Want to Age in Good Health? Build Muscle

Presented below is an old study from 2008, but it's a study that makes a powerful correlation between muscular strength and reduced mortality rates in men. We have seen similar research suggesting that the best way to maintain a strong immune system (in a study of HIV+ men) was to maintain as much muscle mass as possible, which is why anabolic steroids are often part of the treatment protocol for HIV/AIDS.

What more reason can we need to get into the gym and stay in shape? If we are going to age, and modern medicine is determined to see that we will, why not do it in as much health as we can?

Do you want to be 80 and need a walker, or do you want to look like this guy, incredibly fit despite his age? We do not have to age badly and lose vitality - staying fit is the best way to enjoy life for as long as our hearts are beating.

Association between muscular strength and mortality in men: prospective cohort study

Jonatan R Ruiz, Xuemei Sui, Felipe Lobelo, James R Morrow Jr, Allen W Jackson, Michael Sjöström, Steven N Blair

Abstract

Objective To examine prospectively the association between muscular strength and mortality from all causes, cardiovascular disease, and cancer in men.

Design Prospective cohort study.

Setting Aerobics centre longitudinal study.

Participants 8762 men aged 20-80.

Main outcome measures All cause mortality up to 31 December 2003; muscular strength, quantified by combining one repetition maximal measures for leg and bench presses and further categorised as age specific thirds of the combined strength variable; and cardiorespiratory fitness assessed by a maximal exercise test on a treadmill.

Results During an average follow-up of 18.9 years, 503 deaths occurred (145 cardiovascular disease, 199 cancer). Age adjusted death rates per 10 000 person years across incremental thirds of muscular strength were 38.9, 25.9, and 26.6 for all causes; 12.1, 7.6, and 6.6 for cardiovascular disease; and 6.1, 4.9, and 4.2 for cancer (all P<0 .01="" 0.58="" 0.68="" 0.71="" 0.72="" 0.74="" 0.77="" 0.90="" 0.96="" 0.97="" 1.00="" 1.07="" 1.0="" 1.10="" across="" activity="" adjusting="" adjustment="" after="" age="" alcohol="" all="" and="" association="" attenuated="" baseline="" between="" body="" br="" cancer="" cardiorespiratory="" cardiovascular="" cause="" causes="" conditions="" confidence="" death="" disease="" family="" fitness.="" fitness="" for="" from="" further="" hazard="" history="" however="" incremental="" index="" intake="" interval="" linear="" mass="" medical="" mortality="" muscular="" of="" pattern="" persisted="" physical="" ratios="" referent="" smoking="" strength="" the="" thirds="" to="" trend="" was="" were="">

Conclusion Muscular strength is inversely and independently associated with death from all causes and cancer in men, even after adjusting for cardiorespiratory fitness and other potential confounders.

Full Citation:
Ruiz, JR, Sui, X, Lobelo, F, Morrow Jr, JR, Jackson, AW, Sjöström, M, and Blair, SN. (2008, July 1).
Association between muscular strength and mortality in men: prospective cohort study. BMJ; 337:a439. doi: 10.1136/bmj.a439

Rather than bore you with the whole study, here are the final sections, including the Discussion and Strengths and Limitations. The results are pretty clear - more muscular strength equals better health and lower mortality rates.

Discussion

Muscular strength was significantly and inversely associated with risk of death from all causes and cancer after controlling for potential confounders, including cardiorespiratory fitness. The inverse association was consistent in strata of age (<60 60="" adjusted="" adjustment="" after="" age="" all="" analysis="" and="" associated="" association="" at="" attenuated="" body="" both="" br="" cancer="" cardiorespiratory="" cardiovascular="" cause="" causes="" combined="" confounders="" controlling="" death="" disease="" effects="" entered="" fitness.="" fitness="" for="" from="" further="" group="" having="" high="" highlight="" importance="" in="" index="" inversely="" kg="" least="" levels="" lower="" lowest="" m2="" mass="" men.="" men="" model="" moderate="" mortality="" muscular="" not="" of="" on="" once="" other="" population="" potential="" rate="" reduce="" results="" risk="" showed="" significant="" significantly="" strength.="" strength="" than="" that="" the="" these="" this="" to="" unfit="" was="" were="" with="" years="" yet="">
We investigated the association between standardised measures of upper and lower body muscular strength and disease specific risk of mortality in a large cohort of men with extensive follow-up. Muscular strength and cardiorespiratory fitness were moderately correlated (age adjusted partial r=0.33), suggesting that the association between muscular strength and risk of death from cancer works at least partially through different mechanisms than those associated with the protective effects of cardiorespiratory fitness. That the association between muscular strength and risk of death from cardiovascular disease was not significantly independent of cardiorespiratory fitness highlights the key role of cardiorespiratory fitness in the development of cardiovascular disease in men; however, their combined effects cannot be easily disentangled in an observational study. In this cohort the number of deaths from cardiovascular disease was lower than that from cancer (145 and 199, respectively). This may have reduced the statistical power to detect a significant independent association between muscular strength and risk of death from cardiovascular disease.

Apart from our preliminary analyses in the aerobics centre longitudinal study,28 only one study has assessed the association between muscular strength and all cause mortality after adjusting for cardiorespiratory fitness and age, smoking status, and body mass index and found that handgrip strength and upper body strength (push-ups) were not significantly associated with risk of death from all causes.18 A significant inverse association between muscular strength (measured by handgrip strength) and risk of mortality has been reported in several other studies.15 16 17 19 20 21 22 23 24 25 27 The main limitation of this test is that the measurement is highly influenced by the grip span of the dynamometer and hand size.44 45 46 None of these previous studies standardised the grip span or assessed a second muscle group. Furthermore, hand grip uses a relatively small muscle group and is not well correlated with measures of overall muscular strength as determined by measurements of strength using large muscle groups.47 Assessing additional muscle groups may provide a better overall index of muscular strength, especially when measured in large muscle groups. Moreover, cardiorespiratory fitness was not measured in these studies, and we know that cardiorespiratory fitness is strongly associated with morbidity and mortality.7 8 9 10 11 12 13 37 38 39

The apparent protective effect of muscular strength against risk of death might be due to muscular strength in itself, to muscle fibre type or configuration, or as a consequence of regular physical exercise, specifically resistance exercise. Muscle fibre type and configuration has a genetic component and influences strength, yet it is clear that resistance type physical activities are major determinants of muscular strength.5 48 We have previously reported a strong and positive association between the frequency of self reported resistance exercise and maximal muscular strength in men enrolled in the aerobics centre longitudinal study—that is, the higher the participation in resistance exercise the higher the muscular strength.32 This observation suggests that the measurements of muscular strength obtained in the present study provide an adequate representation of the resistance exercise habits in our cohort. Results from intervention studies indicate that resistance training enhances muscular strength and endurance, muscle mass, functional capacity, daily physical activity, risk profile for cardiovascular disease, and quality of life.5 These factors are well known predictors of higher risk of mortality. The benefits of resistance training are evident in men and women, young adults, and older people, in overweight and obese adults as well as in people of normal weight, and in people with or without disability, or with cardiovascular disease.5 We observed an inverse association between muscular strength and risk of death from all causes and cancer in older men (≥60 years) and younger men (<60 age="" also="" and="" as="" associated="" becomes="" benefit="" br="" consequently="" declines="" dependent="" directly="" experience="" from="" functional="" having="" higher="" in="" levels="" mass="" may="" men="" more="" muscle="" muscular="" of="" older="" on="" performance="" strength.="" strength="" suggests="" that="" these="" this="" years="">
The observed association between muscular strength and risk of death from all causes or cancer was also independent of body weight. We showed an inverse association between muscular strength and risk of death from all causes and cancer in overweight and obese men, as well as between muscular strength and risk of all cause mortality in those of normal body weight. Body mass index may have a different meaning in those who have greater muscular strength. For example, leg press strength for a man weighing 60 kg would be expected to be lower than that for a man weighing 90 kg. That is why we included body mass index in the multivariate analyses. Thus we not only controlled for the effect of weight but also height, which might have influenced the torque or force production. A high body mass index can result from a greater amount of fat or muscle. Yet in epidemiological studies most of the people with a higher body mass index also had higher fat levels.

