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Keep Able Reablement Podcasts
Reablement conversations: with Professor Peter Gore
In this episode, Hilary O’Connell has a chat with Professor Peter Gore, Professor of practice in ageing and vitality at the Population Health Science Institute at Newcastle University in the United Kingdom. Peter’s work involves aged-related functional decline and the malleability of ageing.
He has over 33 years of experience in medical product design. One of the tools Peter has developed with his company ADL Smartcare, is the LifeCurve™, which helps people understand how they are ageing and how they can take action toward improving their healthy ageing journey.
Together they discuss what healthy ageing looks like, the importance of sharing trustworthy information with an ageing population and aged care service providers, to change attitudes towards ageing and bring practical examples and tools to improve independence to have more ‘good days’.
Discover more reablement resources at keepable.com.au
Hello and welcome to Conversations about Healthy Aging and Reenablement. My name is Hilary O'Connell. I'm an occupational therapist and the principal advisor of healthy aging and reenablement here at ILA. Thank you for joining us today, where I will be talking to Professor Peter Gore about healthy aging and what we can all do to live well in older age. Healthy aging is a priority policy area, both for the World Health Organization, with a decade of healthy aging focus from 2020 to 2030, and for governments around the world. It's been suggested that a marker of success from this work is that people can enjoy at least five extra healthy independent years of life by 2035, remain independent for longer, continue to participate in work and within their chosen communities, and stay better connected to others. So before going any further, I'd like to introduce you to my guest today, Professor Peter Gore. Pete has been a professor of practice in aging and vitality at the Population Health Science Institute at Newcastle University in the United Kingdom. The work in which he's involved focuses on age-related functional decline and the malleability of aging. Pete has more than 33 years of experience in medical product design and has worked internationally before setting up his own firm, ADL Smart Care Limited, in 22, which develops decision support systems and services around healthy aging. One of these tools is the Life Curve developed by ADL Research and Newcastle University's Institute for Aging, which maps age-related functional decline and helps people understand how they are aging and how they can take action to have the best aging journey. Welcome, Peter. So I'm just going to ask Peter a few questions. And first of all, the Peter, Professor of Practice in Healthy Aging sounds like a very interesting role. Can you tell me a little bit more about it?
SPEAKER_02:Yes, the most academics are about studying a particular subject. My role as a professor of practice is how do we take that research, that understanding, that growing understanding, and put that into practice. Obviously, you know, studying aging for its own sake may be interesting, but ultimately we what we want to do is make a difference to people's lives, and that's what motivates me. So hence the title.
SPEAKER_00:Tell us a little bit about what happens when we age and what's meant by healthy aging.
SPEAKER_02:So the WHO defined healthy aging as being able to do the things that you value as you get older. And the truth is that most of the things that we struggle with as we get older are things that we take for granted. So we've got things that we call activities of daily living. So whether that's walking, washing yourself, all of those kinds of things, they're really important things that we just take for granted. But they become harder as you get older. Because what's going on is we're beginning to lose muscle mass and strength, not at a particular rate, but eventually, and unless we do something to stop that. And those kinds of things reduce our ability to whether it's walk more distance, whether our balance is less good, and all those kinds of things. And so that's really what we're we're trying to engage with. And that's healthy aging is just having more better years, in effect. So rather than more years. So we're not talking about life expectancy, which people often confuse it with. We're talking about the life expectancy where you can do the things that you want. We use the word healthy life expectancy. Health does play into this, but people can still be extremely independent even when they've got multiple health problems, although typically extra health problems will make it harder to do some things.
SPEAKER_00:Thank you. So we know that ageism and age attitudes have an impact on how society views us as we get into our later years. Can you tell us a little bit about what some of the myths around aging are and how age attitudes can influence how older people are seen and what we're capable of as we age?
