Five Points that Increase Life Expectancy without Dementia After the Age of 65

A few weeks ago, I wrote about how the older you are and the more physically active you are, the longer you live disease-free. Real-life data on interventions late in life that increase our healthspans and lifespans is sparse, so when the findings from CHAP (Chicago Health and Aging Project) were recently reported in a paper headed by Klodian Dhana [1], they validated the benefits of a healthy lifestyle to live long healthy with a sound mind and body.

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The CHAP study looked at people over the age of 65, from a geographically defined community in Chicago. Between 1993 and 2012, 10802 people were enrolled. 2449 people from this cohort were eligible for this particular assessment.

Five factors were looked at.

1. Adherence to a Mediterranean-DASH (Dietary Approaches to Stop Hypertension) / MIND Diet Intervention for Neurodegenerative Delay (MIND) diet
2. Late life cognitive activities such as reading, playing cards, solving puzzles, etc
3. Physical activity (PA) - healthy PA was defined as greater than 150 minutes of moderate PA per week.
4. Non-smokers, both reformed and never-smokers.
5. No or light to moderate alcohol consumption (1-15 g/day in women and 1-30 g/day in men).

The results were astounding.

Women above the age of 65 who met 4 or 5 of these health criteria had a live expectancy of 24.2 years (22.8 to 25.5) and lived 3.1 years longer than those with 1 or none of these factors (life expectancy - 21.1 years - 19.5 to 22.4). More importantly, the women with healthy habits (4/5 or 5/5) remained Alzheimer’s free for 89.2% of that life expectancy (21.6 years lived without dementia of those 24.2 years), while the women with an unhealthy lifestyle (0/5 or 1/5) were dementia free for only 80.7% of their remaining years (i.e. 17 years out of their life expectancy of 21.1 years).

It was the same for men. Men with a healthy lifestyle (4/5 or 5/5) lived 23.1 years beyond the age of 65 (21.4 to 24.6) as compared to the unhealthy men (0/5 or 1/5) who had a life expectancy of only 17.4 years (15.8 to 20.1). The healthy men lived 94.9% of their remaining lifespan over 65, dementia free (21.7 years without dementia) compared to the unhealthy men who lived only 88% of their lives dementia free (15.3 years).

So effectively, women with a healthy lifestyle lived 3.1 years longer than women with an unhealthy lifestyle, while with men, the difference was even more at 5.7 years. The same was true of the number of years lived without dementia.

This data is in line with earlier studies that have shown that just 20 minutes of physical activity a day confers a benefit of 3 years of increased longevity as compared to those who are not active. The same has been true with studies on the Mediterranean diet or just eating more fruits and vegetables and adhering to a plant-based diet. Other studies also have shown that building cognitive reserves and physical activity help reduce cognitive decline.

All these 5 points are part of our Healthy 7 / Happy 7 plan. The two missing points that were not studied in this paper are coping mechanisms and healthy relationships. Those may not always be easy to assess anyway.

So, just like it is a good idea to start physical activity at any age, even if you are not or have not been active in early life, it is never too late to start adopting the Healthy 7 plan adding to that some of the other Atmasvasth guide points related to vaccines, not falling, sleeping well and managing cardiovascular risk including hypertension and diabetes.

Footnotes

1. Dhana K et al. BMJ. 2022 Apr 13;377:e068390.