ENLIGHTENED AGING

Life Expectancy or Healthy Longevity: Is There a Choice?

BY ERIC B. LARSON, MD, MPH

Eric B. Larson, MD,

MPH, is the author, with Joan DeClaire, of Enlightened Aging. He is the founding principal investigator of the Adult Changes in Thought (ACT) study, ongoing for about 30 years. ACT recently was awarded a $55.6 million expansion grant from the National Institutes of Health. Were you surprised by recent headlines that for the second consecutive year, U.S. life expectancy decreased? For hundreds of years, and especially in the 20th century, improvements in life expectancy were the norm. Mortality rates between 1970 and 2013 decreased by 44%. However, ominous trends began to appear as we marched into the new millennium when the number of premature deaths in mid-life, nonHispanic whites unexpectedly began to rise.

Princeton economists Anne Case and Angus Deaton point to increased “deaths from despair” (suicides, drug and alcohol overdoses, and alcoholic liver disease), which occur in communities with limited economic opportunities. The economists cited rising inequities in counties without countervailing social support programs. And premature deaths in mid-life are now twice the rate in those without post-high school education.

The lifespan declines in 2020 and 2021— during the pandemic—are different. First is the direct effect from millions of COVID infections causing disproportionate deaths among the frail and most elderly. Sweden had headline-grabbing news from high death rates in long-term care facilities and in persons with Alzheimer’s— related to Sweden’s decision to avoid lockdowns and social isolation. The 2021 decrease in life expectancy will prove to be less a direct effect of COVID infections, as vaccines became available early that year. Rather, it likely reflects effects of isolation and lower life expectancy in under-resourced, impoverished groups. Native Americans comprise the group with the greatest decline.

Participants in our long running Adult Changes in Thought (ACT) study—with high vaccination rates and adherence to testing and isolation—experienced very few COVID deaths. However, they experienced more depression, loneliness, and overall loss of well-being during the pandemic.

Declining life expectancy and its causes are clearly important issues for public health and public policies. But what do they mean for us as individuals who aim to age well?

Most people (older and younger) do want to live a long life. Increased longevity is a both a triumph and blessing of our times. But what most people want is a longer active life—avoiding long periods of dependency and dysfunction.

For individuals at any age, but especially older persons, the goal to pursue is healthy longevity through regular exercise, control of cardiovascular risk (especially maintaining a healthy blood pressure), avoiding excessive alcohol, not smoking, staying engaged in challenging mental undertakings, and maintaining an active life that includes social, spiritual, and other contemplative activities. It’s the usual list, but unfortunately not all that usual in many people’s lives.

The consequences of the pandemic and declines in life expectancy are not surprising. My hope is this will trigger greater awareness of social determinants of health and the absolute necessity that we address them, especially the need for universal high-quality education, and correcting widening economic disparities.

As individuals, we can still expect long lives, enjoying the historical gains in life expectancy. Remember what Eubie Blake, Mickey Mantle, and others have said, “If I’d known I would live this long I would have taken better care of myself.”

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Sounds of Healing Music to Heal Mind, Body,

& Soul BY SALLY FOX

Imagine if you could experience deep relaxation, reset your nervous system, and heal your brain while lying comfortably on your bed or in a chair at home. And what if you could extend your longevity, protect your mind, and improve your quality of life by just opening your mouth?

Welcome to the world of sound healing and the magic made possible by music, rhythm, and sound. Our human connection with music dates back at least 42,000 years, as evidenced by flutes made of bird bone and mammoth ivory discovered in Southern Germany. Our ancestors used song, drumming, and chanting in healing rituals. And Indigenous Peoples and religions around the globe have incorporated music, singing, and chanting into their ceremonies.

While the use of music and sound in rituals and ceremonies go back many millennia, science has been slow to discover the how and why of sound healing. Today, that may change as doctors and scientists search for non-pharmaceutical ways to improve our health and support the brain.

Given the stresses of the world, the brain benefits of sound are more needed than ever. The aftereffects of COVID, worker shortages in many industries, and economic and environmental challenges have led many to depression, burn out, and brain fog. Could music and sound help

restore a sense of balance and brain functioning? The evidence suggests yes. In one Swedish study, a group of burnedout employees achieved more significant, longer-lasting results listening to a specially designed music program than a comparison group receiving the standard psychotherapy intervention.

Other studies suggest that music may stimulate neural activity among Alzheimer’s patients and older adults who learn to improvise on the piano may improve their cognitive flexibility and executive function. Singing may help improve cardiovascular health in older patients with cardiovascular disease. And music may be useful in pain control.