Given that the prevalence of overweight and obesity exceeds 66% in the United States49 and that overweight and obese people are at a substantially higher risk of disability50 and death,51 52 these results have important implications for public health. Exercise recommendations to prevent or treat obesity have focused mainly on aerobic activities, yet resistance exercise is an important complement for weight control, mainly as a result of the increases in metabolically active muscle mass.2 Under most circumstances, and especially during physical inactivity, resting energy expenditure is the largest component of total energy expenditure. The energy expenditure related to muscle metabolism is the only component of resting energy expenditure that might vary considerably.2 The resting metabolic requirements of splanchnic tissues, brain, and skin vary little under normal conditions, mainly because of their relatively constant mass and protein turnover rates. In contrast, large variations in muscle mass are possible, and the rate of muscle protein turnover (synthesis and breakdown) may vary as well. The synthesis and breakdown of muscle protein are principally responsible for the energy expenditure of resting muscle. In theory, every 10 kg difference in lean mass translates to a difference in energy expenditure of about 100 kcal daily, assuming a constant rate of protein turnover.2 A difference in energy expenditure of about 100 kcal daily translates to about 4.7 kg of fat mass yearly. Over a long period the maintenance of a large muscle mass and consequent muscle protein turnover can contribute to the prevention of obesity. Therefore it is reasonable to presume that when sustained over time, resistance exercise training should help to prevent or revert increases in body fat.5

Strengths and limitations

The results of the present study should be interpreted with caution. Generalisation of the findings may only apply to well educated white men of middle to upper socioeconomic status. Values for blood pressure and cholesterol levels, body weight, and cardiorespiratory fitness from participants in the aerobics centre longitudinal study were similar to those reported in two population based studies in North America.8 Moreover, there is no reason to believe that the benefits of muscular strength would be different in other ethnic or socioeconomic groups. Because of the limited sample of women, who contributed relatively few deaths to the main study, we were unable to perform a meaningful parallel analysis on women. Therefore women were not included in this substudy. No detailed information about drug use or diet was available, which may have biased the results through residual confounding. It seems unlikely, however, that these factors would account for all of the observed association between muscular strength and mortality. That none of the participants reported a family history of cancer might be a limitation of the main study owing to self selection bias. In fact, only 1.16% of men in the entire cohort of the aerobics centre longitudinal study reported a family history of cancer. Future studies should include such information whenever possible.

A major strength of this study was the inclusion of objective and standardised maximal tests for muscular strength (upper and lower body) and cardiorespiratory fitness using highly reliable measurement protocols in a large cohort of men with extensive follow-up. Undetected subclinical disease is always a concern in any observational study, but it is less likely to have occurred in our cohort because of the comprehensive physical examination and the clinical assessment completed by each participant. Moreover, participants were healthy enough to achieve at least 85% of aged predicted maximal heart rate during the treadmill test.

Conclusions

Muscular strength was independently associated with risk of death from all causes and cancer in men. These findings are valid for men of normal weight, those who are overweight, and younger or older men, and are valid even after adjusting for several potential confounders, including cardiorespiratory fitness. Muscular strength seems to add to the protective effect of cardiorespiratory fitness against the risk of death in men. Whether the association between muscular strength and risk of death from cardiovascular disease is independent of typical confounders as well as of cardiorespiratory fitness warrants further investigation.

Prospective studies among diverse populations and among women are needed to examine the independent and combined associations of muscular strength and cardiorespiratory fitness with disease specific mortality. It might be possible to reduce all cause mortality among men by promoting regular resistance training involving the major muscle groups of the upper and lower body two or three days a week.5 Resistance training should be a complement to rather than a replacement for aerobic exercise. The recommendation for moderate to vigorous physical activity and resistance training are supported by the current research owing to the reduction in risk of death from all causes and cancer associated with increased cardiorespiratory fitness or muscular strength.3 4 5 6

What is already known on this topic

• Cardiorespiratory fitness provides strong and independent prognostic information about the overall risk of illness and death
• Most prospective studies examining the association between muscular strength and death have had limitations

What this study adds

• Muscular strength in major muscle groups is independently associated with death from all causes and cancer in men aged 20-82
• These findings are valid for those who are of normal weight or overweight, younger or older, and even after adjusting for several potential confounders, including cardiorespiratory fitness
• Muscular strength seems to add to the protective effect of cardiorespiratory fitness against the risk of death in men

Pamela Druckerman - What You Learn in Your 40s (and What I Learned)

This piece from The New York Times is pretty accurate, for men as well as for women. As I approach 47, I tend to think of my 40s as the decade when I finally figured who the hell I am and what my own unique purpose is in this lifetime. I also learned it is okay to fail - most people are too self-obsessed to notice, and those who aren't are my likely to lend a hand than to laugh. I wish I had known that in my teens and 20s.

There are a few things important in my life that are not in Druckerman's list, and these may be issues more important to men than to women (or not).

• Aging does not require that we become overweight and sedentary and, in fact, staying fit makes the numbers we associate with age mean nothing. I was the most fit I have ever been when I turned 40 - and even now I am only a 2-week carb restriction from being that lean again, and now with more muscle. Oh yeah, aging does not mean we still cannot increase muscle mass - it's harder, but it is still possible.
• As libido decreases with age, the quality of sex increases in many profound ways (if you are conscious). Quality is way better than quantity.
• Grey hair and gradual hair loss do not make me old or less masculine. I will never color my hair again . . . unless I go goth again for some strange reason.
• Clothes should comfortable and functional. I could not care less if I am stylish but am not at all comfortable. Utility beats fashion every time for me.
• It's okay for man to have 10 or more pairs of shoes. I have 6 or 7 different pairs of athletic shoes, each with its own functional quality that I like. I have some casual shoes, some dress shoes, and hiking boots. Okay, so maybe I have 15 or more pairs of shoes (not including soccer cleats [2] and cycling shoes [3]).

What have you learned in your 40s?

What You Learn in Your 40s

SundayReview | Contributing Op-Ed Writer
FEB. 28, 2014

Pamela Druckerman 

PARIS — IF all goes according to plan, I’ll turn 44 soon after this column appears. So far in my adult life, I’ve never managed to grasp a decade’s main point until long after it was over. It turns out that I wasn’t supposed to spend my 20s frantically looking for a husband; I should have been building my career and enjoying my last gasp of freedom. I then spent my 30s ruminating on grievances accumulated in my 20s.

This time around, I’d like to save time by figuring out the decade while I’m still in it. Entering middle age in Paris — the world’s epicenter of existentialism — isn’t terribly helpful. With their signature blend of subtlety and pessimism, the French carve up midlife into the “crisis of the 40s,” the “crisis of the 50s” and the “noonday demon” (described by one French writer as “when a man in his 50s falls in love with the babysitter”).

The modern 40s are so busy it’s hard to assess them. Researchers describe the new “rush hour of life,” when career and child-rearing peaks collide. Today’s 40ish professionals are the DITT generation: double income, toddler twins. 

The existing literature treats the 40s as transitional. Victor Hugo supposedly called 40 “the old age of youth.” In Paris, it’s when waiters start calling you “Madame” without an ironic wink. The conventional wisdom is that you’re still reasonably young, but that everything is declining: health, fertility, the certainty that you will one day read “Hamlet” and know how to cook leeks. Among my peers there’s a now-or-never mood: We still have time for a second act, but we’d better get moving on it.

I think the biggest transition of the 40s is realizing that we’ve actually, improbably, managed to learn and grow a bit. In another 10 years, our 40-something revelations will no doubt seem naïve (“Ants can see molecules!” a man told me in college).

