Sharon Leitch
Not many people make their 100th birthday. It’s a big deal, and rightly so: the family celebration and obligatory photos, the card from HRH (not so far off the Big Day herself), perhaps a write-up in the local paper. “Tell us!” the journalist asks, “what is the secret of your longevity?” We collectively lean forward to catch their snippets of wisdom. What is their secret? A Philosopher’s Stone? The Elixir of Life? After all, living for a Very Long Time is as close to immortality as we can achieve in the here-and-now.
Stats NZ estimates there are approximately 400-500 centenarians alive in New Zealand at the present time. Fewer than ten percent are older than 105 years. Centenarians are models of successful aging, and we thought their lives may reveal some of the clues to their longevity. Our study team, led by Yoram Barak, and including Pip Greco, Paul Glue, Andrew Gray and myself, decided to conduct a review of a large set of routinely collected data to see if we could learn some of the secrets of these “Super Agers”.
Everyone in New Zealand who requests, or is referred for, home care support or residential care is required to have an interRAI (international Resident Assessment Instrument) assessment. This internationally validated tool consists of 236 items, which comprehensively assess all elements of a person’s life.
We reviewed the data from all New Zealanders living in the community who had their first interRAI assessment during the past five years. We compared data from more than 73,095 elderly people aged 65-99, with 191 centenarians aged 100 or over. The two groups were very different. The centenarians were significantly more likely to be female, widowed, and free from depression compared to the elderly group. Centenarians were also much less likely to be lonely, with a 22-32% lower risk of loneliness compared to people under the age of 100. We were able to identify three psychosocial variables which were protective against loneliness. These included living with others, having family support, and being free from depression.
During the course of our research I was surprised to learn how detrimental loneliness is to our well-being, so much so that it has been called a public health hazard. People who are lonely are at increased risk of poor mental and physical health, including depression, insomnia, high blood pressure, heart disease, stroke, Alzheimer disease, as well as premature death. Loneliness typically worsens with aging, but we observed the opposite in our data, possibly attributable to the fact our sample population were all based in the community (rather than living in residential care) and had good family support.
The New Zealand population is aging due to increased life expectancy and low fertility rates. The number of Kiwis aged over 65 years has doubled over the past decade to 700,000 in 2016, accounting for 15% of the population. Future estimates predict this group will double again by 2046, to comprise approximately 21-27% of the population. Ensuring that this large group of Kiwis is socially connected and meaningfully engaged will play an important part in improving their health and well-being.
Different ideas for improving social inclusion of the elderly can be found internationally, and may well be worth replicating in New Zealand. Shared and communal housing projects are on the increase in many places, providing mutual support and reduced living costs. Some countries provide incentives allowing students to live cheaply in shared housing arrangements with older folk, in exchange for companionship and assistance with household chores. Intergenerational care started in Japan in 1976 with the integration of a pre-school and residential care home. This unusual but successful model is now found in several other countries including the United States, the United Kingdom and Australia.
Closer to home, New Zealand school children are frequent and popular visitors to local rest homes. They practice their reading, learn to knit, share technology, and provide entertainment in cultural groups. Increasing opportunities for these type of interactions can provide mutual benefit.
Human connections are vital for our well-being. Loneliness is a social problem with serious adverse medical outcomes. We need to consider how we ensure our elderly relatives and neighbours feel included and supported in society, to help reduce the burden of loneliness and avoid the negative health implications that can arise from it.
We have all known the long loneliness, and we have found that the answer is community.” Dorothy Day
Sharon Leitch
References:
- Leitch S, Glue P, Gray A, Greco P, Barak Y. Comparison of Psychosocial Variables associated with Loneliness In Centenarians vs Elderly Populations in New Zealand. JAMA Network Open 2018;1(6):e183880. doi:10.1001/jamanetworkopen.2018.3880
- Ong AD, Uchino BN, Wethington E. Loneliness and Health in Older Adults: A Mini-Review and Synthesis. Gerontology. 2016;62(4):443-449.
- Stats NZ. Population projections overview. March 8, 2017. archive.stats.govt.nz/browse_for_stats/population/estimates_and_projections/projections-overview/nat-pop-proj.aspx
- Harris J. Why some Dutch university students are living in nursing homes. Dec 4, 2016. Independent. www.independent.co.uk/life-style/health-and-families/why-some-dutch-university-students-are-living-in-nursing-homes-demential-a7451486.html
- Handicare UK. How care homes and nurseries are coming together for good. April 26, 2018. Age UK. www.ageukmobility.co.uk/mobility-news/article/intergenerational-care
- Wise C. What happens when a nursing home and a day care center share a roof? PBS NewsHour. May 10, 2016. www.pbs.org/newshour/show/what-happens-when-a-nursing-home-and-a-day-care-center-share-a-roof
Other Corpus articles on a similar theme include The history of loneliness by Barbara Brookes and Smoke in the head by Grace Carlyle
So interesting. My mother in law lived to almost 103. [she passed away yesterday) She was always calm and happy. My sister in law lived with her as a career for the past 18 years, and two grandchildren came to her house every day after school till their mum picked them up after work.
Kia ora, an interesting blog. The research you quote is probably right but I’m 89 and and all except one of my female relatives died in their fifties. I expected to do the same. I credit my longevity half to genetic inheritance (the one woman who lived until she was 73 and the man who lived until 93) but place lot of weight on the fact that I still work, self–employed writer. I live alone, have 2 hours a week help in the house which I pay for myself, and help in the garden, ditto. I have good friends I see outside work hours, live alone, have macular degeneration and arthritis, have survived bi–lateral mastectomy because of cancer. The reason I place a lot of weight on work as a healthy force is because I see that as the difference between me and my contemporaries although I should add that my friends, except for one, are all between 10–20 years younger than me. Maybe that’s a factor? Although I joke that I’m the one who serves them afternoon tea – shouldn’t it be the other way round? Of course it is when I go to their place. I don’t drive any more but manage with help from friends and in Otaki we have a very reasonable shuttle service I can use as well. My appetite has got smaller and sometimes its hard to interest myself in food but I have some good cookbooks or can go online – that’s another boon, technology. I am so grateful for its benefits. but lot of my age group either don’t use it at all or only rarely.
Whether I live till I’m 100 remains to be seen but so far I credit work, technology, friends, for maintaining my relatively good health. The thing I fear most is that I won’t be able to manage independently and will have to go into a Home. Maybe the spur of not wanting to do that also plays a part?
Nga mihi Renee. I’m sure enjoying a long life is more complex than we have been able to tease out of our data, which restricts us to compare measured factors that have potentially influenced hypothetical “average people” from the different groups. Real life is far more nuanced and interrelated, as you have observed and described from your own experience.
Very interesting essay, thanks Sharon.
Sorry for your loss, Sue. We found living with family and good family support were associated with less loneliness, and both these factors were more common in people over the age of 100.
Congratulations for your piece of research. All the best for more.