BY DR. ERIC B. LARSON
This political season’s biggest debate has centered around presidential candidate’s ages and if they are too old for the job. President Biden withdrew from the nomination but there is much we can still learn from our early summer “freakout,” as some have called it.
President Biden’s general demeanor and lapses during the June debate attracted attention and alarm, followed by calls for him to withdraw. Donald Trump has not been spared criticism about his general health and tendency to ramble, sometimes somewhat nonsensically. If he hadn’t withdrawn from the race, the president would have been 86 by the time he completed a second term, Trump 82.
The great unknown for the future of any U.S. president is to what extent their general health will be affected by the stresses of the job. Serious illness or accidents can strike at any age. But when it comes to the likelihood of age-related declines, we do have some data. Average rates of dementia start to increase sharply from unusual to increasingly common after about age 75. Other age-related declines and risks rise with every passing year. These include walking speed, falls and injuries, heart attacks, strokes, and other common conditions like cancer and Parkinson’s Disease.
As many of us enter and march through our third act I think there is a more general issue facing all of us and our aging society—the tendency to deny aging and its accumulative effects. We pay a lot of attention to so-called active aging, the importance of staying engaged, exercising regularly, and maintaining—and ideally improving—our general health and well-being. We emphasize keeping up healthy habits such as hiking, participating in book clubs, volunteering in ways that help others, promoting things we believe in, “making a difference” and making our lives meaningful. And this is all good and important. We want to avoid or minimize age-related decline and loss of abilities for as long as we can. But we are not immortal. Eventually, we all will experience loss and decline before we die.
In my book Enlightened Aging: Building Resilience for a Long Active Life, we emphasize building reserves to stay healthy and active longer, but also the importance of accepting and adapting to changes we wish we weren’t experiencing. I was on a sabbatical in Cambridge University in my late 60s when I began writing the book to summarize what we’ve learned about aging from our research, caring for patients as they aged, and my family’s experiences. Now, 10 years later at age 77, I’m faced with the reality of the age-related changes I wrote about and the more difficult task of accepting changes I didn’t want to experience and thought I might avoid. Rather than just building reserves to combat aging changes, I try to find ways that I hope will minimize the effects of the accumulating declines I am experiencing. Like others, I hope to preserve high levels of functional well-being and happiness, engaging in the world and especially family, friends, and activities in ways that add meaning to my life for as long as I can.
We talk a lot about aging well, but what about the importance of acceptance and adapting? Time will tell how this plays out for President Biden, Trump, and the future of the country and the world. We know the implications of the U.S. presidential race and its outcome for the global stage are colossal and unknown. We also know that for individuals like me and you, it is both challenging and a wonderful opportunity to accept, adapt, and carry on with meaningful, fulfilling, and happy lives as we get older. Aging well and accepting aging itself is a victory worth celebrating.
Eric B. Larson, MD, MPH, is a Professor of Medicine at the University of Washington. He was co-Principal Investigator of the SMARRT trial and formerly Vice President for Research and Healthcare Innovation at Group Health and Kaiser-Permanente Washington. With colleagues he co-founded the long running Adult Changes in Thought (ACT) study in 1986. He continues research through the UW Alzheimer’s Disease Research Center and other projects. He has participated in The Lancet Commission on Dementia since its inception. With co-author Joan DeClaire he wrote the well-received book, Enlightened Aging: Building Resilience for a Long Active Life.