HOW SHOULD WE TALK ABOUT WHAT IS HAPPENING TO US

Learning Outcomes of this module 

By the end of this module you will understand and be able to explain to other people 
  • what is meant by the term ageing
  • how the effects that many people assume are due to ageing are in fact due to three other factors – loss of fitness, disease and negative beliefs and attitudes
  • what his meant by frailty and dementia 
  • the need to encourage other people to be positive about ageing and take action to reduce loss of fitness or preventable disease.

How to talk about living longer better
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Most people, including most clinicians have a muddled concept which they may refer to as ‘ageing’ or ‘growing older’, terms they may use as synonyms. The core mission of our work is to help people see there are four processes that take place – ageing, loss of fitness, disease and the development of  beliefs and attitudes. So too does  a condition newly defined by the medical profession – frailty 

  • Ageing a normal process , starting as the dominant theme from about 30 , but Bradley Wiggins set a new 1 hour record at 35! The effects of ageing are a loss of maximal ability eg pulse rate and a loss of reserve or resilience, that is ability to respond to challenges. The rate of ageing is influenced  by genetic and epigenetic factors but is not a cause of major problems till the age of 90. Biologists use the term senescence which can be considered to be a synonym for ageing,
  • Disease an abnormal process, sometimes related to ageing but more often due to lifestyle and environmental problems 
  • Loss of fitness, resulting from inactivity and having an impact from the age of the first car or the first sedentary job which often occur together, usually in the early twenties the effects loss of fitness are a loss of maximal ability eg muscle strength and a loss of reserve or resilience, that is ability to respond to challenges. These are very similar to the effects of ageing which is one reason these two process are often confused.
  • Growing older, a social process, influenced by personal beliefs and social culture 

These terms are often used loosely and wrongly, for example people talk about ageing when they mean growing older. in addition all generalisations are risky because people who are aged 70 or 80 or whatever differ from one another in many more ways than they resemble one another. One useful way to talk about these complex issues is simply to talk about  living longer, for example " the longer you live the more active you need to become"

Other key terms are 

  • Frailty, is a distinctive health state related to the ageing process in which multiple body systems gradually lose their inbuilt reserves.  It is also important to recognise prefrailty. If frailty is “the presence of three or more out of five indicators: weakness (reduced grip strength), slowness (gait speed), weight loss, low physical activity, and exhaustion.  People with one or two indicators are classified as pre-fail
  • Dementia, is a condition defined by severe impairment of cognitive ability, Alzheimer’s Disease is one of the two most common causes of dementia, the other being disorder  of the blood flow to the brain, vascular dementia
  • Wellbeing is a term increasingly used rather than healthy to describe the outcome that people aspire to. Conventionally, three aspects of wellbeing are evaluative wellbeing (or life satisfaction), hedonic wellbeing (feelings of happiness, sadness), and eudemonic wellbeing (sense of purpose and meaning?

​We now know that frailty and vascular dementia can be prevented or delayed.
 
The four terms ageing, fitness, disease and growing older are inter-related in the following ways 

Inter –relationship of Ageing  with the three other factors
  • With FitnessThe ageing process reduces the capacity to be resilient in the face of challenges for example the challenge of inactivity  therefore fitness is more easily lost, but can be regained at any age. Also the effects of both ageing and loss of fitness are very similar – loss of maximal ability and loss of resilience or reserve 
  • With Disease -The ageing process increases the risk of some diseases but most diseases which cause premature mortality are preventable.
  • With Growing Older -The ageing process and the process of getting older are limited by the beliefs and assumptions of people of all ages, many of which are wrong. Ageing by itself causes relatively little problem till the age ninety

Inter –relationship of Loss of Fitness with the three other factors
  •  With Ageing -Fitness becomes more important as the ageing process takes places because the best possible performance becomes closer to some crucial levels below which independence is compromised and therefore the fitness gap needs to be minimised.
  • With Disease  - Fitness loss is accelerated when disease develops because of the direct effects of the disease and the indirect effects, for example from the belief that rest is best for older people with long term conditions.
  • With Growing Older -Fitness is often associated with youth.

Inter –relationship of Disease with the three other factors
  • With Ageing- Disease is sometimes the result of cellular changes due to ageing but at least as often is caused by lifestyle or environmental factors.
  • With Fitness- Disease often accelerates the loss of fitness and it is always important to prescribe physical activity as well as medication. Disease can cause disability and this may lead to handicap. The degree of disability is determined not only by the severity of the disease and the effectiveness of therapy but also by additional loss of fitness and although some loss of fitness is the direct result of the disease some comes from pessimistic beliefs and attitudes  Frailty is a condition resulting from multiple conditions, complicated by the effects of ageing, in which there is significant loss of resilience to a degree that makes minor deviations from the steady state such as an infection liable to cause sever deterioration
  • With Growing Older -The effects of disease may be incorrectly attributed to ageing as a result of ageism.
 
Inter –relationship of Growing Older with the three other factors
  • With Ageing -Beliefs about the effects of aging are over pessimistic and this leads to unduly negative attitudes towards, and of, older people.
  • With Disease- Beliefs about disease and ageing too often result in the assumption that disease is inevitable whereas many diseases can be prevented, postponed or managed effectively.
  • With Fitness- Wrong beliefs about the benefits of physical, mental and social activity lead to inactivity and preventable decline due to loss of fitness.

Inter-related actions -understand ageing, get fitter, be more positive, prevent and fight disease 
Because the causes of decline are inter-related so too are the solutions 

To explain and promote these concepts is one part of the mission of the Optimal Ageing Programme 

Don't use bad language about older people 

Remember there are also words that should not be used