Australia Australians are living longer but what does it take to reach 100 years old?

23:26  24 july  2021
23:26  24 july  2021 Source:   abc.net.au

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At age 96, Patricia Segal lives alone in an airy Sydney apartment with views of the sea. Time spent with her feels uplifting, invigorating, and when you ask for her secret Segal doesn’t hesitate: her positive and curious attitude is the key to her longevity, she says.

And although scientists don't understand exactly why, research suggests she is correct.

As COVID-19 continues to expose the vulnerability of Australia’s elderly — and an inquiry laid bare abuse in aged care homes — Segal projects a dramatically different image of what it can mean to reach very old age.

She does not appear as a woman eyeballing 100. Segal looks years younger. Stylishly and carefully dressed, with her hair kept dark brown and cropped close, she radiates calm, upbeat confidence.

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Our conversation roves across politics and sociology. The novel she’s currently reading rests on her coffee table — she’s regular a member of two local libraries. Her apartment is decorated with original artwork — the fruits of a painting hobby that she first took up aged 90-something.

"I just thought I’d try it. I walked into the art class one day, everybody said 'hi!’, everybody was smiling. The teacher was fantastic and it's just wonderful," she explains. "Sometimes when I look at the paintings I think 'did I really do that?'"

The best years of your life

Researchers say Australians are entering an era in which remaining vital well into your 90s will be not just possible, but common. And your 80s may well deliver some of the best years of your life.

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The average lifespan of an Australian woman is now about 85, packing on 25 additional years in a century, meaning one in two women will reach this age or beyond.

That's an age Dexter Kruger, Australia's oldest person before he passed away this week aged 111, reached with ease. Research suggests he's not alone: Centenarians are now Australia's fastest-growing demographic.

Between 2000 and 2020 the numbers of Australians aged over 85 grew by 110 per cent, compared with national population growth of 35 per cent. A baby girl born today has an almost 40 per cent chance of reaching 100.

Life expectancy for men is increasing along a similar upwards curve, just behind the long-lived women.

Professor Perminder Sachdev, a neuropsychiatrist at the University of NSW, is leading the Sydney Centenarian Study that is hunting for environmental and genetic determinants of successful ageing. He wants to know how the brain ages, and has enrolled around 450 study participants ranging in age from 95 into their early 100s.

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Although the lifespan of Australians is increasing Sachdev says up to 50 per cent of people will suffer some kind of cognitive decline including dementia or Alzheimer's disease once they near 100.

It is a reality that concerns Segal, who says she does not want to reach a century if she is no longer in control. "Old people can get pretty useless," she says. "I've got a wonderful family but I don't want them to have to worry about me. I'm very, very lucky. I've had a wonderful life. I haven't missed anything."

Solving the riddle of what it takes to not just live longer, but do it with verve and enthusiasm and without mental impairment, is what Sachdev's team hopes to unravel.

Solving the ageing puzzle

There's no one pathway to a healthy long life, Sachdev says. It is a puzzle that is still being completed.

Increasing lifespans have paralleled improvements in healthcare, nutrition and education, as well as rising quality of life for most Australians that helps to ensure things like stable housing, another longevity indicator. Lifestyle improvements have also been significant — particularly a successful campaign to reduce smoking. Even playing tennis has been pinged in one study for its association with greater longevity than other sports.

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"All we have [to work with] are lifestyle factors," Sachdev says, and "we realise that these factors impact from birth. Ideally one wants a lifetime of good effort."

But researchers like Sachdev, and Professor Henry Brodarty who collaborates with him on the centenarian study, note growing evidence that successful ageing includes less tangible and more mysterious influences.

Segal's comment about her attitude to life was spot on. An optimistic personality, strong social connections and what the Japanese call "ikigai", a reason for being, are all core attributes of long lifers.

"We found people who are 100-plus and they are still volunteering in committees and other areas, engaged socially and with their great grandchildren,” Sachdev says. “It is this kind of physical and mental activity we tend to see repeated in different [ageing]  studies around the world."

Quality education in childhood, and lifelong learning, is also key. Precisely how it impacts longevity and brain health is not fully understood.

Sachdev hypothesises that education may raise the likelihood of making sensible lifestyle choices, or offer socioeconomic benefits, like access to higher-paying job that puts a better standard of housing and healthcare within reach and in turn predisposes these people to healthier bodies in old age.

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He also argues that there are indications education builds "better cognitive reserves during the developmental period and you set yourself up for a lifetime of more complex cognitive activity".

"All the data points to the fact that if there is one thing we should do (to maximise healthy aging) it is improve the quality of education," he says. "Because people who had better education preserved their brains."

A recipe for ageing well

The lifestyle ingredients of longevity are so routinely effective as to feel almost predictive of long life. Could there be a "recipe" for successful ageing?

Regions around the world known as "blue zones" — where the populations have unusually high numbers of centenarians – offer clues.

The islands of Sardinia in Italy, Ikaria in Greece and Okinawa in Japan as well as Costa Rica's Nicoya Peninsula and California's community of Seventh Day Adventists in Loma Linda make up five zones where residents outlive the rest of the world.

Researchers have also distilled nine traits of these communities that are credited with underpinning each community's health.

