Aging Expertly

A few months ago, there was something unexpected waiting in my mailbox: a welcome packet from the AARP. It’s a rite of passage for those of us turning the big five-oh, but I’m not going to lie: it was a little disorienting. As a member of Generation X, I may no longer be a spring chicken, but I’m lucky enough to feel pretty springy, and I’d like to stay that way for as long as possible.

UMass faculty and alumni have been working on several fronts to help all of us age gracefully, researching habits of body and mind that even Generation Z can embrace. While there’s no single formula for keeping a spring in our step, there are certain habits that rise to the top. Yes, yes, part of it is diet and exercise. Of course it is! But it’s way more than that, too.

Take a walk

I’ve been hearing it for years: 10,000 steps a day keeps the doctor away. “Physical activity works on multiple mechanisms in the body and is linked to chronic disease prevention,” says Dr. Amanda Paluch, assistant professor in the Department of Kinesiology. “One way this is measured is through taking more steps.”

But 10,000 is a lot of steps. Luckily, Dr. Paluch’s research shows that fewer steps still provide benefits. Her team found that middle-aged adults who manage to get at least 7,000 steps a day lower their risk of premature death by a whopping 50 to 70 percent. They also found that more is more—but only up to a point. “An incremental increase in steps is associated with a lower risk until you hit 10,000. That’s where it plateaus,” Paluch says. “Six thousand steps is better than 5,000, and 7,000 is better than 6,000, but when you get to 10,000, it levels off.”

In other words, there’s no need to get obsessive about the number. Nor does our activity have to be literal steps. “Steps per day is a great metric for public health promotion,” Paluch explains. “Walking is simple—most people can do it and track it, so it is an excellent way to promote moving more for a large proportion of people. If you’re at 10,000, great! But you can still get benefits by increasing from 5,000 to 6,000.”

Aiming for more activity is only one marker of well-being, of course. “To me, well-being is your state of health and happiness,” Paluch says. “It covers those health outcomes we think of, but also quality of life—your ability to keep up and enjoy playing with grandkids, for example.”

Be with friends

Another great thing about walking? It’s easy to do with a friend—and our social connections only become more crucial as we age, in practical as well as psychological terms. “There’s a lot of complexity about social networks that’s new to our understanding,” says Raeann G. LeBlanc, Seedworks Endowed Clinical Associate Professor for Social Justice in the Elaine Marieb College of Nursing. LeBlanc’s work evaluates social networks and quantifies what they refer to as “tie strength.” “There’s a foundation of research on how much social relationships influence health, which is true at any age, but if there begins to be a need for tangible support, the assessment of one’s network becomes really important,” says LeBlanc. Things that interfere with aging in place—mobility deficits, taking medications, and managing finances, among other factors—are addressed by various social services, but they tend to be fragmented. “We end up with a big mess of different resources being provided by people we don’t know,” says LeBlanc. Social relationships help navigate that system and can even circumvent it.

“You can’t just impose or create a network. We have to tend to our social relationships,” LeBlanc says. “Networks get smaller as we age, but in reality, the number of our closest human relationships stays around the same.” That number averages under ten people, and that can be plenty. We just need to keep those ties strong. “A very basic tool—the phone—is so important to psychosocial support,” LeBlanc points out. “In our study, strong friend networks play a huge role. They can be stronger than family networks in reciprocity of psychosocial support, even if they’re just based on shared interests or neighborhoods.” LeBlanc emphasizes how important it is that the relationships feel mutual. “Even if I really need you to do something, like pick up my groceries, it will impact my sense of control and dignity,” she says. “Sometimes the way care is delivered and understood can leave one with a sense of dependence rather than mutual support, and this way of being with people can undermine their confidence in their own selves. It’s not just about providing a resource—it’s how it’s provided and perceived.”

Grab a bite

This balance isn’t as hard to strike as it might seem. In fact, the nationwide system of Meals on Wheels already focuses on exactly this thing: providing meals in a social and compassionate way. And it’s more than that, as Uche Akobundu ’03MS, senior director of Nutrition Strategy, is the first to point out. “The meal is the central service, but people need more than meals,” Akobundu says. “We provide the core elements: meals, safety checks, social connection, and connections to the community in general.”

Akobundu uses the word nourished in the fullest sense of the term. The “meals” part of Meals on Wheels matters deeply—more than 10 million senior citizens in this country are hungry, after all—but they’re also just a starting point. “If it was only meals that people needed, how much simpler that would be,” she says. “To be healthy and independent and safe in your home as you get older, you need much more than a meal.” And this is where the wheels come in: the delivery, which usually involves human interaction and is as important as the food. “That’s the height of a nourished life—the opportunity to engage in one’s community, to receive services on one’s own terms, and to contribute to one’s community as well,” Akobundu says. Community Meals on Wheels programs accept contributions from the very same seniors they serve. “Sometimes we don’t want to take things we don’t think we deserve, or that we think someone else deserves more,” Akobundu explains. “So when Meals on Wheels recipients contribute, even if it’s a dollar or $10, that way they feel they are chipping into the system, and that preserves their dignity.”

Respect Yourself

That word dignity is a concept that Akobundu, LeBlanc, and Paluch have each been circling. Another UMass researcher places it squarely in the center, as a measurement that can affect physical and emotional health. “I’ve spent 15 years understanding what dignity means,” says Cynthia Jacelon, PhD, RN, FAAN, professor and executive associate dean at the Elaine Marieb College of Nursing. Jacelon first became interested in this back in her dissertation days. “I was focused on how older individuals affected the outcome of their hospitalization, and one thing that became apparent was that older individuals are very concerned about being treated with dignity,” she says. “Typically, older adults say that when you go into the hospital, you leave your dignity at the door. So, I wanted to understand this better.”

It didn’t take long for the scope of Jacelon’s research to stretch beyond hospital settings and into the larger community. It’s important for aging adults who still live at home to feel that their dignity is intact, too. It’s not just the caring approach—it’s smarter from an economic perspective. “If we could affect someone’s function by enhancing their dignity, we can help people stay home longer,” Jacelon says. Dignity is a subjective term, however, so Jacelon created an objective measurement that can quantify the level of dignity that a person experiences. She then used it to compare the level of dignity to physical and mental performance. “We can show there’s a correlation between this concept of dignity and actual mental, physical, and social function. More dignity equaled more physical performance. The higher the dignity score, the less pain. That’s really profound,” she says. Jacelon notes that “the next step is to figure out which way do these relationships go? I actually think that enhancing someone’s dignity improves their function. I believe that pretty strongly. That’s just a hunch, but it’s a strong hunch.”

I have a hunch she’s right. So, in addition to eating right, exercising, and making sure to check in with my friends, I’m reimagining what wellness and well-being mean to me. After all, I’d like to stick around for another 50 years.

See how UMass researchers are using artificial intelligence technology to improve care for older adults and those with Alzheimer’s.