Super Super VivereVivere

Reflections on Living Long and Reflections on Living Long and

Ageing Well Ageing Well

Dr Maeve Rea

Susie Rea

Outline

• Background and Introduction

• Methodology used

• Structured questions• Structured questions

• Life stories

• Summary points

Background

Nonagenarian

Numbers are Numbers are

growing

Life Expectancy across WorldLife Expectancy across World

Centenarians on the RiseCentenarians on the Rise

Numbers of US Centenarians are expected to rise exponentially between now and

2050.

In 2050

•1 in 10 in Europe

80+ yrs80+ yrs

Survivors, Delayers, EscapersSurvivors, Delayers, Escapers

• ‘survivors’, 42%

‘delayers, 45%• ‘delayers, 45%

• ‘escapers’, 13%

Perls T, Boston

Healthy Healthy

Ageing

‘escaper’

OKINAWA Study

‘Land of ‘Land of

immortals’

Factors which contribute Factors which contribute

to ‘successful ageingto ‘successful ageing’’to ‘successful ageingto ‘successful ageing’’

GEGEnetics of netics of HHealthy ealthy AAgeinggeing-3200 pairs of 90+ brothers and sisters

across Europe-3200 pairs of 90+ brothers and sisters

across EuropeEU-funded study

-Study to look at genes for healthy ageing

Nuclear and mitochondrial Genes

C1 vs C2

Population structure among GEHA studyPopulation structure among GEHA study

Cluster 1

Cluster 2

Cluster 3

Whole Genome ScanWhole Genome Scan

SurvivorsSurvivors

•• SurvivorsSurvivors interest us all.

• They tell us the possibilities for our own

survival.

We are fascinated by the stories of people • We are fascinated by the stories of people

who survive against the odds in difficult or

extreme circumstances.

Isa

• It in my genes

• My father was

102

• I worked hard• I worked hard

• A glass of wine

Belfast Telegraph Saturday 20 January 2010

Bridging Genes and Gerontology

Seeing the world with a different lens

Background hypotheses

• Life stories may help us understand something

of the personhood of the 90 year old

• What makes them a survivor?

• What value system have they adopted?• What value system have they adopted?

• How do they see their past, their future, their

peers?

• What are the common strands of personality

or memory and coping skills with their

siblings, if any?

Visual Images

• We all have a visual image and form which is

part of the story which we tell

• Both are part of our personhood and are • Both are part of our personhood and are

interdependent

• Combining both visual and verbal stories will

enhance the richness of the life story

Methods

GeHA Recruitment

• Italy 5 pairs

• Poland 5 pairs

• Finland 4 pairs and 1 trio

• Northern Ireland 10 pairs and 3 trio

• Greece• Greece

• France

• Belgium

• Germany

• Ukraine

• Denmark

Narrative

• ‘Tell me your life story ‘

• Research teams already knew sibling pairs or trios

• Already had established a rapport with sibling pairs and families

• Sibling pairs or trios who consented loved giving their stories

• Written consent for recording and photographs

Structured Questions

• What age do you feel?

• What do you think makes you a survivor?

• How makes you happy in your life?

• How do you view the future?• How do you view the future?

Northern Ireland

Thomas 94 and Joyce 96

Belfast

Thomas

William at 96 years young, supposes that his

‘plain diet – not too much sweet stuff or sugar’

has been important in his longevity.

Norman at 95 years says that he had

“No junk food”

“ only good food”

Samuel is 95, ‘going on 25’, and considers that he has always

‘been interested in people and interested in life’.

Dorothy in her 93rd year, tells us that she has

‘always made the ‘always made the best of things’

“Father and

mother lived

long”

“I had cousins

Ellie at 100 reports that

“I had cousins

too”

“The men didn’t

live so long”

Kelvin, Sarah and Kathleen

4 siblings

Belfast

Anne, Kathleen, Sarah, Kelvin

What makes you a Survivor?

N IrelandKathleen 92 ‘good health and my daughter living with me’

Kelvin 93 ‘just my genes; my cousin was 99, my aunt in her 90s’

Sarah 94‘ keeping in touch with news and everything’

Grace 94 ‘my father lived to 94’

Jane 95 ‘good food when we were young’

Pauline 95 ‘its my Guardian Angel; she looks after my mishaps’

Mary 99 ‘ hard work, it was hard work’

Ellen 96 ‘ if you work hard you just survive’

Sarah 94 ‘ we hadn’t very much, but our parents were good’

Lilian 100 ‘I just worked on, I didn’t think of myself’

Dorothy 93 ‘It must be my genes; my mother was 90, my aunt 95 and

another one 94 on father’s side’

Thomas 94 ‘ My father lived to 98; good care and attention’

Norman 96 ‘Hard work that’s the secret’

Poland

Pelagia

‘I worked hard; rather hard.

I did not smoke’

JadwigaJadwiga

‘my

grandmother

lived long; I

like to do

crosswords’

Stranilawa

B Bradnaska

What makes you a Survivor?