SPEAKER_02:So, yeah, that's a big subject. But maybe the starting point on that is there's a study done in the Irish Longitudinal Study on Aging where they tested for the impact of our attitude on aging with what that might affect. And they adjusted for all other factors and just looked at people who had a negative stereotype of aging, people who had a positive stereotype, and followed them for two years and looked at the difference. And what they found was two years later, with a negative stereotype of aging, you'd be walking slower and you would be more cognitively declined. And that's just your attitude. So it's really important. In a way, none of us want to age. I I've never heard anybody say I can't wait to age. Well, maybe a teenager, but certainly not somebody of of our kind of age. It's not this interminable process of decline that you can't do anything about. It's an incredibly malleable process. And to give you an idea, in the UK, if you go to areas where people age the least well, they get twenty less healthy life years than people who are in areas where they're a they age better. And that will be all kinds of things that then impact the quality of their lives and so on. So healthy aging is just about making the most of what you can your inherent abilities within the context of the choices that you're willing to make. So for some people that might be running a marathon, like I did recently, because I can. Some people that would be a ridiculous idea to them. It doesn't matter. What we're really wanting to do is help people do the things that they want to do. But we get this thing, particularly something called sarcopenia, which is you're naturally more likely to lose muscle mass and strength as you get older. It's not inevitable, it's not inevitable at all. But we assume it is. And so we chase it down very often rather than pushing back at it. So you just have to work a bit harder as you get older. Probably sort of midlife onwards depends again on where you started from. So if you've got fantastic muscle mass, you won't notice a bit of difference when you're older. If you've got very little, you'll notice that much sooner. So that's kind of what's going on. There's so many things you can do, but it is really about exercise, it's about diet. You need more protein as you get older to be able to maintain your muscle or grow it if that's what you want to do. So so it's it's uh there's lots of different aspects for it. But if you if you say it's about maintaining your muscle, mass and strength, it's about good diet, and about connectedness to people. They're the key things. And by connectedness I mean you shouldn't feel lonely. If you if you're happy with your own company and you don't feel lonely, it doesn't matter. But if you do feel lonely, then do something about it, because that's very important. It's as bad as smoking 15 cigarettes a day for your health. It's just really bad. Does that answer your question? I hope.
SPEAKER_00:It does, it does. And I I think it sort of answers that that it's really important to change the way in which we think about how people age. And that's sort of when people have age attitudes. I know I I have a an older relative who was told that they were silly to go to the gym when they were in their 80s and sort of, you know, you're too old to be going to the gym, why are you going there? And I was trying to sort of explain to them how important it was that they did go to the gym or did things that kept them as functionally able as possible, even if you don't fancy the gym and that sort of thing, but to stay as strong as possible is so important.
SPEAKER_02:Absolutely. You don't have to go to the gym. My my favorite core muscle training, sadly, what I live as far from water as you can get in the UK, but uh my favorite core muscle training is peddleboarding, stand-up pedalboarding. Um because if you don't have good core muscles, you'll be in the water a lot more often. So it's a yeah, yeah, absolutely. It's it's important to do the things that you want that include the things that you need to do, if that makes sense.
SPEAKER_00:Yeah. I was even talking to a lady the other day who said, Oh, you know, um I I know I need to get a bit stronger, but I I don't want to go anywhere and do it. What can I do in the house? And I I went through a few things with her, some of the sit-to-stands, but I also talked about using some cans of tint of fruit for sort of actually doing some bicep curls and just little bits like that to sort of just to get her going, which she hadn't really thought of. I said that's just one way of starting to improve your strength, which I thought was so important for her. You touched just now on on age-related functional decline and how it can impact on someone's ability to manage everyday activities. How early can age-related functional decline actually start?
SPEAKER_02:Well, in the research we did for the paper we wrote, I found ONS data, so UK government national statistics people, found that um so it was self-declared, but uh 2% of men, 3% of women at the age of 42 can't reach to cut their toenails. Right. So that's a limited range of motion, and that limited range of motion is going to start to affect other things that they'd like to do.
SPEAKER_00:Right. 42.
SPEAKER_02:42. That's frightening, isn't it?
SPEAKER_00:It is frightening, yes, it is.
SPEAKER_02:However, at the other end, I found a small group of women in California who can still do all the functional things that we measure at the age of a hundred. So it's not and and that's a really important point about aging, is not about a chronological age. It's about your physiological age, which is often very, very different.
