By Joseph C. Piscatella
“If I’d known I was going to live this long, I would have taken better care of myself.”
— George Burns
Here’s a radical thought to share with your patients: longevity, the number of years you live, may not be the most important question to be addressed as you age. Rather, what is more significant is how many of those years are spent in good health. That’s known as health span. There is a difference. Longevity is how long you are technically alive, and health span is the length of time you are truly healthy and thriving, living the longest possible life with the fewest years of disability. Health span means preserving the good qualities of younger years, even as the clock hands turn, the planets revolve and the calendar flips. It means, quite simply, longevity plus vitality.
Let’s consider two men who each live to age 84. They both have exceeded their statistical longevity for American males. But while one man spends the last 20 years of his life riding in a golf cart, playing rounds with friends, the other spends those same years in a wheelchair watching daytime television. While both have achieved the same statistical longevity, only one was able to squeeze down the time between the onset of disability and the moment of death. He did that by lengthening his health span before the onset of disability. By doing so, he maximized the years of healthy, independent living. In short, he stayed younger, longer.
Dr. David Katz, director of the Yale University Prevention Research Center, puts it well: “Longevity is only about the years in your life, not about the life in your years. A long life with a high burden of chronic disease, such as heart disease, simply means more time living with illness and disability.”
Please don’t get me wrong. I’m as much interested in a long life as the next person. In fact, in a recent survey the majority of Americans said they would like to live to 100, but only if health is good enough to provide a high quality of life. I feel the same way. The last thing I’d want to do is just extend longevity without extending health span. Living a long life with compromised health – think stroke or Alzheimer’s disease – is not an attractive outcome. The critical issue, then, is how to maximize your health span, experience successful aging and hold on to good health for as long as possible.
How, then, do you extend health span? The fact is that we’ve known the answer for decades: avoid chronic diseases. For years we have known that the root causes of many chronic diseases are lifestyle habits such as a poor diet, lack of exercise, chronic stress, smoking and a pessimistic attitude. But the opposite is also true. When negative lifestyle habits are modified to be healthier, they work in concert to extend longevity and health span. It is estimated that healthy lifestyle habits could prevent 80 percent of chronic disease in older Americans.
Patients need to understand that positive oral health is part of the health span equation. In truth, many patients are not aware of the oral-systemic link, the connection between poor oral health and a number of diseases and debilitating conditions such as diabetes, Alzheimer’s, Metabolic Syndrome, obesity, pneumonia, cancer, stroke and the nation’s #1 killer, heart disease. They often compartmentalize oral health as being different and distinct from overall health and well-being. The health status of their teeth, gums and mouth are seen as being isolated from their cholesterol, BMI, fitness level and overall health. But it is not. Consider this:
- Gum disease can produce a rise in blood sugar that can contribute to diabetes.
- Tooth and gum disease has been linked to a rise in cancer risk.
- Increased bacteria from gum disease can move from the upper throat to the lower respiratory tract and result in COPD and pneumonia.
- And finally, poor oral health can produce inflammation that dramatically increases the risk of heart attack.
Dental health professionals have a great opportunity to set the record straight with patients by educating them not only on the link between good oral health and a lower risk of chronic disease, but about the connection between positive oral health and extended health span.
Joe Piscatella knows the science of healthy living, but he understands the practical aspect as well. At age 32, he went through coronary bypass surgery. The prognosis was not good (one doctor predicted he would not live to age 40.) But he put his effort into developing healthy lifestyle habits and it has worked. He has celebrated the 38th anniversary of that surgery, making him a wonderful example of the effectiveness of healthy lifestyle habits. TIME magazine calls him “a positive force for healthy changes.”