But for now, to cement our small gains, here are some things we know today that we didn’t know a decade ago:

If you worry less about what people think of you, you can pick up an astonishing amount of information about them. You no longer leave conversations wondering what just happened. Other people’s minds and motives are finally revealed.

•People are constantly trying to shape how you view them. In certain extreme cases, they seem to be transmitting a personal motto, such as “I have a relaxed parenting style!”; “I earn in the low six figures!”; “I’m authentic and don’t try to project an image!”

•Eight hours of continuous, unmedicated sleep is one of life’s great pleasures. Actually, scratch “unmedicated.”

•There are no grown-ups. We suspect this when we are younger, but can confirm it only once we are the ones writing books and attending parent-teacher conferences. Everyone is winging it, some just do it more confidently.

•There are no soul mates. Not in the traditional sense, at least. In my 20s someone told me that each person has not one but 30 soul mates walking the earth. (“Yes,” said a colleague, when I informed him of this, “and I’m trying to sleep with all of them.”) In fact, “soul mate” isn’t a pre-existing condition. It’s an earned title. They’re made over time.

•You will miss out on some near soul mates. This goes for friendships, too. There will be unforgettable people with whom you have shared an excellent evening or a few days. Now they live in Hong Kong, and you will never see them again. That’s just how life is.

•Emotional scenes are tiring and pointless. At a wedding many years ago, an older British gentleman who found me sulking in a corner helpfully explained that I was having a G.E.S. — a Ghastly Emotional Scene. In your 40s, these no longer seem necessary. For starters, you’re not invited to weddings anymore. And you and your partner know your ritual arguments so well, you can have them in a tenth of the time.

•Forgive your exes, even the awful ones. They were just winging it, too.

•When you meet someone extremely charming, be cautious instead of dazzled. By your 40s, you’ve gotten better at spotting narcissists before they ruin your life. You know that “nice” isn’t a sufficient quality for friendship, but it’s a necessary one.

•People’s youthful quirks can harden into adult pathologies. What’s adorable at 20 can be worrisome at 30 and dangerous at 40. Also, at 40, you see the outlines of what your peers will look like when they’re 70.

•More about you is universal than not universal. My unscientific assessment is that we are 95 percent cohort, 5 percent unique. Knowing this is a bit of a disappointment, and a bit of a relief.

•But you find your tribe. Jerry Seinfeld said in an interview last year that his favorite part of the Emmy Awards was when the comedy writers went onstage to collect their prize. “You see these gnome-like cretins, just kind of all misshapen. And I go, ‘This is me. This is who I am. That’s my group.’ ” By your 40s, you don’t want to be with the cool people; you want to be with your people.

Just say “no.” Never suggest lunch with people you don’t want to have lunch with. They will be much less disappointed than you think.

•You don’t have to decide whether God exists. Maybe he does and maybe he doesn’t. But when you’re already worrying that the National Security Agency is reading your emails (and as a foreigner in France, that you’re constantly breaking unspoken cultural rules), it’s better not to know whether yet another entity is watching you.

Finally, a few more tips gleaned from four decades of experience:

•Do not buy those too-small jeans, on the expectation that you will soon lose weight.

•If you are invited to lunch with someone who works in the fashion industry, do not wear your most “fashionable” outfit. Wear black.

•If you like the outfit on the mannequin, buy exactly what’s on the mannequin. Do not try to recreate the same look by yourself.

•It’s O.K. if you don’t like jazz.

•When you’re wondering whether she’s his daughter or his girlfriend, she’s his girlfriend.

•When you’re unsure if it’s a woman or a man, it’s a woman. 


~ Pamela Druckerman is the author of “Bringing Up Bébé: One American Mother Discovers the Wisdom of French Parenting,” and a contributing opinion writer.

Lisa Firestone, Ph.D. - What's Getting in the Way of Your Sex Life

Dr. Lisa Firestone is the co-author of Sex and Love in Intimate Relationships (2008) and the Compassion Matters blog at Psychology Today, as well as several other books, including The Self Under Siege: A Therapeutic Model for Differentiation (2012) and Creating a Life of Meaning and Compassion: The Wisdom of Psychotherapy (2003).

This is an interesting, though brief, post on the challenges we all can face in our sex lives over time and as we age.

What's Getting in the Way of Your Sex Life

Why our sexuality changes and what to do about it

Published on October 15, 2013 by Lisa Firestone, Ph.D. in Compassion Matters

Your sexuality can change a lot throughout one lifetime. It can even change a lot throughout one relationship. Some of these changes can be for the better. Others can feel like they're for the worse. When these changes occur, many men and women tend to take the wrong course of action, shutting up or shutting down. You may shy away from talking to your partner or pull away from a physical relationship you valued. You might lose interest in sex altogether or turn against yourself and your body. When people face these challenges, what they'll often find is that talking about sex, while it may feel uncomfortable at first, can be the key to maintaining a healthy sex life and a positive sense of one's own sexuality.

So what are some of the changes that impact a person's sex life? These shifts can be physical or related to age. They can even be caused by medications that strongly affect one's sexual feelings and performance. Although these are often natural alterations that our bodies go through over time, people tend to view them as embarrassing or something to be kept secret. However, the opposite is true.

Talking about these changes, be it with your partner, a friend or your doctor can lead to more understanding and self-compassion and allows you to maintain a satisfying sex life. As your body changes, you can choose to take a healthy approach to these shifts without turning on yourself and giving in to your "critical inner voices," allowing them to tear you down or make you feel insecure. It's important not to listen to what your inner critic tells you about these changes or to allow yourself to shut the door on your sexuality.

In addition to physical adjustments, people of all ages often face an onslaught of psychological influences that can hurt their sexuality. This can have a lot to do with the critical inner voice, which every person possesses. When it comes to sexuality a person's inner critic often comments on their performance, their bodies or what their partner is feeling or not feeling. This "voice" keeps people in their heads instead of in their bodies.

When it comes to sex, most people tend to feel there are a lot of "supposed to's," as if they are supposed to perform this way or feel that way in a sexual encounter. These expectations are fueled by the critical inner voice and can lead people to feel self-conscious, insecure or disconnected when being physically affectionate. Many people can also be critical of their appearance, viewing themselves as too old/fat/unattractive/uncomfortable for sex. With all its input, your inner critic can negatively influence your sexual relationships and eventually prove the false notion that passionate relationships can't last long-term.

The truth is that intimate relationships don't have to lose their excitement. However, as people get closer, they tend to struggle with maintaining an alive and satisfying sexual relationship. Many people find it difficult to combine emotional intimacy and deep loving feelings with passionate sexuality. One reason this can occur, albeit mostly unconsciously, is that old issues from their past begin to surface. People may even start to experience "critical inner voices" about their sexuality that hold familiar themes from their past. For example, if you were hurt or rejected by the people who cared for you, you may have grown up feeling there is something wrong with you on a bodily level. You may have thoughts like "you are so unattractive, he/she is repulsed by you." If you felt a lack of affection as kids, you may feel desperate for affection as an adult, having thoughts like "you need to be aggressive. he/she is not going to come toward you." If you felt intruded on, you may have a tendency to pull away when someone gets close, thinking "he/she is so hungry towards you; you don't really want this."

When people start to get into their heads during sex, they lose a sense of connectedness to their partner. When they feel this distance, the sexual experience often doesn't feel as satisfying or worthwhile. With their head flooded with self-critiques and attacks on their partner, they may start to think about just getting through the sexual situation instead of enjoying it. Emotional closeness is the most important aspect of physical intimacy. Therefore, it becomes all the more important to bring your struggles to light and talk about what's going on.

