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Five pillars of ageing well

Updated Tuesday, 11 July 2023
In this article, Dr Jitka Vseteckova provides easy to follow advice on how to stay healthy in five steps.

This content is associated with The Open University's Health and Social Care courses and qualifications.


As part of the Ageing Well series of Public Talks, I am exploring how important it is, over our lifespan, to maintain a well-balanced nutrition and hydration as well as regular physical and social activity in the older age. As we know we start ageing the moment we are born, it demonstrates more significantly when we reach a certain age, the usual benchmark being 65+, but our ageing starts much sooner, and the way ageing demonstrates when we are over 65 depends on decisions, we have been making over our life span.

As you may know, the main motto about Ageing goes USE IT OR LOSE IT. Therefore, we need to think and decide for ourselves what we want to do if we don’t want to lose the capacity in our vital organs. And we need to systematically / regularly exercise the functions we do not want to lose as we age (and these may be many). Following are the main Five Pillars of Ageing Well: nutrition, hydration, physical, social and cognitive stimulation.

Nutrition

Transcript

Ageing Well series Nutrition Dr Jitka Vseteckova: Hello, my name is Jitka Vseteckova and I am Senior Lecturer in Adult Health in Faculty of Wellbeing, Education and Language Studies at The Open University.

Today, I would like to draw your attention to a series of public talks titled ‘Ageing Well’. These 6 lectures are presented on a monthly basis and aim to facilitate your learning about agerelated changes and things we need to be mindful of, as we grow older.

All the way through the ‘Ageing Well’ series we discuss how important it is to maintain a wellbalanced nutrition and hydration as well as regular physical and social activity in the older age. We explore how using this knowledge might facilitate self-management and delay the ageing processes. Five main pillars of the Ageing Well series are nutrition, hydration, physical, social and cognitive stimulation.

Today I am going to talk about nutrition.

You may know already that our basic metabolic rate and functions slow down with ageing. Regular physical activity and good hydration are known to help raising the basic metabolic rate. Together with good nutritional habits, these are very important elements when it comes to ageing well.

Food provides a variety of substances that are essential for building, upkeep and repair of body tissues in general and for the efficient functioning of the body.

With ageing naturally occurs muscle atrophy, which means that our muscles are decreasing in size/volume and we become weaker. Keeping good quality protein in our daily meals and snacks helps us, together with regular physical activity and hydration, preserve muscles in good function for longer. This means we feel better, stronger, can enjoy being active, are less prone to falls and falls related injuries and in the end, we live independent and in better health for longer.

Not only protein but also carbohydrates, lipids/ fat, vitamins, minerals and again water represent necessary components for healthy blood bringing all the necessary nutrient to all our organs, including our brain (which takes about 20% of glucose and 20% of oxygen consumed in whole by our body). The food we are eating should be varied and fresh, of good quality, and should for sure include fruits, vegetables. General recommendations for ageing well and keeping good nutritional habits are:

• Enjoyable and varied with plenty of fruit and vegetables.

• We opt for healthier fats and include oily fish in our diet.

• Get enough fibre and reduce salt intake.

• Boost vitamins B & D eat calcium rich food, although we need to remember that supplements cannot replace a balanced diet.

• Get enough sleep.

• Reduce the medication/amount of drugs we are taking daily, if possible.

• Don’t smoke, go easy on alcohol and look after our teeth.

• Watch our weight and waist size and thyroid function.

• Keep well hydrated (strict minimum is 1.5 litre per day of ideally water (coffee, tea and alcohol are dehydrating beverages)

• Have regular physical activities and stay outdoor for at least a little every day and stay social.

• Socialising over a meal is a great opportunity to enjoy our meals in a stimulating company.

The same practices that contribute to healthy ageing and physical vitality also contribute to a healthy memory. So, by taking steps early to prevent cognitive decline, we are also improving all other aspects of our life.

There are some genetic predispositions that may slightly speed up or slow down the ageing processes or show us what we need to be aware of in terms of age-related conditioning in our predecessors. However, the genetic predisposition does not affect 100% of how our ageing might look like especially if we decide to help it.

The way we live our lives and the choices we make affect the way we age – IT IS ABOUT THE CHOICES WE MAKE.

So, are we ready to live longer while having a better quality of lives? This will depend mostly on choices we are going to make from now on.