SPEAKER_00:Yep. Yep. Tan, tell me a little bit, you mentioned cutting your toenails, and and whilst I'm aware of um the life curve and the cutting the toenails, tell me the relevance of cutting the toenails and why it's at that uh that first level and why it's important if you can't cut your toenails, and it's not a question of you just got horrible toenails and you can't cut them, but actually not being able to reach them and do that, how important that is.
SPEAKER_02:It it's in effect it's range of motion. So you don't really need strength to reach your toenails, but you do need range of motion. And if you think about a lot of the activities that we we do, if you bathe, for instance, if you can't lift your feet off the floor, or you can't bend your knees and your hips, you're going to struggle to get into a in and out of a bath and in and out of a car and all sorts of and up and down from a chair and so on. So so it's just one uh a very useful early marker because it's uh it's something that it's so easy to fix, you know, so easy to get that ability back. So it's just picking something that's that sort of early sign of you're just that you're stiffening up, you're not kind of moving like you did, and it's just that sort of very first sight indication of decline, which is incredibly reversible.
SPEAKER_00:Knowing that not being able to do certain activities daily living impacts on our independence and quality of life, and it may mean that we need then to rely on others, what can we do to stay as able as possible? And I know your research describes specific evidence-based interventions such as exercise, improving strength and balance, relearning old skills or learning new and using assisted technology. So, what are some of those things that we can do to stay as able as possible?
SPEAKER_02:So the the order in which you would do them, you don't have to, but the best order to do them is first maintain the ability to do the things that you want to do by being active, getting out, walking. You can do, as you just mentioned, you can do strength training without being in the gym. Gardening actually can be a very good form of strength training if you've ever dug lots of holes in the garden and move big plants around or anything like that. It works all kinds of muscles, and for some people at least it's a fun thing to do. So there are lots and lots of activities that we do where we use our muscles and strengthen them, climbing hills, for instance. Another good example. Um that's easy because I live in the hills for me. So, you know, that's a easy exercise. So it's starting to do you're just doing those kinds of things. Making sure actually we we we sit a lot. So I'm sat in front of a screen, um working with a chap who's um struggling to run at the moment because he spends all day sat at a screen, and though he's getting knee pain because basically his calves are shortening, his hands are shortening, and so he's needing to do stretching. So stretching, particularly dynamic stretching, is a good thing to just to keep that range of motion. But you do need to push back against when something's hard, don't stop, just work harder at it so that you can keep it with whatever means works for you. Lower body is is one of the things that that we we see impacted first, though that can be not able to warp for very long. There are other things, I mean I I hate this particular one because it really doesn't fit my personality, but dancing's a really, really good thing. Weirdly like line dancing, because actually what you're doing when you're doing that is the kinds of movements that you would do in everyday life. But you're doing a lot of them in a short period. So actually it's been shown to be a very effective way of maintaining muscle. So it is continuing to do the things that you want to continue to do and pushing hard at those and um and finding other things that sort of mirror those things. So, you know, like stand-up paddle boarding is is much more interesting than being on a wobble board or something to me, because you can have fun doing it. And actually the impact of falling in the water really isn't that bad. So it's finding those kinds of things. It is making sure that you eat the protein that you need, which is two grams per kilo of body weight a day for an older person, less if you're younger, but something like that. And the right kinds of protein. So eating well, connecting with people as we talked about already. Does that answer your question or do you want more detail behind that?
SPEAKER_00:Out of interest, what about assistive technology? Where does that fit with the order of interventions that you talk about?
SPEAKER_02:So eventually, almost regardless of what you push back, but this could be at 100, or it could be very early on, the abilities that you've got won't be sufficient to do the things that you still want to do, like bathing's the thing that triggers most people to realise they've got a problem, because bathing is actually quite complex. It's a slippy surface. Um even a showery, slippy surface, and actually you you need to be a bit of sort of human origami to get into baths very often. And the consequences of it going wrong. So even if you're working on getting ability back, if you feel there are risks there or you're concerned about things, then use assistive technology. That could be a seat that's across the bath so you can sit on it to swing your legs in, which means if it's slippy inside, you're not going to fall over. You can use grab rails, there are lots of things. Uh and these days there are actually often ways of building those into the built environment that can be quite attractive. Um I know grab rails at the front door that are also a plant potholder. So you know it it's it it'll take your weight, but also it looks pretty because you've got a nice planting and so on. So those those things that we call them assistive technology because they assist your lack of ability to do unaided the things that you want to do.
