Preventing imaginary aging | Paloma Navas | TEDxMadrid

Can we age better? Paloma Navas, specialist in preventive medicine and doctor in public health, displays the scientific evidence on how our idea of ​​aging can become a self-fulfilling prophecy of old age itself and proposes simple tips to enjoy those years in a healthy way and in community.

Paloma Navas Gutiérrez is a medical specialist in preventive medicine and public health passionate about the health of the elderly people. A tireless traveler, she has studied and worked in countries such as Germany, Senegal, Puerto Rico, Tanzania or Mexico, which has provided her the knowledge of the different conceptions of health and health systems. Paloma received her Ph.D. from Johns Hopkins University School of Public Health through a Fulbright scholarship. Her research on risk factors and preventive medicine for the elderly has led her to a new understanding of health during aging and to question the old age paradigms that abound in biomedical discourse as well as in social discourse. She works to generate and disseminate scientific knowledge about preventive medicine and aging and to fight against ageism.

This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at https://www.ted.com/tedx

We have worked very hard
to achieve living longer

and yet today we consider
aging as a problem.

I also used to consider
population aging as a problem,

that's why some years ago I packed,
left everything behind

and enroled a top university in the USA,
Johns Hopkins University,

to acquire tools that'd help me
to fight the aging challenge.

What I was not expecting
was to realize that my initial vision,

my perspective on aging, was distorted.

I had a series of beliefs,
stereotypes and prejudices

that prevented me from seeing clearly.

We can think of aging either
as positive or as negative

but we all share one thing:

That idea is conformed
very early in our lives.

Studies in the '70s

conducted interviews
on 4 to 11 year-old children,

a gerontologist, Seefeldt, and others

asked children about
their perception of the elderly.

Results are horrifying.

Two out of three children
believed that older people

were helpess,
unable to take care for themselves,

and generally passive.

And that negative perception
they had about aging

would also become
an expectation of their own aging.

60 percent of those children

already predicted that when they'd be old,
they were going to feel awful.

And how can any 4, 5 or 6 year old
know how'd they feel when elderly?

Probably, what goes on there
is that we are absorbing

that stereotype and that belief
from our environment.

Actually, in the Western world,
Europe and North America,

there's generally
a very negative perception of old age,

it's what we call "ageism"
or discrimination by age.

And what happens
when those children grow up?

By then the stereotype is reinforced,

the belief is replayed

by the mass media, advertising, movies --

If you give a closer look,
how is aging usually portrayed?

Generally not positive.

At most it's warm,
but never as an active aging.

Actually, in the 90s
another very interesting experiment

was conducted by Burke
on healthcare professionals.

He wanted to analyze
why some health professionals

would talk to older people
as if they were children,

we call this the "elder talk",

probably most of you have done it
or at least have seen it:

"Hi Carmencita, how are you today?

Here is your little pill for the heart".

Right? And Carmen is 75 years old,
a professor emeritus at university

and she is in perfect cognitive state.
(Laughter)

Burke proved that healthcare professionals

would speak like this to the elderly

regardless of their cognitive state,

based only on their own beliefs
about old age.

I invite you to never talk like this
to an older person.

(Applause)

In 2008 an article in The New York Times

gathered all the scientific evidence

of why talking like that to older people

is harmful to their health.

In a very simple way we can realize
we are reinforcing their idea

that they are useless and incapable.

No, the elderly are not like children.

In another very interesting study
also starting in the 70s

a gerontologist, Ashley,
went to a town in Ohio

and managed to convince
2/3 of the population over 50

of participating in it.

That's an achievement for any researcher

because nobody wants to take part
in scientific studies,

less if they are periodic.

These people were periodically asked

about their mental health status,
their physical health status,

their working environment, family, etc.

And they were also asked some questions
on their perception of old age:

Do you think you become less happy
as you get older?

Do you think that as you get older
you are less useful?

Well, this study was very interesting,

and had the most powerful results
15 years later.

A social psychologist, Becca Levy,
from Yale University,

has revolutionized the world
-- at least for me, my world --

by proving that
the negative stereotype of old age

becomes a self-fulfilling prophecy.

Meaning that it affects our health,

if we think we are going to age badly,
we most probably will.

Becca Levy with her Ohio study
resolved to test an hypothesis:

do people with a positive vision
of old age live longer?

She went to Ohio and retrieved
all the death certificates

from people participating on the research
who had already died

and compared the life expectancy
of people with a positive vision

with those who had
a negative vision of old age.

And she found that those
with a positive vision lived longer.

How much longer do you think they lived?

One year? Two years?

It's 7.6 years!

That is 7.6 years more of life expectancy

in those with a positive vision of old age.

Monitoring all other factors.

Do you know how much it costs as society

to increase life expectancy ...
in 3 months?

"With surgery ... got another year
of life expectancy ..."

Changing our attitude.

A change in our beliefs about aging.

And how can a belief become
a change in your cells,

in your life expectancy?

It's very revolutionary.

Well, they've managed to understand

how the negative stereotype
is associated to things like memory,

to our performance in cognitive tests.

In 2013, they managed to associate
the negative vision of old age

with the size of our hippocampus.

So, our ideas change
the anatomy of our brain.

And to apply it a little in our day to day

there are many hypotheses
of how this happens,

what is the biological mechanism,
how does this happen?

But there's one thing that
we have all said or listened,

that is: "Me, at my age..."

"What am I doing
wearing sneakers at my age?"

"What am I doing in the gym at my age?"

