Midlife

According to Robert Palmer, MD, head of geriatrics at the Cleveland Clinic, your lifestyle—especially in your 40s, 50s and 60s—largely determines how long you will live and the quality of your life after 70. By “lifestyle,” he means what you eat, whether you smoke, what you weigh, how much you exercise and so on. In his book, Age Well! (2007), written with Eileen Beal Palmer calls exercise “the closest thing there is to a fountain of youth.”

Though aging can slow thought and memory processes somewhat, in other ways your brain changes for the better. Its neurons grow more densely and intricately connected as you accumulate knowledge and experience. During middle age, the right and left hemispheres of your brain become better integrated, and you use both to handle tasks that younger people tackle with just one hemisphere. That growing integration may help explain why some people become more creative as they age, said psychiatrist Gene D. Cohen, author of The Mature Mind: The Positive Power of the Aging Brain (2006).

In their 20s, women are more satisfied with their lives than men, but by the time both sexes are in their 40s, men become the happier gender, according to economists Anke Plagnol, PhD, of Cambridge University, and Richard Easterlin, PhD, of the University of Southern California. Plagnol and Easterlin analyzed data from surveys of 47,000 Americans. They defined “happiness” as getting what you want. Both women and men wanted a happy marriage, and because men tend to marry later, fewer were satisfied with their family lives in their 20s. Both sexes also had material goals—they wanted a TV, a car, a house—and these possessions were more likely to elude younger men. By age 41, however, men were more satisfied with their finances than women, and by 48 the men were happier overall. The researchers note that many women in their 40s who are separated or divorced are less secure financially than when they were younger.

When previous generations hit their 60s, dentures were commonplace. Today, it’s normal to keep most of your teeth throughout your life. Of course, some dental problems do become more common over time. Because glands in older mouths don’t produce as much protective saliva, tartar and plaque can build up more quickly in later years, and cavities are more likely to develop. Also, older teeth break more easily. There are many products that can help prevent problems, especially if you use them regularly in midlife (and earlier), including dental floss and toothpastes that fight plaque and bacteria. Crowns can restore broken teeth, and there are sprays, toothpastes, mouthwashes and artificial saliva for dry mouths.

There’s no hard evidence that stress can rob hair of its natural color, and if it did, the change would happen gradually. Men normally get their first gray hairs around 30, and women, at about 35; the average person is half gray by 50. Scientists believe heredity largely determines the timing of the graying process, but if you smoke, your hair may lose its color prematurely. Hair color is no longer a reliable clue to a person’s age because nearly 60 percent of American women dye their hair today, as do some men.

If you want to be healthy and vigorous beyond 65, you need to start planning and have a conversation with your doctor sometime between age 35 and 50, according to Al Siu, MD, chair of the Geriatrics Department at Mount Sinai and the Bronx VA Medical Center. Fifty-five percent of Americans over 65 have two or more chronic conditions, such as diabetes, osteoporosis or heart disease. To stave off these diseases, you need to take preventive measures beginning decades earlier. Make sure your doctor checks your blood pressure and cholesterol regularly and find out at what age you should be screened for osteoporosis and common cancers that may run in your family. You should also exercise, stop smoking and lose weight, if necessary. “Your health and lifestyle habits in middle age will play a major role in affecting your health decades later,” says Dr. Siu.

That was one conclusion of a 2009 study that followed almost 3,000 older individuals for seven years. Those who had been overweight for most of their adult lives had apparently put such a strain on their joints that, compared to their normal-weight peers, they were much more likely to have trouble walking and climbing steps as they aged. What’s more, the longer they had been overweight, the more likely they were to have problems, according to the study’s lead investigator, gerontologist Denise Houston, PhD, of the School of Medicine at Wake Forest University Baptist Medical Center. Houston also found that even people who were obese at 50 but normal in weight in their 70s were more likely to have trouble getting around than those who weighed a normal amount at both points in time.

So do just 10 percent of men. According to a major study of midlifers undertaken by the MacArthur Foundation and published in 1999, many who have a hard time in middle age have had difficulty dealing with stress throughout their lives. The concept of a midlife crisis is distinctly Western, researchers say—it’s rare in India, for example, where middle-aged people are assumed to be at the top of their games. The infatuation with youth so common in the West has helped to promote the idea that middle-aged crises are common, if not inevitable. The MacArthur project found that most midlifers are not in crisis and have a strong sense of well-being and accomplishment.

Unfortunately, the trend is in the other direction. According to a 2009 analysis of two major, national surveys, over the past 20 years the number of midlifers who eat well (at least five fruits and vegetables a day) has dropped from 42 percent to 26 percent. The number of people this age who exercise regularly is also down, the number who smoke remains steady, and many more people are obese. The study’s lead author, Dana E. King, MD, of the Medical University of South Carolina, finds the results “disappointing and disturbing.” King’s own earlier research indicates that those who change habits and adopt healthy lifestyles in midlife can reduce their risks of heart disease and death by a third within just four years.

Most people know that regular exercise is good and can even prolong life. Now a long-term Swedish study has demonstrated that men who have been sedentary up to age 50—or even 60—can extend their lives by embracing vigorous exercise. It takes a few years for the longevity benefit to kick in, but on average, neophyte exercisers can expect to live about two years longer than men who exercise very little and to equal the life spans of men who have been working out all of their lives. A middle-aged male who smokes can extend his life to about the same extent by giving up cigarettes. This suggests to the study’s lead author, Karl Michaëlsson, MD, of Uppsala University, that not exercising is approximately as risky as smoking. Similar research needs to be done on women, but Michaëlsson believes the results would be much the same.