USA: Recipe for Longevity: No Smoking, Lots of Friends

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NEW YORK, NY / New York Times / Health & Science / July 28, 2010
By Laura Blue

A healthy social life may be as good for your long-term health as avoiding cigarettes, according to a massive research review released Tuesday by the journal PLoS Medicine.

Researchers at Brigham Young University and the University of North Carolina at Chapel Hill pooled data from 148 studies on health outcomes and social relationships — every research paper on the topic they could find, involving more than 300,000 men and women across the developed world — and found that those with poor social connections had on average 50% higher odds of death in the study's follow-up period (an average of 7.5 years) than people with more robust social ties. Photo: Elie Bernager / StockImage / Getty Images

(See 10 smarter ways to reach your retirement goals.)

That boost in longevity is about as large as the mortality difference observed between smokers and nonsmokers, the study's authors say. And it's larger than differences in the risk of death associated with many other well-known lifestyle factors, including lack of exercise and obesity. "This is not just a few studies here and there," says Julianne Holt-Lunstad, lead author on the review and an associate professor of psychology at Brigham Young University. "I'm hoping there will be recognition from the medical community, the public-health community and even the general public about the importance of this."

(See TIME's special report on how to live 100 years.)

The friend effect did not appear to vary by sex or by age, with men and women of all ages and health statuses showing roughly equal benefit. Nor were lonely people unusually susceptible to any one disease in particular.

But if it's true that we get by with a little help from our friends, then how, exactly, do our friends do it? That is, how does "social integration" — measured by surveys and questionnaires about friends, family size, marital status and the number of household residents — influence long life? The short answer is that we don't really know yet. "The truth of the matter is that the critical evidence on psychosocial processes and health have come about only within the last 10 to 15 years — even though there's been a lot of theory on it since the 1970s," says psychology professor Bert Uchino at the University of Utah.

(See TIME's special report on how to not get sick.)

That may help to explain why doctors, for the most part, have yet to embrace social support as a factor in good health, on par with smoking habits, diet or exercise. Without a good sense of the physiological mechanisms that may link feelings of loneliness, for instance, to biological markers like blood pressure and resting heart rate, it has been easy to dismiss the power of social connections as nothing more than an artifact of the data or, worse, as touchy-feely pseudoscience.

To be sure, the direct physical evidence of the health benefits of social support is much more preliminary than the population-level association reported by Holt-Lunstad. But the evidence is mounting, says Uchino, who has written widely on the physiological links between social life and health outcomes. (Uchino did not contribute to the new review in PLoS Medicine, but has collaborated with Holt-Lunstad on other projects and was, once upon a time, also her grad-school adviser.)

We turn to family and friends for obvious tangible support when we're sick — from help preparing meals to keeping track of pills, appointments and insurance forms. And caring about others may also prompt us to take better care of ourselves. "A really good example, of course, is someone who has a child," Uchino says. That new bond is often the impetus to quit smoking, to drink less or to curb any number of risky pastimes.

But the influence of social ties may be even more powerful than that. Social relationships, it seems, may also help our bodies help themselves.

Recent lab studies have shown that, in a stressful situation, blood pressure and heart rate will increase less when people are accompanied by a person who is close to them. Brain imaging also shows neurological differences between a person who is alone and a person who has support: in a lab-induced tense situation, brain activity in the anterior cingulate cortex, a region activated in times of stress, is attenuated when people have a close friend or relative alongside them. And it's not just adult stress. In an experiment published this spring, children who were allowed to talk to their mothers after a stressful encounter — giving an impromptu speech or doing math problems in public — showed increased levels of oxytocin, a neurotransmitter thought to dampen the hormonal stress response, compared with children who did not have contact with their mothers.

In one of the most famous experiments on health and social life, Sheldon Cohen at Carnegie Mellon University exposed hundreds of healthy volunteers to the common cold virus, then quarantined them for several days. Cohen showed that the study participants with more social connections and with more diverse social networks — that is, with friends from a variety of social contexts, such as work, sports teams and church — were less likely to develop a cold than the more socially isolated study participants.

