Old will be gold if we live our lives in a way that encourages mobility and independence when we age.
The four-day 1st World Congress on Healthy Ageing was held in Kuala Lumpur from March 19-22. It was organised by the Malaysian Healthy Ageing Society and co-sponsored by the World Health Organization.
Almost 1,000 participants from all over the world attended, and our own Health Ministry was also one of the main supporters, and had sent several hundred of its staff to attend to learn from world experts.
The four days were packed with interesting and informative plenary sessions, forums, symposiums, workshops and short oral presentations. The topics covered encompassed the whole spectrum of issues affecting ageing, the aged, and the ageing population - spiritual, mental, emotional, physical, socio-economic, legal, environmental, medical, and complementary therapies.
Like all the other participants, I spent the four days criss-crossing from one lecture hall to another trying to learn as much as possible from the hundreds of topics on the programme.
Often, I was faced with a dilemma when there were two or more interesting concurrent sessions that I wanted to attend. I was also invited to conduct a qigong workshop, to introduce qigong as a simple and effective exercise to help maintain health while we age, and to prevent, and even, reverse certain diseases.
I hope to share some of the lessons I learned from this very successful inaugural world congress. But first, I would like to congratulate the organisers for making Malaysia a proud host, setting a benchmark for future world congresses to follow. The next one will be in South Africa in 2015.
The ageing world
Many countries are already facing the problem of ageing populations due to the combination of progressively lower birth rates and higher life expectancies.
Japan is at the top of the list. Coupled with a shrinking young population (0-15 years), the demographic charts of many countries are slowly changing from the traditional pyramid shaped (with the young at the base) to become more expanded at the middle and top, and shrinking at the base.
Japan and several other countries already have a ballooned middle portion (15-65 years), and in future, will have a top-heavy chart (more middle-aged and older people than the younger groups). Only the poorer countries maintain the traditional population distribution according to age.
The definition of old age varies. The more advanced countries use 65+ years, while the poor and developing countries (including Malaysia, Thailand and other countries in the region) use 60+ years as the criteria.
In the past, when life expectancy was not high, 50+ was considered old. Then, as we progressed and achieved longer life spans, the definition of old age also progressively changed. Even the age of pension for government servants has increased from 55, to 56, to 58, and finally to 60 years (beginning this year). In rich and advanced countries, it is generally at 65-67 years.
The shifting demographics pose special challenges to society, and on the authorities and governments managing the ageing population. The burden will be felt in all spheres of life, particularly in the health and disease/disability aspects.
Since Malaysia is also not spared from the ageing trend, it is comforting to know that our Health Ministry sent hundreds of its staff to attend, so that we are equipped with the latest information, and participate in valuable discussions in planning our own solutions to the emerging problem.
The ageing individual
While I have attended many anti-ageing conferences that focus more on how to stay young and reverse ageing (at least temporarily), this healthy ageing congress covered a much wider scope, focusing not only on the ageing individual, but also on the ageing society and all the issues that would ensue.
As far as the ageing individual is concerned, the general view for what would entail healthy ageing is that a holistic approach is important. This would include living a spiritual life (even "scientific" or "secular spirituality" for those who are not religious or don't believe in god - more about this in future articles); adopting a healthy lifestyle, which includes having a nutrient-rich diet and being physically active; being continually engaged in social activities; and having access to adequate health and other necessary facilities.
Prof Suresh Rattan of Denmark, who introduced the concept of secular spirituality, also listed his secrets for a successful healthy ageing and longevity. These are the 7 Spiritual Laws of Health and Longevity: rational optimism (as opposed to blind optimism); adaptability; being socially engaged; having self-love, self-respect and self-acceptance; enjoying guilt-free pleasures; enjoying solitude (when such circumstances arise); and having boundless humour!
He also proposed that healthy ageing means having the ability to conduct daily activities independently, which I agree is a simple, practical definition for healthy ageing in the elderly.
One of the highlights of the congress was the lecture about the secrets of the longevity of the Okinawans, which was presented by Prof Emeritus Makoto Suzuki, who is the leading expert on the Okinawa longevity phenomenon.
The real secret lies in their culture. Their concept of old age is different from ours. They consider themselves young until they are into their 50's. They look to seniors as "elders", not as "oldies". They celebrate life, and longevity is only a natural consequence.
They lead a quality life, and the quantity (enhanced lifespan) comes naturally. Their diet is rich in raw foods, veggies, beans and soya been curds. They are active, and do a lot of physical work as part of their daily routine.
They practise self-reliance, as well as have a strong community support system. Their lifestyle promotes spiritual, mental, emotional and physical health. They don't worry too much about problems, and they lead highly spiritual lives.
A typical woman would pray daily at the altar, gives a daily report to the divine, and seek divine help and blessings for the day.
Unfortunately, the later generation of Okinawans has become Westernised, and their special place as champions of longevity will soon be lost. The youngest generation has embraced hamburgers and hot-dogs, just like our own children!
In 1985, the life expectancy for Okinawans was 80 years (males 76, females 84). The average for Japan was 78 years (males 75, females 81). Although life expectancy continues to rise, the gap between Okinawans and the other Japanese narrowed down to such an extent that by 2000, the life expectancy for males became the same (77 years), while females only had one year's advantage (86 vs 85 years), and perhaps even that has been lost by now.
However, from the cultures and practices of the elder generations, we have learned so much that we can emulate, and hopefully, also enjoy the benefits of the long, healthy lives that made them famous.
Longevity, lifespan and healthspan
The United Nations (UN) data for life expectancy (2005-2010) listed Japan as having the highest at 82.6 years (males 79, females 86.1). Malaysia was joint 65th at 74.2 years (males 72, females 76.7), while Singapore was 7th at 81 years (males 79, females 83).
However, the data for 2011 (estimated figures by CIA World Fact Book) listed Monaco as the best at 89.7 years (males 85.8, females 93.7); Japan is down to 5th at 82.3 years (males 79, females 85.7); Singapore remains 7th at 82.1 years (males 79.5, females 85); and Malaysia a lowly 108th at 73.3 years (males 70.6, females 76.2). Although there are some inconsistencies between the two sets of data, the latest UN estimates also showed that Malaysia had dropped to 80th.
So while we can be proud that our life expectancy has improved over the years, we are far behind our neighbours just across the causeway. Worse still, we have not improved in tandem with the others, and have dropped down the list.
The shocking news is that the life expectancy in Swaziland (Africa) is only 31.9 years (males 31.6, females 32.2)!
Since life expectancy is an important indicator of the health of the people, I hope our Health Ministry personnel who attended the congress will put their newly-acquired knowledge to good use and formulate strategies to improve not only our life expectancy, but more importantly, the healthy portion of our lifespan (healthspan vs lifespan).
Indeed, we should be spending more efforts to improve our health, rather than worry about our lifespan, because a longer lifespan should be a natural consequence of a healthy life. It is not the quantity, but the quality that matters.