Chapter 6
You Are as Young as You Feel — Part 4
There is a brand of happiness typified in the purpose-driven life of Danes. Like all forms of happiness, it assumes basic needs are covered so that people can pursue their passions at work and leisure irrespective of age. Academics refer to this as eudaimonic happiness, a term that comes from the Ancient Greek word for ‘happy’. Worldwide polling company Gallup measures this by asking respondents whether they ‘learned or did something interesting yesterday’. The concept was made popular by Aristotle, who believed that true happiness came only from achieving a life of meaning, of doing what was worth doing.
Winters are long and dark in Denmark; night falls by 4:45 on November afternoons. To compensate, Danes create cosy environments with candles, the warmth of the hearth and the gathering of friends of all ages. Ageism is uncommon in Denmark, as is discrimination on any level. The Danes illustrate that it is possible to achieve a more egalitarian society with eudaimonic happiness at each life phase. As a consequence, life expectancy is one of the highest in the world and consistently growing year on year by 0.18 per cent per year – currently 81.11 years.
Chapter 1: You Are as Young as You Feel
This egalitarian approach is also apparent in the world’s Blue Zones, where generations have respect for each other and friendships transcend age, societal positions and pleasure; friendships and happiness are important for all, independent of age. Our language matters and ageism is exemplified by language and terminology. The terms ‘senile’, ‘demented’ and ‘aged’ are unfortunate terms that are thankfully disappearing. And yet, there is still a term in common use that needs to go: ‘elderly’. Certain words can be convenient but promote stereotyping through their generalisation and lack of specificity. Thus, using the term ‘elderly’ for a person who is robust and independent as well as for a person who is frail and dependent says little about the individual and is an inaccurate and misleading descriptor.
Consider how often you heard references to ‘elderly’ persons or ‘the elderly’ during the recent Covid crisis. The terms are ageist. Ageism, like racism and sexism, is a form of prejudice or prejudgement that shapes perceptions. Ageist terms diminish older adults, yet ageism is rampant, even in healthcare, stereotyping older people as sick, frail and physically dependent. Ageism results in less care, less robust care and negatively affects outcomes.
Chapter 1: You Are as Young as You Feel
Older adults do not like the term ‘elderly’ applied to themselves, even if they use the term to describe someone else, as was the case when my 85-year-old patient talked about her 74-year-old ‘elderly’ neighbour! In a European survey, older individuals displayed a preference for ‘older’ or ‘senior’ and strongly rejected the terms ‘aged’, ‘old’ and – most strongly – ‘elderly’. In 1995, the United Nations Committee on Economic Social and Cultural Rights of Older Persons rejected the term ‘elderly’ in preference for the term ‘older persons’. Additionally, a media guide issued by the International Longevity Centre recommended the term ‘older adults’ over ‘senior’ and ‘elderly’. The report states, ‘After all, we don’t refer to people under 50 as “junior citizens”.’ It is time for our language use to mature: using terms that are precise, accurate, value-free and that older adults prefer makes good sense. I would like to finish where I started, with the science of positive attitudes and successful ageing. The Nun study is a good illustration of how attitudes have far-reaching influence late into the lifespan.
Can you imagine being invited to take part in a study where the researcher asks if you would not only be willing to be examined in detail at regular intervals but also donate your brain to be dissected after you’re gone? That is exactly what was asked of the 678 sisters of School Sisters of Notre Dame in the USA, who agreed to take part in David Snowdon’s longitudinal study in 1991. The sisters were studied with repeated health tests and psychological tests until their demise. All sisters agreed to have brain pathology studies at post-mortem. In this way, the influences of lifelong health and life experiences on the brain were mapped.
Chapter 1: You Are as Young as You Feel
The Nun study was as close as you can get to a long-term human experiment. When conducting experiments, it’s important to control as many factors as possible, so as to better investigate the element in which you are interested – in this case brain health and dementia. In this sense, the nuns were perfect: their marital status was the same and none had children, and almost all had been teachers throughout their lives. They had similar income and socio-economic status, ate regularised diets, lived together in similar surroundings, did not smoke or drink and all had access to similar preventive, nursing, and other medical care services. They rose and went to bed at the same times. In other words, the physical backgrounds and conditions which normally confuse and complicate interpretation of data were about as controlled as they could be. Photographs from the convent archives show reception class from the SSND, in 1927, and the survivors of that class 60 years later (overleaf ). Some of the unexpected factors that affected whether or not the nuns developed dementia were their attitude in early life and their temperaments. An exciting feature available to researchers was an archived letter that all nuns wrote when they were 20, after their candidate year and before taking final vows. This gave an insight into the attitudes of the nuns and how these attitudes affected the ageing process 60 years later. Temperament determines people’s capacity for coping with stress and life challenges. As illustrated by the Dunedin study, coping mechanisms such as a positive attitude and good temperament help to better manage stress. Positive attitudes provide a type of inoculation to brain pathology. Here are two examples of different attitudes apparent in the candidate year letters: Sister 1 (low positive emotion): I was born on September 26, 1909, the eldest of seven children, five girls and two boys. My candidate year was spent in the Motherhouse, teaching Chemistry and Second Year Latin at Notre Dame Institute. With God’s grace, I intend to do my best for our Order, for the spread of religion and for my personal sanctification. Sister 2 (high positive emotion): God started my life off well by bestowing upon me a grace of inestimable value. The past year which I have spent as a candidate studying at Notre Dame College has been a very happy one. Now I look forward with eager joy to receiving the Holy Habit of Our Lady and to a life of union with Love Divine. Simply put, the nuns who expressed more positive emotions lived, on average, a decade longer than their less optimistic peers and were less likely to get dementia. By the age of 80, 60 per cent of the least happy nuns had died. The probability of survival was consistently in favour of the more positive nuns.
Chapter 1: You Are as Young as You Feel
How we perceive ourselves influences the biological pace of ageing. Perceptions can be influenced by societal attitudes, ageism and life course experiences. The more optimistic and positive our perceptions, the more likely that we will live longer, healthier and happier lives. This is explained by changes in biological ageing, as evidenced by the DNA methylation in cells throughout the body. I hope that this awareness will empower individuals to age in the most successful way possible and even enable our last decades to be our best quality years.
Chapter 2: Why Do We Age?
IN 25 YEARS, EVERY FOURTH PERSON LIVING IN EUROPE AND NORTH AMERICA
will be aged 65 or over. The biggest increase will be in the over eighties. The number of persons 80 years or over is projected to triple, from 143 million in 2019 to 426 million in 2050. In 2018, for the first time in history, persons aged over 65 outnumbered children under 5 worldwide.
There are areas of the world where both men and women lead extraordinarily long lives and where the proportion of people living to 100 years and beyond is larger than elsewhere. These areas are known as the Blue Zones.