Live Long, Die Short (2 page)

Range:
Roger Landry’s main purpose in writing this book is to enable people to live long and successfully. In an uncertain world, nothing can guarantee this outcome for each individual, but the accumulating experience of doctors and medical researchers can teach us a great deal about how to improve the odds in our favor. Dr. Landry’s knowledge about successful aging has the depth and practicality that comes from the combination of research and direct doctor-patient experience. The book also includes a kind of autobiographical subtext that adds to both a reader’s interest and confidence in its advice.

That story line takes us from Landry’s graduation from Tufts medical school to his twenty-three years in the Air Force, from which he retired as chief flight surgeon with a rank of colonel. That long career was followed by a shorter interval in the private healthcare industry, and now a third career as a key player in the development and demonstration of a life-changing pattern of successful aging, and as president of an organization that aims to make that pattern increasingly visible and effective in retirement communities. Nor is this the end of the story. Roger Landry is acutely aware of the fact that successful aging in upscale retirement communities, encouraging and crucial as it is, leaves important questions still to be answered: whether and how those opportunities and that lifestyle can be made available to the larger population of low-income, affordable-care residents, and how it can be extended to the far larger population of older men and women who choose—insist—on remaining in their homes, homes chosen without regard to the limitations of old age but filled with the memories and the physical reminders of earlier years and family life.

Scientific validity:
Potential readers of this book should not assume that its colloquial title and its intimate, conversational style involve a casual attitude toward scientific data. The hyphenated adjective
evidence-based
is far more prevalent than the serious demand for evidence and the recognition of its presence or absence. Roger Landry is tough-minded about these issues, and his book benefits from that fact. Masterpiece Living, the initiative that he describes in the initial and final sections of his book, came out of research: ten years of surveys and experiments supported by the MacArthur Foundation and the National Institutes of Health. The Masterpiece Living organization continues to add to that knowledge base, by evaluation of its own efforts at application.

I conclude this brief foreword with a personal note. In my world of academic research, statements about possible conflicts of interest are now required, so here is mine: I have been involved in the development of Masterpiece Living. However, my participation is unpaid, so while my judgment may be biased in its favor, it is not by reimbursement.

Finally, I write this as I am about to celebrate my ninety-fifth birthday. I try to follow the combination of diet, exercise, social relations, and productive activity that is advocated in this book. As to whether I have lived my whole life this way, I reply as a terse New Englander did to a similar question: “Not yet!”

Read this book. You will certainly enjoy it. You will almost certainly learn from it. And most important, it may bring you closer to attaining the ideal of its title: live long, die short.

—Robert L. Kahn, PhD
Ann Arbor, Michigan

People write books for many reasons. For me, it wasn’t an easy decision. With so many fine books on aging by experienced and gifted authors, I wondered what I might add to the accumulating mountain of knowledge on the topic. So I procrastinated. That, as it turned out, was a good thing. It allowed, my friend Bill Crawford tells me, my unique voice to develop further. It allowed the varied elements of my experience—preventive medicine, public health, social research on aging, an avid interest in cultural and biological anthropology, and forty years of attempting to keep people healthy and performing at their best—to simmer, stew, and blend until the end result was indeed unique. It was that uniqueness that cried out for expression. I knew then I had to write this book. Without that procrastination, that ripening of my accumulated experience, I would never have undertaken this journey, or, having begun it prematurely, I would have fallen victim to the lonely and emotionally challenging process of bringing a book to life, and never finished.

And isn’t that a metaphor of sorts? In a book about aging, about what eons of human experience have taught us about being healthy and fulfilled, about the potential pitfalls of pursuing untested or immature concepts about health and aging, isn’t it fitting that its writing be a long and
thoughtful journey? And isn’t it also fitting that this author went through periods of uncertainty, changing views, and development to reach a broader vision? Indeed, like all of us, the idea needed time to mature.

Since we’re going to travel this road together, allow me to introduce myself—in single words. Humanist, husband, father, grandfather, brother, animal lover, naturalist, speaker, writer, biker, horseman, physician, kayaker, traveler, meditator, vegetarian, beachcomber, hiker, Europhile, music lover, pro-military, antiwar, procrastinator, pack rat, cross-country skier, secular, health conscious, romantic, movie lover … OK, you get it. The trait I hold most dear, however, is humanist.

One of the more pressing questions facing humanity today is simply stated: How do we achieve and maintain health as we age? I wrote
Live Long, Die Short
to offer you a harbor in a storm. We are bombarded with the latest research report, with the newest diet, the next miracle fitness machine, all of which claim to help us stay healthy, live longer, to even fight aging (good luck with that!). It’s not that many of these new discoveries don’t have value, but the barrage of claims, many contradictory, many just plain erroneous, have us chasing our tails as we seek to age in a better way. And so.
Live Long, Die Short
is meant to be a practical guide. It answers questions such as

• What can I do to stay independent?
  
• How can I live life to the fullest for as long as possible?
  
• How do I lower the likelihood that I’ll get Alzheimer’s disease?
  
• How can I minimize the effect of diseases and conditions on my life and on my family?
  
• What are my risks for decline and what should I do to lower those risks?
  
