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Longevity is not just about living long, it is also about living well.
More than 1 in 5 Americans will be 65 or older by 2040, the Department of Health and Human Services predicts. And more than 56 percent of those who turn 65 will need some form of long-term care.
Fortunately, there are things you can do at any age to ensure you stay healthy as the years go by, says Dr. John Batsis, a geriatrician at the University of North Carolina at Chapel.
Batsis, an associate professor at UNC Medical School and the Gillings School of Global Public Health, spoke with CNN about what people need to know about healthy aging.
This interview has been lightly edited and shortened for clarity.
CNN: Some people may find it difficult to relate their health behaviors now to outcomes in their later years. Why should people start thinking about healthy aging early?
Doctor John Batsis: There will be people who can get sick and weak. There will be people who are robust into their 90s. I have patients who are still extremely fit and active — they may not be as active as they were 20 years ago, but they are still doing the things they want to do.
You have to find a sense of self, a sense of purpose. You have to find a sense of what makes you happy, and that can be different in every phase of life.
You can’t change your genetics; you can’t change your past. You can try to change your future with things you can change. Whether it means changing what you eat or how much you exercise or participate in your community or quitting smoking or drinking — these are things you can control. And there are tools — like working with your healthcare team and community resources — that can help you get there.
Part of it is you get to a point where you say, “Yes, I’m willing to change.” You have to be willing to change in order to make that change happen.
CNN: What things would you like to see people change earlier in life to affect the way they age?
Bats: That’s a really good question, and one that I get asked a lot — not just by my patients, but by their children and by my own family and friends. There are a number of factors that have been shown over and over again to lead to healthy aging, but you can really boil it down to a few.
First, there’s good nutrition, and that really starts from infancy through childhood through adolescence and even into old age. Second, regular physical activity and movement are critical. And then there’s the third big category: social connections.
We often think of these independently as silos, and really you need to think about them collectively and together and synergistically. One can influence the other, but it really is true that the sum of the parts is greater than the whole.
CNN: What do you mean by good nutrition?
Bats: When we think of healthy eating, we often think of a balanced diet, a Mediterranean diet.
The food environment can often be challenging, especially in Western industrialized societies. The fast food industry is very hard to escape. But home cooked meals — cooking your own fresh fruits and vegetables, thinking about those kinds of meals — are really, really important and nutritious. Really try to stay away from processed foods and think about more holistic types of foods.
This is really thinking more consistently. Food is medicine, and I think that is a concept that is increasingly sought and advocated by both healthcare and non-healthcare providers.
And this goes beyond getting older. Start young, start early, bring it into schools and start engaging individuals and children early so that they develop skills and practices that will last throughout their lives. It becomes part of the routine and it’s not seen as a chore.
CNN: What type of exercise is most important?
Bats: Regular walking, regular activity. The 150 minutes of activity per week divided by 30 minutes more than five days of moderate activity is what is really recommended. And then you have to think not just about aerobic activity, but resistance activity. This is more important as you get older to maintain muscle mass and strength, because we know that you lose that ability to maintain that as you get older.
CNN: Why is social connection so important?
Bats: The importance of social connection as we age is often overlooked, under-researched and underestimated. One of the challenges here in our country is that many of us are spread out, and you don’t see that as much in other countries that are not as spread out geographically, or where family groups live right next to each other or in the same neighborhood.
It often happens that I have patients whose children live on the other side of the country, or whose friends live on the other side of the country.
The social network is really helpful for stimulating conversations. And it’s a sense of self, it’s a sense of well-being, it’s a sense of purpose, it’s sharing stories, sharing a community. It’s having fun. It helps one’s mental health. We know that depression can be a risk for individuals in old age, and it’s really challenging.
CNN: And what about the older adults reading this? Does the advice still apply?
Bats: Healthy aging can happen at any stage of life. It’s not just young adulthood or middle-aged adulthood, it’s not just retirement age. It can continue to happen well into your 80s and 90s.
The definition of what healthy aging means can vary, and it’s really about asking what it means to you. What is important to you at this stage of your life? How can we achieve what is important to you, and then come up with a plan and strategies to help our individual patient achieve that? That’s the key, and it shouldn’t be a top-down approach. It really has to involve the patient, finding out from within what is important to them, and helping them and giving them strategies to help them achieve what is important to them. It comes from within.