WHAT IS "AGING" ANYWAY?

What is aging? 

What do we mean when we say we are aging? 

In this episode, I'll discuss our paradoxical attitude towards aging. On the one hand age implies physical and mental decline and debility. On the other hand age implies wisdom and sagacity. 

I'll discuss the differences between Chronological and Biological Aging and Primary and Secondary Aging, And I'll discuss  the difference between "life expectancy" and "lifespan."

We will also review how scientists determine biological age and why we now suffer from  "age-related diseases."

Chapters

• 0:00 Introduction - What do we mean by aging?
• 1:42 The Paradox of Aging - Decline & Development
• 4:35 Chronological and Biological Aging
• 7:13 How do Scientists Determine Biological Age?
• 8:54 Primary & Secondary Aging
• 13:20 Life Expectancy & Life Span
• 18:01 Summary & Conclusion

Transcript

WHAT IS AGING ANYWAY?

Michael C. Patterson

 2/4/25

Hi there. Welcome to the Flourish as You Age podcast where we explore how to live long and live well, where I am examining strategies I can use to expand and enrich my quality of life as you age. And, I hope that sharing my thoughts and ideas will be of some value to you.

I’ve been thinking, recently, about the term “aging.” What does it mean to age?  I published a couple Synapse newsletters that linked to articles about aging. [Sign up for the Synapse Newsletter at mindramp.org] They got me thinking that we use the term aging all the time, without always being clear exactly are we talking about. If I want to flourish as I age, it will probably be useful to have a clear idea of what I mean by aging.  

So. What is aging and how can we be a bit more precise in our discussions about the aging process?

In this episode, I’ll discuss our paradoxical attitudes towards aging, how we think of it as both a gift and a curse. I’ll talk about the difference between chronological and biological aging, how we determine biological age, and what is meant by primary and secondary age. I’ll talk about why we suffer primarily from  age-associated disease these days, and will clarify the difference between life expectancy and lifespan. 

WHAT IS AGING?

In one sense, we are aging from the moment we are born until the moment we die. We are always getting older. Time is passing. So age, in this sense, is a chronological marker, a counting up of the years.  But there’s more to aging than that. 

The word aging also implies some kind of physical or mental condition that differentiates it from youth and adulthood. The word implies change. What kind of change? Change for the worse, or change for the better? 

Does aging imply increased debility and loss? Is aging a disease?  Or, does aging imply increased wisdom, greater maturity, deeper understanding and a more developed moral character? Is aging a process of growth and development?

In his book THE WISDOM PARADOX: How Your Mind Can Grow Stronger as Your Brain Grows Older  , neuropsychologist Elkhonen Goldberg points out that we have this paradoxical understanding of age that is almost a unity of opposites. 

On the one hand we associated advanced age with debility and disease - we picture a stereotype of a doddering old man stooped over a cane, or an old crone asleep in her rocking chair. We assume that these old folks have diminished cognitive powers. They can’t remember things, they can’t think well. And, some of us do indeed become this stereotype.  

On the other hand, we associate advanced age with great wisdom and sagacity. Our judges, our elders, our wise-men and wise-women are older adults who have lived long, learned from a wealth of experience and are carriers of ancient wisdoms. Respected elders have spent their lifetime developing their sense of justice and their moral values. They have refined their emotional intelligence and resilience, they have learned how to live life with equanimity and flow.

The term aging can imply radically different conditions, so it makes the word rather problematic. The tendency is to assume the negative connotations, so when we want to talk about the positive aspects of aging we have to add a modifier. We talk about “positive aging,” or “creative aging” or “aging well.”

A key point here is that people age differently. No two aging processes are quite the same. With that point in mind, I want to look at some of the ways that we can be a bit more precise about our descriptions of the variety of ways that we grow old.  

BREAK

CHRONOLOGICAL AGE VS. BIOLOGICAL AGE 

To start with, it’s useful to differentiate between chronological age and biological age. 

Chronological age refers to the amount of time you have been alive. We keep track of chronological age by counting each birthday. After birthday number one, we say you are one year old. And many important organizations and services use chronological age to determine eligibility. 

At your 50th birthday, AARP classifies you as an older adult by inviting you to join their advocacy organization for older adults. You become eligible for Social Security benefit at age 62. At age 65 you became eligible to receive Medicare’s health coverage, regardless of the status of your health. 

Now, if we were to pay   attention to the status of your health, rather than the number of years you lived, we would be talking about your biological age.  Biological age is less concerned with the amount of time you’ve been alive, and more concerned with kind of shape you are in. How are you doing physical. How is your health? How are you doing mentally? How well can you perform the usual activities of daily living?  Are you still running marathons or do you struggle to walk up a flight of stairs?