SPEAKER_00:Okay. Well, we don't have very many baths over here in comparison to you in the UK, but I I know some of the most popular assistive products on Live Up, which are our healthy aging platform, are things like jar openers, uh tap terminers, things like that. And one of the most popular of all is something called the colour assist bar, which is a sort of a bar that you can clip to the inside of the car door when it's open and it helps someone lever themselves out of the car. And that's been that's proving to be extremely popular. As you would say, I would rather that the person could could potentially have enough strength to be able to do it themselves, actually get stronger, relearn a different way of actually getting in another colour or use a piece of assisted technology, whichever helps them the most. But um, you know, we've got lots of sort of different pieces of equipment that can actually help. So Peter, just moving on a little bit. Over the last 10 years or so, many countries, including Australia, have introduced what we may call short-term reenablement or restorative care programs into community care. How valuable do you think these sorts of programs are in helping people regain their independence? What do you feel? What sort of evidence-based interventions do you think should be included in these programs? And you've probably touched on them already. But how valuable do you think these sorts of programs are in keeping people as independent as possible? And I know in the UK you have discharge programs and you do have reablement, even though I think things have perhaps changed recently over there.
SPEAKER_02:It's it's not nearly as available as it should. But so uh a week on a bed in hospital is really bad for your health. You know, all sorts of things start to go down, and so it's really important to get those things back. But it's not just people who've had operations a few years, but now we uh decided to go and visit people who were getting care at home and said to them, Are you willing to do exercise? This came out of somebody challenging me and saying, How can we help the people that we're we're doing care with? And it if I'm brutally honest with myself, I thought, yeah, it's probably too late for them. And the guy said, That's not good enough. I thought I heard you say that people even in nursing homes can double their muscle mass and strength. Right, you did. And I go, Yes, I did. And he said, And he said, So what are we going to do for us? And I said, Well, you can go and ask them. So they went and asked them. 60% said, Oh yeah, I'll do exercises. Somebody showed me what to do. And you go, 60%. That's a pretty big win. That's 60% who are getting care now, which is expensive, scarce, and means that they're having somebody else do things that they would rather do for themselves. So just giving people targeted exercises, and what we found was typically they would need 15% less care in the space of six weeks, just using simple exercises, stretchy bands, movements, things like that. And that meant the person was more able to do the things that they wanted without relying on somebody else. And yeah, we all like help being helped out a little bit, but actually most of us want to be able to do the things when we want to do them. And it showed people just bouncing back. It's incredible how the body responds if you challenge it. And that's what reablement is. But it does need to be done either with professional knowledge in person or through some other kind of system where it's been embedded to make sure you're doing the right things for two reasons. One is you you don't want to injure yourself, and the second is you want them to be effective. So you need to focus on the muscles that matter, or you'll be discouraged because you'll be, you know, building your core muscles but your legs won't get you out of the chair.
SPEAKER_01:I get it.
SPEAKER_02:So it's making sure that you do do the right things, focus on the right things. The whole thing about stretching and so on is slightly more controversial. There's different evidence there. But certainly reablement is it's not just a question of that the fifteen percent of care was money that didn't need to be spent, whether that comes out of the public purse or your own purse. It was the fact that you couldn't do things that actually you were always able to do. So it's really important to get those back, especially when somebody's had some kind of incident, gone into hospital, had some sickness, you know, whatever. Yeah, yeah, yeah. Really important to get that back and improve because we know it works. We absolutely know that that works. But it does require the commitment of the individual to try as well.