To expand the scientific understanding of the health benefits of sound and music, the Sound Health Initiative was launched in 2016 under the leadership of the internationally acclaimed soprano Renée Fleming and Dr. Francis Collins, then-director of the National Institute of Health (NIH). In 2019, they were awarded a $20 million NIH grant to support a clearinghouse of existing cross-disciplinary research on sound healing and new studies in the field. Given the potential applications of this data to older adults’ mental and physical health, we owe a “Bravo!” to Fleming and her colleagues.

On the trail of sound healing My exploration of sound healing began during the pandemic when I learned about the work of the late Alfred Tomatis, a French doctor who explored the importance of what we hear on our brains, behavior, and voices. For him, sound was a “nutrient to the nervous system.” Reading about Tomatis and the field of psychoacoustics he helped found, I wondered if my non-correctable hearing loss might affect my attention and focus. I purchased a Tomatisinspired music program online called “The Listening Program” from Advanced Brain Technologies (ABT).

To use it, I put on a headset for a short period daily and listened to classical music modified to support brain performance. The experience was enjoyable, and my coordination and focus improved within a short time. ABT’s rhythm program, called “InTime,” helped tune my internal sense of beat and balance as I listened to original percussive sounds from around the world. Even after completing the programs, I used them as go-to tools when I felt stressed.

I asked Alex Doman, founder of ABT, how their programs and other sound healing approaches compared to meditation when it came to brain support. Doman was quick to endorse the benefits of meditation but reminded me that meditation requires effort, and for those who are very stressed, any extra effort may feel like too much. Listening to sound and music, however, is relaxing, rewarding, easy to do, and may enhance our ability to meditate.

Doman further suggested that working with music and sound healing is almost always safe, unlike some pharmaceutical interventions. So even if research hasn’t yet pinpointed how sound and music affect the brain, you can experiment today and discover what works best for you. Here are other approaches I’ve tried and recommend:

Listen to your favorite music

While using neuro-acoustically modified music like The Listening Program may have particular benefits, many of us find happiness just listening to a favorite piece of music. Studies have documented the

benefits of allowing dementia patients to listen to a playlist built from their favorite tunes. When we’re feeling down, music can offer us emotional support. Perhaps we pick pieces that match our mood and give us comfort. Or maybe we choose tunes that help us shift our mood. Either way can help.

Relax with sounds baths and sound ceremonies

You can search YouTube for “sound bath” recordings, offering deeply relaxing environments created with crystal and Tibetan bowls, gongs, and other instruments. Put in your earbuds, cover your eyes, and enjoy an Could music effortless, meditationand sound help like experience. After reading The Healing restore a sense Power of Sound: Recovery of balance from Life-Threatening Illness Using Sound, and brain Voice, and Music by the functioning? late Dr. Mitchell Gaynor, an oncology physician, I The evidence became fascinated by suggests yes. how he used crystal bowls along with conventional therapies to improve outcomes for his cancer patients. Inspired by his success with the bowls, I bought one to enjoy at home.

Tune up your rhythm with drumming

Our 24-7 Internet-obsessed world can lead us far away from the natural rhythms of life. From my experience, listening to beats or drumming provides a natural tune-up and system synchronizer. Parkinson’s patients were shown to improve their gaits and motor skills by working with a metronome or drumbeat. You can enjoy the benefits of rhythm by joining a drum circle or buying a small drum and studying drumming online.

Reset your nervous system with humming

Everyone can hum, and humming has

some surprising benefits. According to authors Andi and Jonathan Goldman, humming may help lower blood pressure and heart rate, increase lymphatic circulation, and release endorphins and oxytocin. I find 10 minutes of humming in the car much better for my nervous system than listening to the news!

Find joy through chanting

Spiritual groups have practiced chanting over centuries. Still, I never understood the healing benefits of chanting until I had an opportunity to join a kirtan, a session of devotional singing. After about 15 minutes of chanting, my voice melded with others in the room, and I was lifted into an experience of collective joy. Try a round of chanting online with vocalist Krishna Das or others who lead kirtan singing.

Sing your heart and lungs into better health

The benefits of singing include improved breathing and better use of respiratory muscles—and it has been helpful to people with conditions ranging from asthma to cancer. Singing may help the speaking ability of people with Parkinson’s or aphasia following a stroke. Singing is my favorite mood booster. I can’t feel stuck or cynical after singing. Research has shown group singing can reduce stress levels and depression, regulate heart rate, release endorphins, and lower pain thresholds, among other benefits. Choral singing also increases feelings of social connection. All the above activities are pleasurable, available at low cost or no cost, and no further away than your voice and body. They may help speed recovery, protect your brain, and increase longevity. We may not yet know precisely how music and sound healing works, but if Renée Fleming and her colleagues at the Sound Health

Initiative succeed, science may start catching up soon with what people have known through the ages: Sound heals.

