Professor José Viña, partner of ADVANTAGE and expert in aging, was interviewed by El Pais during the Longevity World Forum.
During the interview he underlined that old age is not a disease, but unsatisfactory ageing requires treatment. In this respect research has demonstrated the efficacy of physical activity to delay dependence and improve quality of life in old age.
The full interview in Spanish can be found here
Below you may find part of the interview translated into English:
Q. You argue that improving I the quality of life in old age is not only desirable, but crucial for societies.
A. The population in Spain, Europe and the richer world in general is ageing very much. The population pyramid has been inverted in a few decades. By 2035, the number of people over 65 will outnumber those under 18 in the United States. And in Europe, projections indicate that by 2020 a third of people over 65 will be dependent, and the percentage will increase to 50% by 2040. The consequences will be enormous. A vigorous 65+ spends about 900 euros a year on health care, but a dependent person needs 14 times as much. If we do not manage to change the trend, which involves increasing exercise and improving the nutrition of the elderly, we are going to disaster, to economic unfeasibility.
Q. You propose intervening in the step prior to dependency, which you call the frailty phase. What does it consist of?
A. Frailty is a geriatric characteristic in which a person finds it difficult to do a number of things, such as getting up from a chair, picking up a bottle of water or walking, but can still do them. If you can't, you're already dependent. Exercise is one of the most useful mechanisms to avoid this transition by reversing frailty, as we have concluded through a clinical trial.
Q. What have been the results?
A. With one-hour sessions five days a week, our program, in which a hundred over-65s participated, showed a reduction of almost 50% in the parameters of frailty, while visits to the primary care physician fell by half. This has an impact on health expenditure and most importantly, as a doctor, it means that the person is healthier
Q. What should the exercise be like?
A. It should be multicomponent. In other words, walking is not enough. It should be aerobic, like walking fast or, if possible, even running. There are people in their 70s and 80s who run. But this should be done with caution. I recommend first a medical check-up, followed by a program designed by a specialist. It should also include strength exercises, such as weights and gums. And it should be social; when exercise is done alone abandonment is more likely.
Q. You once believed that too much exercise could be harmful, but you've changed your mind. Why?
A. For years I seriously thought so. With my group we studied the longevity of the Tour de France runners hoping to find that they would live less, but it turned out that they live 11% longer. The study was done among the riders of the Tour between 1930 and 1960. So if you are previously trained and supervised by a doctor, no problem. The more, the better.
Q. It also ensures that exercise improves cognitive decline and prevents Alzheimer's disease.
A. Yes. Exercise is one of the most effective interventions currently available to prevent Alzheimer's disease.
Q. Does it refer to a list of foods, a type of diet, or what?
A. The Mediterranean diet is without doubt good. But older people often have nutritional deficiencies. In Europe, for example, 45% are protein deficient. Many people from the age os 70's or 80's onwards have no appetite, are alone, do not cook, chew badly. On top of that, they need more protein per kilo of weight than a 40-year-old. It is necessary to eat fruit and vegetables, but also proteins. The elderly need a very well-planned diet or, if not, to take supplements, and it is not that I have shares in any company that manufactures them.
Q. Do you have to be thin?
A. Those under 70 or 75 years old, yes. From that age on, it doesn't matter that much. Spontaneous weight loss is a sign of frailty in the elderly.
Q. One of your investigations concludes that centenarians have special genetic characteristics. What are we left with? Does longevity depend on exercise and nutrition or do we have a fixed term?
A. Maximum longevity is limited by genetics. Average longevity and quality of life in old age, by lifestyle. We are given some cards, but then it depends on how we play them.