The immune systems of people with lots of friends simply worked better, fighting off the cold virus often without symptoms. Studies suggest that the immune response may be affected by stress hormones — catecholamines and glucocorticoids — so that a strong social life thus affects immune function by helping people keep physiological stress in check.

But turning such research into full-fledged medical advice isn't easy. "It's hard to legislate social relationships," Holt-Lunstad says. "And we all know that some relationships are better than others, and not all relationships are entirely positive."

Since Holt-Lunstad's new study reviewed the statistical association between mortality risk and relationship quantity, rather than perceived quality, she wonders whether we wouldn't see even stronger benefits if we focused only on the good relationships. Bolstering these connections may ultimately help people stay healthier than trying to build connections between complete strangers, as in, say, a cancer support group. (Studies on the physical health benefits of support groups show mixed results.) "We need to pay better attention to naturally occurring relationships and to fostering those," Holt-Lunstad says.

Read "Study Says Friends Extend Lives. Do Virtual Ones, Too?"

© 2010 Time Inc.

JAPAN: Elderly living alone increasingly dying the same way

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TOKYO, Japan / The Japan Times / Life in Japan / July 21, 2010

GROWING OLD ALONE

Sign of an aging, isolated society:
lack of family, government support


By NATSUKO FUKUE,  Staff writer

Die unnoticed and in two months all that is left is the stench, a rotting corpse and maggots.

And this is not a war zone or even an episode of "CSI." As Japan's population rapidly ages and more seniors find themselves living on their own, many are also dying alone, victims of "kodokushi" (lonely death) who only get noticed well after the fact.


Kodokushi has neither an official definition nor data, but just in Tokyo, people over 65 who died alone in their residence, including by suicide, stood at 2,211 in 2008, compared with 1,364 in 2002, according to the Tokyo Medical Examiner's Office.

"Those who live alone and have no friends tend to be isolated from society," said Katsuhiko Fujimori, manager and chief research associate of social policy at Mizuho Information and Research Institute.


"A lot of young people, especially men, came to big cities to work during the period of postwar economic growth, and now they are old and alone" because they are unmarried or their partner died, he said. "They might have wanted a free lifestyle, escaping from a close-knit community. But now that they're old, they can't live alone, especially if they need nursing care."

Dying alone has become a growing issue as the society rapidly ages. The government has long assumed families would care for the elderly and thus was able to minimize funding for social welfare, compared with nations in Northern Europe that have extensive welfare systems.

Fujimori said the government must confront the problems of social isolation, poverty and nursing care, because not only are more older people living alone but singles in general are increasing.

The 2005 national census determined that one in 10 elderly men and one in four elderly women were living alone. The total in 2005 was 3.86 million, compared with 2.2 million a decade earlier.

Although more women live alone because they tend to live longer than men, Fujimori said men are more likely to experience social exclusion and end up dying lonely deaths because many don't participate in community activities.

Long hours on the job prevented men from attaining a work-life balance, and this has led to isolation after they retire, he said.

Singles are increasingly spending less time with people other than family, according to Fujimori. Among the member states of the Organization for Economic Cooperation and Development, Japan has the highest percentage of people who rarely or never spend time with people other than family members, followed by Mexico and the Czech Republic.

"The Japanese way of interacting with people is based on family," he said.

Experts note elderly people must depend heavily on family help in terms of nursing care even though there are public nursing care services.

A nursing care insurance system was introduced in 2000 under which 90 percent of costs are covered. But 70 percent of households with elderly people eligible to receive such services still rely on their families, Fujimori said, noting at most they can only receive five hours of nursing-care service a day.

These circumstances cause family members great mental and physical stress, and thus it is no surprise when a middle-aged, or older, family member, no longer able to function as a caregiver, murders a parent needing nursing care.

Social security expenses, including medical, pension and other welfare fees, amounted to ¥91.4 trillion in 2009. At quick glance, it would appear the government has allocated huge amounts to cover welfare costs, but the amount is only 22.1 percent of GDP, despite the growing elderly population.

In Europe, social expenditure ratios to GDP in 2005 came to 30.1 percent in Sweden, 29.4 percent in France, 27.1 percent in Germany and 19.1 percent in Britain.