When changes occur in you, be them physical or emotional, it can also affect your partner's feelings about him or herself. It may trigger critical inner voices in them like, you are bored with them or that they're unattractive to you, etc. Talking to your partner and exposing the destructive attitudes of your critical inner voices can bring you back to yourselves and can reestablish the closeness between you and your partner. Closeness, self-esteem and open communication are essential to lasting, healthy sexuality. They are also the biggest factors in sexual satisfaction.

When you open up to your partner about what's going on in your mind in regards to your sexuality, you allow him or her to know you on a deeper level. In a certain sense, conversation can be foreplay, as it allows a couple to feel for each other and get closer. While it may feel awkward or unnatural at first, very often, when they do open up and talk about it, there are major, surprising shifts in a couple's sexual relationship.

Too often, people let years pass without having a conversation about their sexuality. In addition to talking to your partner, you can confide in a close friend or a therapist. It's all too easy to feel alone in your struggles, but you'd be surprised at how many people relate to exactly what you're going through. Staying silent leaves room for your critical inner voices to fester and will make you feel worse and even like giving up on your sexuality. The more you talk, the better you are likely to feel, and the quieter the noise in your head can become.

When it comes to sex, the optimal experience involves feeling emotionally close to your partner, in touch with your body and in the present moment. I have found that by identifying and challenging destructive thought processes or critical inner voices that interfere with closeness and optimal sexual functioning, people can learn to combine love and sexuality and achieve that special combination that is so desirable in an intimate relationship. Taking a chance and talking to your partner can be the first step to achieving this goal.

Read more from Dr. Lisa Firestone at PsychAlive.org

Dr. Lisa Firestone will be presenting a weekend workshop on "Creating a Loving Relationship" Nov. 8-10 in Ojai, CA. The event is open to individuals and couples. Learn more here.

Read Dr. Lisa Firestone's book, Sex and Love in Intimate Relationships.

Men Are More Scared of Going BALD than Becoming Impotent

This is a study of British men, but I suspect this is also true of most American men. Personally, I would not might at all going bald if it meant I never became impotent. Interestingly, more men are also concerned about going gray than about losing their teeth. Really? You can dye your hair, but once your teeth are gone, they're gone.

It's so interesting how men (people in general) are more concerned about their physical appearance than their physical function. That's more than a little strange to me.

Men are more scared of going BALD than becoming impotent

• 94% of men fear going bald while 89% worry about impotence

• 61% worry about losing their teeth and 64% are concerned about getting fat

• A third are also scared of going deaf while 45% are afraid of needing very thick glasses

By Emma Innes

PUBLISHED: 20 September 2013

There are many undesirable side effects of aging and now new research has revealed which ones strike the most fear into youthful hearts.

A survey has found that men in the UK fear going bald more than they dread impotence.

Two thousand men were quizzed about their biggest fears about aging and ending up with a ‘cue ball’ head came out top.

Some 89 per cent of men fear becoming impotent as they get older. Men also worry about putting on weight, needing thick glasses, going deaf and losing their teeth

Being bald beat being impotent, having bad breath, middle-aged spread and needing thick glasses as the thing that men fear most.

Overall, 94 per cent of men questioned said they worry about going bald - compared to 89 per cent who said being impotent was their greatest concern.

‘Going bald is a frightening prospect for most men,’ said HIS Hair Clinics’ Ian Watson.

‘It’s an open invitation for baldie jokes and snide remarks for everyone from family to strangers in the pub, and it’s just too personal to be funny.

‘I lost my hair in my 20s. I’ve had countless people rub my head like a lucky Buddha, and been called everything from baldilocks to Fester.

‘It wears thin pretty quickly, and soon became downright upsetting.’

THE ASPECTS OF AGING MEN FEAR THE MOST:

• 94% worry about going bald
• 89% are scared of becoming impotent
• 75% are worried about going grey
• 64% are scared of getting fat
• 61% fear losing their teeth
• 45% dread needing ‘jam jar’ glasses
• 31% are scared of going deaf
• 24% are frightened of getting bad breath

The survey asked men in the UK what aspects of ageing they feared most.

Sixty per cent feared losing their teeth, a third were also scared of going deaf, 24 per cent feared bad breath and 64 per cent worried about getting fat.

The thought of getting grey hair scared three quarters of men while 45 per cent were scared of needing ‘jam jar’ glasses.

While hair loss for women is rightly seen as a tragic and upsetting situation, men are often expected to ‘get on with it’, said psychotherapist, Toni Mackenzie.

She said: ‘Hair loss can be genuinely distressing for men. It can’t be easily disguised and people do seem to think it’s fair game for jokes, unlike things like putting on weight or going grey.

‘Men who lose their hair are expected to adopt a laissez-faire attitude and take insults with good humour. The pressure this causes can have a huge effect on men’s self-confidence, which has knock-on effects on their physical and mental wellbeing.’

Mr Watson added: ‘Other than wearing a hat - which you can’t do all the time - there’s not a lot that can be done to hide a completely bald head, unless you spend the cash on a treatment like scalp micro-pigmentation.

Discussing Purpose in Life with Very Old Men (80+ Years Old)

As part of the Umeå 85+ study in the north of Sweden, which focused on the health and outlook of the very old, researches combed the data to try to understand how older men look at purpose in life. From the original sample, twenty-three men who were administered the purpose in life (PIL) scale narrated about their meaning or purpose in life. Eight of the participants were 85 years old, ten were 90 years old, and five were 95 years of age or older.

The participants talked about purpose in life from various perspectives, which were categorized into three main discourses: 1) Talking of purpose of life in general, including the categories work, struggle, forming a family, and confidence, 2) Talking of own purpose in life, including the categories happiness, adaptation, and looking forward, and 3) Reflecting on purpose in life including the categories limited meaning, health, an honorable life, and the ability to face death.

This is an interesting study.

I'm not sure I want to live to be 90 or older*, but it feels like a good thought exercise to imagine myself at that age and looking back on what I felt to be the meaning or purpose in my life.

I do not have a family and never wanted children. Generally I have sought work I can enjoy rather than work that makes me a lot of money. And unlike these men, the idea of an honorable life has never occurred to me. From this alone, my reflections will be different than many of these men, and rightfully so since I half their age.

[* Unless I am still healthy in body and mind.]

Full Citation:
Hedberg, P. , Gustafson, Y. , Brulin, C. and Aléx, L. (2013). Purpose in life among very old men. Advances in Aging Research, 2(3), 100-105. doi: 10.4236/aar.2013.23014

Purpose in life among very old men

Pia Hedberg, Yngve Gustafson, Christine Brulin, and Lena Aléx

Copyright © 2013 Pia Hedberg et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

This paper provides very old men’s experiences of and reflections on purpose in life. The answers from an interview question about purpose in life from 23 men were analyzed by using qualitative content analysis. The results revealed three content areas: talking of purpose of life in general, talking of own purpose in life and reflections on purpose in life. Our findings showed that very old men experienced purpose in life most strongly when remembering the past and describing their earlier work. The old men reflected on purpose in life not just from their own individual perspectives, but also from a more reflective and analytic perspective.

1. INTRODUCTION

This study is part of the Umeå 85+ study in the north of Sweden, which focuses on health and outlook on life in the very old. The research in the Umeå 85+ study has resulted in several theses e.g. [1-5] describing the very old from various perspectives—both the good aging and the threats against the good aging. The intent of this study was to describe how very old men experience and reflect on purpose in life. In the first part of the 20th century, men and women lived mainly in separate spheres; being a man in Sweden was characterized by being the breadwinner of the family, while being a woman was characterized by taking care of the children and the household [6]. Hirdman [7] pointed out that in Swedish society men have usually been seen as the norm and have been more highly valued than women. Her theory, however, was grounded on men and women who still active in society. Research into various life experiences among older men is lacking. Courtney [8] has found that old men do not fully use the physical and mental health services available for their physical and mental health needs, nor do they seek medical help as often as women. Courtenay [9] also suggests that men commonly suffer in silence, deal with their problems alone, and may refuse to seek medical help because their ideas about normative masculinity demand an appropriately stoic behavior from a man. However, gender researchers have pointed out that there is more than one masculinity, and these various masculinities can be constructed in different ways depending on historical and societal circumstances [10,11].