(End of Mini Lecture)

With ageing naturally occurs muscle atrophy, which means that our muscles are decreasing in size/volume and we may become… and feel weaker. Keeping good quality protein in our daily meals and snacks helps us, together with regular physical activity and hydration, preserve muscles in good function for longer. This means we feel better, stronger, can enjoy being active, are less prone to falls and falls related injuries and in the end, we maintain our independence and better health for longer.

General recommendations for ageing well and keeping good nutritional habits are:

  • Enjoyable and varied food with plenty of fruit and vegetables, enough fibre, reducing salt intake, keep an eye on having enough vitamins in our diet,
  • Get enough sleep, reduce medication if possible, stop smoking and go easy on alcohol (avoid if possible)
  • Keep well hydrated (strict minimum is 1.5 litre per day of ideally water (coffee, tea and alcohol are dehydrating beverages).

Hydration

Transcript

Ageing Well series

Hydration

Dr Jitka Vseteckova:

Hello, my name is Jitka Vseteckova and I am Senior Lecturer in Adult Health in Faculty of Wellbeing, Education and Language Studies at The Open University.

As part of the Ageing Well series of mini lectures, we’ll be exploring how important it is, over our lifespan, to maintain a well-balanced nutrition and hydration as well as a regular physical and social activity in the older age. We explore how using this knowledge might facilitate selfmanagement and delay the ageing processes for as much as we can. As we know we start ageing the moment we are born, it demonstrates more significantly when we reach a certain age, the usual benchmark being 65+, but our ageing starts much much sooner, and the way ageing demonstrates when we are over 65 depends a lot on decisions, we have been making over our life span.

Today we’ll focus on hydration.

Ageing brings about changes in metabolic rate and muscles, brain, liver, kidneys, and overall mobility. All these changes affect how well do on a daily basis in terms of hydration. Also, our daily hydration (the amount of water, liquids we drink every day) will affect further changes and speed of these changes on the metabolic rate, liver and kidney function, muscle function, nervous system and overall feeling of wellbeing and mobility.

When we don’t drink enough:

• Metabolic rate decreases – slowing further down metabolic processes in our body (how fast we process food, drugs/medication we are taking.

• Our, already, ageing liver and kidneys suffer from insufficient hydration, processing drugs/medication is slowed down, and we are more likely to suffer negative side effects of drugs we are taking AND we risk that the drugs were taking will have a further cumulative effect in our body…

• This is closely linking to how drugs are moving through our body. We NEED TO BE concerned about how we can eliminate quickly all drugs from the system, as a cumulation of drugs leads to many negative effects.

• And also, how the drugs take effect. Ageing changes result in different responses to the same amount of the same drugs we have been taking over our lifespan. Drugs take longer to act and longer to clear out. - This is in a relatively hydrated body, so further dehydration makes all metabolic processes much slower, prolonging the negative effects the drugs.

• This negatively influences our muscle function and neural system functions … this, in turn, increases our sedation, we feel weaker, dizzier, wobblier and have higher risks of falls and falls related injuries – one of the main consequences here is immobility and loss of independence in our lives.

• Dehydration long-term can cause memory loss and other symptoms mimicking early signs of dementia or Alzheimer disease, when drinking plenty these are usually reversible.

The strict minimum of water intake in our daily diet is 1.5 litres per day (of course if we are taking any diuretics, laxatives we need to drink more). This is only to make sure the metabolic processes (and there are many) can go ahead. Ideally, this should be much closer to 2 litres per day excluding coffee, tea, alcohol as these are dehydrating beverages and have a further diuretic effect. For each cup of coffee or tea or alcohol, we would ideally have another glass of water. Staying hydrated is good and very necessary for our physical and mental wellbeing. Please be mindful as we grow older, we may also forget to drink, and our feeling of thirst decreases with increasing age so please let others remind you to drink. Drink when you are not thirsty and have a measure of what you have drunk so far throughout the day. If you have a water or water fountain near you, please go and get a water cuppa! Here’s to your good health… and thanks for watching!

(End of Mini Lecture)

The changes ageing brings about affect how we do on a daily basis in terms of hydration. Also, our daily hydration (the amount of water, liquids we drink every day) will affect further changes and speed of these changes on the metabolic rate, liver and kidney function, muscle function, nervous system and overall feel of wellbeing and mobility.

With insufficient hydration:

  • Metabolic rate decreases – slowing further down metabolic processes in our body (how fast we process food, drugs/medication we are taking, hormonal secretion chains where secretion of one hormone influences secretion of another one etc).
  • This negatively influences our muscle function and neural system functions … this, in turn, increases our sedation, we feel weaker, dizzier, wobblier and have higher risks of falls and falls related injuries – one of which is immobility and loss of independence in our lives.

