【正文】 。 We don’t not stop working because we are old。 ? Kujala, 1998, Finnish Twin Cohort, JAMA: leisuretime physical activity associated with reduced mortality, even after geic and familial factors accounted for ? Kujala, 1998, Finnish Twin Cohort, JAMA:甚至在可以解釋的基因和家族因素后， ? 業(yè)余時間的體力活動伴隨死亡率下降 Healthy Aging健康地老齡化 Myers, 2020, NEJM: After adjustment for age, treadmill peak exercise capacity was the strongest predictor of mortality in normal subjects and those with cardiovascular disease. 在年齡調(diào)節(jié)后，平板高峰運(yùn)動能力是正常個體和有心臟病者最強(qiáng)的死亡預(yù)測因素。 Healthy Aging健康地老齡化 Numerous Studies Demonstrate Benefits of Exercise in Reduction of AllCause Mortality 大量的研究顯示鍛煉在減少全因死亡率的益處 ? Kaplan, 1987, Alameda County Study : increased risk of death in persons 70 who reported low levels of activity ? Kaplan, 1987, Alameda 縣研究：低水平活動量增加年齡 70 的人的死亡風(fēng)險 ? Blair, 1989, JAMA : 10,224 men, 3,120 women. Allcause mortality decreased across quintiles of treadmilldetermined physical fitness. ? Blair, 1989, JAMA : 10,224 男士 , 3,120 女士。 K. BrummelSmith, . 2020. Optimal Aging, Part I: Demographics and Definitions. Annals of Longterm Care. 15(11).: 2628 Healthy Aging健康地老齡化 New England Centenarian Study Thomas T. Perls, MD MPH, Margery Silver EdD 新英格蘭百歲老人研究 Thomas T. Perls, MD MPH, Margery Silver EdD ? 169 centenarians in 8 munities near Boston ? 居住在靠波士頓的 18個社區(qū)的 169個百歲老人 ? 85% female ? 85%是女性 ? 15% living independently, 35% with family, 50% in nursing homes ? 15%獨(dú)立生活、 35%與家庭、 50%在護(hù)理院 ? 25% free of cognitive disorders ? 25%無認(rèn)知障礙 ? 4/5 male centenarians have extremely good mental and physical health ? 4/5男性百歲老人擁有極好的精神和身體健康 ? Female centenarians: wide spectrum of mental and physical health 女性百歲老人：寬廣的精神和身體健康譜 Healthy Aging健康地老齡化 Characteristics of Centenarians : NECS 百歲老人的特點(diǎn)： ? 95% physically healthy, cognitively independent into 90s ? 95%身體健康、認(rèn)知獨(dú)立進(jìn)入 90歲 ? Significantly lower scores for “neuroticism” and “negative emotionality”。 and active engagement with life. 沒有疾病和殘疾 。 K. BrummelSmith, . 2020. Optimal Aging, Part I: Demographics and Definitions. Annals of Longterm Care. 15(11).: 2628 Healthy Aging:健康地老齡化 Successful成功的 Absence of disease and disability。 ? Use both free weights and weight machines, and do strength training 23 times per week. ? 用自由重物也用重物機(jī)器，并且每周 23次重物訓(xùn)練。 ? Stand up and sit down on chairs using one leg (with hand support if needed). ? 用一條腿站立或坐在椅子上（如果需要用手支持 ） K. BrummelSmith, . 2020. Optimal Aging, Part II: EvidenceBased Practical Steps to Achieve it. Annals of Longterm Care. 15(12).: 3239. Healthy Aging:健康地老齡化 Exercise to Improve Strength 鍛煉以改善力量 ? Lift small weights (one can of peas) in a plastic shopping bag, 10 repetitions on each side (vary the muscle groups) ? 拎塑料購物袋中的小重物（一罐豌豆），每邊重復(fù) 10次（變化肌肉群） ? Bag handles with a can inside can be placed over feet to exercise the leg muscles. ? 內(nèi)中有罐的袋子提手可以放在腳上以鍛煉腿的肌肉群。 ? While standing in line or cooking, stand on one leg (or with feet in tandem). ? 當(dāng)站隊(duì)和烹飪時，用一條腿站立（或兩腳前后站立）。 ? Park a long distance from the main door when shopping. ? 購物時在離大門遠(yuǎn)的距離停車。 ? Don’t use remote control devices. ? 不要使用遙控裝置。 ? Never use an elevator or escalator when stairs are available. ? 如有樓梯時，從來不用電梯或自動扶梯。 ? Get adequate sleep. ? 獲得充足的睡眠。 ? Exercise regularly. ? 有規(guī)律地鍛煉。 ? Engage in mentally stimulating activities. ? 參與用腦的刺激性活動。 ? Take a daily multivitamin. ? 攝取日常的多種維生素。 ? Eat plenty of fruits and vegetables. ? 吃大量水果和蔬菜。 ? Substitute wholegrain carbohydrates for refinedgrain carbohydrates. 用完整谷類碳水化合物代替精細(xì)谷類化合物。 從 3555她需要好的人格； and from 55 on she needs cash.” 從 55開始她需要現(xiàn)金。 “從出生到 18歲，女孩子需要好的父母； from 1835 she needs good looks。 underproduction, or decreased activity of GH/insulin signaling pathway, increases longevity. 近來的動物研究：生長激素過度產(chǎn)生縮短壽命；生產(chǎn)不足或減弱 人生長激素或胰島素信號通路的活性，增加壽命。 ? Subsequent studies have investigated potential benefits of rhGH in malnourished, frail, and critically ill older persons. ? 后來的研究調(diào)查了 rh 生長激素對營養(yǎng)不良、虛弱及重病老年病人的潛在好處。 16. ? Rudman 等， 人生長激素對大于 60歲男士的作用， NEJM 323（ 1990）； 16。 Claims of this kind have been made for thousands of years, and they are as false today as they were in the past.” 這種主張已有數(shù)千年，今天仍然和過去一樣是錯誤的。 Vol. 59A, No. 6, 568572. Healthy Aging: Theoretical Pathways to Increase in Longevity and Delay in Dysfunction健康地老齡化：增加長壽和延緩機(jī)能不良的理論途徑 ? Preventing disease ? 預(yù)防疾病 ? Control of free radical damage ? 控制自由基的損傷 ? Delay of immunosenescence ? 延緩免疫衰老 ? Caloric restriction ? 控制熱量 ? Stem cells and cell replacement ? 干細(xì)胞和細(xì)胞移植 ? Gene regulation ? 基因調(diào)節(jié) Healthy Aging健康地老齡化 What should we be telling our patients? 我們應(yīng)該告訴病人什么？ Is There An “AntiAging” Medicine? 存在“抗衰老”藥嗎？ Healthy Aging 健康地老齡化 ? Luigi Cornaro, 1550: extreme longevity possible by maintaining reserves of vital energy through