We haven’t figured out how to stop aging. Even so, research shows there is much we can do to stay healthy as we age. Mark Williams, director of the UNC-CH Program on Aging, compares getting older to skiing down a slope. “The ski lift is your genetic design,” he says, “but you decide how you’re going to get down the hill. The trip down might be fast and exciting, or slow and leisurely, or somewhere in between.”

Williams cites research by the MacArthur Foundation Consortium on Successful Aging that shows genes determine only about 30 percent of the characteristics of aging, with lifestyle and environmental factors deciding the other 70 percent. By studying people who are still healthy and independent as they enter their eighties, the researchers found that much of the loss in physical and mental functioning often attributed to old age isn’t inevitable, but can often be prevented or reversed by practicing good nutrition and staying physically, socially, and mentally active.

And findings from two Carolina researchers debunk the stereotype that getting older means reaching a dead end. Jean Kincade, research fellow at the Cecil G. Sheps Center for Health Services Research, analyzed data from the 1991 National Survey of Self-Care and Aging. Of 3,485 people aged 65 and older, 31 percent report helping others with personal care, such as bathing and dressing; 16 percent provide child care; 40 percent offer advice and support; and 20 percent do volunteer work. Elizabeth Mutran, associate professor of health behavior and health education, and her colleagues have been following more than 800 full-time workers ages 58 to 64. As these men and women move into retirement, almost 90 percent say retirement is meaningful and full, 79 percent report being active in retirement, and 70 percent are very happy that they retired.

Still, Williams points out, many people believe what he calls “the myth of ageism”that all older people are the same and are falling apart. “The reality couldn’t be farther from the truth,” he says. “People in this country are not only growing older,” Williams says, “but they’re growing better. A person who is seventy-five in nineteen ninety-six is the physiologic equivalent of what it was like to be sixty-five years old in nineteen sixty.”

The National Long Term Care Surveys, an annual federal study of people aged 65 and older, shows that every year since 1982, there has been a smaller percentage of people in this age group who are disabledunable to go about their daily activities or dress and feed themselves. The percentage of older people with chronic diseases, such as high blood pressure, arthritis, and emphysema, has also declined.

Everyone ages differently.

Even so, some older people believe that illness is an inevitable part of normal aging, Williams says, which can lead them to under-report treatable problems. Doctors can sometimes reinforce this stereotype, Williams says. “I’m reminded of the joke where the gentleman went to see his doctor and said, ‘I have a pain in my left knee.’ The doctor said, ‘Well what do you expect? You’re eighty-five years old,’ and the man said, ‘Well, my right knee’s eighty-five, and it feels fine.’”

Williams adds that different people age at different rates, and even different bodily processes age at their own rate. “It’s not at all rare for me to see a person who has a young brain but old joints, or a young heart but an old bladder,” he says. “It’s comfortable for us to talk about chronological age, how old a person is. But chronological age and biological age are not the same.”

What your mother said about diet was true.

The question we still have is, what is normal aging, and what is disease?” says Susan Gaylord, a research associate in Carolina’s aging program. For instance, Gaylord says, people once believed that heart disease was a normal part of aging, but now we realize that often it’s caused by diet. As for diet, says Pamela Haines, UNC-CH associate professor of nutrition, “What your mother told you is still true”we need to eat our vegetables, especially leafy green and orange ones. Limiting fat intake is also important to lessen the risk of cancer as well as heart disease. “We really need to change people’s thinking about what food is, and what they should eat for snacks,” Haines says. “The bulk of their diet has got to come from fruits, vegetables, and grains.”

Getting enough vitamins D and K helps decrease the risk of bone fractures, a common cause of hospitalization in the elderly, say John Anderson and Martin Kohlmeier, professors of nutrition at Carolina. In a study of people over age 65, Anderson and Kohlmeier found that one-third of the affluent subjects and one-half of the middle-class subjects ate less than two-thirds of the U.S. Recommended Dietary Allowance of these vitamins. Anderson and Kohlmeier stress that the problem is easily avoided by eating fish and fortified dairy products for vitamin D, and dark green vegetables such as broccoli, brussels sprouts, kale, chard, and spinach for vitamin K. Kohlmeier is beginning a long-term study to determine if supplementation of vitamin K can help reduce bone loss in elderly people.