"It is common for countries where families no longer play a key role in elderly care to try to expand the social security net," said Toru Suzuki, senior researcher at the National Institute of Population and Social Security Research, adding Japan needs to strengthen social welfare support for the elderly.

Fujimori said public support for the elderly living alone is well established in Northern Europe, particularly in terms of housing. "It's a big difference (compared with Japan)," he said.

Britain, Denmark and Sweden provide financial support for barrier-free housing with caretakers or nurses who can watch seniors around the clock.

"What's more, (Europeans) get 'informal care' from friends," said Fujimori, indicating voluntary nursing care by family, friends and neighbors. In Japan, such informal care provided by nonfamily members amounted to just 3 percent, according to a 2005 OECD report, compared with 53 percent in Sweden, 45 percent in Canada, and 35 percent in the U.S. and the U.K.

Researchers also point out that Japan lags greatly in taking measures to help impoverished seniors living alone.

Although the average income and financial assets of singles exceed those of couples when they are working, the situation is reversed at age 65, when singles are more likely to have an annual income of less than ¥1.5 million, Fujimori said.

In addition, he said, most married couples in their 60s own their homes, compared with half the single people in the same age group.

In the next 20 years, poverty is expected to spread to single men in their 50s, as one in four in their 50s and 60s will probably remain single.

The number of single men aged 65 and older is expected to increase sharply to 1.68 million in 2030 from 260,000 in 2005. Meanwhile, single elderly women will reach 1.2 million in 20 years, from 520,000 in 2005, according to Fujimori.

Unemployment, especially among single men in their 50s, is also becoming an acute problem. Men in this age group will probably be denied welfare because they are regarded as still young enough to work but not old enough to draw a pension, Fujimori said. "Single men in their 50s tend to fall into the gap of public financial support."

Suzuki also noted poverty is not just a problem for men.  He said data indicate women with stable incomes have higher chances of getting married. "The less fortunate they are, the greater likelihood that they will remain single," he said.

Fujimori said the government should improve social welfare by increasing taxes and restoring the nation's finances from their current heavily indebted state.

"We should discuss a redistribution of income, and allocate more to welfare and medical costs," Suzuki said.

Fujimori noted, however, that Japanese may be unwilling to share the burden because their trust in the government has flagged. He said the government must make every effort to convince the public of the need to remedy the nation's financial situation as soon as possible.
--------------------------------------------------------------------------------

GROWING OLD ALONE
Neighbors, more than kin, face onus of keeping tabs on seniors
By NATSUKO FUKUE

Cleanup after unnoticed death now a growing industry
By MIZUHO AOKI
(C) The Japan Times

CHINA: Special slogan from grandpa warns against drunk driving

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BEIJING, China / People's Daily / Life & Culture / Society / July 13, 2010

By Wang Hanlu, People's Daily

If you watch the back of vehicles moving on the road, you will find many funny slogans pasted on them such as "Don't touch me", "Love me, then stay away from me" and so on. It seems like using vehicle slogans has become a fad among youth.

However, an 82-year-old grandpa in Xi'an is a fashion pioneer too. Recently, he pasted a slogan that said "Drunk-driving makes me worried" on his tricycle. Someone took pictures of the grandpa and posted them on online forums. They made the old man popular and he is now known as, "Grandpa Worried" on the Internet, according to Xi'an Evening.

The grandpa with a grizzled beard wears a white shirt, bib pants, cowboy hat and sun glasses and rides a tricycle with the funny slogan on the back to warn people not to drive when drunk.
(Photo by Xi'an Evening)

According to the old man, the idea of pasting such a slogan came up to him after his tricycle was hit by a drunk driver once. Now he does this to warn people not to drive cars when they get drunk. He also tries to tell his sons and grandsons not to drive after getting drunk.

Since the photos were released on the Internet, the grandpa has become very popular among netizens and he has been called "Grandpa Worried." It is said that the old man often rides his tricycle around on the streets of Xi'an and would like to let more people see the slogan.