Sally Fox, PhD, is a life transitions and creativity coach and author of Meeting the Muse After Midlife: A Journey to Joy through Creative Expression, to be published in early 2023. Find her at www. engagingpresence.com.

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Why wait? Explore the happier, healthier senior lifestyle today!

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TO LIVE YOUR BEST LIFE REACH FOR MORE THAN JUST THE BASICS

BY SUE ROWELL

Maslow’s Hierarchy of Needs illustrates five ascending physical and psychological levels of need that lead to a life of fulfillment and ease. At the base of the pyramid are things we need to survive such as food, water, and shelter. Second, we seek safety and security. Next is what gives us a sense of belonging and love. These first three steps are essential for wellbeing as we age. However, while researching senior living, you’ll miss the opportunity to thrive, as opposed to just survive, if you base your decision on just these first three levels.

At the higher levels of Maslow’s hierarchy are esteem and selfactualization. It’s here that life is not only easier, but also becomes more fulfilling and enjoyable.

Esteem, or respect for yourself and others, is felt when residents are proud of their home and want it to succeed. At Quail Park of Lynnwood, one way we support esteem is by fostering a community whose personality and culture reflects our residents, employees, families, and supporters. For example, we recently took part in the annual Walk to End Alzheimer’s. Participants included residents, staff, and family members. Those who couldn’t walk donated to the team in other ways. It brought us together as a family instead of just individuals sharing a home.

Self-Actualization, or realizing your full potential, is the pinnacle of the hierarchy. You’re pursuing your passions, feel happy, and are content. What things make you feel fulfilled? Travel, volunteer work, time with loved ones, exercise, reading, learning something new? When researching and visiting senior living communities, look beyond the basic needs and ask how they’re fulfilling the higher needs that help us all to age well and easier. Things like educational speakers, book clubs, advancements in technology, music…whatever you are seeking to reach those upper levels on the hierarchy.

Any senior living community can provide the basic needs. Quail Park of Lynnwood reaches higher. Don’t forget to reach for the top and fulfill your desires as well.

Call Today to Schedule a Tour or For More Information Quail Park of Lynnwood 425-329-6591 QuailParkofLynnwood.com

Auditory Attitude Auditory Attitude

Although I sometimes wish for a cure that would let me hear normally again, hearing loss has brought unexpected gifts into my life. I admit this grudgingly. Losing my hearing is an unwelcome—and often painful—experience for me.

I first noticed I was missing some everyday sounds and people seemed to be mumbling. This began some 20 years ago while in the throes of a hard-won career working with individuals with disabilities and other marginalized people. My work was meaningful and important to me. The fear I might have hearing loss—and its possible effect on my ability to do my work—hit me with a wave of anxiety and uncertainty. I postponed a hearing test for months before taking the plunge. Finally, sitting in a soundproof booth, I strained to hear the tones and sounds of the hearing test as well as I could. When it was over, the technician shrugged off my questions and simply told me I needed hearing aids.

My hearing loss has gradually increased over the years, and I continue to strain and push myself in those hearing tests as if the outcome will make it easier for me to hear in the real world. The cruel reality of hearing loss isn’t that voices aren’t loud enough to hear, it’s the nuances of speech that can be missed or misinterpreted. Even wearing high tech, expensive hearing aids, which take time getting used to, I’m dependent on reading environmental cues, or lip reading. Background noises, someone speaking who has an accent, someone whispering, and riding in a car are stiff competitors in what feels like a contest to carry on a basic conversation. I must accept that no matter how hard

I try, there are situations where I’m not going to hear or hear as well as I want to. I continued to work for many years and was able to meet my clients’ needs and concerns, as well as participate in meetings with CONFRONTING parents, caregivers, staff members, and HEARING LOSS colleagues. I felt I had BY SANDRA MACLEOD accepted my hearing loss and successfully managed how it affected my life. But I didn’t anticipate my hearing would continue to get worse. At first, I was able to manage using well-worn strategies of lip reading and by letting others know—even though I wore hearing aids—I had trouble hearing some things. I would say things like, “I want to be sure I’m hearing you, could you say that again?” Or repeat what I had heard them say. Despite these and other tactics, I feared what people thought

of me. I’d feel embarrassed and that somehow this was my fault—I wasn’t trying hard enough. Being completely identified with my role as a competent, highly trained professional didn’t leave room for self-doubt and feels of worthlessness.

