Brain training and living younger for longer

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Health Report 28 min 2 speakers 8 chapters transcribed 3 days ago

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What is the main focus of the health report on brain training and longevity?

Unknown 0:02

This is an ABC Podcast.

Dr. Norman Swan 0:06

Hello and welcome to this week's health report with me, Norman Swan. Today, getting the balance right between training your brain and your body to prevent dementia. Australians may now be on this slippery dip to more heart attacks and strokes after decades of reduced risk. Why? And are we really living younger and longer? Or are we, despite what we see around us, of older people jogging around the park and working beyond what used to be retirement age? just heading for an extended period of misery before we die. Thirty years ago, when the experts began to wake up to the fact that we were living longer, there began a controversy which hasn't really gone away. Most doctors, and remember, most doctors see sick people from morning till night, argued that as we got older, our extra years would be miserable with added years of crippling disability.

Dr. Norman Swan 0:53

On the other side, one researcher in particular, Jim Fries of Stanford University in California, argued for something called compression. depressed morbidity. In other words, most of our added years would not be miserable at all, and in fact the years spent in severe disability would shrink. Well, have they? And will it last? This is the focus of Eric Stallard's research. He's co-director of the Biodemography of Aging Research Unit at Duke University in North Carolina.

Eric Stallard 1:20

That was the debate as it started in nineteen eighty when James Fries published his first paper on the topic in the New England Journal of Medicine.

Dr. Norman Swan 1:29

How time flies when you're getting older.

Eric Stallard 1:31

Right. Thirty nine years. Prior to that, Morton Kramer and Ernest Gloomberg, who were well known in the field, wrote two key papers. Uh Gloomberg had a paper in the Millbank Memorial Fund quarterly called The Failures of Success. and he outlined all the different bad things that'll happen if you can keep people living to the older ages. Morton Kramer had a paper he published called The Rising Pandemic of Mental Disorders and Associated Chronic Diseases and Disabilities. Both of those papers, it's fair to say, were very influential. So when James Fries published his paper, it was really a ground earth shaking type of perspective. because he essentially said what everybody else was proposing w was simply not gonna happen.

Eric Stallard 2:30

The main message was it would be possible over the ensuing decades for many people in the population to not only live longer but have a higher proportion of that additional longevity being in relatively good health or be lived as years where they have good physical and cognitive functioning.

How did the debate on compression of morbidity originate and who were the key researchers?

Dr. Norman Swan 2:56

Eric Stallard has since the nineteen eighties had access to a database of nearly fifty thousand people aged over sixty five, who were regularly surveyed for the age at which they died and their level of disability. It allowed a naturarial analysis similar to the way insurance companies assessed future risk using a lifetable.

Eric Stallard 3:15

So we ended up over a period of twenty two years, we had constant instrumentation which was used to measure the physical and cognitive functioning of the older US population using a nationally representative sample. The analytic period I focused on went from nineteen eighty four to two thousand four. This was a large scale operation. And it opened the possibility of getting very precise measurements over two decades in order to answer the question as to whether Fries' hypothesis was in fact correct or was it flawed.

Dr. Norman Swan 4:00

We'll put aside where America sits on the life expectancy scale internationally, which has always been lower than it should be, but those were the golden days where life expectancy in the United States was going up at about three months a year every year. It's slowed down since. We'll come back to that later. What did you find?

Eric Stallard 4:18

Even though we were following what's called a cohort, it's a close group of individuals. We did our measurements using what's commonly called a period lifetable approach. If you take the probability of death for a one year period that we say what's the probability that a person of a given age and a given gender would survive over that time period or conversely what's the probability that they would die?