“You can be aged at 50 and young at 90”: the main geriatrician of the Ministry of Health about longevity and causes of male mortality
Life expectancy in Russia is growing - now it is 72.9 years, and some regions have entered the "80+ club", said the chief geriatrician of the Russian Ministry of Health, Olga Tkachyova, in an interview with RT. According to her, the key factor of longevity is not genes and not ecology, but the attitude of a person towards his health. The specialist explained why the problem of male mortality is still acute in Russia, how scientists are going to fight the aging process and how long people of the next generations will live.
- How has life expectancy changed in Russia lately?
- It, as well as all over the world, is growing: this is a global trend - and we are not an exception. If last year we have an expected life expectancy of 72.7 years, this year it is already 72.9 years. For comparison: in the mid-1990s, the figure for Russia was 64-65 years. Moreover, in our country there are some zones that are included in or belong to the “club 80+”, for example, Ingushetia, Moscow, St. Petersburg. I hope that there will be more such regions of long-livers.
- What affects life expectancy in the regions? Everything is more or less clear with the Caucasus, but the same Moscow and St. Petersburg are not the most prosperous cities in terms of ecology or bad habits of local residents.
- Life expectancy is determined by many processes, and not only by ecology. Most strongly affect how many years a person will live, the so-called behavioral risk factors.
If ecology affects life expectancy by 10%, then a person’s attitude to his health is almost 50%.
And the fact that now a healthy lifestyle comes into vogue - regular exercise, avoiding the use of tobacco and alcohol - is of paramount importance. Of course, the level of health care and the comfort of life is important, but the key influence is on people's behavior.
- If you take the situation in the world, is Japan still considered the record holder for long-livers?
- There are several "blue zones" on the planet, where people live for a long time. This is Japan (in particular, Okinawa), Costa Rica, one of the territories of California, Sardinia. At the same time, it is not completely clear why there are so many long-livers in these zones. Scientists are now trying to figure out the cause, because they found a genetic background only in Okinawa.
- Who is now called older man?
- According to the classification of the World Health Organization, this category includes people over 60 years old. Those who are over 75 years old are already in the age group. But in fact, you can be aged at 50 and young at 90.
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- What determines how much a person is physically and psychologically young?
- The current 50-year-olds are approximately 20 years in fact younger than their peers in the mid-twentieth century. If earlier the age of 50 years was considered to be the beginning of aging, entering the plateau, now it is a zone where there is another 20-25 years ahead.
Moreover, the concepts of “older” and “younger” refer not only to some social things, but also to biological ones. Studies have shown that the physical and mental activity of people is now much more preserved and less quenched than 50 years ago. The more information the brain consumes, the slower a person ages.
So if people continue to learn something, use gadgets, communicate with other people, travel and learn new things, they will remain younger than their actual age.
- What factors make the life of Russians shorter?
- In our country, the most important problem is the high mortality of men at young and middle age, the peak of which falls on 25-45 years. The main causes are cardiovascular diseases. The risk factors here have long been well known. And if a person himself does not understand that he must control his weight, blood pressure, engage in physical activity, do so that he does not develop diabetes, eat right, reduce salt in the diet and increase the proportion of vegetables with fruits, then it is unlikely that high technology in medicine can make a difference. The use of tobacco and alcohol is also of paramount importance among the causes of male mortality.
- Tkachev on the causes of male mortality
- At the same time, probably, everyone will have an example of a person who drank, smoked and lived to be a hundred years old.
- Of course, genetics makes a significant contribution to life expectancy - about 20%. A good genetic code gives grounds for optimism even to those who have some bad habits.
But I think that if, for example, Churchill led a more active and healthy lifestyle, he would be not just a long-liver, but a super-long-liver.
We are all different, we have different genetics. Therefore, to determine the life expectancy of people in the future will be precisely preventive technologies, that is, prevention, not treatment of diseases.
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- Is it possible to make any predictions about how many years people will live next generations?
- Worldwide life expectancy is increasing. But the maximum has stabilized and lately almost does not change, fluctuates about 115 years. This is the age that we and the next generation can count on.
As for the forecasts of the development of medicine, we are waiting for new technologies, primarily related to genetics, epigenetics, gene regulation. Today, more than 500 genes responsible for aging have been identified. And I think that this particular area of research is very promising.
- Are there any predictions about future diseases?
- To some extent, we can present this picture now. First, habitual diseases used to appear in 50-60-year-old people, and now they are found in people at the age of 80, at the age of 90, and at the same time they are atypical. In connection with this, it is necessary to treat them completely differently, and, by the way, the prognosis of the same operation will not always be worse.
Secondly, it is now possible to distinguish six whales, which are already becoming epidemics. These are cardiovascular diseases that contribute to the mortality of approximately 50% of the elderly, oncological diseases (16% of them), diabetes, Alzheimer's disease, diseases of the musculoskeletal system, chronic obstructive bronchitis. Here are six major problems that we will soon feel as catastrophic, because with the aging of the population, these diseases are expected to grow.
- Tkacheva about future epidemics
- What can science answer to this?
- There is a view that these six diseases reflect one or another aging process and they have a common root. The main task of science is to find this root and to prevent not the disease itself, but aging, which manifests itself in the form of a disease. There are a lot of similar studies in the world today, including in Russia. For example, our scientist Alexey Olovnikov was the first to discover telomeres - the end sections of chromosomes, which allow us to determine how long a cell will live. Now a lot of work is being done at MSU: Academician Vladimir Skulachev, in particular, is developing drugs that affect the aging process.
- What is the state of health of the elderly now?
- Medical assistance to senior citizens is actively developing, because older people are being treated not only by geriatricians, but also by doctors of various specialties. As for geriatrics as a help system, we see significant dynamics. For example, almost 4 thousand geriatric beds have already been opened in the country, which is two times more than last year. Over 500 offices have been opened, over 900 doctors have geriatric certificates.
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We must understand that we will not see rapid growth in this area, because geriatrics is a complex specialty. It does not require expensive equipment, state-of-the-art technology and the investment of enormous money in diagnostic equipment. First of all, knowledge and skills are important here, and this, in turn, takes time. Nevertheless, I believe that by 2024 we will reach the target figures: about 2 thousand geriatricians, about 7 thousand geriatric beds.
- What is successful aging and are there successfully aging people in Russia?
- This is a completely new concept. We used to talk about healthy aging, that is, about physical and social health, financial well-being, and positive emotional state of a person.
Successful aging is not some kind of prosperous plateau, but the continuation of development, when a person has not just everything is good, but there is a sense of purpose, desire, he is engaged in creativity, education, moves somewhere permanently. In Russia, such people, of course, also exist, but for the time being it cannot be said that this is a mass story.
- How relevant is the problem of ageism in the world and in Russia now?
“Recently, they have begun to talk about this more often, because we have entered the demographic zone, when the elderly are no longer a minority.
The problem of ageism, that is, disregard for someone because of age, has always been. For example, they often say, they say, doctors believe that since an old man, then let him be ill - there is nothing to heal. But now this trend has decreased significantly: we operate on people in 80, 90 years and older. And the percentage of high-tech care that now turns out to be for older people in Russia is growing at times.
Strangely enough, older people themselves are most susceptible to ageism in Russia, which is confirmed by research. They say: “I have a pain, because I'm old. It is even inconvenient for doctors to deal with this, as it should be, I have no right to be healthy and happy. ” In Europe, such views are more evenly distributed between different ages. At the same time, young Russians, as it turned out, are much more loyal to aging than the old people themselves. Such a worldview must, of course, be changed. And I think that the next generation of older people will already be completely different - more incorporated into modern life.