"What am I doing, being 40,
with those who are 20?"

Suddenly, we stop doing things
that are good for our health

because there's some kind
of expiration date

from which we throw in the towel.

It seems like the day we turn 65,

"game over", we are done,

we can no longer introduce any
positive activity for our health

because it's not worth it,
there's no turning back,

aging is negative by definition,
it is inexorable.

Actually that number, 65 years,

I tried to find out where it came from,

and the most probable cause
is called Otto Von Bismarck,

who was the German Chancellor
in the late 1800s.

In 1893 he introduced
the world's first retirement policy.

The right to retirement is very recent,

the workers were protesting a lot

and he wanted to calm things down a bit,

so he stablished
the retirement age in 70 years.

When I researched a little

about which was the life expectancy
in Germany in 1893 --

(Laughter)

How long do you think
people lived in 1893?

Life expectancy at birth was 39 years old.
(Laughter)

Otto Von Bismarck was a genius --
(Laughter)

Those who were lucky
and managed to reach 30,

would live on average
another 30 years, that is, 60.

Otto Von Bismarck lived up to 78,
more or less,

good for him, but not for the rest.
(Laughter)

Can you see there's no ground for this?
There is no medical basis for 65.

The other countries acquired
that number, 70, 60 --

actually, in the United States
it's said that 65 was adopted

because someone said "60",
another said "70",

and a third said "let's not argue: 65".

And now in the collective mind
it has become some kind of halfway point

in which we go deep into
not having a solution nor remedy,

and we do have a remedy.

There are changes in our lifestyle
that'd benefit us no matter when,

for example, if after this talk
you resolve to quit smoking,

tomorrow, in 24 hours,
your cardiovascular risk

would have decreased,
regardless of your age:

20, 40, 60, 80...

In two days, you'd recover
your senses of smell and taste.

Reducing our overweight,
that constant struggle,

at any time of our life,

even if we are 80 years old,

reducing overweight is positive,
especially abdominal fat,

the belly, which is a very important
predictor of cardiovascular events,

I'm sorry to break it to you.
(Laughter)

And let's point out not only
the most physical things

but also the cognitive and social,

how about signing up to do something new,

enroll a course, meet new people.

The social environment, the people we meet

is also essential in our aging,
in our life in general.

When I started researching,

my goal was to find
preventive medicine interventions

that could improve the quality of life
and life expectancy of older people,

not only consider prevention in children,

but also in older people.

And I, as a doctor,
thought about the classic issues:

overweight, tobacco,
excessive alcohol, sedentary lifestyle --

However, as I was researching,

I had a US database which is
representative of the whole country,

its results are very solid,

and people over 65

were asked three questions
about their neighborhood:

Do you think that your neighbors
know each other well?

Do you think that those neighbors
are willing to help each other?

Can you trust your neighbors?

It's a measure of social cohesion

that sociologists used for other areas,

not for preventive medicine.

But it caught my attention
and I included it in my models.

And it turns out that people
who had a high social cohesion,

feeling that in their neighborhood people
knew, helped and trusted each other,

they have a 40 percent lower risk
of suffering a cardiovascular event.

Besides the classic risk factors,

there's also the social risk factors,

and our neighborhood, our environment,
is very important for our health.

Your neighbors affect your health.
(Laughter)

And you, are you good neighbors?

Do you greet?

There's a lot of scientific evidence
being published and accumulating

on how neighborhoods affect health,
not just the social environment,

but also the physical,
sidewalks that are walkable.

Actually here in Spain
there is a leading group

at the University of Alcalá de Henares,

I recommend checking their results
because they are fascinating.

I believe that in the future
the real state ads will say:

two bathrooms, one bedroom,
and social cohesion.

(Applause)

And how should your neighbors be,
how a neighbor affects you,

-- besides you liking them more or less --

how does a neighbor affect
your cardiovascular risk,

it's a leap.

There are many mechanisms of action
and also different hypotheses,

but I believe that
a very simple one is walking,

specially if we are considering
people over 65,

to whom walking is perhaps
the easiest physical exercise

and the most recommended.

Do you think people not feeling safe
or sheltered in their neighborhood

will practice physical exercise in it,
or go for a walk?

How important it is
to go for a walk accompanied.

I was fascinated by a paper
published in 2016,

also in Madrid, at Universidad Autónoma,

at the Department of Preventive Medicine,

leading in cardiovascular research,

they are doing a research relating
hypertension or blood pressure

with social support.

A very intelligent researcher
had the idea of introducing this question:

Do you walk alone or accompanied?

People who walked accompanied
had less nocturnal blood pressure.

It was hugely beneficial for their health

because it is not just walking
and moving the muscles, legs or heart.

It's also the company, talking.

Aging is not a problem,

aging is a privilege

and a fact.

In little more than ten years

we will be one of the oldest countries
in the world.

Of every three persons,
one will be over 60 years old.

Where do we want to grow old?

Where do we want our parents to age,
or our grandparents?

In what society?

We have to get rid
of that negative vision of old age,

first because it affects our health,

and second because
it affects the health of others.

I invite you to question these stereotypes

that are sometimes unconscious,

about what a person can or cannot do
based on their appearance.

And I also invite you to build a society

in which we all fit,

a person of 20, a person of 80,

a person pushing a cart
and a person carrying a cane

or in a wheelchair.

A society in which
we can age with quality,

in which we can age with health,

in which we can grow old
walking together.

Thank you very much.

(Applause)