Chronological Age Isn’t Good Health Predictor, Doctor Says

By Daniel Dullum
Spectrum staff writer

Without really trying, Dr. Michael McCloud discovered his own secret to successful aging.

For nearly the first 13 years of his medical career, McCloud, a geriatrician at UC Davis Medical Center, worked as a general internist in San Francisco. During that time, his family could tell how his day went as soon as he came home.

“My wife and family could always tell when I went to see my older patients on visits to nursing homes. I would come home with a smile and a new joke to tell them,” he explained. “I was asked if I wasn’t sure that this wasn’t what I wanted to specialize in.”

When he realized that geriatric medicine was his calling, McCloud sold his practice and accepted a geriatric fellowship at Duke University in North Carolina.

“I’ve never looked back,” McCloud said. “Medical students will ask, ‘Why would you want to spend your time passing tubes in a nursing home?’ I tell them, ‘Follow me around. You may never see the inside of a nursing home.’” McCloud’s career choice is not a common one in the medical field. He cited statistics stating that less than 2 percent of the nation’s 500,000 physicians are trained and certified in geriatrics, and only three of America’s 126 medical schools have a department of geriatrics.

“I’m one of those people who wakes up and says, ‘I’m so happy it’s Monday,’” he continued. “I enjoy going to work and I love working with this population. I get a lot more from it than they do.”

McCloud spoke about the anatomy of aging and successful aging at Eskaton Village in Carmichael on April 9, helping an attentive crowd understand why some people who are in their 80s look like they’re 50, and why some people who are 50 look 75.

“Basically, genetics plays a role, but it’s not a dominant role,” McCloud explained.

“Luck plays a factor, the environment —we’re fortunate that we’re here and not in Iraq. The quality of our health and how we would appear by age 90 is dramatically different. Lifestyle and healthcare choices, I think happens to be dominant. How much sunlight we’re going to expose ourselves to, how much moderation in use of alcohol, if one person is a smoker and the other isn’t. That dramatically ages our physical appearance.”

McCloud calls “grit” the final 10 percent of the successful aging equation.
“Some people have this determination to stay well,” he said. “They outlive their spouse, they outlive their friends and their children.”

McCloud also stressed the overall importance of a positive, healthy outlook on life.

“In many ways, we’re as healthy as we allow ourselves to be and we’re as sick as we believe we are. Having a positive attitude, a social network, maintaining friends as we get older, they all contribute.

“Social isolation is a huge threat to mental and physical health. For many people, as much as they love the home they lived in for 45 or 50 years — and you can understand why they want to stay in familiar environs — it’s not always the wisest choice. They’re better off living where they’re going to be surrounded by friends, and have meals with others.”

McCloud believes the study of geriatrics is especially important as the average longevity of the population increases. He noted that in 1950, the United States had 3,000 centenarians, a number that has increased to 50,454 now and is expected to reach 1 million in 2050.

“People over 85 are the fastest growing segment of the population,” McCloud said.

“That’s because of a reduction in perinatal and younger life mortality, introduction of federal entitlement programs like Social Security and Medicare and better late life healthcare and lifestyle choices.”

McCloud also pointed out that according to the Baltimore Longitudinal Study of Aging, there is no evidence that human organs age at the same rate from individual to individual.

The report also said that chronological age is a poor predictor of performance, and that some things, like resting heart rate or personality, do not change with age.

“Of all the systems, the digestive changes the least with aging,” he said. “However, swallowing is less coordinated, with an increased risk of aspiration [food going down the wrong pipe]. And stomach acid production decreases.”

McCloud gave the group a list of eight common qualities of successful agers:

• Maintain your own health records.

• Keep a healthy distrust of medications.

• Eat a highly varied diet and ignore the latest herbal remedy fad.

• Have only one doctor give your prescriptions.

• Have a social network outside your home.

• Go for a walk every day.

• Strive for more education.

• Seek to avoid hospitalization.

“One of the greatest threats we face in later life is overmedication,” McCloud said.

“Thirteen percent of the population that’s 65 and older takes 30 percent of all prescription medication, and 5 to 15 percent of acute hospital admissions after age 65 are for adverse drug reactions.

“When multiple doctors make your prescriptions, they may forget which medications you no longer need. Sometimes a medication is only needed for short time.”

McCloud calls immunizations “the best health insurance available,” and recommended one daily no-iron vitamin supplement, increased intake of cruciferous and green leafy vegetables to reduce stroke risk, and special attention to avoiding fall-related injuries.

McCloud concluded his talk quoting Dr. Walter Bortz, author of “Dare to Be 100,” with simple advice:

“No drug in current or prospective use holds as much promise for sustained health as a lifetime program of physical exercise and proper nutrition.”