July is my birthday month. As I move closer to Medicare eligibility, I remember that as a child and young adult, this age seemed so far in the future that I was sure it would take eons to reach. Alas-Tempus fugit! My mind tells me there must be a mistake because my real-time experience is not what I had anticipated. Thinking further on this, I decided I needed to put all of this in the proper perspective. A quote from the famous baseball player Satchel Paige set the stage: "How old would you be if you didn't know how old you were?"
Age self-defined
I jumped at the chance to self-define my age. I selected one of the popular "real-age" quizzes on the Internet. At the time, it did not matter to me whether or not it was valid because the results were affirming. I answered all the questions as truthfully as I could, and the results indicated I was 19 years younger than the age on my driver's license. What a relief to learn that I was not old yet or at least not the age the calendar showed. Perceptions of age and becoming older change over time; however, traditionally verified numbers become less important. Herein lies the difference between chronological and biological age.
Chronological age vs. biological age
Chronological age is simply the number of years since one's birth, calculated objectively without considering any other factors. In infancy and early childhood, our age is stated in months until 3 years old; then we become 31/2 or 93/4. Soon we advance to "almost" 13 or 18 "in 4 months." Next, we become just the number (25) until we reach the age of Jack Benny-39, at which time counting ceases. After 39, it is simply, "I am close to" (40) or "soon I will have a big one" (50), and so on with lots of secrecy surrounding one's age. Finally, we are 65 and can claim our earned participation in Medicare insurance. If we reach 85 or 100, we proudly proclaim our chronological age to the world. This age may be correct; however, chronological age does not capture the person.
We can then turn to discussions about biological age, which considers other factors that contribute to who you are as a person and how old you are to yourself and to others. Internal and external factors include the body's physical structure and function, status of past and current health conditions, the mind and cognitive abilities, degree of mobility, state of mind and mood, and others. Scientists have not perfected how to reliably determine biological age.
Genetics and the environment are part of the puzzle. But subjective factors definitely play a role as well. We all know people who appear much younger than their stated age-"I feel better today at 60 than I did when I was 40"-and those who seem much older than their calendar years-"I am only 40 but I feel like a 60-year-old."
What accounts for these differences? Other dynamics might be related to psychological and social ages. People and events influence our perceptions of age as well. With the arrival of social media, these influences are stronger and more prevalent than ever.
As healthcare professionals, we must not catalog our patients into conventional groups based on date of birth. Chronological age does not define an individual. When developing appropriate management plans, we have to take these points into consideration and individualize our approach. After all-age is only a number.
Jamesetta Newland, PhD, RN, FNP-BC, FAANP, DPNAP
EDITOR-IN-CHIEF [email protected]