New standard measures employees’ real’ age

Quantifying health may help induce change

Nearly everything we do in life can be measured by a number — our grades in school, our salaries, our golf score . . . why not our "health age?" Why not, indeed, echoes Michael Roizen, MD, department chairman of anesthesiology and critical care at the University of Chicago.

"I was seeing a patient who was not complying with his anti-hypertensive medicine," Roizen recalls. "I told him, ’Not many people would bother with a blood pressure of 140/90, but it could make you five years older if you don’t take your medicine.’ The patient told me that people may have warned him he’d die sooner, but no one ever said he’d live older."

While we have numerical targets for nearly everything in our life, says Roizen, "We didn’t have numerical targets for the most important thing to us — our health. Such targets let people know how much difference their choices make."

It was this desire to create such numerical targets that led Roizen to develop the "RealAge" concept, an assessment program that can provide an individual with his "RealAge," as opposed to his numerical age. (Roizen, for example, has a calendar age of 52, but a RealAge of 37.)

Your RealAge is determined by the answers you give on an interactive survey that takes about 30 minutes to complete. The survey covers a broad range of subjects - from nutrition to exercise to family life to driving habits. Once your RealAge has been determined, the program provides recommendations on how you can lower your own RealAge.

What are the sources Roizen used for his age measures? "There are 145 different areas [addressed in the survey]; on each one we combed the literature and did what is called an evidence-based review. If you look at the articles we read in detail, we mathematically analyzed on average ten per topic." In all, Roizen said, he and his researchers reviewed a total of approximately 25,000 articles. (A partial list of the more significant articles is provided on p 143.)

After reviewing the papers, Roizen and his team applied what are called Kaplan-Meyer survival curves, which allow one to calculate the effect of any single factor (in this case, survival), and the influence of a number of factors on that factor.

Numbers provide motivation

From a wellness perspective, the significance of knowing your "real" age is motivation, asserts Charlie Silver, president of RealAge Inc., San Diego. RealAge Inc. is the sponsor of a site on the World Wide Web (www.RealAge.com) that people can visit to take the survey free "What RealAge is is a motivating measurement; through the process of age reduction planning, you can see how things affect you," Silver says.

For example, if your chronological age is 45 and your RealAge is 50, you can lower that age by, say, quitting smoking, losing 20 pounds, taking vitamin supplements, or driving more slowly. Once you have made a lifestyle change, you can revisit the site, take the test again, and see how much "younger" you have become.

"We know we have to eat more vegetables, and get more exercise, but that doesn’t necessarily have meaning," Silver asserts. "We give it meaning by attaching a RealAge to it."

Roizen adds: "You know what $100 can buy you. Now, you can know what certain lifestyle changes can buy’ you in terms of health."

But some Health Risk Appraisals (HRAs) currently use numerical measurements to indicate a certain level of risk.

How does that differ from RealAge? "I believe you need a target that is meaningful, and age is a very meaningful one to us in health," Roizen replies. "Let’s say you are 40 and you score 90% on an HRA; if you go up to 100%, what does that really mean? But if the RealAge program says you are really 45; this how you can get your body to be physiologically 43. You know you have a chance of getting farther from the time you may have a long-term disability."

Applying it to your program

As previously indicated, the RealAge program is provided without cost. Roizen says wellness professionals may find it a useful adjunct to their existing program.

"Have your employees take the survey. Ask them to write down both their current real age and their goals, and have them update it every two months," he suggests. "Have the employees pick two or three things they say they are going to change."

Typically, Roizen says, if the employee picks four things to change, they may do two or three. "In a few months, when they see the benefit of what they have done, they will probably add another change," he says. "Traditionally, that’s what has happened among my patients."

"If you already have an Intranet or Internet site, you can make the program available to your employees by creating a link on your page," adds Silver.

Silver notes that over the next several years, RealAge will be the subject of significant scientific research programs.

"Cornell and Columbia medical schools have applied to the NIH [National Institutes of Health] for $10 million grants to do a long-term longitudinal study of cardiac bypass patients — with one group using RealAge, and the other not using the program," he says. Silver notes that the goal of the research will be "To see if the program can help achieve long-term changes in the quality of health."

Charlie Silver, RealAge Inc., 6498 Weathers Place, Suite 100, San Diego, CA 92121. Telephone: (619) 784-3720, ext. 202. Fax: (619) 784-3721.

Michael Roizen, MD, Professor, The University of Chicago, 5841 South Maryland Ave., Chicago, IL 60637. Telephone: (773) 702-2545. Fax: (773) 702-2190. E-mail: mrzz@midway.uchicago.edu.