Aging to Perfection

By Tara Kirkpatrick
Photography by Tom Spitz

Groucho Marx famously said, “Anyone can get old. All you have to do is live long enough.” However, the challenge is to still remain healthy and vital. We spoke to three Tucson experts on aging who share the results of years of research findings. 

What if we could all live well past 100 years old? And for most of those years, we would be healthy, vibrant and a contributing member of society. What if Alzheimer’s disease and dementia were not inevitable parts of growing old? These ideas are not impossible, according to renowned local experts who have devoted their careers to exploring every aspect of aging, from the body to the brain.
Already, people are proving that it’s possible to age and thrive. Right now, a 93-year-old pilot in California continues to make rural mail drops because he passes his test from the Federal Aviation Administration each year. A 77-year-old woman in Denver competes as a body builder. A 93-year-old yoga instructor in New York can still manage the most difficult poses and dance the salsa. This new concept of longevity is indeed possible, especially when U.S. Census figures suggest we are more likely than ever before to live to age 90 or older. But, as these experts say, we must take steps now to better our lives and our health.

Janko Nikolich-Žugich, M.D., Ph.D.clientuploads/Tucson_Lifestyle/Feature_Stories/2013/January/AgingtoPerfectp49.jpg
Bowman Professor and Head, UA Department of Immunobiology
Co-Director, Arizona Center on Aging
Perhaps Dr. Janko Nikolich-Žugich’s own family could be an inspiration for his research on aging. His father has lived a long, fruitful life because, Nikolich jokes, he is “bad at retiring,” having worked in health and medicine well into his 80s. A fulfilling life is really the promise of today’s aging research, he says. “The idea is not to extend our life spans to live forever, but rather to live the years that we have as fully and capably as we can,” Nikolich says. “That is the promise of the biology of aging that hopefully we can deliver on.”
Essentially, no one is 100 percent certain why humans grow old, but there are many theories. Nikolich explains that the very complex, highly ordered system of cells that help develop us early in life, can turn against us as we age. “Some cells do great things early, but bad things later.” Our cells also are incredibly diversified. For example, gut cells divide 5,000 times yet others do not divide at all. “Both dividing cells and cells that don’t divide lose function in old age,” he says. Cell resistance to damage and stress appears to be a key indicator of aging gracefully. “If your cells deal with damage well, you will age well,” he says.
Nikolich’s focus in aging research is on the aging of the immune system. One of his studies investigates the insulin pathway, or the way bodies absorb and manage nutrients. “The rate of aging is somehow linked to the way we deal with nutrients,” he says. “We are currently bathing in tons of calories for the first time as a race.” Nikolich is experimenting with interventions in the lab that dampen or shut down those pathways that take in the food through reducing calories, giving cells the signal to recycle and rejuvenate. “We feel this is the way. You are not only extending life span but also dealing with all of the major problems your body develops as you grow old.”
Nonetheless, caloric restriction may be best achieved in a drug, he says. “Most likely, restriction of calories is not practical for the majority of the population. We are, anyway, trying to understand the mechanisms of how this works so we can trick the cells and organs into thinking that there is not enough food at least some of the time.”
Research such as Nikolich’s truly needs more investment, given the large population increase in older adults. Federal dollars for aging research amount to a mere $22 per person. Compare that to the investment to conquer cancer, which is about $800 to $1,000 per patient, which has paid off and shows us as a nation how far we need to go. “We must increase health span, not just better aging. We need to build a world and health care system where we can grow old. We should not have an expiration date on our foreheads where we become invisible.”
In the meantime, it’s never too late to change your aging destiny, especially when it comes to exercise and nutrition. “Exercise is really good for you,” he says. “It’s the most wonderful thing not only for your body but your mind. There’s not a single better intervention to stave off neurodegenerative disease. No amount of Sudoku will give you the same benefit as one half hour of exercise a day.
“Eating sensibly — good food — is critically important. Our way of life is set up in that dinner is our biggest meal of the day, which is completely against everything our body does. We are ready to devour a dinosaur in the morning, but not at night. We’re mistreating our bodies in many ways.” Nikolich also expresses skepticism toward large amounts of fruit and snacking. “Fruit is probably overrated because of the sugar. You really only need three meals a day, well-spaced, and nothing in between. Every time you eat anything, your insulin spikes up. You’re causing a roller coaster of insulin with every snack.
“It’s not ever too late to have healthy habits,” he says. “It works even if you’re 75 or 80, and the sooner the better. That is the potential and the message.”