I started playing it safe so there was no risk of embarrassment or feeling left out by skipping meetings (the work that connected me to others), avoiding talking with colleagues, and keeping questions on an interesting talk to myself, lest I give away that I didn’t hear something.

When an old friend I hadn’t seen in many years became impatient with having to repeat something she said to me, and got annoyed at having to face me when she spoke or say something another way, I was hurt and angry. But I also became curious about what was happening. Slowly, it dawned on me that her impatience mirrored my own. I was impatient with myself when I didn’t hear, and I didn’t show myself enough compassion in my struggle to stay connected.

Seeing through my friend what I was doing to myself, I was able to step back and reconsider the path I want my life to take despite hearing loss. Do I want to stick with what is familiar and comfortable? Or do I allow myself to be a whole person who happens to have hearing loss? Fear, embarrassment, and feeling dismissed may still accompany me, but I can choose to listen to my heart and passion rather than the raspy voice of my inner critic. The choice is mine, I can hear it.

Sandra MacLeod is an educator and clinician who works with individuals with disabilities, chronic health concerns, and dementia. She is passionate about creating positive environments that foster well-being and growth. She loves trail running, hiking, and kayaking on the beautiful Olympic Peninsula in Washington, where she lives with her husband and three cats.

More Than Not Being Able to Hear the TV

Avoiding treatment for hearing loss can keep us isolated from others, but it has a bigger cost in putting us at risk for dementia. According to research conducted at the Johns Hopkins School of Public Health, hearing loss is one of the major, but modifiable, risk factors for dementia, yet only 15-20% of Americans who have hearing loss seek treatment. If you have hearing loss, hearing aids can help reduce your risk of dementia by keeping you socially connected, and your brain stimulated and active.

The process of finding a hearing aid provider and managing the fears and judgments that may come along for the ride can be daunting. Here are some suggestions to get started on your path to better hearing and brain health:

See an Audiologist: If you suspect that you may have hearing loss, see an audiologist who is an expert, often a doctor of audiology, who diagnoses hearing loss and helps you select a hearing aid. The audiologist is a key player in helping you hear better, so look for someone you feel comfortable with and who listens to your needs. Referrals for an audiologist come from friends, an Ear, Nose & Throat specialist, or your health care practitioner. The audiologist uses a hearing test indicating sounds you can and cannot hear to diagnose your hearing loss and help guide your choice of hearing aid.

Customizable Hearing Aids:

Customizable hearing aids are programmed base on hearing needs according to your hearing test and lifestyle, as well as controls keeping you hearing well whether you are in a noisy restaurant, playing bridge with friends, or listening to your granddaughter telling you about her day. These features make customizable hearing aids more expensive but essential for helping you hear consistently better no matter where you are.

Note: Over the counter (OTC) hearing aids for milder hearing loss can be less expensive and more accessible than customizable hearing aids. OTC hearing aids may have some drawbacks for your hearing loss and may not be returnable, so it’s wise to get as much information as you can before purchasing.

Don’t Hide Your Hearing Loss: Your new hearing aids will feel awkward at first and the sound quality will differ from your natural hearing, but using them in your normal routines and activities helps you adjust to a new way of hearing. You may be tempted to hide your hearing aids, but instead, tell others starting with friends and family that you’re wearing hearing aids but may still miss some things. You will. You may feel impatient with yourself and your hearing aids but instead of buying into these messages from your inner critic, turn toward who and what you care about and why you want to hear.

If I Should Fall

by CORWIN P. KING

Many years ago, I walked past the house of an elderly lady on my way to work. One winter morning I saw her sitting on her porch steps with a couple of people gathered around. “I fell! I fell!,” she was shouting, obviously scared and confused.

“Too bad,” I thought. “I guess that’s what happens to old people who aren’t careful.”

Now, it’s happened to me. Walking to the alley behind our house, I slipped on an icy step from our deck and fell hard on my bottom. As soon as I knew I could move my legs, I crawled back up the steps and grabbed the deck railing.

That’s where my wife found me, head down, dizzy, breathing heavily, and sweating in the 20-degree weather. “I fell,” I said, still trying to get my bearings. “I slipped and fell.”

I got into the house and sat down. I was pretty sure I hadn’t broken anything, but every joint in my body felt shaken. That was the beginning of weeks of pain and uncertainty.

We had a trip planned in a few days, and I was determined to go. With the help of lots of Tylenol and a seat cushion, I endured the six-hour flight to our destination and the car ride to our rented condo. But I was stiff and couldn’t walk far and turning over in bed was agony.

