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Posted: February 15, 2005

Professional Caregiving

Dying Young as Late as Possible

Dr. David Snowden has brought a wealth of knowledge based in research to develop ways we can help our clients and caregivers understand the steps they can take to lead longer, healthier and more meaningful lives.

Dr. Snowden, professor of neurology and the director of the Nun Study at the University of Kentucky Medical Center, addressed a group of aging professionals at Washington University in the spring of this year (that is, professionals working with the elderly, and yes, we are also aging!).He was speaking from the lessons learned detailed in his book Aging with Grace: What the Nun Study Teaches Us about Leading Longer, Healthier and more Meaningful Lives. You can also go to for more information on this intriguing research project.

In 1986, a pilot study began in Minnesota, in which causal scaffolding was used to break down the quality of life for aged nuns. What in fact has their lifestyle, environment and health demonstrated when exploring the impact of dementia and general health, from the early to middle then late stages of life.

They examined nurses born before 1916, who in 1991 would have been 75 or older. This population was unique in that the life experiences enabled many co-existing factors or variables to be more easily controlled, (such as socio-economic factors, meals, activity levels, living arrangements, unmarried status to name a few) than with a mix of socio-economic, life-choice disparate groups. ?A population of Roman Catholic sisters (nuns) were divided into a high education group (i.e. at least a Bachelor's degree) and a low education group (i.e. less than a Bachelor's degree). Prevalence data on 132, 75-94 year old, sisters indicated that the high-educated had better mobility and hand coordination, stronger handgrip, better distant and near visual acuity, and fewer mental impairments than the low-educated group.? This has imparted to the field of aging studies, the knowledge that with greater stimulation of the brain, as comes from higher education, one?s aging can be positively affected.

The very unique and interesting component of this study used autobiographical writings of the nuns in their younger years to determine complexity of thought processes or idea density. These, when correlated with the prevalence of dementia in this same group, demonstrated that those with a higher level of thought process, extended the average age of dementia diagnosis. Thus, the statement, ?if you don?t use it, you lose it,? became associated with dementia-focused outcomes. To be more exact, the findings demonstrated that the lower 25% of idea density has a three-times prevalence of Alzheimer?s disease and overall mortality.

Additional early life emotional expression and the use of emotional words (love, happy, etc.) had comparable outcomes. The lower positive emotional expressions had a 2.5 fold risk on mortality. There was a 10 year difference in longevity between the low and high average. Findings showed that the women with the highest positive emotional expression, who also had stress reactions, showed they came back to baseline more quickly after experiencing stress than those who had lower positive emotional expression in the writing of their early years.

Even more astounding was the finding that if you had all three risk factors -- lower education (no college), low emotional expression and low idea complexity ?there was a mortality rate that was five times higher!

These findings direct us to an intervention model with younger and older generations that is environmental in nature. It also may prove to be as protective of cognitive health and long life as any prescription or health regimen. By leveraging higher education, greater emotional expression and ways to engage our minds to deepen the idea complexity ? in essence, the depth and breadth of thought ? we end up with goals all of us as should hold as life-long goals.

This study supports that.

Dr. Snowdon wrapped up his lecture by speaking about our industry?s dual dilemma: How to help aging individuals maintain the highest quality of life they can hope for, and when and if disabling conditions challenge this effort, how can we make life for them as meaningful as possible? Dying young as late as possible is his mantra. Think about it. Helping people maintain their energy and general health, increase interactions with others and emphasize mental stimulation with new ideas and activities are the backbone of any life-long health regimen.


Sylvia Nissenboim is a licensed clinical social worker and who has been working in the field of adult day services in the St. Louis area. She is the director of four adult care and enrichment centers for the American Red Cross and also operates a personal and professional coaching firm, LifeWork Transitions, specializing in caregiving concerns, adult day care management and other aging services, such as virtual coaching and family care giving support groups. She co-authored The Positive Interactions Program, is a national speaker, and has served as president of the Missouri Adult Day Care Association and as a member of the Missouri Governor's Advisory Council on Aging..

© 2005 Pederson Publishing, Inc. All Rights Reserved.
Commercial use, redistribution or other forms of reuse of this information is strictly prohibited without the prior written permission of Pederson Publishing.

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