Carol Barnes, Ph.D.clientuploads/Tucson_Lifestyle/Feature_Stories/2013/January/AgingtoPerfectp51.jpg
Director, Evelyn F. McKnight Brain Institute
Associate Director, BIO5 Institute
Dr. Carol Barnes has studied the brain for more than three decades and still can’t believe the misconceptions that persist about our most vital organ. The brain does indeed age, she says, but it doesn’t just rot away as many people wrongly believe. Barnes’ work is heralding a different approach in defining information processing and memory in the elderly.
“The perception of aging is that you get old, you get senile and your brain deteriorates,” says Barnes. “It’s wrong, and I knew it was wrong even in the early years of my research. I had examples in my own family. My great Aunt Nan was 93 and sharp as a tack.” In fact, the brain is constantly changing and adapting to solve problems as we age. Her studies with rats underscore this, she says. “Older rats were able to complete the same tasks as younger ones by avoiding the use of the hippocampus, a part of the brain that does change with age, and by compensating with the use of an alternative structure that is not impaired during aging,” Barnes explains. Another misconception is that neurons, the building blocks of the brain and nervous system, wither and die during aging, when in fact they can remain healthy until death. The brain does lose volume in aging, but cell loss is not widespread.
Barnes is very excited about the hopefulness of understanding and promoting “healthy” aging as a background against which it is possible to better assess the effects of pathological changes such as Alzheimer’s disease. “We first have to define the normal markers of aging in order to determine what is truly disease.” Additionally, while memory changes and lapses are a normal part of aging, Alzheimer’s disease is not, Barnes says. The best data to date shows that roughly 14 percent of people ages 71 and older will have some form of dementia, like Alzheimer’s disease. “That means 86 percent of us will age normally.” To that end, a Swedish study of people over age 100 who were followed until they died found that 73 percent of them were free of dementia at the end of their lives.
Barnes also points to centenarians and super centenarians who maintain strong cognition well past 100. “There is objective evidence that a significant portion of centenarians have high cognitive function until right before their death,” she says. “It is possible to live a very long life, and enjoy cognitive health well past 100 years, with the length of health span virtually the same as the length of life.
“The very best thing people can do is to develop healthy habits as early in life as possible,” she says, referencing a study of women to determine when exercise was most effective in protecting mental processes. “The strongest correlations with good cognition in old age came from those groups of women who had been very active during their teenage years,” she says. “I actually believe that exercise is always important, but particularly when young.” Education and new learning also appear to help preserve brain function. “The answer to ‘how does education help preserve brain function?’ is not understood completely,” says Barnes. “The observation is that the more education one has, the lower the risk for Alzheimer’s disease. But this can’t be the complete story. Okinawa has some of the longest-lived people but also some of the lowest education levels in all of Japan. So, it has to be come combination of lifelong learning, genetics, as well as formal education.”

Dharma Singh Khalsa, M.D.clientuploads/Tucson_Lifestyle/Feature_Stories/2013/January/AgingtoPerfectp53.jpg
Distinguished Author
President and Medical Director, Alzheimer’s Research and Prevention Foundation
One of the country’s most notable experts on brain longevity and prevention of Alzheimer’s disease has very simple advice for our stressed, angry, technology-obsessed society:
Slow down.
“The pace of the last 10 years, this age of stress and anger, is not good for our health,” says Dr. Dharma Singh Khalsa. “It creates subtle changes in a person’s hormonal system and brain patterns. We need to slow down and take time to put our health first. The No. 1 thing is stress management. Chronic, unbalanced stress kills brain cells.”
Board certified in anesthesiology, pain management and anti-aging medicine, Khalsa founded the Alzheimer’s Research and Prevention Foundation (ARPF) in 1993, advocating a lifestyle approach to the prevention and treatment of memory loss and Alzheimer’s disease. A Sikh devoted to yoga and meditation, Khalsa has authored not only medical textbook chapters for Harvard Medical School and the University of Arizona, but at least seven books on pain management, nutrition, meditation and wellness, including the book Brain Longevity in 1997. His foundation works with top universities such as the University of Pennsylvania, UCLA and the University of California and others on brain and memory research. In fact, a meditation strategy he’s working on now might hold the key to reversing memory loss, Khalsa says.
Called Kirtan Kriya, it is essentially a singing memory exercise paired with finger movements from the Kundalini yoga tradition. Practicing it for just 12 minutes a day is purported to reduce stress and increase activity in areas of the brain that control memory, according to the ARPF website, which details how to practice Kirtan Kriya.  “It doesn’t take any training, just a CD player,” he says. “We’ve seen, just by doing this simple exercise, that it changes blood flow to the brain and sharpens your mind.” In the UCLA study, 49 caregivers who practiced the meditation for eight weeks showed improved memory, increased energy and they were happier compared to a group who relaxed in a quiet place with soft music. The meditation also slowed cellular aging. “The brain is flesh and blood like the body, there are things you can do for it,” Khalsa says.
There are other simple things that people can do to keep the brain active, such as “awareness walking,” Khalsa says. “You take a walk and while you’re walking, look up at the sky and around you and tell yourself what you see. Like, ‘the clouds are white, the sky is blue.’ It lights up your brain. We’ve done brain scans on this — it works. Go outside, take a deep breath and tell yourself what you see.”
Living well, as long as you can, is certainly important, Khalsa says, but how you live is tantamount. “Why bother to live to 120 if you’re unhappy? At the end, you need to ask yourself, did I love enough? Did I have a connection with my spirit? The person who can answer, ‘Yes,’ to those questions has lived a good life without regret. They are at peace.”