Human aging is a remarkable process which takes us on a path through our lives often without notice. There are many losses of function that can occur with aging. What can we do to manage these declines and improve our outcomes with aging? This matter can be best considered with consideration of these fundamental questions: Is aging inevitable? Does it happen to everyone? Also, are the declines with aging universal?
It is widely believed that aging is inevitable. I am concerned that this perceived inability to avoid aging leads to a unfortunate denial of our personal involvement in our own outcomes. A person may say: “If declines are going to happen no matter what, I might as well live well.” Or, “When you’re gonna go, you’re gonna go.”
The fundamental reality is that aging is not inevitable, as does not happen to everyone. The best example may be Princess Diana, who died at the age of 37. She did not have an opportunity to get to be “old”. And all of us have personal memories of those we have known and loved who did not live long enough to be considered aged. Furthermore, the declines in aging are not inevitable. It is possible for a 60 year old person who drinks too much, is overweight and has bad dietary habits (and smokes) to be in better physical and mental condition at the age of 70, if the needed changes in lifestyle take place.
The realization that aging declines are not inevitable leads to the inevitable conclusion that aging is an opportunity; an opportunity to pay attention to ourselves and to our world so that we can have the most optimal and meaningful life as we get older.
I propose a theory of the multiple reserves which describes how we can enhance our reserve capacities (resilience), to expand our opportunity to experience optimal aging. Cognitive reserve describes the brain’s ability to work effectively and perform its higher functions and maintain resilience despite challenges. Physical reserve is a capacity of all the body systems to perform well despite changes caused by aging and the challenges which develop. Psychological reserve is our ability to maintain healthy mental function and avoid agitation, anxiety, depression and other unhealthy mental states. Finally, social reserve describes our interpersonal networks and support systems and our ability to be connected to others in society.
Unaging: The Four Factors That Impact How You Age describes how attention to our lifestyle factors, including cognitive and physical activities, diet, oral health, social involvement, gut bacteria, as well as avoidance of toxins and trauma can all contribute to the highest possible level of reserve capacity. Enhancing our multiple reserves improves our maintenance or function as we get older and also decreases the risk of systemic illnesses, including Alzheimer’s, heart disease, stroke and cancer, among others.
As the great Viennese psychiatrist Victor Frankl said, “Our greatest freedom is the freedom to choose our attitude”. If we recognize aging as an opportunity we can adjust our four multiple reserves to enhance health, fitness and resist disease.