A strict minimum of water intake in our daily diet is 1.5 litres per day (of course if we are taking any diuretics, laxatives we need to drink more). This is only to make sure the metabolic processes (and there are many) can go ahead. Ideally, this should be much closer to 2 litres per day excluding coffee, tea, alcohol as these are dehydrating beverages and have a further diuretic effect.

Staying hydrated is good and very necessary for our physical and mental wellbeing. As we grow older we may also forget to drink and our feeling of thirst decreases with increasing age so please let others remind you to drink. Drink when you are not thirsty and have a measure of what you have drunk so far throughout the day.

Physical activity

Transcript

Ageing Well series

Physical Stimulation

Dr Jitka Vseteckova:

As part of the Ageing Well series of films, we’ll be exploring how important it is, over our lifespan, to maintain a well-balanced nutrition and hydration as well as regular physical and social activity in the older age. We explore how using this knowledge might facilitate selfmanagement and delay the ageing processes for as much as we can. As we know we start ageing the moment we are born, it demonstrates more significantly when we reach a certain age, the usual benchmark being 65+, but our ageing starts much much sooner, and the way ageing demonstrates when we are over 65 depends on decisions, we have been making over our life span.

Over the course of these series or mini lectures, we will cover the main Five Pillars of Ageing Well which are: nutrition, hydration, physical, social and cognitive stimulation. Today we’ll focus on physical stimulation / physical activity.

In the previous lectures, we have briefly discussed changes brought about by ageing. Changes in metabolic rate, liver, kidneys, neural & muscle function and overall mobility and physical and mental wellbeing. We have been through how important nutrition and hydration is to both physical and mental health & wellbeing. To keep our good health while we are getting older, we need to keep the blood regularly circulating. Here we are helped mainly with good hydration (drinking plenty) and regular physical activity. Physical activity does not always means running, swimming or going to the gym or attend classes. It is even better if we do but may not be suitable for all for us. Being physically active means also not avoiding stairs and walking somewhere where we need to go instead of taking lifts and cars. Being physically active is very much about not avoiding moving whenever and wherever we have the chance.

If we are still fit to swim, run, trek, walk, attend gym classes etc. It is great and we need to keep that going. The regularity of us moving and exercising has immense benefits to our bodies. Outdoors is even better.

• Our organs and tissues need a regular input in terms of blood bringing all the necessary nutrients and oxygen. This is great for our muscles, our liver, kidneys, hears, lungs and brain!

• With regular blood circulation and good hydration and nutrition, we will maintain our tissues (such as muscles, tendons) and organs in good function for longer. This will increase our fitness, feelings of health and wellbeing both physical and mental.

• Regular physical activity together with good hydration and nutrition will enable our brain to function well for longer too.

• As you may know, the main motto about Ageing goes USE IT OR LOSE IT. Therefore, we need to think and decide for ourselves what we want to do if we don’t want to lose the capacity in our vital organs. And we need to systematically / regularly exercise the functions we do not want to lose as we age (and these may be many).

The sooner we start the better ageing we have ahead of us. Have you been sitting for a while now? Why not getting up and getting yourself a drink of water, making a few steps and perhaps going for a short walk… thanks for watching!

(End of Mini Lecture)

To keep our good health while we are getting older we need to keep the blood regularly circulating. Here we are helped mainly with good hydration (drinking plenty) and regular physical activity. Physical activity does not always means running, swimming or going to the gym or attend classes. It is even better if we do but may not be suitable for all for us. Being physically active means also not avoiding stairs and walking somewhere where we need to go instead of taking lifts and cars. Being physically active is very much about not avoiding moving whenever and wherever we have the chance.

If we are still fit to swim, run, trek, walk, attend gym classes etc. it is great, and we need to keep that going. The regularity of us moving and exercising has immense benefits to our bodies.

The sooner we start the better ageing we have ahead of us. Have you been sitting for a while now? Why not getting up and getting yourself a drink of water, making a few steps and perhaps going for a short walk.

Cognitive stimulation

Transcript

Ageing Well series

Cognitive Stimulation

Dr Jitka Vseteckova:

Hello, my name is Jitka Vseteckova and I am Senior Lecturer in Adult Health in Faculty of Wellbeing, Education and Language Studies at The Open University.