Copyright by People's Daily Online

USA: Robert Butler, Expert on Aging, Dies at 83

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Robert Butler Coined 'Ageism' 

The Associated Press, New York,  reported July 6 morning death of  Dr. Robert Butler, an expert on aging who coined the phrase "ageism," has died in New York City.

Christine Butler says her father died Sunday at Mount Sinai Medical Center at age 83. The cause was leukemia.

Photo credit: worldbbnews.com

Butler was a gerontologist and psychiatrist. He was the founding director of the National Institute on Aging, one of the National Institutes of Health.


He was also the founding chairman of the nation's first department of geriatrics at the Mount Sinai School of Medicine and also founding President of the International Longevity Center-USA in New York City.

He wrote several books on aging, including the Pulitzer Prize-winning
"Why Survive: Being Old in America."

USA: Her 110th Birthday Is One To Savor

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SAN DIEGO, California / Union Tribune / July 6, 2010

By Diane Bell, Union Tribune Columnist

Today marks not just the 110th birthday of Frederica Maas, but her first day as a supercentenarian.

She is the second-oldest person in California on record at the Los Angeles Gerontology Research Group, which corroborates birth data and age documentation. Soledad Mexia, also 110 and a San Diego resident, is nearly 11 months older. Institute researcher Robert Young says there very likely are other supercentenarians living in our state, but they haven’t come to the group’s attention and often don’t until their deaths.

Meanwhile, Maas, known as Freddie to her friends, is savoring her moment. She requested a chocolate cake for today’s party at the Country Villa health care center in La Mesa, where she has lived for the past eight years. Like many super seniors, she has her good days and her not-so-good days. Though she is dependent on a wheelchair and needs physical assistance, her mind is still sharp.

She never had children, but will be joined today by a niece and her grandnephew, San Diegan Tony Tovar, and his family.

Maas lived a storied Hollywood past. She was a women’s libber in the 1920s before the term was coined. As a screenwriter, she worked on several silent movies starring “It Girl” Clara Bow, including “The Plastic Age” (1925) and “Dance Madness” (1926). Maas also worked for MGM on film projects that featured such stars as Joan Crawford, Greta Garbo, John Gilbert, Norma Shearer and Erich von Stroheim.

She was still active on her 99th birthday when she published her autobiography, “The Shocking Miss Pilgrim,” in honor of the script she cowrote with her husband, Ernest, in 1947, that later showcased Betty Grable.

“I was born in a cold water railroad flat on 101st Street near Madison Avenue on July 6, 1900,” Maas wrote. “My mother was her own midwife with the help of my oldest sister, Vera, who was then 17. It was early afternoon. Papa was, of course, at biz. There was no time to call a doctor so mom delivered me herself. ‘Another girl,’ she said softly. ‘Your Papa will not like that. He wanted a son.’ ”

It didn’t take Maas long to prove, however, that she was strong-minded and could hold her own in a man’s world.

I interviewed Maas on her 99th birthday. She had a book signing session and a PBS interview scheduled that day. The next day she was heading to L.A. for an interview with film critic Leonard Maltin and an American Radio Network broadcast.

Today’s hallmark birthday comes on the heels of research published July 1 in the journal Science. Researchers at Boston University Medical Center have identified genes that helped them predict “exceptional longevity” with 77 percent accuracy.

In the interest of unlocking the secrets to long life and the aging process, Maas has authorized the University of Southern California’s Alzheimer’s Disease Research Center to examine her brain after her death.

While she has taken good care of her health, Dr. Frank Kalmar, her San Diego physician, says the key to her longevity was her choice of grandparents. He adds, only partly tongue-in-cheek, that because she had no children she may also have been under less stress.

© Copyright 2010 The San Diego Union-Tribune, LLC

See earlier report about Frederica Maas

CANADA: Our idea of 'too old' is going to have to change

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OTTAWA, Ontario / Ottawa Citizen / LIFE / July 2, 2010
By Dan Gardner, The Ottawa Citizen

John de Chastelain, the acclaimed general and diplomat, said something enormously important last week when he responded to rumours that he would be the next governor general. It's not on, said de Chastelain, who will be 73 in July. He's too old. "It would be appropriate to have someone younger and perhaps with better qualifications than mine," de Chastelain told the Globe and Mail.

