Living Longer

We will have more good years than any other generation in human history has ever enjoyed. Some researchers are saying we should have 50 good years after 50. But that’s if we take care of ourselves, so we can live more fruitfully and more fully. Here’s where we collect the latest information on how you can do that.

Nov 032015

Health care providers must have detailed discussions with their older adult patients to better determine their true life expectancy, as older adults do not accurately predict their own prognosis, a key factor in making decisions about future health interventions, according to researchers at UC San Francisco and San Francisco Veterans Affairs Medical Center.

Their research letter appears online in JAMA Internal Medicine.

“We thought older people would have a good sense of how long they had to live and have better estimates than a prognostic calculator that is based on things like age, gender and chronic diseases,” said lead author Rafael Romo, PhD, RN, doctoral graduate in the UCSF School of Nursing and VA Quality Scholars Nurse Fellow at the San Francisco VA Medical Center, “but we were wrong.”

“It turns out that older people are not very good at predicting their prognosis compared to either their actual survival or a calculated estimate. Further, the older you are, the worse you are at predicting.”

Many professional guidelines recommend using life expectancy in considering diagnostic or treatment interventions in cases where the time to benefit may exceed patient survival. Otherwise, the patient is at-risk for up-front harms with little chance of benefit.

The patients’ perceptions of prognosis also are important. Those who underestimate their survival may choose to forego interventions likely to help them, while those who overestimate may choose interventions more likely to cause harm. However, little is known about how well older adults estimate their survival.

Soliciting Direct Input from Older Adults

In this JAMA Internal Medicine research letter, Romo and his colleagues drew a sample of 2,018 participants ages 64, 69, 74, 79, 84 and 89 from the 2000 wave of the Health and Retirement Study (HRS), a prospective cohort study of U.S. adults. They were asked the percentage chance they would live another 10 years or more.

The participants’ subjective estimates then were compared both to observed survival and the objective estimates determined from a best-fit analysis. Under- or overestimated survival occurred if the estimate was more than 25 percent less or greater than the calculated prediction. The final sample included 1,722 participants, with the 84-year-old and 89-year-old age groups combined due to small response size.

Overall, 54.7 percent of the study participants had similar estimates to the objective calculation, with 32.7 percent underestimating and 11.5 percent overestimating. Underestimation was relatively similar across age groups, but overestimation increased significantly with age.

Further, those participants age 64 and 69 were moderately able to estimate survival, but older participants were no better than chance alone.

“We were surprised to find that people tended to underestimate how long they have to live – not overestimate – compared to the clinical estimates,” Romo said. “This goes against common wisdom that says older people are more likely to overestimate.”

As a result of these findings, the discrepancy between older people’s perceived prognosis and their clinical circumstances may create conflict when clinicians make recommendations based on clinical indicators.

“We need to understand how these differences impact patient-clinician communication and the type of treatments and care they receive,” Romo said. “Of particular interest is whether those who underestimate their prognosis forgo procedures and tests that may be beneficial to them. This is just as harmful to patients as receiving treatments that will not have a benefit, so we need to understand what is happening in both groups.”


Nov 032015

It is widely recognised that our physical fitness is reflected in our mental fitness, especially as we get older. How does being physically fit affect our aging brains? Neuroimaging studies, in which the activity of different parts of the brain can be visualised, have provided some clues. Until now, however, no study has directly linked

Sep 222015

The aging process is associated with declines in brain function, including memory and how fast our brain processes information, yet previous research has found that higher levels of cardiorespiratory fitness in older adults leads to better executive function in the brain, which helps with reasoning and problem solving. Higher cardiorespiratory fitness levels have also been found to increase brain volume in key brain regions.

Aug 242015

In human cells, shortened telomeres, the protective caps at the ends of chromosomes, are both a sign of aging and contribute to it. Scientists at Emory University School of Medicine have found that the dietary supplement alpha lipoic acid (ALA) can stimulate telomerase, the enzyme that lengthens telomeres, with positive effects in a mouse model

Jul 162015

New research conducted at the University of Kansas Medical Center indicates that older adults can improve brain function by raising their fitness level. Jeffrey Burns, M.D., professor of neurology and co-director of the KU Alzheimer’s Disease Center, led a six-month trial conducted with healthy adults ages 65 and older who showed no signs of cognitive

Apr 082015

Physical activity that makes you puff and sweat is key to avoiding an early death, a large Australian study of middle-aged and older adults has found.
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