Le Choix: Mourir Vieux ou Vieillir Jeune

Not a day passes without some new finding or study being reported in medical and related literature about the phenomenon of old age. Perhaps this interest is driven by the fact of our changing demographics, especially in developed countries where the proportion of the elderly is increasing. There is an associated expected rise in the chronic conditions associated with old age, such as failing memory, loneliness, reduced physical mobility, weakening heart, impairment of bowel and bladder functions (constipation and incontinence becoming a major issue in this age group).

Over and above all this is added what is considered to be the social and financial burden of providing for the care of the elderly, which all societies have to face and deal with. Different societies have evolved their own coping strategies, but there is a set of common problems which have their origin in the bodily changes that take place with ageing. This is where the work of scientists is helping not only to understand the processes underlying the phenomenon. Further, based on this understanding, scientists devise drugs and devices meant to ease the difficulties of ageing, and doctors and other health professionals then give advice and prescribe accordingly.

We must be thankful to the scientists who take a keen interest in pursuing this line of study, which has also been given a fillip by new techniques that involve collaboration among several disciplines of science and technology, such as the life sciences, engineering, electronics and computing. They allow the exploration of ageing of the human body at the basic level where this is actually taking place: the cell, and even deeper still inside the even tinier parts of the cell reaching to the chromosomes and genes, which are responsible for the transmission of traits such as colour of eyes, height, susceptibility to disease and so on.

That ongoing work finds its way in lay magazines too so as to be accessible to the public at large. This is how my attention was drawn to a series of articles on the subject that appear in the French magazine L’EXPRESS of 25 June 2014. Titled ‘Rester jeune jusqu’a 100 ans’, the articles cover the latest scientific advances, the secrets of ageing well and medical advice, along with a very interesting interview of a leading American researcher, Elizabeth Blackburn.

She received the Nobel prize in 2009 for her work on telomeres, which are bits of DNA (deoxyribonucleic acid – the basic chemical constituent of living organisms) found at the tips of chromosomes. They have a given length, like the pieces of metal that ‘close’ the ends of a shoelace. They shorten by a certain amount during division of the cells as a normal process. Their length correlates with longevity: the shorter they become, the shorter is one’s life. Stress, for example, has been found to accelerate their shortening. The good news is that, conversely, when the stress is removed, they can regain length and therefore to some extent restore longevity.

This brings up the age-old question about what is more important: nature or nurture? In modern terms this would be asked as: genes or environment? Fortunately for us, the relationship between the two is now considered to be more complex than was formerly believed and stated as being 50/50 or 30/70. The current view is that it is not possible to give any ratio as such, but that the span of one’s life is ‘une question de mode de vie, bien plus que de capital génétique.’ And that, ‘désormais, il ne s’agit plus de mourir vieux mais de vieillir jeune!’

This optimistic tone would no doubt cheer hearts, but it also calls us to the individual responsibility of, almost literally, taking our health in our own hands: do I want to live longer and healthier? Then it’s up to me! And as Elizabeth Blackburn recommends, obviously on solid scientific grounds, ‘mieux vaudrait surtout, dès maintenant, faire de l’exercice physique, manger correctement, cesser de fumer et maintenir un état d’esprit positif. C’est gratuit et valide scientifiquement !’

That is what nowadays is referred to as lifestyle, and it is the most difficult thing on earth, as all health professionals know, to persuade people to get up and go! Once the World Cup in Brazil is over, will the screen gazers lift themselves up, brave the weather if need be (Curepipe!) and ‘faire de l’exercice physique’? Alas, I must confess as a doctor that I am somewhat pessimistic, but I do hope that people will be sufficiently interested in their own health that they will act on the advice that has been reiterated a million times over and keeps being freely dispensed in all forms of media. Along with the inspirational messages that can help to enhance positivity in one’s life.

But lifestyle is not only about taking care of the physical needs of the body. It is also about the mental, emotional and social aspects. Here again, many studies have shown that the elderly who keep up a level of intellectual activity, which includes reading/writing and solving puzzles such as crosswords and Sudoku among other things, as well as socialize regularly, are less likely to develop mental problems, one extreme form of which is Alzheimer’s disease. Each society must make provision for such interactions among the elderly because at the end of the day it is society collectively that has to face their problems.

The work of scientists and health professionals is showing the clear way ahead for human beings to deal with the demographic shift, through the adoption of relatively simple and commonsensical preventive measures. If one begins early, from the childhood years under the guidance of parents who must themselves lead by example, and then as one attains the age of reason in the adolescent years through to the totality of one’s adult life, then there is no reason why one may not live both healthier and longer.

The ball is squarely in our court: take it or leave it!

* Published in print edition on 4 July 2014