Others continue to study whether taking antioxidant vitamins such as selenium, vitamin E, or vitamin C will slow aging or prevent cancers. One study from the University of Arizona shows that vitamin E, in amounts equivalent to a human dose of about 400 international units a day, prolongs the life of brain and immune system cells in rats. But evidence is inconclusive as to whether supplements alone can make a difference, Haines says. The vitamins may work only in combination with some foods.

Williams notes that it’s also important to avoid such hazards as cigarette smoking, loud noise that can damage our ears, or too much ultraviolet sunlight that predisposes us to skin cancer or cataracts.

Activity can help us stay healthy.

Exercise, of course, is also crucial to staying healthy throughout our life span. Even those who already have some disability can improve their mobility by exercising, says Carol Hogue, associate professor of nursing. Hogue leads a study in which older adults with osteoarthritis of the hip and knee have shown marked improvement after participating in an exercise program of walking, riding an exercise bicycle, and resistance training. Some subjects who were able to walk only 30 or 40 feet at the beginning of the study can walk two miles now, as the study nears completion.

We can also stay mentally fit. Researchers from Pennsylvania State University found that many older people in the commu nity they studied did not lose significant amounts of mental function with age, and those who did could help prevent decline and improve function by reading, taking courses, even doing word puzzles or jigsaw puzzles. Marilyn Hartman, professor of psychology at UNC-CH, tests memory ability in the laboratory. She says her research and that of many others shows there is some difference in performance between older and younger people as groups.

But there are lots of individual differences,” Hartman says. “In some tests, there are no age differences, and in other tests as many as half of the older people do just as well as younger people.” Researchers at the University of Southern California in Los Angeles found that support from family and friends helps older people stay mentally healthy, in part because it improves self-image.

But that support shouldn’t include interfering with an older person’s autonomy. In studies conducted in the late 1970s, nursing home patients who were allowed to control such things as the scheduling of visitors showed increased activity, improvement in sleeping and eating patterns, and decreases in feelings of hopelessness.

We shape our future selves.

Williams advises that we think of aging not as something that begins once we turn 65, but as a lifelong process that takes some thought. People are living longer than ever, he says. “That means that we need to plan for our old age. You just can’t wait until you’re seventy or eighty and then say, ‘now how do I deal with it?’

You can’t escape from who you have been,” Williams continues. “Old age is no refuge from an empty life. Aging confronts each of us with a tensionbetween ourselves here and now, and ourselves in the future. The question is, who are we becoming?

Elderly people are not a disenfranchised minority, they’re ourselves in the future. If we have limited, outmoded stereo types about older people, we’re sealing our futures, we’re shortchanging ourselves.”

Mollie Hargraves, 65, worked as a surgical technologist for 30 years, 25 of them at UNC Hospitals. She specialized in assisting neurosurgery. “I put my whole self into it, because I said, ‘This is one time I can do something for someone who cannot do for themselves,’” she says. “I liked knowing that I could go home and feel I had done my best.”

Hargraves retired from her job a couple of years ago. Or maybe not retired—just transferred her energy. She cares for family, volunteers at a homeless shelter, and spends three mornings a week at the Carrboro Senior Center.

Hargraves is president and chief cheerleader for the senior center’s “Meet Your Neighbor Club,” whose members participate in crafts, trips, and social activities. She smiles more often than not, and when she talks, she looks you straight in the eye. She says she often tells the others, “‘Just because we’re getting older, it doesn’t mean that we’re not important.’ Everybody doesn’t have the same talents, but even if they’re able to come over here with a smile, or a touch, that’s important to some one.”

What is a good life?” wonders Marguerite Watson, 85. “You have to be willing to do a little experimenting, find things that can help you. And devote your life to service.”