SPEAKER_00:And I and I'd sort of also be thinking most people, if if they can be a shown a different way or can be shown sort of different movements and activities that will help them say regain their independence in particularly things like showering and dressing, personal care, that's then then not having to wait around for someone to come and do those things for them, that they get their life back. Minimum having worked in reenablement programmes, focusing first on some of those physical attributes and regaining independence in those personal care activities. But then someone said, Look, now I really feel like I can get back to my social activities. I feel more mobile, I feel more confident, I feel safer. And now I my goal would be to return to some social activities. Can we work on that now? And I thought that was really important as well.
SPEAKER_02:The danger is when you can't do a lot of these things, you'll get stuck in your home. If you want to be at home, that's probably a good thing. But getting out and engaging with others and doing other things is just really important. We weren't really designed to be sat in a chair watching a TV all day. Although even if you did that, just doing a decent bit of exercise every now and again, well regularly, um, will actually mitigate even the impact of that. Although I don't encourage you to sit watching the TV all day. That's just not a good idea.
SPEAKER_00:No, that's true. I remember I remember reading a great quote, I think it might have been from the British Medical Journal, I can't remember, or it could have been British uh sports journal. I was movement is medicine, and just hearing that term just can sometimes help people think, all right, if I can move a little bit more today than I did yesterday, or move a bit more tomorrow than I did today, then I've started. I'm starting sort of making changes, however small they may be.
SPEAKER_02:It's extraordinary how the body responds to that. One of the things that happened to me when I got this professor job was I had to travel up to I don't live near Newcastle, so I had to go up there every other week. And before I went, there's a hill behind Oz that used to take me about an hour to walk up the top and round. And just before we went, I went up with a youngster who forced me to go faster and I thought I was going to die. And I just about managed to do it in 45 minutes. And then I go off to a university that has four campuses, and I'm because bosses all uh are on sort of spokes, you know, it's it's quicker to walk. So I walked everywhere between all of these different departments. And I came back at Christmas and I could walk it in forty-five minutes without breaking a sweat. And you go, What happened here? And the body goes, Oh, you want to do that, do you? And responded to that in the space of two months. It was extraordinary.
SPEAKER_00:So you didn't even train for it. It just happened. Your body just responded to it.
SPEAKER_02:It was just I was walking, and because I'm not very good at allowing enough time to get from A to B, I end up walking faster than I needed to. Um so I get some good cardiorespiratory. So I have no problem getting my moderate to vigorous physical activity as in cardiorespiratory challenge, which is something that you need. You need essentially 150 minutes a week, two and a half hours a week, of in total, of not less than ten minutes at a time, of raising your heart level. If you raise it a lot, so uh if you raise it a little so you can't sing, that's called moderate activity. If you can't really hold a conversation, that's vigorous physical activity, those minutes count as two. It's ever so easy to get that. But the difference that that makes, both to your fitness and general health, but also the risk of so many different things, whether it's cancer, whether it's prostate, breast cancer, dementia, all sorts of other things, those risks are lower if you do that. So that's another really important thing to consider.
SPEAKER_00:And presumably the more physically active you are in some ways, the more socially active. It can also then lead to more social activity because you're often doing it with someone else or in a group or in attending a group. And we know that there's a lot of evidence around the negative impact of being socially isolated. And that, you know, part of that physical side of things is going to encourage you to what should be social as well, which I think is important. Okay, we we've partly touched on this as well. Changing attitudes to what we are capable of as we age is critical to the uptake of healthy aging strategies. You'll be aware that IMLMA has, with funding from the Australian Department of Health and Age, can uh develop LiverMap, which is a digital healthy aging platform targeted at older Australians. And that gives them access to information, local activities, down to their postcode that supports re-enablement. We've got exercise and strengths programmes, supports prevention social groups and low-risk AT. And so far, our campaigns have reached more than five million people. And I know you've talked before about the need to have more public awareness campaigns to spread the message around healthy aging. And Hansel, how valuable do you feel like providing access to this sort of information that's on LiveApp around healthy aging and what kind of what you can do to actually help yourself and take control of how you age? How important do you think that is in a public sphere?