Knodel and Ofstedal [12] argue that old men are made invisible in research about old people and that it is necessary to focus on this group. Calasanti and King [13] suggest that old men struggle not only against society’s attitudes toward very old people, but also against society no longer seeing them as men, as age quickly overshadows gender in how they are viewed. Because old men tend both to keep silent about their needs and to be overlooked by society, it is important that their lives and perceptions be further researched.

The very old age group in Sweden is increasing, and the average life expectancy for men at birth in Sweden is now 78.4 years [14]. Research on purpose in life in the elderly has been carried out in various ways. For example Pinquart [15] found that having a high quantity and quality of social contacts are associated with higher purpose in life among older people.

Earlier research has shown that men aged over 75 years who live alone were more isolated than women and had less developed social networks compared to women in the same age [16,17]. Davidson et al. [17] showed that old men in day centers are not involved in social organizations to the same extent as older women. Because social contacts have been shown to be associated with purpose in life and old men live more isolated lives, we were interested in studying old men’s experiences of purpose in life.

Purpose or meaning in life is a psychological construct that refers to people’s ability to find meaning in their life experiences and their everyday situations [18]. Frankl [18] posited the will to find meaning as the primary driving force for all human beings. Failure to find meaning in life, he wrote, produces negative psychological effects, especially feelings of boredom and emptiness, described as an existential vacuum [19].

Several cross-sectional studies of purpose in life in middle-aged men focus on the association between purpose in life and various health problems that men may live with, for example HIV [20,21], recovery from knee surgery [22], and spinal cord injury [23]. An earlier study within the Umeå 85+ study focused on purpose in life among very old women [24], but as far as we know no study has yet described experiences of purpose in life among very old men.

Research in purpose in life in very old men is very sparse and should be further investigated. The aim of this study, therefore, is to illuminate very old men’s experiences of and reflections on purpose in life.

2. METHOD

This study was performed in the years 2000 and 2002 and included people living in a medium-sized town and surrounding rural areas in a county in northern Sweden. As part of the Umeå 85+ project [1,2], invitation to participate was extended to all individuals aged 95 or over, all individuals aged 90, and every second individual aged 85. The inclusion criteria were age, being able to answer Likert-type questionnaires, and having the strength to participate in interviews. The participants were assured confidentiality and anonymity in the presentation of the results, and they were assured they could withdraw from the study without having to give a reason. The study was approved by the Ethics Committee of the Medical Faculty, Umeå University (Um dnr 99-326, 00-171).

2.1. Participants

Of the 69 men who had answered the purpose in life (PIL) scale [24], 51 were interviewed about various aspects of their experiences of becoming and being very old. These interviews were tape-recorded and transcribed verbatim. In the first step of the selection of the text, all the text containing various aspects of their lives, such as experiences of aging, difficult and positive life events, and PIL from 30 interviews (10 interviews from those measuring highest and 10 from those measuring lowest and 10 from those who had estimated themselves as average of the PIL scale) was analyzed. After this first analysis of all the text only the text from the specific questions about PIL was chosen for analysis. Twenty-three men out of 30 had narrated about their meaning of purpose in life and these narratives were included in this study. Eight of the participants were 85 years old, ten were 90 years old, and five were 95 years of age or older. A majority of the men lived alone (n = 18), five lived in an institution, ten were independent in activities in daily life (ADL), two had impaired reading vision, and ten of the men had impaired hearing. None of the men included in the study was diagnosed as depressed.

2.2. Data Collection

The participants were informed about the study and invited to take part by letter and by telephone. Initially, the participants answered a number of questionnaires, including the Purpose in Life test [25]. On a second occasion specific to this study, about one week later, narrative interviews were performed at the participants’ homes. The interviews lasted between 30 and 90 minutes each and were conducted by two men and five women, all nurse researchers belonging to the same research team. In this study, we focus on answers from the specific questions asked about purpose in life.

2.3. Analysis

The interviews were analyzed using qualitative content analysis a method useful in analysis of person’s experiences, reflections, and attitudes as described by [26- 28]. In the first step all the text about PIL was read through by two of the authors to obtain an overall picture of how purpose in life was narrated. The interviews were divided into “meaning units” (sentences and fragments with latent meanings), codes, and categories, and sorted into three content areas. Thereafter we looked for discourses about the way PIL was being addressed and “talked” about. The analysis was performed separately by two of the authors and discussed in depth by two of the authors until consensus was reached. To confirm the results, the categories and the found discourses (as shown in Table 1) were discussed and reflected upon several times by all the authors. The results are presented in three content areas with underlying categories illustrated by quotations.

3. RESULTS

The participants talked about purpose in life from various perspectives, which were categorized into three main discourses: 1) Talking of purpose of life in general, including the categories work, struggle, forming a family, and confidence, 2) Talking of own purpose in life, including the categories happiness, adaptation, and looking forward, and 3) Reflecting on purpose in life including the categories limited meaning, health, an honorable life, and the ability to face death.

3.1. Talking of Purpose of Life in General

Table 1. Content areas and categories.

Work was stressed as an important source of purpose for men who had worked hard earlier in life, whose work had dominated their lives, and who described themselves as “workaholics.” Work building their own homes was very important to their experiences of purpose in life, as were feelings of self-respect and personal worth from their previous work: “Purpose in life is primarily work. I had a fantastic job and I was keen to manage my job well.” The men had experienced hard times and lack of resources, and their earlier lives were described as dominated by hard work.

Struggle was expressed in terms of the struggle for money, and this struggle gave the very old generation strength and purpose. “In my childhood there was never 25 cents left, and that was of course a hard time.” While they were proud of their earlier struggles, the old men felt that younger people did not respect or appreciate the older generation’s hard work to survive. Some thought that people today made too much money for too little effort compared with the old days when it was much harder to earn a living.

Forming a family was also a main purpose in life— both living with a loving wife and feeling that the marriage had been totally perfect without any disputes. One man’s purpose in life was expressed in terms of the joy of having married, settled down, and “created a family.”

One man said: “I met my lovely wife, and we have had it very nice together and got very nice children and grandchildren, so it has always been positive.” Having children and grandchildren was stressed as important for purpose in life. One man talked about how taking care of his grandchild for long periods contributed to his having a purpose in life.

To have confidence in relation to other people, society, and a higher power were stressed as important for experiencing purpose in life as a whole. The confidence in God was expressed as the ability during life to rely on God and place everything in God’s hands. To have confidence and rely on God made both daily news and the reality of death understandable, as one man said: “When I read the newspaper and see all the obituaries, I feel confident that there is a higher power, and this faith gives me strength.”

3.2. Talking of Own Purpose in Life

Experiencing purpose in life was also described as being happy in everyday life and thinking positively in every situation. Making the most of one’s day was expressed as a purposeful act: “I see the positive in every day, and tomorrow is a new day.” Finding joy in everyday situations and taking each day as it comes were important for purpose in life: “I take the day as it comes. I never dig myself into things. I always see things from the bright side. I go to the shop and talk to people.”

Being able to adapt to bodily changes, to continue to feel satisfied in life despite functional decline, and maintaining everyday activities were also mentioned as contributing to purpose in life: “For me, purpose in life is being able to get up in the morning and get dressed. That is worth a great deal. If you can’t do that and you just lay in bed, there would be no purpose in life at all.” Adaption was described by one man who expressed relief about knowing that he would soon move into an apartment in a block with services for the elderly and not have to worry about his daily shopping anymore.

