POSITIVE PSYCHOLOGY: Getting older is inevitable but a better attitude smooths the path to the senior years

PEOPLE are living longer than ever before.

An Irish man can now expect to live to 78.4 years and an Irish woman to 82.8 years according to the most recent Central Statistics Office figures. We are an ageing population though, and with old age often comes more compromised physical health. The more chronic health problems such as heart disease, hypertension, diabetes, arthritis become more common as we age.

In addition there can be age-related issues with mobility, hearing and vision. Ageing can also pose a challenge to our psychological health. The increase in the number of people with Alzheimer’s disease and other dementias and neurodegenerative conditions is in part due to the fact that people are living longer lives. However, these conditions are not a normal part of ageing. Likewise, while the incidence of depression does increase in older adults, depression is not a normal aspect of ageing.

Depression can be harder to recognise as a clinical disorder in older adults because there can be comorbid physical conditions that are causing distress to the person. Sleep also tends to get reduced in quantity and quality as we age, while disruption to sleep patterns can also be a symptom of depression. Once recognised and diagnosed though depression in older adults can be treated effectively.

It seems that prevention is better than cure, when it comes to both the physical and psychological aspects of ageing. The term “ageing well” was coined in 1987 by scientists John Wallis Rowe and Robert Kahn in the US; these researchers identified three factors involved in ageing well: being free of disabiity or disease; having high cognitive or physical abilities; interacting with others in meaningful ways.

Medical and psychological research studies also point to the importance of factors such as nutrition, exercise, stress management and attitude.

There is also an interesting relationship between depression and heart disease. We know that depression increases the risk of heart disease and that heart disease can trigger depression. While gender and genetics are viewed as the uncontrollable risk factors for heart disease, lifestyle, stress management, nutrition, smoking and exercise are viewed as the risk factors that we can exert some control over.

Cardiac Rehabilitation (CR) programmes have been in development in Ireland since the 1970s. Modern CR programmes aim to help people optimise their cardiac health by managing these controllable risk factors. CR is a hospital-based multi-pronged programme that is offered (where available) to people who for example, have experienced cardiac events such as heart attacks, bypass surgery, angioplasty and stenting.

We are fortunate that such programmes are run in a number of local hospitals here in the Midlands. These programmes are offered when appropriate regardless of age, although participants are more likely to be older than younger since cardiac events and surgical intervention is less likely in young people.

These programmes typically incorporate twice-weekly exercise sessions over two months alongside education which typically comprises: nutritional advice about diet and healthy food choices; psycho-education about, for example, coping with stress; introduction to stress management techniques; occupational therapy input to advise patients about issues such as activity levels and energy conservation; physiotherapy input to instruct about appropriate movement and exercise routines.

The outcomes of such programmes are encouraging. The evidence shows that cardiac rehabilitation reduces premature deaths and improves quality of life.

People experience weight loss, begin to exercise more and with confidence. People learn about the relevance of a proper diet and managing the stress in their lives. In addition, outcomes are positive in terms of psychological well-being. As a result cardiac rehabilitation is recommended by international health guidelines.

We often tell our clients and those who attend our classes that physical exercise is the best form of exercise for the brain. In addition, the research evidence suggests that more sedendary exercise such as reading listening to music, playing board games, cards, jigsaws, crosswords, word searches and so on decreases the risk of Alzheimer's.

Medical research disseminated by Harvard Health Publishing has identified a group of people who have managed to age exceptionally well, “super-agers”.

These “super-agers” are people in their 70s and 80s who are performing as well cogitively and physically as people decades younger. Magnetic Resonance Imaging (MRI) of the brains of these super people suggests that they have better thickness in areas of the brain particularly responsible for language and emotion. Conversely, in us less super humans, we expect brain cells to shrink and atrophy with age.

So what is their secret? The researchers found that they exercised regularly most days of the week at a fairly good intensity. They tended to challenge themselves cognitively, for example, by learning a new language or how to play an instrument or often something more mundane such as filing their own tax return for the first time.

But most important (more important than their intelligence quotient or educational level) seems to be their attitude. They embrace change and challenge, manage frustration well and seek the support of others.

We often describe the benefits of mindfulness and mindful meditation here in this column (as well as to our clients, class attendees etc.). The Buddhists have understood for over 2,500 years that mindfulness is good for you.

Modern MRI scanning can now back that understanding up. Research evidence links regular meditation with heightened attention, awareness, working memory and greater mental efficiency and mental flexibility.

Researchers at UCLA found that experienced meditators have higher concentrations of grey matter tissue in certain parts of their brains that are normally depleted when we age.

Sara Lazar and her colleagues at Harvard found that eight weeks of mindfulness based stress reduction (MBSR) actually increased cell thickness in the hippocampus. The hippocampus is important for memory and learning. Interestingly, meditation was found to shrink cell matter in the amygdala.

The amygdala is that tricky part of the limbic system that sets off our threat system and causes considerable fear, anxiety and stress.

So, ageing is inevitable. Normal ageing - while challenging physically and psychologically - does not include depression or dementia. Research tells us that if we look after a number of factors - our stress levels, our nutrition, our exercise – and seek out mental challenges and mental and social stimulation we are more likely to age well.

Even if we experience ill health such as acute or chronic cardiac conditions, we can significantly improve our outcome through focus on these factors.

And lastly, mindful meditation can actually make physical changes to the brain that result in improved psychological functioning and well-being.

Julie O'Flaherty and Imelda Ferguson are chartered clinical psychologists, both based in private practice in Tullamore. Through Mind Your Self Midlands, they run courses on Positive Psychology and mindfulness throughout the year. They can be contacted through the Psychological Society of Ireland www.psychologicalsociety.ie website (Find A Psychologist section) or on their Facebook page, Mind Your Self Midlands.