- 10 months ago
In this episode of "The Future You," Dr. Linda Fried explains how loneliness and loss of purpose accelerate aging, and why generational connection boosts cognitive and physical health for everyone involved.
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00:00Another topic that you focused on earlier in your career, which again not many people were talking
00:04about, very popular now, is loneliness. Social engagement with your family, friends, community.
00:13When did you first start thinking about that as something that clinically physicians or you
00:18specifically should be aware of when dealing with patients? Welcome to The Future You, a new series
00:24by Men's Health where we talk to the leading experts in health and longevity to help you live
00:28longer and stronger. I'm your host, Rich Dormant. In this episode, we're talking with longevity
00:33expert Dr. Linda Freed about connection and purpose and the relationship with aging.
00:38So I was taught about loneliness and also the need to stay connected and engaged by my patients.
00:46About the same time, maybe a little after, I started being challenged by what I was seeing
00:52in my patients that looked to me to be frailty. That they were losing weight unintentionally,
01:01that they were a little weak, that they were slowing down with less activity and less energy.
01:11That was early frailty. But what I learned from my patients was that everybody, no matter what age
01:19they are, need several things. We all need to have a reason to get up in the morning.
01:25Purpose. Exactly. It doesn't matter if you're 15 or if you're 100. You have to have a reason to get up
01:33in the morning. And people who don't have that reason and don't have a place to go to, it was shown
01:40many years ago, as they get older, they get sick and die. Not the next day, but over time they're more likely
01:49to get sick and die. It's the most deep of human needs. The other deep human need
01:58in the doing of things is that human beings are, you talked about genes, human beings are genetically
02:05encoded to need social connection. Now my wonderful colleague, John Cassioppo, who founded the field of
02:14loneliness science, said, talked a lot about the evolutionary origins of why human beings would need
02:23that. Why should we care? And you know, the evidence is very strong that over human history,
02:31traveling together got more accomplished, more safely, more effectively than traveling alone.
02:39And that you, whether you're worrying about safety or you're worrying about producing the conditions for
02:48better lives, we need each other. And so we're genetically encoded as it turns out to need each
02:55other where we need to feel positive connection with another person, with many other people. And
03:03there, you know, if I was going to get technical, I'd say there are lots of different kinds of
03:08positive connections that have been characterized with people like you, with people not like you,
03:14people older than you, younger than you, but we need a whole, it's all good.
03:18Yeah. And we need something in it. We need to feel like we get positive meaning and that we're
03:26positively valued in that interaction. There are lots of interactions where you walk away wishing you
03:33hadn't had it, but that's not the connections that I'm talking about. And we need those positive
03:40connections, both to feel like others value us as a human being and that the connections are nurturing,
03:48but that we get pleasure and enjoyment. Tell me about the Experience Corps.
03:53My pleasure. Your pleasure, your pride, perhaps? It's one of them. Yeah, for sure. So I learned these
04:00issues from my patients because for many years I saw people in their sixties or seventies or eighties or older
04:07who had retired. And often what I saw was that, and I'll give you one example of a gentleman who I
04:17took care of, who was, he was a youngster. He was 67. He had retired eight weeks before as this, from being
04:26the CEO of a big corporation. And he was ill. He didn't know why he was ill. And he'd been to see a few
04:33other doctors who really didn't see anything. But in talking to him, it was very clear to me that he was
04:40feeling ill because he went from being on top of the world to being invisible as an older person walking
04:47around the streets. Nobody saw him and he had no reason to get up in the morning and no sense of what you
04:55said, Rich, which is meaning and purpose. And he felt like he was in free fall and he couldn't get his
05:03balance. And it really made him feel sick and he was getting sick. And I started out, I was very used
05:12to grading prescriptions for exercise because I have a bit of that background. So I wrote him a
05:18prescription, which I'd never written before to say, go and find, he didn't need a medicine. He
05:25needed to find something that mattered to him and do it. So I wrote him a prescription saying,
05:30please do that and find something that matters and do it and report back. So I realized it's not a
05:37characteristic prescription, but there was no medicine that would have solved this to my judgment.
