How will today's healthy people fare as they age?

In My Humble Opinion
1

There is a lot of emphasis on the growing rates of obesity in the US these days, and rightly so. However, I was thinking about the other side of the coin - those that are taking care of themselves.

When I was young (70s and 80s), no one (OK, very few) took part in marathons, half-marathons, 10Ks, 5Ks and other running events, for example. Running was a sport limited to high school track and cross country, and the Olympics. Now, on any given metro area, you can run one of these, or more, on any given weekend. There are even a few 50K, 50 mile, and 100 mile events that draw hundreds of runners. Running events have become big fundraisers, and it is not uncommon for these things to exceed 10K participants, with 99.99% of the runners not expecting to win anything, as they are just running for fitness, camaraderie, the cause, etc. Where I live there is a large active community of runners, bicyclists, and tri-athletes, who seem pretty dedicated to their health and their sport, and take part in several of these events in a given year.

So, what’s the future look like for this group of people? Assuming they maintain their healthy ways, will there be more healthy people in their 80s and 90s than today? Will they have better quality of life in those years?

2

I think long-term, long-distance running and participating in triathlons aren’t particularly good ways to stay healthy well into old age. The risk of injuries is very high for those and osteoarthritis (wear and tear joint problems) builds over time and can become a very serious issue even in middle age if you don’t keep things somewhat moderate. Joint problems can screw up a person’s quality of life in many serious ways.

Cycling and fast walking are good though as well as moderate weight training to maintain muscle strength and nutrition is as good as it has ever been if someone actually follows the recommendations. In short, everything I have read and experienced suggests that most people can stay healthy and vigorous much longer today and in the future than the vast majority did in the past if they take a few simple but moderate dietary and exercise measures and lets modern medicine do its thing.

In short, I think the 45 year old vegetarian who does yoga three times a week and walks at a fast pace regularly has a much better chance of being a very healthy old person than the gym rat that does Tough Mudder or Iron Man competitions. There are very few people that can do the latter for their whole lives but the former is completely sustainable and very healthy for your entire life.

3

The statistics I’ve seen indicated the baby boomers that run and cycle have more joint problems. 20 years of running wears out joints much quicker. Years and years of Cycling wears out knees and hips.

All things in moderation. imho I cycle and go hiking. But in moderation. No marathons for me.

4

Running can damage your joints, which is pretty unpleasant. Exercise alone doesn’t do that much to add to your life expectancy. One study I looked at found something like a 5% higher chance of living an extra 10 years at age 75 for people who exercise heavily. I still see no evidence that people who eat healthy and exercise add 20-30 years of pain, disease and disability free years to their life.

I have no idea how healthy living affects disability rates. Are americans any healthier than we were 20 years ago? I’ve heard both, disability rates are going down and up. I have no idea what is true or not.

5

More isn’t always better. Too much vigorous exercise can contribute to all kinds of heart issues. (That link in and of itself is crap that leads towards selling a fitness system; it does give a decent summary and links to studies at the bottom.) Triathlons and marathons have also started seeing higher rates of heart attacks during events as their demographics shift older.

I’d bet the “uber-healthy” overexerters die earlier than the moderately active. Even worse if they keep overexerting as they age (high levels of exertion combined with the preexisting damage they’ve built up over the years.) I wouldn’t be surprised if overtime we start seeing more middle age people who’ve “always been healthy” dead by the side of the road like Jim Fixx.

6

Care to share them?

Because the statistics I’ve seen seem to say otherwise.

That would be pretty damn impressive! Really a link would be appreciated. I can only find things like a bit under 5 yearsof extra life expectancy at the high end. But that is an on average and yours is a 5% subset.

Living better is another thing of course.

Regular exercise may help prevent dementia.

And continued resistance training is key to preventing the strength and muscle mass loss that otherwise accompanies aging (sarcopenia). That strength loss is what leads to much of the loss in physical function as we age. Resistance exercise in older age can help some, but having more muscle mass in the bank to begin with is a huge advantage.

Might be true. The dose-response curve so to speak is still unclear.

According to some experts (based on some data) 2 to 3 hours per week of running may be the sweet spot. Over 20 miles a week long term, in at least one study, was associated with decreased life expectancy than more moderate mileage. And high intensity 5 or more times a week has less benefit observed in those with stable heart disease than doing such 2 to 4 times a week.

Of course other data suggests other conclusions.

(Bolding mine.)
So solid evidence that up to 20 miles a week of running and regular resistance exercise is associated with longer life expectancy and moreso longer disability free life expectancy. Clear that the biggest benefits are between no exercise even a very modest program with returns that diminish and perhaps at some point reverse.

7

For men the additional odds of living another 10 years at 75 if they exercise (other lifestyle factors being the same) varies from 5-6%. For women it is 2-3%.

The original paper might be in Swiss, I’m having trouble finding it.

How is that impressive? A person who doesn’t exercise may have a 53% chance of living another 10 years at 75, a person who does may have a 57% chance.

That study found not smoking was more important than exercise, eating fruit and low alcohol consumption combined.

