Thursday, May 29, 2014

Dare to Be 100: Aging and the Serenity Prayer

Now in my 85th year of life I have learned from an innumerable number of texts. Most of these were written into my protoplasm by natural selection. Eat when you are hungry, drink when you are thirsty, sleep when you're tired, stay warm, sex feels good, avoid pain whenever possible. Each of these survival strategies were coded into my being long before there was a me. But other important lessons were learned on the job.



The Golden Rule I found out about in Sunday school, and its precepts still hold true because it works. Another powerful tenet is the Serenity Prayer that goes, "Change what you can, accept what you must, AND know the difference."



As I age, this precious text becomes more and more relevant. I asked my close Stanford colleague Albert Bandura, "When can I stop working on my self efficacy?" and he answered, predictably, "Never."



As I, we age each day brings challenges and doubts. When to stop is a survival question.



The Serenity Prayer helps a lot because it commands "know the difference." Before now we didn't know the difference. Now we do which defines when to stop.



I am a constant student of frailty because it seems to indicate when the red light is about to come on. Until now most of us tacitly presumed that frailty was an intimate part of growing old. Wrong. I am 84 years old and still run marathons, chop wood, and write books.



So frailty is not just aging. Sure aging plays a role in frailty. I am now much slower than I used to be, but I still run. The Serenity Prayer is an essential guide post that is helping to define frailty and aging.



Linda Fried, dean of the important Columbia School of Public Health, has done most to help understand frailty, and has published about it extensively.



Importantly, she shows that frailty isn't secondary to a defect in a part of the body, not just your heart, or lungs, or even the brain. Frailty is a system problem. Further, frailty is not the result of just a moment's dereliction. It is cumulative. Frailty is time coded, and is partially reversible.



So as I, we age know what we can change and what we must accept. We know that we can't stop the drain of the grains of sand in the hourglass, but we can snug up the size of the aperture through which they fall.



The Serenity Prayer beckons us to keep snugging.



Reference:



Fried, L. et al 2001 The frailty Phenotype J. Geront.56: M146



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