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Keeping Healthy in Kungsholmen

Modifiable lifestyle factors can add six years to men and five years to women’s lifespan at age 75. They can even expand survival by four years in those aged 85.

These are some of the results of an important study from the Karolinska Institute in Stockholm, published in the British Medical Journal.

What you do is what you become—even among the oldest. And half the 75-year-olds lived to be 90. 

How Was the Study Done?

All the residents 75 and over in the Kungsholmen district of central Stockholm were followed up over 18 years. Of the 2,368 people living at home or in institutions, 13 percent refused to be in the study, a relatively low number.

What Determined Who Lived and Who Died?

The usual factors like medical illness and smoking affected lifespan. This study looked at what people themselves did that made them live longer. Interestingly, drinking some alcohol provided a positive outcome—though heavy use did not. Even in the very old, a tiny, regular tipple can delay demise.

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What Made People Live Longer?

Physical activity—no surprise there. People who regularly walked or swam (Sweden has tax-supported public pools) or did “gymnastics” and regular stretching lived two years longer. 

Other factors that proved important in promoting survival were a rich social environment—lots of people to interact with; hobbies and other interests like playing cards or hiking with friends; and “productive activities” like gardening, housekeeping, cooking, sewing, crocheting or doing volunteer work.

Were the Effects of Hobbies and Moving Large?

By public health standards, they were. Medical care may expand survival—for all of one’s life—by two to three years. Here, lifestyle was increasing survival by four years—in people 85 and over.

What Does This Mean Biologically?

That human bodies are constantly rebuilding and regenerating very late in life, and how you live markedly improves or worsens your chances of getting that regeneration right. Lifestyle appeared to have a major impact at pretty much every age—notable in a group which had already survived to 75.

Interestingly, it was the combination of factors that seemed to produce the most impressive results. People who walked around, socialized, went to concerts, gardened and got out of the house did very, very well. Social networks appeared to be big factors in survival. It was not just a matter of friends. “Social” events like going to the theater seemed to have an impact.

How Is Kungsholmen Different from Populations In the U.S.?

First, the district is near the heart of multiple-island Stockholm, and has within its limits City Hall—but not the well-known hospitals of the Karolinska, which are across the water. Called “famine island” in the nineteenth century, much of Kungsholmen was rebuilt in the 1930s as the Social Democrats took power for a period that extended more than 40 years.

Sweden is of course a very different society from the U.S. Taxes are high—with the overall economy expanding nicely since the financial banking crises of the early nineties. At the moment Sweden is doing better economically than the U.S. or the euro zone and has shown solid, consistent growth. The elderly have guaranteed social services and regionalized, organized health care quite different from ours. They generally don’t worry about becoming destitute as they grow old, and worry far, far less about whether there will be provisions for medical care.

Nevertheless, this study was about modifiable lifestyle factors. In a country with organized social and health benefits open pretty much to all, how people as individuals lived markedly changed their lifespan.

Bottom Line

How you live changes how well and how long you’ll live—at any age. That modifiable lifestyle factors could increase lifespan by four years in 85-year-olds is telling.

Lifespan is about lifestyle—and for most of us, it's under our personal control. 

Matthew Edlund, M.D. researches rest, sleep, performance, and public health; he is the author of Healthy Without Health Insurance and The Power of Rest.

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