05:44And he came back to me a couple of months later and he said, Dr. Fried, I went and volunteered
05:50in an organization I care about a lot. And they put me in a corner licking stamps
05:57because they decided I am an old, old volunteer. Nobody asked me about my background. Nobody asked
06:04me what I know. That's what they did. And he said, and I stopped going back because I have limited time
06:11on the earth and that's not how I want to use it. And I wasn't being valued in terms of what I bring to
06:17the table. So I started thinking about that. And then I had many other patients with similar needs.
06:26And what I learned was I, people kept coming back to me without being able to fill their prescription.
06:32And I realized that we have this really important, somewhat novel, really novel situation going on,
06:42which we need to develop new approaches to. We as a society have created long lives.
06:49They didn't just happen. We made investments over the last hundred years,
06:53years, which enabled us to live longer and longer. Sanitation, the ability to breathe clean air and
07:03have safe water, nutrition, the ability to be physically active, the prevention of and treatment
07:11of infectious diseases. More recently, the ability to prevent chronic diseases like heart disease and
07:18stroke. All of those things added up to living longer. But what we haven't done is build the next
07:27stage. This next century's task is to figure out how to live longer with meaning and purpose and the
07:35health that enables people to carry that out. That's the century's task is to add that to longer lives.
07:42And I realized for my patients, we were not prepared for this. So after thinking about a long time and
07:50getting frustrated, quite frankly, that my prescriptions couldn't be filled because I thought they could
07:58make a difference for people, that I decided I wanted to see if it was possible to demonstrate something
08:08I saw in my older patients, which science now supports. This is all a good news story,
08:18which is that as we get older, we actually cumulatively and not miraculously develop skills
08:27and abilities we never had when we were younger. And those skills and abilities are quite astounding.
08:33People, of course, we acquire a lot of knowledge and expertise that we didn't have when we were 15
08:40or 20 or even 25. And we don't lose it the day we retire. If we retire, we acquire the ability to
08:49evaluate that knowledge and think about when it needs to get used. We have a lifetime of problem solving,
08:55both on work-related tasks and on life-related tasks. And as people get older, they bring that all
09:02together and an ability to actually use that with some judgment about what really matters,
09:10because people really think about that a lot. And the ability to handle ambiguity and shades of gray
09:18and make hard decisions in the face of ambiguity. And then as we get older, we get two other attributes.
09:26People become more what scientists would call pro-social. They care more about doing good things for their
09:33neighbor, taking care of their grandkids, making a contribution to an organization they care about,
09:42and they become more generative. Now that's a fancy word for wanting to leave the future better than you
09:50found it and future generations better off. So think about that package. To me, when I realized that in
09:58my late 30s, it took my breath away that we have created a world of people getting to not just live
10:07longer lives, but accrue these capabilities. But every time I gave them a prescription to use them,
10:14they couldn't cash it in. There was nowhere to do it. So I decided I needed to at least try to see if it
10:24was possible to build a new social organization and new kind of social institution that could use these
10:31capabilities and demonstrate how profoundly valuable they could be both for the older person to be able
10:39to use them for things they cared about and for society, because these are assets we've never had
10:46before. And if we have 20% of the population with these generous and generative assets.
10:53And nowhere for them to use it.
10:55I know what, that's, we're leaving, we're, we're leaving a lot on the table.
10:59So I decided I would start with something I deeply care about, which might, this was in the late 80s,
11:07early 90s, that I thought also society might be able to value. And that was public education and
11:15whether our children in this country are succeeding in public education. And so I started learning a lot
11:21about public education and realized that if children are not succeeding by third grade, they're
11:26track to drop out later. And it seemed to me like an easy match in the public eye to place older adults
11:37in roles that supported the success of kids in public education. Fast forward many years of designing
11:45the program, implementing it, carrying it out, evaluating it. We, the design is that we place
11:54whole teams of older people. So they have friends, colleagues, and critical mass to raise up all
12:00kids in public elementary schools and kindergarten through third grade. And we train them in roles
12:08that support the teacher's success, are there for the children's success. And that actually are there,
12:16is there also to improve the health of the older adults, including preventing frailty. And it works.