Biological age is a measure of comparative dysfunction. It looks at whether your body and mind are working as well as one would expect for the average person of your age. If your tissues and organs are showing greater dysfunction than the average, your biological age is higher than your chronological age. You are aging faster than you should be. If you are experiencing less dysfunction than the average, your biological age indicates you have been able to slow the aging process. 

This is what we want, obviously - to slow down the aging process, to slow down the rate and the extent of decline and dysfunction. We can’t stop the process altogether, but we can have some control on how much dysfunction we experience and how fast it happens. 

So, let’s dig a little deeper into the meaning of biological age? How do scientists determine one’s biological age?

DETERMINING BIOLOGICAL AGE

Scientists determine biological age in a number of ways.  They test how well organs and body systems are functioning, looking at things like lung capacity, blood pressure, vision, hearing, cardiovascular fitness and joint mobility. They also test for cognitive function, looking at things like memory, attention, problem solving ability, and speed of processing. 

Scientists are also interested in looking deeper, all the way down to the function of individual cells in your body or brain. One important marker of biological age is the status of your genes.  In broader terms, greater “genetic instability” indicates older biological aging.  Greater gene dysfunction indicates faster aging. 

The strands of DNA inside your cells are capped at the ends by structures called telomeres. Scientists have found a correlation between the length of these telomeres and the overall health of the cell. The shorter the telomere, the lower the health of the cell - they are experiencing greater levels of dysfunction. So, the shorter your telomere length, the higher your biological age.  

So, clearly, when we talk about flourishing with age we are more concerned with biological age than with chronological age. We would rather be 80 in good health than 70 in poor health. 

PRIMARY AND SECONDARY AGING

Some people make a distinction between primary aging and secondary aging. The difference here pivots around the presence or absence of disease. Again, notice that the term aging is equated with debility, deficits and disease, not with anything positive. 

Primary aging is considered to be (quote-unquote) “normal” aging, which includes some degree of decline in physical and mental abilities. Homeostatic balance becomes harder to maintain, we slow down a bit and find it harder to recall names and so on. 

Secondary aging includes all of these so-called normal deficits, but is further complicated by the presence of disease or injury. So, the deficits and debilities are exacerbated. With secondary aging, decline is more rapid and more profound. 

AGE-ASSOCIATED DISEASES 

The diseases associated with secondary aging are a specific kind of disease, age-associated diseases. These are diseases that tend not to afflict us when we are young. They take time to develop. They are the result of years and years of insult and injury to body and mind. The symptoms don’t manifest themselves until later in life.

In the 19th century, people were more likely to die from infectious diseases, accidents and from childhood diseases. But as we moved into the 20th century there are improvements in public health policies, in our understanding of the nature of disease, improvements in our ability to prevent diseases through vaccinations and simple things like washing our hands. 

All of these improvements enabled more people to live beyond childhood, make it through adulthood and even to survive into old age. So now, we are suffering with and dying from a different set of diseases - chronic non-infectious diseases. Diseases that take time to develop.

These include conditions like: cardiovascular diseases, cancer, dementia, Parkinson’s disease, osteoporosis, arthritis, type 2 diabetes, hearing loss, vision loss, COPD and hypertension, chronic back and neck pain.

 Many of us now suffer, for example, from what is called metabolic syndrome, which is a cluster of conditions that increases the risk of heart disease, stroke and diabetes. These conditions include high blood pressure, high blood sugar, too much body fat around the waist and irregular cholesterol levels. 

Metabolic syndrome is not only associated with age, it is also associated with bad lifestyle habits.  So, eating a lousy diet of fast foods and processed meat all our life, eventually takes a toll on body and brain. Drinking sugary sodas every day eventually screws up our bodies ability to regulate the sugar in our blood and we get Type 2 diabetes. 

So, this is a good news, bad news story. The bad news, of course, is that we are making ourselves sick and are suffering. The good news is we can do something about it. We can change our diet. We can stop eating crap. We can get more exercise. 

Some of these chronic age-related diseases are caused by lousy environmental conditions, like lead in our drinking water, or pollutants in our air caused by the burning of fossil fuels or now, the burning of our forests because of the weirding of climate conditions. We can do our best to avoid breathing the air and drinking the water, but the real remedy is to insist on changes in public policy. Until we get state and federal governments to clean up our environment, we will continue to suffer the consequences. 