As part of the Ageing Well series of films, we’ll be exploring how important it is, over our lifespan, to maintain a well-balanced nutrition and hydration as well as a regular physical and social activity in the older age. We explore how using this knowledge might facilitate selfmanagement and delay the ageing processes for as much as we can. As we know we start ageing the moment we are born, it demonstrates more significantly when we reach a certain age, the usual benchmark being 65+, but our ageing starts much much sooner, and the way ageing demonstrates when we are over 65 depends on decisions, we have been making over our life span.

Today we’ll focus on cognitive stimulation.

Previously we have mentioned the main changes brought about by ageing. These were changes in metabolic rate, heart, liver, kidneys, brain, neural & muscle function and overall mobility and physical and mental wellbeing. We have been through how important regular exercise, nutrition and hydration is to both physical and mental health & wellbeing. Our cognitive functions are very important, and we need to help our brain to keep its plasticity, and capacity for as long as we are able to. Brain, like muscles really, works better the more it gets stimulated. Stimulation can be various, through observing (people, places, nature etc) trough interacting with people and engaging with the world we live in and surrounds us. We can read newspapers, magazines, books, learning new languages, take drawing classes, computer classes, sewing and other handcraft classes, learning to play musical instruments (Piano is highly recommended as a brain stimulation as using both hands at different times really challenges our brain).

• The best way to do it? engaging with whatever you have around you will help you to stay well for longer enjoying better physical and mental health.

• Talk to people, go places, nature, or just your street, being physically active, (by that I mean not just exercise) but generally moving about walking and taking the stairs whenever and wherever you can instead of using a car and lifts for example. We need to remember to keep an eye on our hydration, if we are getting forgetful, we need to find a way to be remembered, by someone or something. We need to remember that dehydration, not drinking enough of water can worsen the age-related memory loss and mimic early onset dementia symptoms including confusedness. We need to drink. If at some point we have a feeling that we forget more than we perhaps should we need to go and see our GPs.

• We need to keep an eye on possible adverse drug effects and or cumulative effects – largely due to dehydration. This can affect our cognition, memory and slow us down…

• We also need to alert our GPs if we feel we are getting depressed and uninterested in things around us. Sometimes this may be due to severe dehydration or hormonal changes associated with ageing and can be easily helped and reversed. • We need to sleep as much as we can. This is not easy as we are getting older, but we still need the rest so that we can go and be active afterwards. Regular exercise may help to get better sleep.

• We need to check our B12 vitamin levels, sometimes B12 deficiency is behind some memory loss problems. This is treatable and reversible.

• We need to keep an eye on our thyroid function. The thyroid gland controls in large part, our metabolism. If the thyroid is hyperactive, we may feel confused if it is too slow, we feel sluggish and depressed. Thyroid problems can cause memory loss and forgetfulness and difficulty concentrating. Appropriate medication can reverse the symptoms.

• We should avoid alcohol. Alcohol in larger portions is toxic for our bodies & brains, dehydrating and contributes to neural cell death, brain shrinkage and memory loss.

• We need to stay social. Social contact is immensely beneficial and stimulating to our brain and I will talk about this more in the next lecture.

With plenty water to drink, reasonable nutrition and being physically active and engaging with the world, people, places, nature around us we will delay the onset of cognitive ageing and we will be able to preserve well-functioning brain and body for as much as we can. So, go get yourselves a drink of water and while you are on the go why not enjoying a short walk in the neighbourhood to see what and who is near where you live! Thanks for watching!

(End of Mini Lecture)

We have been through how important regular exercise, nutrition and hydration is to both physical and mental health & wellbeing. Our cognitive functions are very important, and we need to help our brain to keep its plasticity, and capacity for as long as we are able to. Brain, like muscles really, works better the more it gets stimulated. Stimulation can be various, through observing (people, places, nature etc) trough interacting with people and engaging with the world we live in and surrounds us. We can read newspapers, magazines, books, learning new languages, take drawing classes, computer classes, sewing and other handcraft classes, learning to play musical instruments (Piano is highly recommended as a brain stimulation as using both hands at different times really challenges our brain).

  • Basically, engage with whatever you have around you.
  • People, places, nature, world.

This brings the next pillar which is:

Social stimulation

Transcript

Ageing Well series: Social Stimulation

Dr Jitka Vseteckova:

Hello, my name is Jitka Vseteckova and I am Senior Lecturer in Adult Health in Faculty of Wellbeing, Education and Language Studies at The Open University.

