneous fat from looking at a person; even slim people can carry
lots of visceral fat. So doctors are increasingly ordering scans. "A
single CT image through your abdomen is all I need to find out which
type you have," says Fein, whose center is renowned for its
comprehensive "executive physicals."

The remedy for visceral fat: a low-carbohydrate diet, an exercise
program and possible dietary supplementation.

*Parliamo Italiano!*

We hear a lot about how aging brains benefit from "brain training" --
learning a new language, or taking up a musical instrument, or playing
certain types of video games. But does reality match the hype?

"I'm skeptical about these programs," says Harvard-based geriatric
psychiatrist Deborah Blacker. She explains that the evidence that they
specifically prevent or delay dementia is flimsy. "Keep active doing
something that you like rather than something that someone has marketed
to you," says Blacker. By all means learn Italian if you want to
converse with the locals on your next trip to the Mediterranean, but
don't take up the violin if you don't have a real desire to learn.

Cabaret artist Marilyn Maye is a case in point. She appeared on the
Johnny Carson show 76 times, and at age 80 (looking 65), she still
maintains a hectic performance schedule. She runs her own business --
from contracts and travel to rehearsals, choreography and lighting. And
that may help keep her going. "I live in the details," she says.

*E-X-E-R-C-I-S-E*

Your internist has battered you with advice to help lower your risk of
heart disease, but now Alzheimer's experts are singing the same song.
"The measures we take to improve cardiovascular fitness, including the
control of blood pressure, cholesterol, body weight, and increased
aerobic exercise, also prevent dementia. This is a win-win," says
Harvard's Blacker.

"At a minimum, the damage done to your brain by Alzheimer's is additive
with the damage done by vascular disease," she explains. "These
processes may even be synergistic, with vascular disease worsening the
changes caused by Alzheimer's."

"The evidence that cardiovascular fitness reduces the risk of dementia
is so strong that I advise people to really push themselves in this
area," Blacker says. "Even if you don't like to exercise, the benefits
to your brain make the effort well worthwhile."

*Mind Your Bones*

Since exercise is so vital to continued good health, you've got to
ensure that you can continue. Hip and other fractures sideline older
people and often mark the beginning of a permanent decline. That's why
men -- not just women -- should consider getting tested for
osteoporosis. "As many as 40% of our male patients aged 40 and older
have low bone density that predisposes to fractures," says Fein. "One
third of these have low testosterone levels. We bring that up to a
normal level, and we recommend calcium, vitamin D, weight-bearing
exercise and weight training, just as we do in women."

Pay attention to your joints, too. "Do flexibility, range of motion and
joint-strengthening exercises so you don't end up in a wheelchair or in
need of multiple joint replacements," advises Houston-based podiatrist
Jeffrey A. Ross. He recommends yoga and Pilates, along with swimming,
walking and biking. Runners and walkers, he adds, should have a foot or
sports-medicine specialist analyze their gait for biomechanical problems
that could lead to hip, knee or ankle damage. Wearing prescription
orthotics now could prevent pain and disability later.

*Your Choice: Eat or Drink Your Polyphenols*

Evidence has been building for 20 years that at least in some animals,
extreme caloric deprivation triggers a process that curbs degenerative
aging. Most people would find the amount of required caloric restriction
(about 30%) too hard to maintain. But scientists have found that a
chemical called resveratrol, famously present in red wine, may mimic the
effects of caloric restriction.

Earlier this month, Richard Weindruch, a professor at the University of
Wisconsin-Madison Institute on Aging, and colleagues published a study
in the online journal PLoS One showing that resveratrol may delay aging
in mice at lower doses than previously thought. "No other nutrients that
I'm aware of have the ability to increase maximum life expectancy in
mice. It's striking," says Weindruch. The findings, he adds, suggest
that resveratrol and other polyphenol compounds "have the ability to
oppose multiple aspects of aging." Some good sources of polyphenols:
coffee, black tea, apples, wheat bran and cherries.

*Lighten Up*

What can we learn from the very old? Thomas Perls of the New England
Centenarian Study, a Boston University project billed as the
largest-ever study of centenarians, says people who live to 100 and
beyond know how to keep their cool. "They use a lot of humor in their
daily lives and are gregarious," he says. "These characteristics help
them develop important social networks, which do two things: They
provide a social safety net and keep people mentally stimulated, which
is incredibly important."

A study to be published in the July issue of the American Journal of
Public Health supports this, showing that cognitive function is
preserved when women have large social networks. "Men may not get quite
the same lift, probably because women are better networkers," says lead
author Valerie Crooks of Kaiser Permanente, the nonprofit health-care
plan. Women make up 85% of centenarians.

Gentlemen, start your networks. And we're talking poker nights and
bowling, not corporate computers.

------------------------------------------------------------------------

MARY PINKOWISH, a writer based in Larchmont, N.Y., specializes in
medical development topics and publishes a blog about medical
developments, at www.marydpinkowish.com <http://www.marydpinkowish.com/>.

------------------------------------------------------------------------

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