Chapter 1 Introduction

Rick’s Health Letter 1.0
Chapter 1.0 Introduction
Issue 1.0 8/2007
Rick Cowlishaw
rcowlishaw@comcast.net


Why the Health Letter
You may ask the question, "Why write about men's health 60 years old and older?" Simply answered; there is not much written about this age group, so we need information. I was born in 1940 and I am learning about what works for me. I want to share what I have learned with others. This is written for men over 60. Yet, there is information here that men of all ages may find useful, as well as women.

Retire at 60
We want to retire at 60 if we can afford it. We may love our work, yet we can do much the same thing as a consultant, or for a few months of the year. Otherwise, we are borrowing time from our great new retirement life, and we are spending the prime healthiest years to keep working. So if we can’t retire at 60, then we will do it as soon as we can.

Traveling the Road
Some of us say, “I'm retired now. Why shouldn't I drink and eat what I want, when I want, and as much as I want? Working out at a gym makes me tired. It’s better if I lie down until I get over it.”

Well, there is a great reason not to do this. We can live a better life, be in better health, eliminate years of suffering, and we may even live longer if we take care of ourselves. Yet we know there is a big catch. We will need to do something to earn this healthier life.

Picture a men’s club where members live a long, enjoyable and vigorous life, with a brief collapse at the end. Members of “Life is good” Club live up to 10 years longer. Members of this club do not smoke, eat healthy, exercise daily, use their knowledge and minds, drink moderately and maintain a weight no more than 15 pounds above their ideal weight. Yes, that is the catch.

This is a journey for men 60 and older in search for good health. We want to make our trip more pleasurable day-to-day by being healthy. We want to make the most of our years to come.

Think of when we have been really sick. What good are great riches or being retired if we are too sick to enjoy it? We want to be in great physical health. We want to avoid colds, the flu and pneumonia. With good health, we will enjoy life more; we want to feel vibrant and alive.

Introduction
We are the "Age Advantaged." We are old enough to have "been there and done that." We have the advantage of time, a history of experiences we can draw on. Our perspective has the benefit of many years of experience and we can take advantage of those experiences. We are retired, so we have the advantage of having time to plan, of doing what we want, and of reflecting on the past.

Retirement
I imagine that most men over 60 are getting close to retirement, and that some are already retired. Congratulations! This is something we have worked hard for all our life. And we will soon reach our goal.

"If your gift is that of serving others, serve them well. If you are a teacher, do a good job of teaching. If your gift is to encourage others, do it! If you have money, share it generously. If God has given you leadership ability, take the responsibility seriously. And if you have the gift for showing kindness to others, do it gladly." [Romans 12:6 NLT]

These are the years of choice. We can choose our paths. We can select new paths, or stay with what we have learned. We can use our gifts. Our choices are no longer governed by making a living. We are free!

We can make a choice of what to do with our gifts, and we can have fun doing it! If we maintain our health, we can stay active in things that we care about. We can use our skills to help others, to give back for our good fortune.

We have the choice to pursue better health for ourselves. This will enable us to better exercise our gifts, and we will enjoy life more while we are doing it.

Expectations of our future
I somehow expected that I would be different, that old age symptoms and problems would not apply to me. What was I thinking! I know that now they do apply. The question becomes "what can me and others do about it?"

Changes after 60
The average person after retirement with no exercise gains 2 to 3 pounds per year. In 5 years we will be 10 pounds overweight and in 10 years, 20 pounds overweight. The amount of stress on our bodies increases as our weight increases. Our joints and muscles become stiffer as we age, and we lose our flexibility. It becomes more difficult getting up from chairs because of our knees. We weigh more. This is the extra load that we carry. We load our knees, hips, our heart and our lungs.

We pull muscles easier. We actually pull shoulder muscles rolling over in bed! We begin to lose our balance from time to time. We feel tired more often, and get sleepy during the day. We probably have arthritis somewhere in our body. We are more likely to catch a cold. We are more prone to pneumonia.

The Art of the Possible
We want to consider living our remaining years to the fullest in the best possible health. We want to enjoy these later years, these years from 60 on. Then we want to see if these good years can be extended. So what is it we can do to bring about these changes?

We can greatly increase the odds in our favor. We can improve by exercise, diet, eliminating smoking, limiting alcohol consumption, and being less than 15 pounds overweight. We can reduce our stress. We can protect ourselves against getting sick. We can have a positive outlook.