Alfred John Gardyne Drummond de Chastelain OC CH CMM CD (born July 30, 1937) is a retired Canadian soldier and diplomat,  former Chief of the Defence Staff Canadian Armed Forces

Discount that bit about qualifications. The accomplishments expected of a governor general have been declining for a generation and de Chastelain's résumé towers over that of any recent occupant of Rideau Hall. But he is indeed almost 73. And he is far from alone in thinking that makes him too old.

Which is a problem for all of us. A big problem.

No, this is not going to turn into a thunderous denunciation of the horror that is "ageism." My heart wouldn't be in it. As someone born in the trough following the baby boom, a little more "ageism" could do wonders for my career prospects. Go ahead and arbitrarily dismiss older people, I say. Clear out the baby boomers. Put them all out to pasture. That would suit my self-interest nicely.

For a few more years, anyway. But then things would take a nasty turn ... for my generation and others.

Anyone who has read a newspaper in the last decade knows about "population aging." Thanks to high and rising longevity, fertility rates in the cellar, and the advancing years of the baby boom cohort, the age of the average person in Canada and other developed countries is going up rapidly.

According to Statistics Canada's latest demographic projections, the number of seniors is expected to more than double between 2009 and 2036, growing from 4.7 million to between 9.9 and 10.9 million. Seniors' proportion of the population will almost double, rising from 14 per cent today to between 23 and 25 per cent in 2036.

For the first time in history, seniors will outnumber children. For economists, the number that really matters is the ratio between people of working age and those who depend on them, namely kids and retirees. The lower the ratio, the greater the burden on workers and economies. Thanks to low fertility rates, the ratio of workers to kids is high and isn't likely to change. But the story with retirees is very different. In 2005, the retiree population was 20 per cent of the size of the working-age population. Over the next several decades, it will become 40 per cent. By mid-century, there may only be two workers per retiree.

What that shift means for the average person is simple. Your taxes will go through the roof and the social programs you value, such as health care, will be slashed. It has to happen. Math will not be denied. But math can be modified. One way we can ease the pain of population aging is to keep older people in the work force longer.

For those of us raised on dreams of "Freedom 55," sailboats and travelling the world, that won't sound terribly enticing. But the reality of retirement isn't nearly so wonderful as advertisers make it seem. And staying in the work force longer isn't so awful. For most, it means maintaining a sense of connection, capability and purpose that may otherwise be lost. It's also good for the savings account, which improves retirement when it does come.

A little historical perspective should also be borne in mind. For decades, the effective age of retirement steadily dropped. This wasn't just a luxury we could afford with rising prosperity. It was a deliberate policy intended to get older workers out faster in order to make room for the swollen ranks of young workers. The situation is very different today, so pushing the retirement age back up only makes sense.

And remember that the very concept of retirement was essentially invented when Bismarck's Germany created an old-age security system in 1889. Payments kicked in at age 70 -- at a time when life expectancy was much less than 50 and the average septuagenarian was afflicted by disease and disability. Today, life expectancy has topped 80 and seniors are far healthier and more capable than ever. Not that some weren't in the past: Bismarck was 74 when he created old-age security and a few years later Britain's legendary William Gladstone became prime minister for the fourth time. He was 82.

So, is 73 too old for a governor general to do a fine job at Rideau Hall? Should a younger person automatically be preferred? With all due respect to Gen. de Chastelain, that is nonsense.

But that nonsense is ingrained in our culture. Thanks largely to the emergence of the baby boom generation in the 1960s, we are obsessed with youth. We idealize it. We give it automatic preference. The qualities of youth are valued above the experience and judgment that comes with age and so, where other cultures are respectful of "elders" and value their counsel, we are dismissive of "old people" and wish that they would shut up.

Baby boomers left youth behind long ago but the cult of youth they inspired lives on. Have a look at last week's New Yorker, where an ad placed by this country's federal government touts the strength of the Canadian economy: Above a list of serious and important statistics, five corporate types huddle around a boardroom table, poring over blueprints. Not one looks older than 30.

