The myth of age-related illnesses of middle age

You know this, right? Age-related diseases—at least, those of middle age—mostly aren’t. Rather, they’re lifestyle diseases that seem age-related because it takes years or decades for the harm done by the lifestyle to start showing up as symptoms.

I’m prompted to write this by something Charles Stross wrote over a year ago, where he talks about the symptoms of aging. I almost didn’t link to that post, because he’s really talking about something else—his post is about the political effects of reasonably foreseeable improvements in medicine—but along the way, he describes his current circumstance:

. . . chronic low-grade pain of the middle-aged body: joints that creak and pop, muscles that need an extra stretch, sore feet.

And goes on to compare it to his hypothetical world with science-fictional medicine:

Unlike today’s senior citizens, you don’t ache whenever you get out of bed, you’re physically fit, you don’t have cancer or heart disease or diabetes or Alzheimer’s, you aren’t deaf or blind or suffering from anosmia or peripheral neuropathy or other sensory impairments, and you’re physically able to enjoy your sex life.

Of course there are age-related diseases—Alzheimer’s and anosmia probably are. But especially the ones in the first quote—the age-related difficulties of the middle-aged body—aren’t age-related at all. To imagine that they are is to make a category mistake—and a serious one, because the error makes it much more difficult to recover your health.

I’ve hesitated to write this post, because I realize that I’m speaking from a position of privilege—I’m healthy. This is partially a matter of luck, partially a matter of good genes, partially a matter of a lifetime history of good health care, access to adequate nutrition, and so on.

Even so, I’ve got real first-hand experience with exactly the list of middle-aged body problems that Stross lists.

Eight or ten years ago, I was feeling old. Tasks that required strength were more daunting than they had been—especially ones, such as carrying things up or down steps, that added additional weight to my already excessive body weight. My balance wasn’t as good, making slippery tubs and icy sidewalks seem like serious threats. My plantar fasciitis was kept at bay only by being scrupulous about wearing supportive shoes and by limiting the amount of standing I did. I could still get down on the floor and get up again, but it was hard enough that I didn’t do it when I didn’t have to. I had trouble getting a good night’s sleep, because my back would ache when I lay still too long, and when I did sleep through the night I’d need considerable stretching before I could move normally the next morning.

I viewed all this as normal aging. Partially, I think that was because I was actually in pretty good shape. I could walk 5 or 6 miles. I routinely bicycled to work when the weather was nice. I went to the fitness center two or three times a week to use the weight machines and do some stretching. Despite all that, my physical capabilities were declining, and I didn’t see anything I could do about it, except perhaps spend even more time exercising, which didn’t seem practical for someone with a day job.

It wasn’t true, though. Over the past six or seven years, I have felt better each year. It is not a strain to carry things of ordinary weight, even going up and down stairs. My static balance is excellent—I no longer fear slippery tubs, although I do still try to be careful on ice. My feet don’t hurt when I stand a lot, even when I’m barefoot. I make a point of sitting on the floor, just to add some variety to the day. I sleep well, and I wake up able to move.

What did I do? Nothing extraordinary.

Starting to do tai chi was probably the key shift, because it changed so many things at once about my movement practice. Somewhere along the line I ran across parkour, and then even before I had done more than play with that I discovered natural movement as a thing—and that was what gave me a framework for thinking about movement the same way I’d come to think about food.

Trying to figure out the best diet is a waste of time. It’s computationally infeasible, and anyway unnecessary—just eat a wide variety of foods (and limit your consumption of industrially produced food-like substances) and your body takes care of the rest. (See Michael Pollan’s In Defense of Food for details.)

Similarly, trying to figure out the best exercise regime is a waste of time. You are far better off to get a wide variety of movement (and limit the time spent doing things like sitting in chairs and wearing shoes). Once again, your body will take care of the rest.

What struck me—what prompted me to write this post—was that Stross’s description of what his science-fictional medicine feels like is what I’ve felt like. It’s not exactly aging backwards, but it is a recovery of a feeling of ease and comfort that had slipped away under cover of “normal” aging.

My life feels kind of like a science fiction story, with the science-fictional medicine being just recovering normal patterns of movement.

It makes me want to advocate these lifestyle changes, perhaps more strongly than is advisable. As I say, I recognize that I’m writing from a position of health that isn’t available to just everyone. I can’t say that if you’ll just start walking and running and bicycling and lifting weights and doing taiji and experimenting with parkour and natural movement, you will reverse the aging process and feel young again. There are kinds of impairments that cannot be completely recovered from, and perhaps some that cannot even be improved.

And yet, I do advocate these lifestyle changes. Move better. Move more. Eat food. I bet you’ll feel better—especially if you’re starting to suffer from the symptoms of “normal” aging.