Continuing with hobbies was also stressed as giving purpose in life: “I went fishing this spring in the river, and I got seven large graylings, and I have fish left in the freezer. I have always had this as a hobby.” Looking forward, continuing with life, and making plans for the future despite very old age were important. One man’s plans for the summer and for the future were especially ambitious: “I have very clear goals and purpose; I have announced that I will plant six acres of forest.” Maintaining interest in life and what is happening in the world and looking ahead contributed to meaningfulness. Despite the fact that some of the men were prevented by disability from continuing to work outside the home, it was still important to feel that they could do their duty to make life meaningful: “I have to fill in my income-tax return and do my duty.”

3.3. Reflection on Purpose in Life

Reflections on purpose in life included questioning whether there was a purpose in life at all, feelings of complete boredom, and the sense that every day was exactly the same as the day before. The view that purpose in life was limited was expressed assertions that all humans were totally bound by heredity and environment and was therefore powerless to do or say anything to change that fact. “Well, you see, I have in fact given up on everything.”

Reflecting on purpose in life in relation to their physical abilities, the men talked about their treatment by other people who see them as no longer physically capable. “Since I retired, it is like I have to break in to get my voice heard in a conversation.” Within this category they stressed the importance of being healthy, both for themselves and for their families.

Living an honorable life, being good to others, knowing they had done their best and been decent were important to feeling purpose in life: “Just to live decently, you don’t need to live like a king.” Some men said it was important to “love your neighbor as you love yourself.” Living an exciting and challenging life was also seen to contribute to purpose in life. One man talked about his experiences of traveling around the world and seeing different things as an old man; however, he wondered whether traveling could be the purpose in life, or whether it was just something fun or pleasurable to do. “It was nice to travel, but I’m not really sure if this is really the meaning, because before we had those opportunities to travel, there was also meaning in life.” The narratives indicated that the men experienced more purpose in life when they were younger. “When I was younger I wanted so much. I wanted to go forward, so I think purpose in life was greater then.” The men reflected on why people are born, work all their life, and then die, and what might happen after death. Their reflections upon death were told without any fear and with acceptance that there was nothing they could do to avoid it. “You have to face death when it comes.”

4. DISCUSSION

The aim of the study was to illuminate very old men’s experiences of and reflections on purpose in life. The results revealed three content areas: purpose of life as a whole; purpose in everyday life; and reflections on purpose in life. The joy of work was prominent in almost all of the narratives and pride in previous work was stressed as important to purpose in life. From the historical perspective, in the first part of the 19th century “being a man” entailed being the provider and usually the sole financial support for the household [6]. These men’s emphasis on their own physical hard work as important for purpose in life can be seen in light of Connell’s [29] (1995) theory of hegemonic masculinity, which is the masculinity that is the most valued in a specific historical society and requires all men to position themselves in relation to it [10]. Men’s emphasis on the importance of work in this study was probably influenced by the importance of the traditional role requirement of a man to be a strong man. The men had also experienced poverty as children, and their lives were characterized by that hard work was a possibility to increase their economic status.

The men told with pride how they had built their own houses and created their homes. Russell [30] reported that older men and women discuss the meaning of home differently. Men attribute their feelings for home in terms of building and renovating their physical houses, which they see as identical to forming the home. The meaning of home for women, on the other hand, is deeply connected to their personal identities: women see the home as both an extension of themselves and the place where they should be [30].

The men described their ability to adapt as important to their ability to experience purpose in life. Men who belonged to the oldest old spoke of adapting in terms of the importance of being able to get up and get dressed. Baltes and Baltes [31] have constructed a model of successful aging called selective optimization with compensation (SOC). The SOC model builds on the assumption that throughout life people have both opportunities and limitations, including illnesses that can be managed or mastered by using a combination of the three components of the model: selection, optimization, and compensation [31]. Freud and Baltes [32] found that people who used SOC life-management behaviors such as compensation were more satisfied in life. Reflecting on past achievements to reconnect to associated self-respect and personal worth is one way older people may independently, or with use of the SOC model use as a strategic model for maintaining purpose in life.

Our study showed that the oldest old men experienced and reflected over purpose in life which can be seen as a contradiction to other descriptions of belonging to the oldest old as for instance in Ferrucci et al., [33] who describe that very old people just tend to be described as a homogenous group with functional decline and high consumption of health care resources. Calasanti and King [13] have reflected over how old men are described in media. They argued that a more refined form of agism is an attempt to portray old men in a more positive light by setting up middle-aged men as the standard of virility and health. Doing so the description of being a man seems not be congruent with being old in reality. Green [34] argued that views on very old men are focused on the predominant effort to understand men’s aging bodies and health problems, in particular their medical problems. He means that it t is vitally important that very old men are seen as a heterogeneous group with various levels of strength and abilities instead of a homogeneous group defined by frailty [34]. Our study shows that in spite of their very old age, the oldest old men do experienced purpose in life.

Our study shows the importance of having hobbies and making future plans in maintaining purpose in life. Being healthy was stressed as important for purpose in life. Healthy aging is a complex process of adapting to physical, psychological, and social changes across the life span [35]. According to Rowe and Khan’s [36] model of healthy aging, it is necessary for older people to play an active role in maintaining their physical and mental health and to optimize their capacity as much as possible until the end of life and Purpose in life has long been hypothesized to be an important determinant for physical health and well-being [37]. Thus, these concepts seem to be closely interrelated.

This study shows that very old men experience purpose in life mainly when remembering the past and when making future plans, which is in contrast to the Hedberg et al. [38] study of purpose in life in very old women. The women in that study seemed to enjoy life and were grateful even for small daily things, such as having the strength to wipe off the table. The women expressed purpose in life as taking the day as it comes, and having family and friends around for a chat was seen as purposeful, while the men’s narratives of purpose in life focused mainly on their previous work. Very old men and women seem to find purpose in life in different terms, with very old men finding purpose in life either in the past or in the future, and very old women finding purpose in the present and their everyday life. Men, however, seem to reflect more over the concept purpose in life than women do [5]. This finding may be interpreted as men are socialized to become reflecting subjects, while women are socialized to become immanent objects.

One man in our study expressed negative feelings about purpose in life and said that he had practically given up. From the perspective of Frankl [18], he can be seen as living in an existential vacuum and; from a biological medical perspective he is likely depressed. It is essential in the care of very old men and women to help them maintain purpose in life in order to prevent the risk of existential vacuum, which can lead to psychological ill-health. Purpose in life seems to be relevant and worth being reflected on for very old men even in their latest part of life. Likewise if there were statements that showed that purpose in life was connected to faith in god, no men told about that in addition to purpose in life there also could be a purpose in death.

5. METHODOLOGICAL CONSIDERATION

For this study we analyzed data about purpose in life from 23 men who completed the PIL questionnaire. Throughout the process we discussed the analysis and our interpretation in depth, both among the authors and within a seminar group, in order to ensure that we did not over-interpret the text. Our analysis is also strengthened by our first analysis of 30 interviews. The PIL scores among the 23 included men ranging from 77 to 134, and can therefore be seen as a representative sample of all men answering the PIL test (n = 69) in the larger study. One limitation of this study is that the participants were a selected group of cognitively healthy individuals who cannot be assumed to be representative of the entire population of very old people. However, we believe that our results may be transferable to other very old people in a similar context.

6. CONCLUSION

Our findings showed that very old men talked about PIL in various ways. They experienced purpose in life most strongly when remembering the past and describing their earlier work. The old men also reflected on purpose in life not just from their own individual perspectives, but also from a more reflective and analytic perspective. From a nursing perspective it ought to be of importance to listen to, and open up for how old men talk about PIL for enhancing their possibility to either experience PIL, or their ability to create PIL in their everyday life.

7. ACKNOWLEDGEMENTS

We are grateful an anonymous referee for helpful comments. All errors are ours.