12:23Tell me how it works. Well, it works in many ways. It's very clear from the data on experience score,
12:30which is now in over 20 U.S. cities in multiple countries, that experience, having a critical mass of older
12:39adults in the school as volunteers with training in roles that the principal and teachers think would
12:47matter to support the kids' success. That they provide an ear for the kids, so that kids who are
12:54floundering in class don't fall behind, don't act out negatively, can stay with the class. The teachers
13:03feel like they are more successful at teaching because the class is in there with them, and you don't
13:09have kids acting out. You see a big improvement in the school climate. When there are several teams of
13:18older adults in a school of kindergarten through third graders, the whole school calms down.
13:24You know, I remember there was one school in Baltimore where a man who used to be a lithographer
13:34and volunteered for Experience Corps, on his own steam, would stand at the front door every morning and
13:44give every single child a high five as they walked in. You know, it changed the school climate. It also
13:51did a lot for his own loneliness. I was going to say, what a great way for him to start the day.
13:56It was right. He was there every morning. He was there every morning. So it had amazing effects for
14:03the students and for the educational community. Tell me about the observed impact that it had on the
14:09older participants. So I'm a public health scientist and I brought together a large team of scientists to
14:18think about how to design something that people wanted to do, that they would be gratified to do,
14:24that they saw made a difference in doing. Because like my CEO who quit because they were giving him
14:33stuff that didn't use his skills well, I needed to fulfill those criteria. But I'm a person who believes
14:42in preventing ill health. And it seemed to me this was a perfect opportunity if we could put this in
14:50every public school in the country to deliver health promotion and prevention to older adults
14:56simultaneously. But it had to be like, I don't know, an Easter egg, which was pretty on the outside
15:02that people wanted to show up for, but had lots of protein inside.
15:05And data, right? And data to tell you that it worked.
15:09And a huge amount of data. So we designed Experience Corps to do a number of things that
15:14people need as they get older. To have a reason to get up in the morning. To have a place to go to
15:22that they cared about building the future through. And older adults deeply care that the next generation
15:30was succeeded. That it would give them a way without signing up for an exercise program
15:37to get a lot of physical activity. And we've shown that it does. You know, think about getting up and
15:42down from those little chairs all day. It's good for you. And walking or taking the bus to school or whatever.
15:49We designed the roles carefully to use your mind. So they use their minds in ways that cognitive
16:01scientists have shown are really good for building memory and maintaining complex thinking. And as one
16:09of our volunteers said to me, who was a 78-year-old African-American woman, she said, you know, I feel
16:17like I'm dusting off the cobwebs in my head doing this. So we designed it for physical activity,
16:24for cognitive activity, and we designed it very carefully to build social activity and connection
16:31at many levels. With the other volunteers thinking about loneliness prevention. And in fact, what we've
16:38seen is that Experience Corps volunteers say that they have new people who they could turn to for help.
16:44And a new social network of people who they're friendly with. They may not be best friends, but,
16:53you know, replacing some of the social networks that people lose as they get older and as they retire.
17:00And we designed it to also create connection with people of different generations. So with the teachers
17:08and the principals for whom they became valued members of the team as volunteers and with the children.
17:14And it had a positive impact on the health and physical and mental health of them.
17:18We have shown over the years that this program, as it was designed, as it was designed,
17:26is effective in maintaining or even improving complex
17:32and maintaining what we call executive function and which is very important for just everyday living
17:45and actually slowing or preventing memory loss.
17:49I think it's important to reflect on what we've learned from the Experience Corps experiment,
17:56which is that what older people bring to the table is unique and can be transformational if the
18:04program is designed to bring out the transformation. And we have also emerged into a different era than we
18:12were in the 90s when people were not willing to see older people in any role.
18:20And but countenance seeing them with young children.
18:24I think we're now ready to build new roles for all of us as we get older that can make a difference in our
18:33communities and for ourselves. Roles that extend to include children's education and the education of
18:43teenagers and and mentoring of older adults. But there is a vast array of roles where the assets and
18:50capabilities of all of us as we get older could make a huge difference.
18:54And we need I think this is a moment for a grand act of imagination
19:00to think about the complex problems we have to solve
19:03and where we need more human capital and social capital and how the assets that older people
19:12would want to bring to that table could be transformational and then build the institutions
19:17that enable people to contribute as they get older. A grand act of imagination.
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