They include:

  • Regular physical activity that is a part of the lifestyle like walking to the shops rather than using a vehicle.
  • Having something meaningful that motivates you to get up every day.
  • Rhythms and rituals that reduce stress. In Okinawa the women enjoy tea ceremonies, the Loma Linda religious community has prayer groups and in Italy and Greece the siesta fills the stress release gap.
  • A healthy plant-based diet, that's also low in meat, fish and dairy.
  • Not just a healthy diet, but eating patterns that favour being 80 per cent full, or "hara hachi bu" as Confucious used to teach. It's a philosophy that's been taken up by the Western wellness culture's 5:2 or 16:8 diet trends
  • Blue zone cultures love a drink – but in very moderate amounts.
  • Engaging in social groups that are focused around healthy activities.
  • Religion is good for long life – perhaps because it encourages social connections and rituals offer a stress-reducing dimension.
  • Maintaining close relationships between family members

Do we have blue zones here?

Blue zones are less pronounced in Australia and pockets of longer-lived citizens tend to be linked to socioeconomic advantage. The ACT and Sydney's affluent suburbs of Mosman, Hunters Hill as well as the Hills District, emerge as areas where residents have a slightly higher than average life expectancy.

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In the Northern Territory, however, life expectancy is concerningly below the national average. Yet NT has also shown the greatest percentage growth in over 85s in Australia, suggesting disadvantage is slowing.

Longevity zones in Australia are also linked to retirement communities, Henry Brodarty notes, where higher concentrations of older people in turn creates a greater probability of encountering the 95-plus cohort. This is a quirk of internal migration rather than a true, blue zone.

A real-world masterclass

In Segal’s case, as we talk, it's astounding how consistently her natural choices throughout life offer a real-world masterclass in hitting those longevity KPIs: never a smoker, a light and occasional drinker, Segal remains close to her two children, four grandchildren and 10 great grandchildren.

She's been active throughout life, a regular at the tennis club, and now walks everywhere ("I'm considering getting a walking stick not for stability but because it allows me walk even faster"). And she eats small, healthy meals that she cooks herself ("I've never cared about food").

And what about her self-acknowledged positive attitude to life?

One of the difficulties of living into very old age is that lifelong friends pass away, become ill or do not maintain the same attitude to living, Segal says. Her husband died four years ago at age 95, and Segal is matter-of-fact as she explains that loneliness can be one of the hazards of a long life.

Unwilling to slow down and give up her social nature, Segal enlisted her granddaughters to match her up with the grandmothers of their friends so she could expand and rebuild her friendship group as she aged.

"I've been lucky, I've made new friends," she says with trademark pragmatism. "I like to go out at least twice a week. I probably go out more than that but as long as I'm out twice a week I'm quite happy on other days to stay home and just read or write."

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Even COVID lockdown hasn't slowed her down. Segal continues to swap books and the library and keep in touch with friends and family.

Segal also acknowledges how fate has worked in her favour. She fled Berlin with her Jewish family just before World War II, escaping the horrors that were to unfold in Europe. She grew up in a loving home and had a very happy marriage without financial pressure.

What about genetic luck?

It's impossible to talk about longevity without considering the genetic lottery. Our DNA can protect or betray us no matter what healthy lifestyle choices we make.

Sachdev points out that genetics is an important part of the long-life puzzle, particularly for those who reach extreme old age, 100-plus, in great health. Hitting a century is where genes start to have real impact, and the limits of medical science begin to be felt, he says.

"The genetic factors are polygenic," says Sachdev, meaning that many genes are involved in predisposing someone to a long lifespan. Just how to manipulate these genes to deliver the same genetic advantage to everyone has not been solved.

"You notice that many people who reach 100 or above have been able to avoid illness altogether," he says.

"They have not developed the chronic illnesses that affect most of us, things like hypertension, diabetes or arthritis. Alternatively, if they do develop these problems, then they develop them at a later age, say their 80s or 90s rather than the 60s and 70s."

When you look at global blue zones on a map two fascinating facts emerge: many are islands, and all lie in regions where the weather is warm and sunny for a good part of the year.

The warm weather may well encourage people to leave their homes and congregate in groups, building the social connections and optimism that are traits of those who age well.

These blue zone communities are also somewhat cut off from the outside – islands, or peninsulas or closed religious communities: it is possible that generations of good genes were distilled within these groups and go some way to explaining why residents have such long lives.

Genes don't offer all the answers

In Segal's case it's debatable how much her genetics has influenced how well she has aged. Her father died at 72 and although her mother lived to 92, she was unwell from her late 80s but this would still have been beyond the life expectancy for women at that time.

Jim Hennington's job is to take one of life's biggest mysteries – how long we might live – and spin it into the kind of mathematical data that is so reliable he’s willing to bet literally millions of dollars on it as part of his work in superannuation.

Hennington, a fellow of the Institute of Actuaries of Australia, says the data on human lifespan is remarkably predictable.

He points to a steady increase in average lifespan over decades and the smooth, comforting curves they produce when graphed mathematically. While the length of an individual life will always be unknown, he says, across a population the patterns are undeniable.

Those patterns hide even more interesting statistics, Herrington says, that influencing superannuation policy.

While the average life expectancy of an Australian woman is now 85, in reality, if an Aussie woman hits 65 in good health and with quality housing and lifestyle, she has as much chance of reaching 100 as dying before 86, Herrington says.

Where to next?

The remarkable lives of people like French woman Jeanne Calment, who lived to 122 and was assessed as cognitively sharp at age 121, raise hopes that years of healthy, active life can be further extended.

Sachdev believes that evidence humans can routinely survive to 110, 120 or even 150, is "not really that strong".

But surviving into your 90s, and staying mentally sharp and physically active, and more and more of us hitting the big 1-0-0, is a very real possibility, he says.

And as Patricia Segal knows, that's something to feel optimistic about.

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