SPEAKER_02:Because most of what most of us think about aging, particularly healthy aging, is evidentially wrong. It's really important to have a place where you can go and learn the facts. The internet, if you're discerning and you know what you're looking for, is also a good place to go and find things. But actually curated, carefully curated information is probably the best place to start. So at least you develop that sort of critical thinking about what people are saying before you go off and search for your own things. So I think having a a place where you know you can trust this information, it's been carefully developed, robustly reviewed, and all of that kind of stuff, that's it's vital that we we point people to that kind of stuff so that they can learn what they need to so that they can kind of have a better aging experience. I mean that's ultimately what this is about is if you choose to age badly because you know what you need to do and you choose not to do it, that's your choice. I'm okay with that. It wouldn't be my choice, but I'm okay with that. But most people are not choosing to age badly. It's done out of lack of knowledge. So a place where you can go, where it's trustworthy knowledge is just so, so important. And you can engage as much or as little. The nice thing about that sort of digital kind of means is that you know if you're bored or you don't nobody's in your face. You know, you it's it you get as much as you ask for. And if you do need to talk to somebody, because actually you still don't understand something, then there's somebody there at the end of the phone that will talk to you. So you you can push further, but it's in in your control, and I think that's really important.
SPEAKER_00:Yeah, no, I agree. And I I think you're you I'm glad you've pointed out the fact that we you know we do have people that someone can ring and talk to that's not utterly reliant on them having really good digital skills necessarily, can ring up and talk to us as well. We've also sort of here at ILMA developed something called Keep Able, which is a wellness and reenablement information hub, and it's really just targeted at building the knowledge of age and community care workforce on what reenablement is and and how important it is. How important do you think it is to develop the understanding and knowledge of community care organizations to better understand how they could deliver reablement? And I know you've worked with some home care organizations and you mentioned that before. So I'm interested sort of what the knowledge is that you've seen in community care organizations and how important it is to actually provide information so so the workforce can work in a reablement way.
SPEAKER_02:Obviously, I think it's uh very important, but I think it's very important because we we need to recalibrate thinking around care. So people that go into formal care, providing formal care, um and actually even people that do it the friends and family. They're not educated around aging and reablement and things like that. And the problem is there are things that you need to understand and and ways you need to understand about what's going on with somebody and how they react. So we were at a conference a while back now and there was a social media person there and She'd heard me say that premature care is disabling. She looked at her partner and said, You know, every time your dad says, Make us a cup of tea, will you? We went and made him a cup of tea. And I think he's saying that's a bad idea. And I said, Yes, I was. So actually what they did was turned it round and said, Why don't you make a cup of tea this time? And we know you like going down to the park, so we'll go with you afterwards. And she said it transformed him because he went from just depending on us to do things because it was easy to making more of his ability. And the next thing he's flying halfway around the world to visit friends. And he'd just been sat in a chair at home. So understanding that everybody's different. So the the skill of a carer is understanding the person that they're caring for and wanting them to make the most of their ability and being there to help them do that and to back off. It's not like we're shorter people to care for. Your job's not going away. But it's important to know how to sort of not if if you do more than somebody needs you to do, they become dependent on you. And that's called disabling, not enabling. And we don't want people to go down that. But that's easy to say in a sentence like this. And actually, it's there's much more detail to learn as you know how you motivate different people or And actually it's important that that they learn that, they learn where they shouldn't go, they learn what people can do, how people respond to challenge, when to use assistive technology instead of exercise. There'll always be times for that. Everybody ultimately will probably end up using some kind of assistive technology. But to to understand their their client and understand how to help them make the most of their ability rather than do simple time and task. And we're trying to change that model and in fact starting to see a little bit of light at the end of the tunnel of that, where commissioners even are beginning to say, do you know what? Actually thinking about care differently is a reabling workforce that does things for people that they can't do for themselves, rather than does everything that they are funded to deliver sort of thing.
SPEAKER_00:Yes. Out of interest, I mean with the work that you've done with the life curve and it and such like, how do you think that could support reablement in a community care organization? Have you got any thoughts around that? Just as a visual tool from a life curve perspective, but also the system that sits behind it.
