Mr. Deetlefs Sings in Cavalleria Rusticana

Hannes Deetlefs is an active – we might even say busy – pensioner. He writes books, offers others help with their English, tends to his self-made model railway in the garden, sings in choirs, paints with oils, likes to cook (and experiment), has celebrated his fiftieth wedding anniversary and is “still in love”. Having recently passed his “audition” with the cantonal doctor, the 76-year-old is still permitted to drive buses, coaches, and trucks – and large motorbikes, a fact he underlines as pursuing his passion for heavy vehicles is another hobby. By profession, Hannes Deetlefs was a teacher of languages and mathematics.

Deetlefs is one of 150 participants in MOASIS, a study conducted for the University’s research priority program “Dynamics of Healthy Aging”. MOASIS stands for Mobility, Activity and Social Interactions Study, and involves test persons aged between 65 and 90 years old whose everyday behavior is recorded over a period of 30 days. The aim of the interdisciplinary long-term study, which will be continued this year, is to understand what healthy older people do every day and how this affects their health and well-being.

The study is unique in that it measures various dimensions of a person’s everyday behavior simultaneously. Two factors make this possible: the sophistication of the study’s design, and uTrail, a small device with several functions. uTrail is a portable sensor that can be attached to a person, for example on their belt. Using a GPS tracker, it tracks the person’s movement in space, measures their physical activity and captures snippets of their conversations with a microphone.

In addition to the data provided by uTrail, the test persons were required to answer questions several times a day – played to them on their smartphones – about their behavior and well-being. They also had to quickly solve a few mental exercises to provide information about how well their working memory functioned. Working memory is a good indicator of cognitive fitness, as its performance is influenced by what we do every day. Testing working memory is therefore another way of measuring the extent to which everyday activities, like holding a conversation, can affect all kinds of health factors, including cognitive skills.

“All these different bits of information enable us to draw a relatively accurate picture of the participants’ everyday lives,” says psychologist Christina Röcke, who’s leading the study with geographer Robert Weibel. What’s important, she adds, is to compare, check and classify the information correctly, and place it in the respective situational context. This is only possible thanks to the range of information collected: in addition to GPS and movement-generated data, the information includes the answers to the short questions set during the course of the day, and the short audio recordings made several times a day.

Hannes Deetlefs gives an example to illustrate the importance of context: “I spend quite a lot of time in the living room. Based on this information, it was first assumed I was watching TV there.” But far from it: “I don’t watch TV but play the piano a lot.” The researchers assessed this quite differently from watching TV, as it’s active and cognitively much more challenging. This gives a very different picture of Mr. Deetlefs and his lifestyle – no couch potato but a piano virtuoso. Knowing what people do all day long is the first step in MOASIS research. This information is valuable and can be evaluated in many ways – even as far as making linguistic analyses of the conversation fragments.

What Christina Röcke and her colleagues are ultimately interested in, however, is whether people’s everyday behavior makes them healthy and happy – or not. Initial results already show interesting correlations. Basically, the more active we are in old age, the better. Being active is something like the Mediterranean cuisine of behavior – healthy and beneficial. However, Christina Röcke emphasizes that quality is more important than quantity: “We recommend that people are active in as many ways as possible. Those who constantly set themselves new challenges train their cognitive and physical abilities.”

An important aspect of mental fitness is our social life. A good conversation challenges us intellectually and improves or maintains our ability to think. Being mobile – not only mentally but also geographically – is good for us too. “Our data shows that the more diverse the places they visited, the happier our test persons were,” Röcke says. For this reason, traveling by train boosts well-being, probably because this mode of travel makes it easier to visit unfamiliar and different places. An SBB general season ticket could therefore be a valuable investment in our personal level of life satisfaction – all of which now explains the beaming faces on pensioners happily boarding the early morning and evening trains, especially those kitted out for a hiking trip. Variety adds interest to life and keeps us healthy. So, what would a retired couple’s ideal day look like, Christina Röcke? “She’d do something sporty, meet a friend and work in the garden. He’d look after the grandchildren, walk the dog and do a crossword puzzle. The important thing is to do things that you love and make sure you have variety.”