REFERENCES

1. von Heideken Wågert, P. (2006) Health, physical ability, falls and morale in very old people: The Umeå 85+ study. Umeå University Medical Dissertations, New Series No. 1038-ISSN 0346-6612-ISBN 91-7264-130-4, Umeå University, Umeå.
2. Nygren, B. (2006) Inner strength among the oldest old; a good aging. Umeå University Medical Dissertations, New Series No. 1065-ISBN 91-7264-201-7, Umeå University, Umeå.
3. Bergdahl, E. (2007) Depression among the very old. Umeå University Medical Dissertations, New Series No. 1132- ISSN 0346-6612-ISBN 978-7264-423-6, Umeå University, Umeå.
4. Aléx, L. (2007) Old people’s narratives about growing and being old from gender and ethnicity perspectives. Umeå University Medical Dissertations, New Series No. 1081-ISSN 0346-6612-ISBN 978-7264-248-5, Umeå University, Umeå.
5. Hedberg, P. (2010) Purpose in life among very old people. Umeå University Medical Dissertations, New Series No 1384. ISSN 0346-6612, ISBN 978-91-7459-106-4, Umeå University, Umeå.
6. Hirdman, Y. and Andreasen, Y. (1991) The gender system. In: Andreasen, T., Borchorst, A., Dahlerup, D., Lous, L. and Nielsen, R., Eds., Moving On, Aarhus University Press, Aarhus, 187-207.
7. Hirdman, Y. (1994) Women—From possibility to problem? Arbetslivscentrum, Stockholm.
8. Courtenay, W.H. (2000) Constructions of masculinity and their influence on men’s well-being: A theory of gender and health. Social Science and Medicine, 50, 1385-1402.doi:10.1016/S0277-9536(99)00390-1
9. Courtenay, W.H. (2000) Behavioral factors associated with disease, injury and death among men. Evidence and implications for prevention. The Journal of Men’s Studies, 9, 81-142. doi:10.3149/jms.0901.81
10. Connell, R.W. and Messerschmidt, J.W. (2005) Hegemonic masculinity. Rethinking the concept. Gender & Society, 19, 829-859. doi:10.1177/0891243205278639
11. Aléx, L., Hammarström, A., Norberg, A. and Lundman, B. (2008) Construction of masculinities among men aged 85 and older in the north of Sweden. Journal of Clinical Nursing, 17, 451-459. doi:10.1111/j.1365-2702.2007.01961.x
12. Knodel, J. and Ofstedal, M.B. (2003) Gender and aging in the developing world: Where are the men? Population and Development Review, 29, 677-698. doi:10.1111/j.1728-4457.2003.00677.x
13. Calasanti, T. and King, N. (2005) Firming the floppy penis: Age, class, and gender relations in the lives of old men. Men and Masculinities, 8, 23.doi:10.1177/1097184X04268799
14. Swedish Statistics Bureau (SCB) (2009) Population of Sweden in a cohort 2007-2050. Statistics Sweden, Stockholm.
15. Pinquart, M. (2002) Creating and maintaining purpose in life in old age: A meta-analysis. Ageing International, 27, 90-114. doi:10.1007/s12126-002-1004-2
16. Encel, S., Kay, M. and Zidekowski, G. (1996) Keeping in touch: Older people living alone. New South Wales Consultative Committee on Ageing, Sydney.
17. Davidson, K., Daly, T. and Arber, S. (2003) Older men, social integration and organizational activities. Social Policy & Society, 2, 81-89.doi:10.1017/S1474746403001118
18. Frankl, V. (1958) The will to meaning. Journal of Pastoral Care, 12, 82-88.
19. Frankl, V. (1955) The doctor and the soul. Alfred A Knopf, New York.
20. Bechtel, G. (1994) Purpose in life among gay men with HIV disease. Nurse Connections, 7, 5-11.
21. Lewis, M.P., Erlen, J.A., Dabbs, A.D., Breneman, K. and Cook, C. (2006) The utility of the purpose-in-life test in persons with AIDS. Journal of the Association of Nurses in AIDS Care, 17, 51-59. doi:10.1016/j.jana.2005.11.005
22. Smith, B.W. and Zautra, A.J. (2004) The role of purpose in life in recovery from knee surgery. International Journal of Behavioral Medicine, 11, 197-202.doi:10.1207/s15327558ijbm1104_2
23. Kruse, A. and Schmitt, E. (2006) A multidimensional scale for the measurement of agreement with age stereotypes and the salience of age in social interaction. Ageing and Society, 26, 393-411. doi:10.1017/S0144686X06004703
24. Hedberg, P., Gustafson, Y. and Brulin, C. (2010) Purpose in life among men and women aged 85 years and older. International Journal of Aging and Human Development, 70, 213-229. doi:10.2190/AG.70.3.c
25. Crumbaugh, J. and Maholick, L.T. (1964) An experimental study in existentialism: The psychometric approach to Frankl’s concept of noogenic neurosis. Journal of Clinical Psychology, 20, 200-207. doi:10.1002/1097-4679(196404)20:2<200::aid-jclp2270200203>3.0.CO;2-U
26. Downe-Wamboldt, B. (1992) Content analysis: Method, applications, and issues. Health Care for Women International, 13, 313-321. doi:10.1080/07399339209516006
27. Graneheim, U.H. and Lundman, B. (2004) Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24, 105-112. doi:10.1016/j.nedt.2003.10.001
28. Kripendorff, K. (2004) Content analysis: An introduction to its methodology. Sage, Thousand Oaks.
29. Connell, R.W. (1995) Masculinities. University of California Press, Berkley.
30. Russell, C. (2007) What do older women and men want? Gender differences in the lived experience of ageing. Current Sociology, 55, 173-192. doi:10.1177/0011392107073300
31. Baltes, P.B. and Baltes, M.M. (1990) Psychological perspectives on successful aging: The model of selective optimization with compensation. In: Baltes, P.B. and Baltes, M.M., Eds., Successful Aging: Perspectives from the Behavioral Sciences, Cambridge University Press, New York, 1-34. doi:10.1017/CBO9780511665684.003
32. Freund, A.M. and Baltes, P.B. (1998) Selection, optimization, and compensation as strategies of life management: Correlation with subjective indicators of successful aging. Psychology and Aging, 13, 531-543. doi:10.1037/0882-7974.13.4.531
33. Ferrucci, L., Guralnik, J.M., Studentski, S., Fried, L.P., Cutler Jr., G.B. and Walston, J.D. (2004) Designing randomized controlled trials aimed at preventing or delaying functional decline and disability in frail older persons: A consensus report. Journal of American Geriatric Society, 52, 625-634. doi:10.1111/j.1532-5415.2004.52174.x
34. Green, B.S. (1993) Gerontology and the construction of old age: A study in discourse analysis. Aldine de Gruyter, Hawthorne.
35. Peel, N., Bartlett, H. and McClure, R. (2004) Healthy ageing: How is it defined and measured? Australasian Journal on Ageing, 23, 115-119. doi:10.1111/j.1741-6612.2004.00035.x
36. Rowe, J.W. and Khan, R.I. (1994) Successful aging. The Gerontologist, 37, 433-440.doi:10.1093/geront/37.4.433
37. Ryff, C.D., Singer, B.H. and Dienberg, L.G. (2004) Positive health: Connecting well-being with biology. Philosophical Transactions of the Royal Society of London, Series B, Biological Sciences, 359, 1383-1394. doi:10.1098/rstb.2004.1521
38. Hedberg, P., Brulin, C. and Aléx, L. (2009) Experiences of purpose in life when becoming and being a very old woman. Journal of Women & Aging, 21, 125-137.doi:10.1080/08952840902837145

New research using a murine model (mice) suggests that a sudden decrease in testosterone levels in men can create Parkinson's Disease symptoms in men. In the study, mice that were castrated experienced dramatic increases in brain levels of inducible nitric oxide synthase (iNOS) and nitric oxide. Too much nitric oxide (which are generated by the iNOS) kills neurons in the brain. The researchers note, "Interestingly, castration does not cause Parkinson's like symptoms in male mice deficient in iNOS gene, indicating that loss of testosterone causes symptoms via increased nitric oxide production."