8

Okay actually looking at the article you link to (and the abstract of the article they reference) I am not so impressed, mainly because it really isn’t answering the question we are asking, plus the absract doesn’t tell us what “little exercise” was. Still, I am so dismissive of those numbers as you are, just that they do seem consistent with the overall numbers of at most 5 years of additional life expectancy all age groups. At 75 the odds of living somewhere past 85 were a bit higher for those exercised regularly than for those exercised only a little or not at all. And the odds of getting to 75 are higher if you exercise regularly before that.

No shock that a 75 year old who smokes is on borrowed time.

9

As always, it’s hard to do good studies and it’s hard to interpret the results of studies of all kinds.

When it turns out that runners don’t have significant joint issues, I’m not surprised, because it’s hard to keep running with busted knees. The real question is whether the incidence of joint problems is higher in people who ran in the past vs people who exercised in ways that don’t stress joints vs people who exercised less.

I’ve heard a lot about studies that show exercise is good for your brain. So today’s exercisers will probably have lower rates of dementia later in life.

Exercise is also good for your cardiovascular system, but then we know how to treat those diseases quite well these days so I’m not sure whether the difference will be significant here. (Although I’d much rather be healthy than have to take drugs or undergo surgery to fix problems.)

Exercisers will have more muscle and bone mass, so they can probably stay active and take care of themselves longer.

I’d say the people who were careful and/or lucky enough to avoid injury and accidents will be healthier longer than their inactive counterparts, but others will be about the same or will be worse off because of those injuries or accidents.

Of course all of this just means you get to live long enough for your body to really start breaking down… The ideal would be to be healthy into old age and then just drop dead. But that’s not how it usually works.

All else being equal, obviously it makes sense to choose forms of exercise that have lower risks of injury and accidents. I know boxing is great exercise, if only it didn’t involve getting hit on the head. Currently, I cycle, (somewhat risky depending on traffic), I walk (pretty safe), walk stairs (high intensity, low impact) and inline skate (moderately risky).

I’m thinking about taking up running at some point, but I think I’ll wait until my BMI is under 30 to avoid overtaxing my knees and ankles. Also, I’m worried that bouncing up and down while still relatively fat will stretch my skin and increase the risk of loose skin.

10

Thanks for the replies. DSeid, that is good information and links. I like the 2-3 hours/20 miles rule for running - that seems sound. I used running as only one type of activity. I know there are many more that people enjoy and count for maintaining good health that may be easier on aging bodies (cycling and swimming come to mind).

A friend of mine (pharmacist) once told me that the longer you can delay having to use maintenance medications (those you need to take regularly for the rest of your life), the better off you will be in your later years. I guess that is also part of the nature of my OP - not just living more years, buy having the best quality of life during those years, and feeling good enough to do the things one wants to do.

I dont know how many more half marathons I have left in me, but I can definitely see myself doing 20 miles a week of running for the duration. iljitsch, I agree not many of us will be living great into our 80s and then just drop one day, but I suppose that could be something to shoot for.

11

They found that the 4 lifestyle factors had little impact on mortality at 55. At 65 a person who did all 4 things wrong had about the same chance of living 10 years as a person who did all 4 things right does at 75 (about 66% or so).

And again, exercise didn’t have that much of an impact, it was smoking that made up about 57% of the difference. Exercise, alcohol and fruit intake (no idea why they only discussed that and not vegetable or fiber intake) each made up about 15% of the difference.

12

Not seeing the 55 year olds data at all. And not getting how you can see those results as not that much of an impact. Those at 65 who fail on the four will not make to 75 roughly 44% of the time (!), whereas those 75 who hit all four will make it to 85 roughly 66% of the time. Or to put it another way - those at 65 who did all four wrong had as much chance to die by 75 as those at 75 who did all four right had to die by 85. Yes, smoking was by far the biggest single contributor to that risk. Huge that one.

But rather than dissect that report how about I offer up some additional data?

  1. A meta-analysis: 70% greater all-cause mortality rate in those with lower cardiorespiratory fitness (CRF) than in those with higher. Low had a 40% higher mortality rate than intermediate CRF as well.*

  2. But is it just a marker? The way to figure that out is to study it in a long term prospective fashion - say of tens of thousands of people over a mean of 24 years. (Gotta love Norway.) HR is “hazard ratio.”

Or as the NYT summarized today:

  1. Another prospective study:
  1. Their earlier article of the same cohort focused a bit more specifically on the wear and tear issue, iljitsch, specifically addressing your concern that perhaps those runners hurt are selected out of the pool analyzed. Again, prospectively following “ever runners” compared to “never runners” (and those in running clubs vs community controls) and looking at the broad group of musculoskeletal complaints at the 14 year mark.

So while they did get injured a slight bit more often, the incidence of pain and disability is lower in people who ran in the past compared to those who never ran.

The authors propose that what is happening is pretty close what you see as the ideal, a dramatic reduction in the period of life that those who exercise live disabled … they go stay fairly fit with little disability into a ripe old age and then spend a short period of time disabled before they die: a “compression of morbidity” rather than living close to the same age but with many more of those years significantly disabled.
*To put high, intermediate, and low maximal aerobic capacity in context: “low CRF (< 7.9 METs), intermediate CRF (7.9-10.8 METs), or high CRF (> or = 10.9 METs).” That means maximal achievable of low is walking quickly or jogging at a 13 minute/mile pace to a maximum for high of at a bit under a ten minute/mile pace.