I spent most of the trip sitting in soft chairs with an ice pack. I tried to play golf a couple of times, but couldn’t swing a club, so I mostly rode around in the golf cart. One night, we went to a concert where I spent half the time leaning against a wall to ease my back.

The worst thing, though, was the fear of falling again. I thought I was in good shape for my age (79), but now I was unsteady on my legs. My balance was off. I feared walking on uneven surfaces. Every wet leaf, every muddy place in my path was a potential hazard. I went up and down stairs slowly, watching my feet and holding onto bannisters.

Eventually, the pain went away, and I regained my confidence. But it left me with a new respect for people you see shuffling along with walkers or canes for support. According to the website PubMed, more than a third of all people over 65 fall every year, and in half those cases the falls are recurrent.

Some falls are caused by unsafe environments (slippery steps), but most come from medical conditions, cognitive or vision problems, declining muscle strength, side effects of medications, or substance abuse. Regardless, the World Health Organization estimates that in the U.S., 20-30% of older people suffer moderate to severe injuries due to falls. In many cases, the falls lead to the thing most dreaded by older people—permanent disability and a loss of independence.

Falls can happen to anyone, often when they’re least expected. Being aware of that is the first step to preventing them. Taking simple precautions like watching your footing is the second. You can’t be too careful, after all.

Corwin P. King is a retired university professor now serving as an adjunct faculty member at Pacific Northwest University of Health Sciences in Yakima. His articles on health and other topics have appeared in The Seattle Times, Seattle Post-Intelligencer, The Christian Science Monitor, and The Mensa Bulletin. He lives in Ellensburg.

The Joy of E-Biking BY MIKE HARMS

Iwas on the verge of taking my first e-bike ride. I strapped my helmet on and I walked my e-bike for one block.

I had scheduled a test ride at G&O Family Cyclery in Seattle. One of their helpful bike pros suggested that I should start my ride a block west of the shop, on a quieter street. I think she could tell I was a little nervous.

“You’ll feel like you’re riding with a superpower,” she said, with encouragement. That sounded fun.

I started pedaling on a sleek Gazelle Ultimate C380. The first few pedal strokes felt familiar. Then, whoosh, the electric assist kicked in. I surged forward. Sure enough, it did kinda feel like a superpower.

In a New York Times column titled, "How an E-Bike Changed My Life," Jennifer Finney Boylan wrote:

“Cycling, like everything else, has gotten harder as I’ve grown older. … Since I got the e-bike, though, I’ve been riding 15 and 20 miles a day, four or five days a week. It’s been life altering, not just making me fitter, but also raising my spirits, getting me out of the house and back into the mountains.”

That column appeared in August 2019, prior to the pandemic. Since then, e-bike ridership surged during COVID. E-bikes were the number-one selling electric vehicle in America last year, outselling electric cars, according to Bloomberg. If you’ve been thinking about getting an e-bike, here are three things to consider: 1) An e-bike can help us stay active as we age. The “e” in e-bike stands for electric assist. It provides power when pedaling, to help riders climb hills, keep pace with other riders, accelerate around obstacles, and ultimately reach their destination.

My personal training client Terry who’s 69, varies the intensity of his e-bike rides with some unassisted intervals. “Get an e-bike with gears so you can shut off the power and sweat until you get tired of sweating,” Terry says. “Then you can turn the power back on and make it easier on yourself for a while.” 2) Try before you buy. An e-bike is a significant purchase. The models that I tested ranged in price from $1,999 to $4,199. You’ll get the most for your money by visiting different shops, speaking with their experts, and testing different bikes.

“Test drives are a must,” Terry says. “Ask about the bike’s maintenance needs and the seller’s service department.” 3) Some safety considerations. “Just a word of caution,” Terry says. “E-bikes generally weigh more and go faster than non-e-bikes.”

The e-bikes that I rode ranged in weight from 48 to 64 pounds. By comparison, my standard bike weighs about 33 pounds. When it comes to speed, e-bikes typically provide assistance up to 20 or 28 miles per hour, so invest in a good helmet and remember to wear it.

Terry and his wife, Mary, both ride e-bikes. Mary got hers first. Terry saw how much fun she was having and now, he’s hooked.

“I can ride with younger, fitter riders,” Terry says. “I can go farther and higher. I can turn off the power and use my seven standard gears to get a workout. …Best of all, it has a horn.”

Mike Harms is an author, personal trainer, and owner of Muscle & Hustle gym in Seattle.