A demographic shift is coming. That much is inevitable. Much less certain is whether we will make the cultural shift the demographic shift demands.

Dan Gardner
E-mail: dgardner@thecitizen. canwest.com

© Copyright (c) The Ottawa Citizen

ASIA: Alzheimer's scourge hangs over ill-prepared Asia

HONG KONG / Reuters / July 1, 2010

By Tan Ee Lyn, Reuters

Asia's fast-aging population will make up more than half of the world's dementia patients in 40 years, with China shouldering the biggest chunk.

With very few skilled nursing homes, daycare facilities or plans to build many more, health experts say the region is ill-prepared to cope with the sharp increase in patients needing such specialized and intensive care.

A woman dressed in a traditional Chinese wedding costume smiles during memory training at the community ambulatory care in Hong Kong on June 21, 2010.
Photograph by: Tyrone Siu, Reuters

"Asia will bear the burden because of the aging population in China ... figures in China will be tremendous," Dr. David Dai, coordinator of the Hong Kong Alzheimer's Disease Association.

"We are not prepared. The whole of southeast Asia is not prepared," gerontologist Dai said in an interview.

More than 35 million people suffer from Alzheimer's disease (AD) and other forms of dementia, a number expected to almost double by 2030 and pass 115 million by 2050, according to Alzheimer's Disease International (ADI). Alzheimer's, the most common form of dementia, robs people of their memory and thought processes and, eventually, bodily functions.

In Asia, 13.7 million people had Alzheimer's or other forms of dementia in 2005. That is expected to grow to 23.7 million by 2020 and 64.6 million by 2050. China alone will have 27 million sufferers by 2050 and India 16 million, according to ADI.

ONE FOR EVERY FAMILY

About 10 percent of those in their 70s can expect to have dementia, and 30 percent of those in their 80s.

"Everyone will experience this, every family. It is now common to live to your 80s," said Peter Yuen, director of the Public Policy Research Institute at the Hong Kong Polytechnic University.

In the United States, the annual amount spent by the government, private insurance and individuals to care for people with AD, is projected to jump more than six-fold to $1.08 trillion by 2050, according to the Alzheimer's Association. The costs are just as substantial elsewhere.

Yuen, whose mother has Alzheimer's, told a recent AD symposium in Hong Kong that four years of daycare and two years of residential care in a general nursing home in Hong Kong would cost HK$540,000 (US$69,000) per patient.

But even that is an underestimate for 82-year-old Aw Bek-sum, whose children have had to fork out HK$15,000 (US$1,920) each month to take care of her since she was diagnosed with Alzheimer's four years ago. The sum covers daycare, visits to the doctor, a domestic helper and household expenses.

"It's devastating for families with AD patients. There is just not enough support," Yuen said

He proposes long-term financing or some form of pooled insurance for patients who are chronically ill so that services will be made available once the ability to pay is assured.

BUT FEW FACILITIES

Dedicated facilities for AD patients are scarce in Asia. Hong Kong has 110,000 patients but only 299 places in four daycare centers, and not a single residential care facility. Many end-stage sufferers are put into general nursing homes where staff are not trained to care for them.

"In nursing homes, their conditions get worse because they are normally tied down and they don't have any social interaction, then they die quickly," Dai said.

In Malaysia, an estimated 50,000 people suffer from dementia.

"Very few private nursing homes are dedicated to the care of the AD sufferer, although some homes will accept a few AD sufferers if they are not behaviorally challenged," said Philip Poi, head of Geriatric Medicine at University Malaya.

"Malaysia is starting to appreciate there is a problem, but currently, care giving is provided mainly by the informal careers such as the spouse or child."

China has up to 8 million dementia patients, but very few hospitals in the country have independent dementia units. By 2030, one in every four Chinese will be over 60.

"Because of China's aging population, the government sees stronger demand for care and medical facilities for the old. It's possible that in the next few years, China will establish more facilities and organizations for old people and dementia patients," said Zhang Shouzi, deputy manager of the Beijing Geriatric Hospital's dementia unit.

© Copyright (c) Reuters