AGING AND OLDING

I must express gratitude to whoever shared with me the tale of a small cat, visible every day for hours on end, gazing at a garden near its home. Regardless of how many times it passed by, each morning felt like a new beginning. Whenever I recall it, I envision this tiny creature gracefully practicing its steps on the grass, still slightly damp from the morning dew yet vibrant in its radiant green under the early sun. I can picture its front paws stretched out to feel the grass, its delicate head turning in various directions, and its perfect ears attuned in radar position, exploring the same scene and garden each day with lively curiosity. Occasionally, it would elegantly interact with a colorful butterfly fluttering about. As per the enthusiastic account from my unidentified informant, this darling creature appeared utterly captivated by the familiar landscape each morning. With its non-judgmental eyes and boundless energy, it absorbed every aspect of the garden and somehow engaged with the abundance of stimuli to its feline senses. Let's reserve this metaphor of youth for when we talk about aging later.

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Aging. The ultimate and natural cycle of human life and all biological beings. An inevitable stage of the life process that, if we are fortunate enough, immediately precedes death.

We don't often remember that we can grow old at any age, even when we still have plenty of life ahead of us. And the reverse is also true: we can remain youthful even as we inhabit a body that bears the marks of time. So let's talk a bit about being old. Not just elderly, but aged. Not just physically, but mentally.

Viewed through a biological lens, the aging process is intricate and multifaceted, indicating it has numerous contributing factors. We doctors often say that aging involves the gradual depletion of the body's functional reserves. In youth, the body efficiently manages daily demands and sustains optimal function even when faced with stressful events such as trauma or infection, maintaining a state of equilibrium or homeostasis. As time passes, these reserves gradually diminish, leading the organism to operate closer to its capacity, striving to meet both metabolic demands and those arising from internal and external environments. Eventually, it reaches a point where it can no longer adequately fulfill these needs, resulting in the complete exhaustion of the reserves that once kept the physiological system active.

Of course, nothing stops us from working throughout life to age with our vital functions at a level that perfectly satisfies all our needs, despite the passage of time.

And this is where I suggest we use a new term: "olding"—meaning aging gracefully, maturing in contrast to "aging"—the natural process of gradual loss of functional, molecular, cellular, or systemic reserves, whether they be physical or mental, individual or societal.

While aging involves the impact of time on biological processes or their dependent functions, "olding" focuses on the social, cultural, and psychological aspects of time passing—not just on the organism, but on the person. This includes how well individuals and society perceive and experience aging, as well as changes in social status, relationships, and perceptions of identity and purpose in life.

In that sense, are you aging or are you "olding"?

We're aware that aging is a taboo topic. It's easy to see why nobody wants to age. The thought of inhabiting an aged body is something many of us fear or outright reject. Our standard of beauty is tied to having smooth, firm skin and a youthful appearance. Gray hair is seen as a sign of the outdated nature of our existence. And the idea of losing our functional abilities? Simply humiliating.

But if these changes reflect aging, what does "olding" entail? I'll spare you the lengthy discussion and share my personal conclusion, which, while possibly flawed, is the best I've reached so far: the "olded" differ from the "aged" in their ability to interact with the world around them. As we've seen, aging at the organic level corresponds to the loss of functional reserves, and this process is no different at the mental level. For the mind, the reserves lost over time, if we do nothing to prevent their depletion, jeopardize our ability to engage with our surroundings. These interactions, which I refer to as symbolic exchanges, are the ones we humans, with our abstract minds operating on concrete brains, constantly engage in without realizing that they provide us with the feeling of being mentally alive.

Biologically, our cells interact with the body's internal environment to maintain their vital functions. Mentally, we keep our psychic functions alive in much the same way that the awake and enthusiastic kitten we discussed earlier responds to external stimuli: by engaging with them.

I find this perspective compelling. Aging occurs when one stops actively engaging with the world, becoming desensitized to the stimuli around them. While they may maintain minimal interaction, they lose the capacity to renew symbolic exchanges with their environment. These symbolic exchanges are just as essential to mental vitality as gas exchanges are to cellular function.

The aged, regardless of their chronological age, are those who, due to poorly processed experiences or an inherent lack of resources to embrace life as it is, find themselves trapped within their own experiences. They are overly preoccupied with their internal world, neglecting to engage with anything beyond themselves. They merely replay, time and again, the same thought patterns, old emotional reactions to life's events, and a consistently negative outlook towards others. They confine themselves to repeating the same content without alteration or self-reflection, failing to revisit or rejuvenate it. In other words, they are no longer surprised by what they see, interpreting the world through a fixed lens. Unable to perceive the old as anything new, they tend to respond to everything with the same worn-out script that once served them well.

On the other hand, the youthful individual of any age – the "olded" – draws on past experiences but does not merely follow previous blueprints. They perceive the world and connect with others in an open manner, willing to learn new ways to interpret what they perceive and to introduce new patterns of behavior, in other words, fresh ways to respond to stimuli. They tend to be genuinely interested in what others think, feel, and experience, finding joy in discovering the positive aspects of every event and, when faced with challenges, in seeking creative solutions, whether they are new or old. Kittens in the garden.

My "medical recommendation" is simple: take care. Regardless of your age, be mindful of how much you talk versus listen in conversations. They aren’t monologues. Don’t talk as if everything revolves around you, as if others don’t have their own opinions, desires, or topics to share. Interact, listen, ask questions that don’t concern you, and be genuinely interested in the answers you will hear.

Take care of your tendency to conclude that, when you are alone, it’s because people you care about don’t want to give you attention. Don’t cling to the idea that you can’t make new friends or that the only true relationships you had were the ones that no longer exist. Be cautious when you think your dated solutions are the only remedies that will work for you. Or when you think that nothing works for you at all. Take care of your inability to nurture expectations of change for better. Be open to new music, new behaviors, new world problems, the challenges of the new generations, the hope and hopelessness of people around you. Avoid categorizing them as ‘good’ or ‘bad’ because it rigidly divides the world instead of fostering unity. Refrain from being so entrenched in your own opinions that you're unable to appreciate the internal logic behind individuals with differing political beliefs, religious affiliations, ethnic backgrounds, cultural contexts, or even preferences in soccer teams. And let's not even delve into the myriad expressions of sexuality.

Beware how you spend your time, because wasting it is the greatest evidence of the mismatch between a disrupted way of existing and the preciousness of life.

I have elderly patients, one of them in his nineties, who are far from being just aged. I have patients with tired, achy bodies, but with souls still fully engaging with the world, even while bearing the scars collected along the journey.

I hope that throughout your life, you remain open to absorbing the beauty of the world and marvel at it as if each day were the first. I wish for you a life filled with wonder and meaning, where each day brings new discoveries. May you endure many vivid years that ultimately prove to have been truly worth living.

I wish for you to become a healthy and happy elderly person who never identifies solely with being aged. I hope you continue to engage with yourself, with others, and with the world, approaching each day with an open heart and a pure spirit.

I wish you grow old gracefully, never losing your interest or zest for life.

I wish you live fully until the very end.

Image source: the author