SPEAKER_02:Yeah, so the one of the biggest advantages is of, you know, people will argue about whether everybody takes these exact trajectories and you know, all this kind of stuff. But when you see you see a list of things and you see what it will look like if you declined ultimately down to the bottom of that. And people, when asked years ago in a survey, how they felt about said they'd rather die than not be able to do those things, but they don't know what to do. And so showing people that there is a an approach and a methodology that allows them to make the most of their abilities subject to the choices that they're able and willing to make is just you go, oh gosh, it can be different. That's fantastic. And once people believe that, then they often have a very different trajectory. When you understand that you could it could be different, now where do you go to understand the detail of that? Because wanting to be able to walk 400 yards again doesn't mean you should just go out unaided and bomb off down the road, because you'll probably won't be a good experience and is not necessarily a safe thing to do. So you can't just suddenly change. So you need what do you do? Well, you might use the walking stick. That doesn't mean you have to use a walking stick forever. It just means that at the moment you might need a walking stick to be safe. So go use that, and then as you build core muscles, which might be the simple exercises. I know this sounds sad, but I brush my teeth standing on one leg every day just because it maintains a little bit of balance training. Um close your eyes and try and do it. That's really hard. So it's really important, I think, that getting access to that really expert knowledge about what do I do and what do I do now, and then also being able to see my improvement. I mean it's very exciting to look back and go, do you know what? Three weeks ago I couldn't do this, and now I can. And it can be as little as that. I mean, it's probably more likely six weeks for most older people, but even so, that's not very long to find that you can do something that you couldn't do. No, you can now do it.
SPEAKER_00:And it's something that, say, say, community aircraft organisations with staff can actually support someone and motivate someone to be able to do those things. Fantastic. So, Peter, just to sort of to summarise, we know that the vast majority of people as they age want to stay in their own homes, live as independently as possible, be connected with family, friends and community, and have a good quality of life well into their advanced years. What in your opinion are the top three things we need to be doing at a societal and individual level to enable this to happen? That's a big ask, a big question. W what what do you think? What would you consider to be the top three things that we need to do?
SPEAKER_02:I think number one is to both tell people and show people it can be different. So we need to publicize, to promote those stories, those people that have actually turned things round and had a different trajectory as a result of it. They're usually very happy to tell you what's happened to them when they're because people get very excited when they can do things that they thought they'd never be able to do again. Um so those stories are really important. And and then I think also showing people that for a lot of people, exercise is something certainly exercise in the gym, it would just be their worst nightmare. And you don't have to go in a gym. Some people make that choice, most people don't. But to show them that there are things that you can do and and and understand and hear stories about people who've done things. And the mantra I always try to use is help people find something that they like to do that includes what they need to do. And that means looking at stories, seeing what other people do, and you go, ooh, I like that. I mean when somebody told me they did stand-up peddleboarding for the over 85s, well, I'm not over 85 yet, but you go, you just go, Wow, I'd love to do that. And there's really I mean, other than the Arctic where you hit the ice rather than water, you know, there's not many places you couldn't do stand-up paddleboarding with the right gear. So the there's lots of things that you could do. And if you go, well, you know, I can't do it now, well, if you're willing to work at it and then start easy. And th there are different things for different people. And I know people who dance. It just ask my family whether it's a good idea if I dance. I mean, uh there just is you know, uh there are lots of things I can't do, but that's top of the list. It's just a really bad idea. So find those things, and that means explaining to people the variety of stuff that's out there and how it might be impacting them. So it can be different. Let's hear some of the stories. I'm inspired by a chap personally who took up marathon running at 85 by accident. And you go, really? How do you deal with how do you do that by accident?
SPEAKER_00:Yes.
SPEAKER_02:Um, because he thought he was signing up for a 26k, not a 26 miles. Right. Big difference.
SPEAKER_01:Yes.