As part of the Ageing Well series of mini lectures, we’ll be exploring how important it is, over our lifespan, to maintain a well-balanced nutrition and hydration as well as regular physical and social activity in the older age. We explore how using this knowledge might facilitate selfmanagement and delay the ageing processes for as much as we can. As we know we start ageing the moment we are born, it demonstrates more significantly when we reach a certain age, the usual benchmark being 65+, but our ageing starts much much sooner, and the way ageing demonstrates when we are over 65 depends a lot on decisions, we have been making over our life span.

Today we’ll focus on social stimulation. Linking cognitive and physical stimulation with social stimulation has been shown to be very effective in sharpening, protecting and preserving our social, cognitive and physical skills.

Social stimulation enhances massively cognitive functions. If we want to stay in good physical and mental health for longer, we need to engage with things, places, people the world around us, together with keeping an eye as well on nutrition, good hydration, physical and cognitive stimulation.

As we grow older it is very important to make time for activities we have always enjoyed in our lives. Continuing favourite activities can ensure the sustainability of cognitive stimulation and keep the practical functional benefits (skills and capacities we do not want to lose).

Adding some new cognitive and /or social challenges is also great! Trying new activities enhances the brain plasticity by requiring new learning or development of new cognitive strategies. Music lessons, learning a new language, new sports – aqua aerobics, dances etc. brings about phenomenal cognitive stimulation but also a social aspect of it.

Meeting new people and keeping interest in people we have known for a long time is very important and besides this being hugely cognitively stimulating it is also a chance for us to get out on fresh air, meet someone over a coffee with plenty of water on the side (please remember the importance of being well hydrated).

Social engagements make us feel alive. Even if we do not necessarily agree with everyone we meet, they are massively brain stimulating and usually require us to go somewhere too (which brings about the physical activity). For example, enjoying a good meal in a company is great and very stimulating too.

If you like a challenge you can engage in cognitively or socially challenging activities generating so called ‘mental sweat’ – things you have been doing forever and know inside out will not stimulate your brain so much anymore, so something new and challenging is a good alternative. Different types of cognitive and social activities have been for years now associated with preserving good cognitive skills and delaying the physical and cognitive decline usually associated with ageing.

Regular activities both cognitive and physical are necessary for preserving our brain and body functions. Meeting new people and keeping going sometimes because we have met interesting people that make us feel emotion, laughter, sometimes anger, but foremost making us feel alive, maybe another reason why we will go on a walking tour with people we know even if we don’t feel up to it and would rather stay home, because it is cold a miserable outside…

• Whatever motivates you to go somewhere and do something use it.

• Research has also shown that broader social networks and engagement with people have been associated with reduced Alzheimer disease risk.

• So, whatever it is that motivates you, the main thing is that you keep doing it!

I hope these mini lectures were helpful and the useful tips might help you to enjoy your life fully and independently for longer. Don’t forget that the GP is your good partner in keeping you in a good physical and mental health and wellbeing state. But only you can make the decisions about what you are going to do, who you are going to meet, how much water you are going to drink today and whether or not you will go out instead of staying home and even worse sitting. By not going out you are missing a lot of what is happening and some of it may even cheer you up. So, on your way to pick up a glass of water get your coat too and, on the way, to enjoy the world say also hi to your neighbour… and thanks for watching!

(End of Mini Lecture)

It is a well-known fact that social stimulation enhances massively cognitive functions. If we want to stay in good physical and mental health for longer, we need to engage with things, places, people the world around us. Together with being physically active, (by that I mean not just exercise) but generally moving about walking and taking the stairs whenever and wherever you can instead of using a car and lifts for example, and hydrating well (at least 1.5 litres per day of water) and keeping an eye on good nutrition engaging with whatever you have around you will help you to stay well for longer enjoying better physical and mental health and wellbeing.

I hope these lectures were helpful and will help you to enjoy your life as fuller and independent for longer. Don’t forget that the GP is your good partner in keeping you in a good physical and mental health and wellbeing state. But only you can make the decisions about what you are going to do, who you are going to meet, how much water you are going to drink today and whether or not you will go out instead of staying home and even worse sitting. By not going out you are missing a lot of what is happening and some of it may even cheer you up. So, on your way to pick up a glass of water get your coat too, and on the way to enjoy the world say also hi to your neighbour

Please see a short promo video here:


I hope these five pillars give you lots of ideas to see how small, daily changes can help you to age well.

  

 

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