• Can I really change my lifestyle?
  
• How will the aging of America affect my life and that of my family?
  

Be reassured that you are not alone if you are struggling with these questions. My goal is to offer you answers and, more importantly, to provide you basic knowledge and tools with which to evaluate the endless assault of new and often sensational claims you face every day in your quest for better health. Rather than give you the proverbial fish, I wish to teach you to fish. I offer you a gold standard to assess any health claims, a standard based on what we humans require to maintain health and to age well, a set
of necessities I call
authentic needs
. “Authentic” because they are solidly based on who we are as humans. “Authentic” because these needs are firmly established over the eons of time man has walked the earth and because they are durable despite the dramatic changes in how humans live today. An appreciation and understanding of these authentic needs will act as true north as you maneuver through the stormy seas of new “discoveries,” of quick-fix solutions to complex issues of aging, of “anti-aging” claims. Understanding these needs will help you realize that aging is fundamentally a gift, a natural and wonder-filled process, which despite its highs and lows can lead to an outcome we all want and can achieve: authentic health and successful aging.

Another goal of this book is to present a challenge to each one of you, to your organizations, and to our towns, cities, and society—a challenge to incorporate what we have learned about aging into our opinions, practices, and very way of living, so that all can reach their full potential at any age. The aging of our population leaves us a choice: grow or decline. Either we provide environments and public policy that allow older adults to grow or our very societies will decline with them.
Live Long, Die Short
is a call to action, for just as Albert Einstein admonished—“Those who have the privilege to know, have the duty to act”—we all, knowing what is possible, cannot accept the status quo of aging as decline. Whether in our private lives or in the public policy we accept, we must speak out for a more enlightened view.

Live Long, Die Short
is also the story of my journey with Masterpiece Living, an exciting organization that has accelerated a movement to change how we age. This book is the encapsulation of what my associates at Masterpiece Living and I have learned over the last fourteen years from older adults striving to age in a better way, from researchers, and from the outcomes and observations of thousands of aging men and women. What is particularly unique about this book, however, is that we have resisted the common impulse to merely report findings and recommend that the reader change accordingly. Rather, we have evaluated our newly acquired knowledge in context. First, in the context of us as a unique species, hundreds of thousands of years in the making, formed in radically different environments than today’s; second, in the context of a modern lifestyle marked by unprecedented levels of stress; and lastly, in the context of a culture with an obsession for short-term outcomes and unrealistic expectations for change, accomplishment, and success.

No matter who you are—older adult, aging boomer, college student, or anything in between—if you are reading this book, you are most
likely curious, well educated, active, positive, concerned about your health, and an early adopter of new ideas. As we travel through this book together, let’s have a conversation. Read, react, and write to me at
[email protected]
. Perhaps we can also continue the dialogue at
www.livelongdieshort.com
.

This book will change your life.
It will help guide you on your path to aging successfully. We have discovered that we can indeed shorten the length of our period of decline. We therefore have every reason to believe that by living a lifestyle that reduces our risks for disease and impairment, we can indeed live long also. Not like the Greek mythological unfortunate Tithonus, whose lover asked the gods to allow him to live forever without considering how he would age. Her wish was granted by Zeus, and Tithonus was doomed to live forever, getting older, declining, becoming more feeble. Rather, my goal for you is to be the very best you can be, for as long as possible; or, as the beloved Mister Spock from
Star Trek
said so well in Vulcan:
dif-tor heh smusma
, live long and prosper.

Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.
—MARGARET MEAD

I
live in New England. The spectacular colors of the fall foliage are compensation for long winters, spring insects, and temperatures not so temperate. I am drawn to the brilliant reds, oranges, and yellows of autumn, and I’ve decided that these magnificent leaves are a metaphor for how I want to age. I want to become more colorful as I grow older; I would like to blend with others to make more beauty than I can alone; and when my time comes, I want to fall from the tree.

Yet, in the twenty-first century, the main causes of death for those of us living in developed countries have shifted from infections and accidents to chronic diseases, and I am now less likely to age according to my metaphor. Longer life expectancy, and the preeminence of heart disease, cancer, stroke, diabetes, chronic lung disease, and Alzheimer’s as companions in this longer life, will statistically relegate me to an end more like a death scene from an old Western movie: long and painful (and expensive). No wonder we hear many say they have no wish to live to be a hundred. Wouldn’t most of us choose quality over quantity? Wouldn’t we choose to avoid what could
be a decade or more of decline associated with loss: loss of function, social connection, independence, dignity, and control over our own lives?

But for most of the last century, we accepted that there was no choice. We believed either genes or luck determined how we would age. Some of us would live highly functional lives well into their ninth and even tenth decade, but these were few, and it didn’t change the overall belief that aging was a crapshoot. Get through those turbulent young years and you might live long, but with a good chance of unwanted conditions continuously nipping away at the quality of your life.

Enter Jonas Salk, the medical researcher and virologist who discovered and developed the first effective vaccine against polio. As a highly influential member of the board of directors of the celebrated John D. and Catherine T. MacArthur Foundation in the early eighties, he challenged that board to study success and failure in aging.