Poland

Pelagia 93 ‘I worked hard, rather hard; I did not smoke’

Jadwiga 94 ‘my grandmother lived long; I like to do crosswords’

Koldra 93 ‘hard-bitten in work; fed healthy food in the forest’Koldra 93 ‘hard-bitten in work; fed healthy food in the forest’

Marcjanna 94 ‘I tell the priest I drink vodka every day; but it isn’t true!’

Janina 96 ‘joyful; they say I look young’

Fausta 99 ‘don’t know’

Stranilawa 92 ‘I enjoyed a bit of vodka to help me’

Bradnaska 90 ‘ I have always worked; I have been working’

Bologna

Italy

AntoniettaAntonietta 9696

‘Well I feel a

bit old-bit old-

but my head is

still healthy,

even if my legs

aren’t’ so

good’

Antionietta’sAntionietta’s

KitchenKitchen

‘We had cod-‘We had cod-

liver oil to

drink every

morning till

we were 15

or 16’

This is meThis is me

‘One of us

always wants always wants

to be right

But I won’t

tell you which

one!’

AussantaAussanta 9999

‘Getting old

is no fun’is no fun’

’life has

been hard’

Giovanna

Giovanna and Dante

What makes you a Survivor?

ItalyAntonietta93 ‘they gave us cod liver oil to drink, till we were 15 or 16’

Assunta 100 ‘working so hard, heavy jobs’

Augusta 95 ‘Health, a quiet life;I don’t feel melancholy’

Giula 94 ‘working hard, working a lot’

Germana 96 ‘working hard, I had 4 men to look after!’

Fausta 99 ‘don’t know’

Virginia 97 ‘I have been happy, our mother loved us’

Adelma 90 ‘ I have always been healthy; I have been working’

Dante 96 ‘I feel young, I don’t have ill health’

Giovanna 96 ‘I have always lived day by day; I don’t know’

Finland

KarlKarl

‘ the last ‘ the last ‘ the last ‘ the last

package from package from

my mother my mother

saved my life’saved my life’

EVA

‘This is my ‘This is my ‘This is my ‘This is my

country country

I can speak I can speak

Finnish’Finnish’

Hilkka, Pulmu and Maija

What makes you a Survivor?

Finland

Maila 93 ‘hard to say-well genes’

Meeri 98 ‘my father was 91; I have lived to 98’

Hilkka 95 ‘it’s how it plays out and luck’

Pulmu 93 ‘ Heavenly care and strength for each day dawning’

Maija ‘You settle for what comes along’Maija ‘You settle for what comes along’

Matti 94 ‘a joyful character, that doesn’t worry unnecessarily’

Anna 90 ‘I was only ill last summer for the first time’

Laura 91 ‘it might be my fighting spirit’

Sylvie90 ‘it’s no good taking the gloomy view’

Karl 95 ‘ the last package from my mother saved my life’

Eva 92 ‘this is my country now, I can speak Finnish’

Good Health

Genes Physical Activity

Eating well

Social Connections

90 year

old

Smoking

Alcohol

???

Don’t Worry

Luck Mental Activity

old

Survivor

Summary

-Maintain mental and physical health

-Hard work and determination-Eat properly -Good sense of Humour

-Good family and social support

-Choose long-living parents!

Summary

Is this what we see in our sibling pairs who start with a good gene capital, but then build upon this with a common, then build upon this with a common, perhaps good family, life experience and this facilitates their ‘ageing-well profile’?

Can we slowing Ageing ?

Keep healthy, Keep Active

All Photos copyright Susie Rea

http://www.susierea.com/

Broccoli

Green Tea

RED WINE

Kaplan-Meier survival curves for individual subjects with diet score up to 3 and 4 or more

Copyright ©1995 BMJ Publishing Group Ltd.

Trichopoulou, A. et al. BMJ 1995;311:1457-1460

Kaplan-Meier Curves for Number of Healthful Lifestyle Factors

Copyright restrictions may apply.

Knoops, K. T. B. et al. JAMA 2004;292:1433-1439.

Social Integration

SupportSupport

Confucius Temple

Summary

Throughout the interviews, across all the countries, we seem to see

a sense of positivity optimism optimism a self deprecating sense of humouradaptabilitya feisty independence

emerging as the phenotype for the successful ageing personality.

GENESGENES Environment Environment

Behaviours Behaviours

Special thanks to

GEHA teams

in

Italy, Poland, Finland and N IrelandItaly, Poland, Finland and N Ireland

Laura and Elisa and Claudio

Kasia and Ewa

Antii and medical students

Anne and Susie

Digital Stories

• Combine Narrative and Photographs

• 90 year old sibling pairs across Europe

• Powerful empowerment tool for Older People• Powerful empowerment tool for Older People

• Dissemination tool for GEHA and ACUME2

Changing Ageing Partnership(Queens University Initative)

-empowering older people

-enhancing positive attitudes

to ageingto ageing

-giving older people a voice

Questions ?

i.rea@qub.ac.uk