Selasa, 19 November 2013

The Importance of Independence (and Interdependence)

by Baxter
Bee & Flower by Melina Meza
Yesterday Nina dove into three key aspects of Healthy Aging, and I wanted to pick up the ball on the middle concept, that of maintaining “independence.” As Nina mentioned in her post What is Healthy Aging, Anyway?, one goal of aging well is to “continue to live independently and care for ourselves as long as possible. And Nina outlined many of the independent skills we would ideally love to preserve as time goes on: “the basic daily self care activities, such as dressing, going to the toilet, getting up and down from a chair, doing light housework, and so on as well as the ability to continue to do the activities we love.” And indeed, a regular asana practice that is appropriate for our stage of life, as well as our unique health and physical challenges, will likely keep us on track in maintaining our independence. 

As I have mentioned in previous posts, loss of independence in my patients can be one of the most dramatic and potentially devastating changes that they will face in their lifetime. The more significant the loss of function, whether physical, mental or emotional, the more likely the individual will require intensive help from others to deal with the daily issues of life, possibly requiring in-home or nursing home care to stay safe and alive while recovering or adjusting to their new reality. Anything we can do to preserve independence is really crucial the older we get.  As we discussed a few months back (see From Independence to True Longevity), the simple ability to go from standing to sitting on the floor and back to standing is also a predictor of mortality, or the likelihood of death. The study done in Brazil noted that the worse you scored on the rating scale of what we call “transfer ability,” the more likely you were to die in the six years the study lasted.

So lately in my teaching, I have been emphasizing yoga postures that contribute to the ability to get up and down from the floor with greater strength, balance and ease. Variations of Powerful Pose (Utkatasana) seem to be popping up in just about every class I teach. In my Back Care class, we even practice transferring from standing to sitting in a chair and back to standing, keeping the feet symmetric, finding the safest alignment of the spine and pelvis, and maintaining as much control of the speed of descent and ascent when sitting and standing. And because of the high rates of osteoporosis in both women and men (50% of women over 65 and 25% of men over 65), that kind of control may translate into fewer falls for those with or without OP, and fewer fractures. If you don’t fracture your hip, you are much more likely to be around in two years than if you do! 

The other place were we want to be independent is on the mental level. Maintaining mental agility and learning new tasks as we age is going to also contribute to our independence. As an online educational text from the Cleveland Clinic noted:

“Decline in cognitive abilities contributes to decline in functional independence. With normal aging, processing speed of the brain declines and recall time increases.”


The researcher pointed out that western medicine deals with this not in preventative way, but by treating conditions like dementia after they arise in a patient. As they clearly note : “Current research has been focused on treating the consequences of dementia, but no treatment modality is currently available to reverse the process or halt its progression.”

Could yoga be that modality? Something as accepted and commonplace in our culture as using a computer or smart phone can be daunting to use or learn for some as they age, but utilizing the practices of yoga that cultivate mental and emotional calmness and lower our perceived stress levels can contribute to better and faster learning skills. And a recent study has showed that meditation practice may actually strengthen the brain (see Meditation and Brain Strength). Researchers found that long-term meditators have larger amounts of gyrification (“folding” of the cortex, which may allow the brain to process information faster) than people who do not meditate.

And the ability to maintain emotional equilibrium that Nina mentioned in relation to “Equanimity” yesterday, I believe, will also contribute to overall independence. It is also important to stress that when I talk about independence, I don’t necessarily mean living alone as we age.  Studies show that men live longer when married versus single, and women tend to live longer if they have a strong support community versus being in or feeling like they are in isolation. So we are talking about having a good degree of personal independence while acknowledging the importance of interdependence and community. In fact, a 2005 study done in Israel, looked at the factors that influenced genetics in contributing to longevity in adults from 70-82 years of age.  They found that “Increased physical and social activity is an important tool to lengthen the span of robust function.” So the group dynamics and sense of community of our modern yoga classes could actually be another way to feed that social factor that can also contribute to maintaining independence as we age.
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