Further, "We found that the supplementation of testosterone in the form of 5-alpha dihydrotestosterone (DHT) pellets reverses Parkinson's pathology in male mice."

Currently, it's not clear if the sudden decrease in testosterone has the same effect in human males. But further research is planned.

If this result can be replicated in humans, there are serious implications for male health. Testosterone levels are clearly linked to many disease processes. In most males, testosterone levels reach their peak from late teens to late 20s. Here is a sample distribution from the study cited below.

Simon D. Nahoul K. Chades MA. (1996). Sex hormones, ageing, ethnicity and insulin sensitivity in men: An overview of the Telecom study. In: Androgens and the ageing male.  Eds. Oddens B. Vermeulen A. Parthenon Publishing. New York.

          Testosterone levels measured in ng/dl

Age	Subjects	Mean	Standard Deviation	Median
< 25	125	692	158	697
25-29	354	669	206	637
30-34	330	621	194	597
35-39	212	597	189	567
40-44	148	597	198	597
45-49	154	546	163	527
50-54	164	544	187	518
55-59	155	552	174	547

However, testosterone levels may fall drastically due to chronic stress or highly stressful life events (death, divorce, job less, and so on). Other factors for low testosterone can be environmental toxins (xenoestrogens, for example), inflammation, free radicals (causing mitochondrial damage), dietary choices (soy extracts [genistein, daidzein], black licorice extract [a sweetener], alcohol), and obesity (increases estrogen levels and causes inflammation) This list could go on an on.

Finally, there is one other major concern here. One half of all men will be diagnosed with prostate cancer in their lifetimes (and the other half would if they lived long enough). One of the frontline treatments, despite a lot of evidence that the health risks for those who survive far outweigh the extra few months a man might get if his cancer is aggressive and terminal, is androgen depletion therapy (ADT). Never let a doctor do this to you. Aggressive (i.e., deadly) forms of prostate cancer are NOT androgen-dependent - they are estrogen dependent.

ADT has been linked to muscle loss, weight gain, gynecomastia, diabetes, impotence, depression, bone loss, and a series of other issues. According to this new study, we may be able to add Parkinson's Disease to that list.

Sudden Decline in Testosterone May Cause Parkinson's Disease Symptoms in Men

July 26, 2013 — The results of a new study by neurological researchers at Rush University Medical Center show that a sudden decrease of testosterone, the male sex hormone, may cause Parkinson's like symptoms in male mice. The findings were recently published in the Journal of Biological Chemistry.

One of the major roadblocks for discovering drugs against Parkinson's disease is the unavailability of a reliable animal model for this disease.

"While scientists use different toxins and a number of complex genetic approaches to model Parkinson's disease in mice, we have found that the sudden drop in the levels of testosterone following castration is sufficient to cause persistent Parkinson's like pathology and symptoms in male mice," said Dr. Kalipada Pahan, lead author of the study and the Floyd A. Davis endowed professor of neurology at Rush. "We found that the supplementation of testosterone in the form of 5-alpha dihydrotestosterone (DHT) pellets reverses Parkinson's pathology in male mice."

"In men, testosterone levels are intimately coupled to many disease processes," said Pahan. Typically, in healthy males, testosterone level is the maximum in the mid-30s, which then drop about one percent each year. However, testosterone levels may dip drastically due to stress or sudden turn of other life events, which may make somebody more vulnerable to Parkinson's disease.

"Therefore, preservation of testosterone in males may be an important step to become resistant to Parkinson's disease," said Pahan.

Understanding how the disease works is important to developing effective drugs that protect the brain and stop the progression of Parkinson's disease. Nitric oxide is an important molecule for our brain and the body.

"However, when nitric oxide is produced within the brain in excess by a protein called inducible nitric oxide synthase, neurons start dying," said Pahan.

"This study has become more fascinating than we thought," said Pahan. "After castration, levels of inducible nitric oxide synthase (iNOS) and nitric oxide go up in the brain dramatically. Interestingly, castration does not cause Parkinson's like symptoms in male mice deficient in iNOS gene, indicating that loss of testosterone causes symptoms via increased nitric oxide production."

"Further research must be conducted to see how we could potentially target testosterone levels in human males in order to find a viable treatment," said Pahan.

Other researchers at Rush involved in this study were Saurabh Khasnavis, PhD, student, Anamitra Ghosh, PhD, student, and Avik Roy, PhD, research assistant professor.

This research was supported by a grant from the National Institutes of Health that received the highest score for its scientific merit in the particular cycle it was reviewed.

Parkinson's is a slowly progressive disease that affects a small area of cells within the mid-brain known as the substantia nigra. Gradual degeneration of these cells causes a reduction in a vital chemical neurotransmitter, dopamine. The decrease in dopamine results in one or more of the classic signs of Parkinson's disease that includes resting tremor on one side of the body; generalized slowness of movement; stiffness of limbs and gait or balance problems. The cause of the disease is unknown. Both environmental and genetic causes of the disease have been postulated.

Parkinson's disease affects about 1.2 million patients in the United States and Canada. Although 15 percent of patients are diagnosed before age 50, it is generally considered a disease that targets older adults, affecting one of every 100 persons over the age of 60. This disease appears to be slightly more common in men than women.

Story Source:

The above story is based on materials provided by Rush University Medical Center.

Journal Reference:

S. Khasnavis, A. Ghosh, A. Roy, K. Pahan. (2013, Jun 6). Castration Induces Parkinson Disease Pathologies in Young Male Mice via Inducible Nitric-oxide Synthase. Journal of Biological Chemistry; 288 (29): 20843-20855. DOI:10.1074/jbc.M112.443556

Full Title and Abstract:

Castration Induces Parkinson Disease Pathologies in Young Male Mice via Inducible Nitric-oxide Synthase

Saurabh Khasnavis, Anamitra Ghosh, Avik Roy, and Kalipada Pahan

Capsule

• Background: Developing a simple irreversible animal model to study nigrostriatal pathologies is important for Parkinson disease (PD).
• Results: Castration induces glial activation and death of dopaminergic neurons in wild type, but not iNOS−/−, young male mice.
• Conclusion: Castration induces nigrostriatal pathologies via iNOS.
• Significance: Castrated male mice may be used as a simple, toxin-free, nontransgenic, and irreversible animal model for PD.

Abstract

Although Parkinson disease (PD) is a progressive neurodegenerative disorder, available animal models do not exhibit irreversible neurodegeneration, and this is a major obstacle in finding out an effective drug against this disease. Here we delineate a new irreversible model to study PD pathogenesis. The model is based on simple castration of young male mice. Levels of inducible nitric-oxide synthase (iNOS), glial markers (glial fibrillary acidic protein and CD11b), and α-synuclein were higher in nigra of castrated male mice than normal male mice. On the other hand, after castration, the level of glial-derived neurotrophic factor (GDNF) markedly decreased in the nigra of male mice. Accordingly, castration also induced the loss of tyrosine hydroxylase-positive neurons in the nigra and decrease in tyrosine hydroxylase-positive fibers and neurotransmitters in the striatum. Reversal of nigrostriatal pathologies in castrated male mice by subcutaneous implantation of 5α-dihydrotestosterone pellets validates an important role of male sex hormone in castration-induced nigrostriatal pathology. Interestingly, castration was unable to cause glial activation, decrease nigral GDNF, augment the death of nigral dopaminergic neurons, induce the loss of striatal fibers, and impair neurotransmitters in iNOS−/− male mice. Furthermore, we demonstrate that iNOS-derived NO is responsible for decreased expression of GDNF in activated astrocytes. Together, our results suggest that castration induces nigrostriatal pathologies via iNOS-mediated decrease in GDNF. These results are important because castrated young male mice may be used as a simple, toxin-free, and nontransgenic animal model to study PD-related nigrostriatal pathologies, paving the way for easy drug screening against PD.