Jean-Pierre Zosso, another MOASIS participant, has also learned this: “I exercise every day, but I don’t just stick to the same things as before.” His goal is to activate his brain cells and body in as many ways as possible every day, the 88-year-old says. Thanks to the study, he’s also met new people and made new contacts, he adds. But what’s the point of it all – why should we be striving to be so active when we’re retired instead of enjoying an easy life and resting on our laurels? “So that we can lead as independent a life as possible for as long as possible,” is the answer that aging research gives. After all, being old today no longer automatically means being banished to the scrap heap. Today we’re getting ever older, staying healthy for ever longer, and doing things that were no longer possible for older people in the past. In its new model of healthy aging (2020), the World Health Organization WHO stresses that older people should remain functionally healthy for as long as possible, which means being mobile, maintaining relationships and being able to contribute to society, “always with a focus on what’s important to them in all these areas of activity and what gives them pleasure,” Christina Röcke says.

All this contributes to quality of life – the essence of which depends on having sufficient physical and cognitive reserves to lead an independent and self-determined life in old age. “We accumulate these reserves throughout the course of our life and draw upon them in old age,” Christina Röcke explains. Just like the financial reserves we set aside. With enough physical and mental activity, we can help build up the reserves and maintain them for as long as possible. “Think of it like a sponge that fills up and is then squeezed out,” Röcke says. Losses are to be expected in old age, but the aging process varies from person to person. Part of the art of aging is to accept such losses and, when we’re no longer able to do a certain activity, look for alternatives that also give us pleasure. For example, when jogging becomes too strenuous or too painful, we can switch to long walks; or get a transport service to chauffeur us to our weekly bridge session instead of driving ourselves there in our own car.

The greater our reserves, the better we’re able to cope with setbacks and the longer we’re able to stay above the “critical threshold” that allows us to live independently. It’s when our abilities fall below this threshold that we’re dependent on help.

So, we’ve learned that if we want to live a good and independent life for as long as possible, we mustn’t allow ourselves to get too comfortable. However, Röcke stresses, each person has a different idea of what a good life is or what kind activity does them good – also over different periods in their own life. Some people need less social interaction than others, for example. And some people travel home tired but fulfilled after a long mountain hike, while others are happy walking the dog. In the same way, many people have their own personal rhythm when it comes to the need for social time and quiet time alone, for example.

Such variations can be observed not only between different people, but also in an individual person. “That’s why it’s so important from a research perspective to collect data from people’s everyday lives and over longer periods of time. And it’s important for each individual to know what works for them in the context of each stage of life and everyday setting,” Röcke says. “Especially when we want to change our behavior. It has to make sense to us and feel right. Otherwise it’s not sustainable.”

MOASIS helps the researchers to understand such connections, precisely because it covers the participants’ everyday lives so closely. This year it’s going into its second round and the participants in the first study, conducted in 2018, will be surveyed again. But the group will gain reinforcements: more older people are to be included as well as a comparison group of younger adults (see box below for information). The aim of the new study is to see how everyday activities affect people’s health in the long term. As Christina Röcke explains: “We’re wondering, for example, whether a variety of activities and places visited not only have a favorable effect on people’s short-term working memory, but also serve to protect and maintain their memory more generally and through the future stages of the aging process.” Thanks to MOASIS research, we’ll become ever better at knowing what’s good for us and how to age more healthily. In the meantime, Hannes Deetlefs has started learning Italian. He’s singing in the opera Cavallaria rusticana by Pietro Mascagni to be performed by the Musiktheater Wil next year.

This text is taken from the dossier "Aging Well" from the current UZH Magazin 3/2023