LIFE EXPECTANCY VS. LIFESPAN

Let me bring this to a close by saying a few words about the difference between life expectancy and lifespan. They are not the same thing, so we should be careful not to confuse them when talking about age. 

Life expectancy refers to how long - how many years - you are likely to stay alive.  We can refer to the life expectancy of an individual, or the life expectancy of large groups of people. 

According to one recent report, white men in the United States, for example, had an average life expectancy of 76.1 years. This is, of course, an average. Some men die when they are younger, some when they are older. I’m happy to report that, at age 77, I have beaten the average life expectancy for  white men and I hope to live to the ripe old age of  . . . Well, old is it possible for me to be?

Now, here is where lifespan comes into play. How long can I reasonably, plausibly, expect to live if everything goes really well - if I stay healthy in body and mind. Lifespan refers to how long it is possible for a particular species to life. 

The lifespan for human beings is considered to be around 120 years. The oldest person on record, Madame Marie Calment of Arles, France died at age 122. Calment seems to have reached the farthest limit of human lifespan, so far. 

If I were a Greenland Shark, my lifespan potential would be closer to 400 or 500 years! If I were a coastal redwood tree, and escaped the saws of the lumber companies, I could live for as long as 2,500 years. 

That’s lifespan.  

So, human beings have a lifespan of up to 120 years - the potential to live over a century - but on average, only have a life expectancy of age 75 or 80.  Why doesn’t our life expectancy live up to our lifespan potential? Why do most of us fall about 2/3 of the way short?  

I should point out that that same report on American life expectancy reported that black men and women lived shorter lives than did white men and women. Black women have a life expectancy of 76.1 years, as compared to 80.5 for white women. Black men, on average, life to age 69 years as compared to the 75.3 for white men.  

Why do black people, on average, live shorter lives than white people? One clue is that, according to an NIH report, black populations suffer higher death rates from heart disease, cancers, homicides, diabetes, and perinatal conditions.  Okay, so why do black people have higher rates of these diseases? 

It doesn’t appear to have anything to do with genetic differences. There are a plethora of factors that affect our life expectancy and black populations, unfortunately, tend to get the short end of the stick on many of the socioeconomic and environmental factors, such as systemic racism, poverty, wealth inequalities, access to healthcare as well as lots of different lifestyle differences.   

So, one reason we fail to live to out potential lifespan is because we are vulnerable to a range of insults, injuries and diseases that cause us to get sick and to die prematurely.  

The longer we live, the greater our exposure to the environment. And our environment, the ecosystems that we live in, are not, as a rule, very healthy environments. And, of course, some ecosystems are worse - a lot worse - than others.  Living in poverty or a war zone is, obviously more detrimental to life expectancy than is living in an affluent suburb, for example. 

SUMMARY

To sum up, we fail to take advantage of our full lifespan potential because: a) we don’t take care of ourselves, and b) we don’t run our societies in ways that prioritize our health and wellbeing. I’ll explore these factors in upcoming podcasts. 

All right. That’s it for now. Thanks for listening. Here’s hoping you live long and enjoy health and happiness throughout your life. 

 | 
 | Another important distinction we should make when talking about aging is the difference between life expectancy and lifespan. And then putting these context with heath and wellbeing. LIFE EXPECTANCY & WELLNESS EXPECTANCY 
 Even though I might possibly live to be 120 years old, I might not want to live that long. It would depend on how I felt, on how healthy and fit I was, on my physical and mental well-being. I want to stay alive as long as being alive is still pleasurable and fulfilling. I don’t want to stay alive if I am suffering excruciating pain, or if I can’t breathe without the help of ventilators can’t eat without feeding tubes.  When those things happened my healthspan would come to a close. Doctors might be able to keep me alive, artificially, but my quality of life would be out the window, and I would want to be out the door.  More and more these days, people are talking about wanting a long healthspan - to live for as long as we can while maintaining a fulfilling sense of well-being.  

NORMAL AGING - ACCELERATED AGING

Age is still seen as a great thing, a condition to be desired. 

But, at some point, the turns around and we no longer want to be older. We want to be considered young, not old. We want to be considered - and to feel - youthful and vibrant. At some point in our lives it feels as though we stop growing and developing. The arc of development, which has been on an upward trajectory since birth, starts moving in the other direction. 

So, perhaps it’s at that point in our lives that we think of ourselves as aging. We aren’t getting stronger each day, we are getting weaker. Suddenly, we start gaining weight, developing a little midriff bulge, a beer belly. And we can’t get rid of it.  We don’t recover from injuries as quickly as we used to. We start noticing the appearance of gray hairs, or really that our hair is falling out.