SPEAKER_02:But he trained anyway and did 40 marathons till he was 104. He's now 111 and runs up a hill in Scotland every week. He's a a real inspiration um for me, because you go, well, if he can be doing that at 85, I might not be as good as him, but I've got a good chance, so I'll work at it. And he's just finding those things. So telling the stories of people who are not the the people who are aging well who are lifting 200 kilos or something. I mean, th they're outliers, but they're and so's my runner. But the people that's normal people that are doing things, you go, Oh, I'd love to have a go at that. I think that kind of stuff is just really important. So seeing the wealth of what's out there and then making sure that people understand some of the other things that you know you can go out and do these things, but if you do everything on your own and you feel lonely, that's not good for you. So connect with people, you know, not everybody's social to the same level, but that could just be a mate or two, or it could be a whole crowd. That there's not a right and wrong, it's how you respond to it. So I think that range of things and understanding you do need what you eat and also getting good sleep. Your body's very good at building muscle while you're asleep if you give it stuff to build it with. And lettuce is not enough.
SPEAKER_00:And lettuce is not enough. And I think the other thing is um I know a lot of people are very uh scared of getting dementia or anything like that, and that we know also that activity and social engagement and being with others and sleeping well all is partly protective against that as well. Absolutely. Yeah, yeah. And sort of like, you know, e exercise and activity and social activity for the brain matters as much.
SPEAKER_02:Yes. For every flight of stairs you climb daily, your brain is just over half a year physiologically younger. And that's just blood flow going around. So I climb dozens and dozens of flights of stairs daily deliberately, because it just all sorts of exercises, all sorts of implications on your body. So it's really important. The cardiorespiratory stuff is really important, whether that's tennis maybe in your case, or uh running in my case, or whatever, it doesn't matter what you do, but that raised heart level. Somebody asked me once, I sat I was sat in a group of blokes who, to be honest, some of them really weren't aged, they were half my age, probably, and not aging very well. And the boss in this group said, Peter, you've got one minute to tell this group of people one thing that they could do that would mean they would age better. And I said, Do 150 minutes of cardiorespiratory exercise, which is just your heart rate and breathing rate raised for a minimum of ten minutes at a time. If you look at that, we followed, I think something like 40 million people for 25 years in terms of their records, and there is a study of all the studies of those people, and you look at it and you go risk of cancer dramatically reduced, like 40% lower. Now that doesn't mean you won't get it, it just means you're much less likely to get it. And everything that you don't want to get is lower. Breast cancer, prostate cancer, all sorts of other kinds of things. And actually, just to pick a simple one that you could do that has a really good there's some really good evidence around it recently. You you mentioned it earlier is getting up from a chair. Count how many times put your hands over your chest. Count how many times you can get up from the chair in 30 seconds, standing up fully, safely, chair that's 17 inches high, whatever that is in centimetres. Why? Because actually the number that you do is predictive of how you'll look at 95 if you get there. Because actually it's yes, your upper body muscles matter, your balance matters, you although you use balance to get up from a chair, your hands matter. We always used to measure hand grip strength, but it turns out that your lower body strength is the biggest predictor. And you can just measure how quickly not how quickly you've got 30 seconds, how many times you can do that. How many times? That's predictive. So that one thing is showing what's going to happen to you later on. And so work on that, if nothing else.
SPEAKER_00:And I think if anything, if listeners take away the the uh going up and down the stairs and the impact on on your brain, I think that's incredible. That one. That's a real stat to remember.
SPEAKER_02:And it's the same with years in education. Every year in education, your brain's 0.95 of a year younger. And just because you're not a youngster doesn't mean you can't we we had an 85-year-old while I was at up at the university, did a PhD. It's important to keep learning.
SPEAKER_00:No, it's important to keep learning. Well, I think we've come probably come to the end of our discussion today. So I'd very much like to thank Professor Peter Gore, which for what I hope you've found a very interesting conversation. The podcast is brought to you by an IMLM. My name's Hilary McConnell, and it's been a pleasure bringing this podcast to you. Um for those of you who want more information about ILM and our work, please do visit www.imlastralia.org. And if you want to know a little bit more about LIVA and the live colours, then please visit live up.org.au or give us a call on one eight hundred nine five one nine seven one. Thank you very much for listening and thank you to Peter.
unknown:Thank you.