Watson’s service is helping people take better care of themselves through her non-profit businessselling audio tapes of stretching and strengthening exercises she has designed for senior citizens.

Many senior centers offer free lunch programs; Watson believes they should offer free exercise sessions as well. Several centers in North Carolina are using Watson’s tapes to do just that. Two physical therapists helped Watson develop the tapes, which are endorsed by the North Carolina Governor’s Council on Physical Fitness and Health. One set includes only sitting exercises, while the other combines sitting, standing, and lying-down positions.

Watson, who exercises every day, competed in the 1500-meter walk in the Orange County Senior Games this spring. “I’m grateful to be able to do this. I do feel that my commitment to taking care of my body has paid off,” she says. She eats healthful foods, doesn’t smoke, and hasn’t drunk alcohol or caffeine since 1948.

I do think life takes a little thought,” Watson says. “Unfortunately, so many of us go on automatic pilot.”

Highlights of research on aging at UNC-CH

It will take all of us to meet the demands of the well-educated, sophisticated population about to become older adults,” says Gordon DeFriese, acting director of the new Institute on Aging at UNC-CH. The institute will offer training to North Carolina students and professionals as well as coordinate the efforts of nearly 100 researchers. Here are some highlights of aging research at Carolina.

By studying 2,400 people age 45 and over who have osteoarthritis, researchers at the Thurston Arthritis Research Center have found that the intensity of knee pain is a better predictor of disability than X-ray evidence of osteoarthri tis, and that obesity contributes to disability and compounds limitations from knee pain. In the next two years, re searchers will recruit 1,200 more residents of rural Johnston County to participate in the study, says Joanne Jordan, research assistant professor of medicine.

The School of Public Health offers North Carolina’s only training program that prepares skilled nursing home adminstrators for state licensing. The program is directed by James E. Allen, associate professor of public health.

In the Program on Aging’s North Carolina Rural Telemedicine System, health-care workers use interactive video to consult with colleagues and patients at three sites in North-hampton and Halifax counties. North Carolina’s state wide fiber-optic cable network allows video and sound signals to be combined and trans-mitted at high speeds. Telemedicine can help alleviate the isolation of patients in rural areas, which may be three or four hours away from large institutions with a variety of specialists.

The Center for Aging Research and Educational Services, directed by Gary Nelson, associate professor of social work, helps shape state policies, compiles demographic data, and trains professionals in assessment and case management related to older adults.

In a longitudinal study, James Beck, Kenan professor of dental ecology, and Steven Offenbacher, professor of period ontology, have found that people with severe gum disease are more likely to develop heart disease than those without gum problems. They have begun the largest study ever of possible links between the two. Beck is also leading a longitudinal study of the causes and patterns of tooth loss, dental cavities, and periodontal disease in older adults in five North Carolina counties. The project includes a large number of older African-Americans, whose oral health is not well known.

Philip Sloane, professor of family medicine, has studied the effectiveness of techniques for caring for Alzheimer’s patients. He and Ann Louise Barrick, clinical assistant professor of psychology, have developed methods to bathe Alzheimer’s patients that reduce agitation. Also, Sloane has just begun a four-year study of the care given in residential -care facilities, which provide housing and personal assistance to elderly residents.

Virginia Neelon, professor of nursing, and her colleagues have been developing better ways of detecting and measur ing dementia in elderly people. Neelon has developed a widely used scale to measure acute confusion. And Ph.D. student Barbara Waag-Carlson is working to develop ways to more readily detect dementia in its early stages.

Glen H. Elder, Odum Distinguished professor of sociology, has analyzed data from such projects as the Lewis Terman study at Stanford University, which surveyed the same group of people every six years from 1922 to 1992. Elder found, for example, that men who began serving in World War II at age 30 or older ended up with a higher risk of divorce, declining health, work disruption, and lower incomes at retirement than men who entered the war at an earlier age. The older men lost momentum in their careers, Elder says, while some younger men were eligible for the GI bill and could complete their education when the war was over.