Age Graph
Imagine a graph, ages from 0 to 100 years on the horizontal axis, and percents of health from 0 to 100 on the vertical axis. If we optimize our health, our lifeline will be declining, but it will remain above the 70 percent mark well into our 80's. Then, we will drop through this 70 percent heath line. Our death will come quickly, in less than 6 months. For people who do not optimize their health, they will drop below this line much sooner, perhaps in their early 60's and they will remain struggling for years and years in poor health. See the graph example. This is a theory, but if correct, then we have a great reason for choosing good health. If we have our druthers, we want the period of poor health to be of short duration, and the end to come quickly.

Rationale: The reason we will live longer is partly by increasing our beneficial behaviors and partly by reducing or eliminating our undesirable behaviors. We will improve our quality of life by our beneficial behaviors. We will feel more alive, more positive as we go on our journey. Our pain will be less. Our journey will last longer, and our good years will be better. Our period of enjoyment will be longer and suffering will be much shorter.

Compression of Morbidity
At first I thought this meant to die soon. That’s not it. So, what is it?

Morbidity
We need to define morbidity. It is a time span near the end of our lives where we have continuous ill health (disability), which results in our needing help, and we continue to decline until death. Put simply, it is the time period when we begin assisted care until death.

"Happy, healthy, happy, healthy, happy, healthy ... dead".

Compression of morbidity means to compress or shorten the time period of ill health (morbidity) down to our last few months instead of over several years. Not only is our suffering greatly reduced, but the period of enjoyable time is extended. We may live the same length of time, but there will be much more quality time. We will postpone illness for as long as possible.

This greatly effects whether we need to save for long term care or need insurance for long term care. We know long term care is expensive, currently about $3000 to $5000 a month. We could burn through our savings at $60,000 a year or more. Long term care insurance is currently about $200 a month and rising. We may not have to save very much if we only need it for a few months.

Studies
In 1980 Dr. James Fries published a hypothesis of compression of morbidity in the New England Journal of Medicine[1]. The theory states that since chronic illness and disability occur in late life, that cumulative lifetime disability could be reduced by primary preventive measures. This would result in an increase in the age at the time of disability with a shorter time of disability.

University Alumni Study
In 1998 Fries reported a study of 1741 university alumni whereby they were placed in high risk, medium risk and low risk groups based on level of smoking, body mass index, and exercise patterns. Persons in the high risk group had twice the disability of the low risk group. They concluded that persons with better health habits survive longer and that disability was postponed and compressed into fewer years at the end of life[2].

Running Club Study
Fries performed another study of 537 members of a running club compared to 423 community members and found that exercising persons developed disability at the rate of one-fourth that of those that did not exercise, muscle pain was reduced by 20 percent and medical care costs were 25 percent less for the exercising group[3].

Fitness Club Study
In a study of a fitness club group, the members had postponed a major chronic illness more than 12 years compared to the normal population.

Other studies have reinforced Fries theory. A summary of Fries work may be seen at http://www.healthandfuture.org/publications/issue_briefs/pdf/Morbidty.pdf

We can shorten the time we suffer, shorten the time we are dependent, and lengthen the time we live. We can do this while making most of our remaining years enjoyable, active and independent.

The Major Choice
We will have a time period of ill health (morbidity) at the end of our life span. It is up to us whether it is a few months or several years. We choose if most of our later years are spent in relatively good health and if the end will come quickly. Several long term studies have shown we can make lifestyle choices that return huge dividends in the form of many later years of an active productive life[4].

Summary
We can have relatively trouble-free later years by eating healthy, eliminating smoking, exercising, and by maintaining a normal body/mass index (no more than 15 pounds overweight). Other studies support moderate alcohol consumption of two drinks or less a day[5].
We can combine this with reducing stress and illness as much as possible. We will cover this in future chapters. These are the years when better living habits return the dividends!

References
[1] Fries, J.F. 1980, Aging, natural death, and the compression of morbidity. N Engl J Med 1980 303:130–5.

[2] Fries, J.F. Compression of Morbidity, In Retrospect and in Prospect, Alliance for the Health and for the Future, Pg 3. International longevity center

[3] Wang, B.W., D.R. Ramey, J.D. Schettler, H.B. Hubert, and J.F. Fries. 2002. Postponed development of disability in elderly runners: a 13-year longitudinal study. Arch Int Med

[4] Freedman, V.A., L.G. Martin, and R.F. Schoeni. 2002. Recent trends in disability and functioning among older adults in the United States: a systematic review. JAMA
288:3137–46.

[5]http://www2.potsdam.edu/hansondj/alcoholandhealth.html