100 and counting
LI YEUNG AND Lee Shi are members of one of Hong Kong's most exclusive clubs. Both are centenarians and according to the 2001 census, Hong Kong is home to only 697 people over the age of 100.
Neither of the women has had an easy life. Both recall hard labour in the fields, not enough to eat and few playthings as their childhood memories. As young women their lives were thrown into chaos by the second world war. Lee was stranded in the Philippines until the war was over. For Li, who was in Hong Kong for the duration of the conflict, the pain of never knowing what happened to her two sons after their disappearance is still apparent today. Simply by virtue of living so long they have witnessed and experienced more of life's ups and downs than most people, but when asked whether they are glad to have lived so long, both answer with a resounding yes. 'There's nothing to be unhappy about living to be so old,' says Lee, whose official age, thanks to a mix-up when asked her age on entry to the Philippines, is 110 but who is estimated to be closer to 100. 'I never expected to live to be this old ... but every night I pray that God gives me a long life.'
Li, 103, attributes her longevity to being surrounded by a loving family of four children and 14 grandchildren and 19 great-grandchildren, staying active and being positive. 'During the war, we lived from one meal to the next,' she says. 'I've got food, and I live a peaceful life without being in conflict with anyone, so I'm happy.' Both women advocate a simple diet of rice, vegetables and fruit, and eating little at night. Although they are now in care and attention homes, until recently both stayed physically and mentally active. Their experience mirrors what research has shown - that good lifelong habits, connection to the community and a spiritual dimension to life help ensure a long and relatively healthy old age. As an increasing proportion of Hong Kong's population grows old, the issue of healthy ageing becomes more pressing. By 2011 the post-war baby-boomer generation will turn 65 and by 2021 about one in six people in Hong Kong will be aged 65 or above. Life expectancy continues to climb, Hong Kong enjoys the third-highest life expectancy in the world after Japan and Sweden, currently 78.7 years for men and 84.7 for women.
While the next generation generally have a better start in life than their now-elderly parents, they are not necessarily set up for a healthier old age. The impact of non-communicable disease on Hong Kong has increased sharply. Cancer and cardiovascular and respiratory diseases account for about 77 per cent of all deaths, an increase from 38 per cent in 1961. The move away from a simple diet to a more westernised one that is higher in saturated fat has caused an epidemic of diabetes and hypertension, which combined with a more sedentary lifestyle can lead to a life plagued by chronic illness. The message from the experts is that a healthy old age starts with how we treat our bodies and minds earlier in life to reduce the cumulative impact of bad habits, such as poor diet, smoking and lack of exercise. But it is never too late to change. 'Being active can help older people remain independent for as long as possible,' says Dr Chan Wai-man, assistant director of health and head of the Department of Health's Elderly Health Services. 'It can help to prevent the onset of heart diseases in healthy elders, and among heart attack patients, relapse. Regular, moderate physical activity reduces the risk of cardiac death by 20 per cent to 25 per cent among people with heart disease. Exercise can substantially reduce the severity of disabilities associated with heart disease and other chronic illnesses and also helps to delay functional decline and improve functional independence by enhancing muscle mass, cardiovascular endurance, bone density and mobility.' Exercise can also reduce the risk of falls, especially tai chi, she adds. 'Regular exercise has been shown to provide psychological benefits such as preserving cognitive function, alleviating depression and improving the sense of personal control and self-efficacy,' the doctor says.
Mentally stimulating activities have been associated with lower risk of Alzheimer's disease. A recent study in Sweden found that getting involved in social and leisure activities reduced the risk of dementia in old age. 'Mentally stimulating activity ties in with physical exercise and social networking and it may be difficult to distinguish the benefits, but generally if you engage in stimulating activities you can slow down mental decline,' says Dr Susanne Ho, professor in the department of community and family medicine at the Chinese University of Hong Kong.
Results of research on diet and reducing the risk of Alzheimer's disease are inconclusive but some interesting findings are emerging. 'Studies have shown that populations with a high concentration of fish in their diet have low risk of Alzheimer's disease,' says Ho. 'Populations whose diet is high in mono-unsaturated fatty acids such as olive oil also seem to have lower prevalence. Vitamins B6 and B12 seem to be protective against cognitive decline.'
Education also plays a role - research led by Ho into cognitive decline in the elderly Chinese population found that the lower the level of education the higher the risk of cognitive impairment. For those who have missed out on education the first time around, lifelong learning can help and should be a policy priority to promote healthy ageing, according to a report by the Elderly Commission. Citing studies that have shown continued participation in education enhances elderly people's ability to lead an active life and cope with problems, the report recommends that lifelong learning should be promoted, not only for personal enrichment but for purposes of civic participation and social contribution.
Worldwide almost 1,000 studies have been done which have found that people who attend a place of worship, regardless of religion, tend to live longer than those who do not. Lee and Li are Christians. 'I live each day as a gift from God and take each day as it comes,' says Lee.