Reviewed by Wendy Lipke
In Secrets of Women’s Healthy Ageing, Professor Cassandra Szoeke shares the wisdom revealed by a comprehensive study into women’s health as they age. Originally it was planned as a ‘longitudinal prospective’ investigation into health over the menopausal transition encompassing a period of five years. The study has extended over three decades and shows how to promote overall wellness thus providing the key ingredients for women to live a long and healthy life.
The Women’s Healthy Ageing Project, to date, is the longest ongoing study of its kind in Australia and the team of international investigators has compiled a remarkable amount of data, aiming to raise awareness of modifiable risk factors in women’s health. Their findings cover brain, heart and gut health, diet, sleep, exercise, and the benefits of socialising. But importantly, they highlight how the results relate directly to women’s wellbeing.
The information in the book has been presented as if it were for a talk to an audience, where it is important to have key points presented visually to maintain audience attention. There is a feeling of being in a conversation with someone who is imparting information they have discovered. It seems quite personal. There is some repetition of information as would be expected since the human body is made up of several integrated systems. This repetition can be overlooked because the information imparted is vitally important and needs to be reinforced.
The text is broken up with subheadings, graphs, simple illustrations, tables and also anecdotes and observations made by participating women from all walks of life. An academic work, the book contains a table of contents, pages of notes and an index. The prologue tells the reader about the study and gives an overview of the book itself, which in turn provides information on the project supporters and a paragraph on each of the members of the project scientific advisory panel.
All the chapter topics are addressed ethically with a deep understanding of the issues. When addressing the topic of hormone therapy, the author stresses the importance of seeking advice ‘from your own trusted medical professional’ because a ‘book like this one sits at the frontier of new knowledge and understanding and can state only what is thought to be true at the time it is written’ (130).
In the book, Secrets of Women’s Healthy Ageing, the reader is informed that healthy ageing has two components. One is prevention and minimisation of disease, the other is quality of life and optimisation of ability which put simply is finding ways to make the most of what you have (13). The book reveals ways to maximize optimal health and well-being into old age and gives the reader a crash course in today’s medicine to explain ‘why’, not just ‘what’ (14).
Since regulated research began into human diseases, most projects have been conducted with male participants mainly because women’s health has always appeared to be focussed on ‘bikini health’, obstetrics and gynaecology. The observational study of which this book reports shows that there is ‘value of knowing what we do not know’ and highlights the truth that knowledge takes a long time to be translated from what researchers have discovered to how we as individuals change our practices. There is a need to understand disease evolution, and this is where this long study has been important (142).
The World Health Organisation estimates that 80% of chronic diseases associated with ageing are preventable. Secrets of Women’s Healthy Ageing outlines key areas in life where change can reduce the chance of illness (15). As a result of the project, we now understand that chronic diseases slowly develop from middle age, that things you do in your 40s, 50s and 60s will determine your health in your 70s and that not all diseases affect both genders in the same way. In heart related diseases, women tend to have ‘small vessel’ disease, which slowly strains the heart and is harder to treat while men tend to succumb to ‘large vessel’ heart disease and experience more massive heart attacks (17).
Professor Cassandra Szoeke is well positioned to write this book. She is the principal investigator and chief medical officer of the Women’s Healthy Ageing Project which began in 1990. Professor of medicine, doctor, scientist and clinical researcher, she is an expert in women’s health and is a multi-award-winning clinical researcher who has published more than 200 journal articles. During her career she has held many significant academic positions. In 2012 she was named a Worldwide Who’s Who Professional of the Year in Clinical Research. These distinguished special honourees are selected for their professional accomplishments, academic achievements, leadership abilities, and years of service.
Key points I gleaned from this book were that poor health in old age is not inevitable, and is not simply a consequence of clocking up a lot of years (158); that a key secret to maintaining quality in life in ageing is to adapt to change making the most of our abilities and opportunities (13) and that if you educate a man, you educate an individual but if you educate a woman, you educate a nation (21). I really appreciated that last one.
The message from the women participants is the need to be active, connect and find purpose while taking care to eat well and making regular appointments with your doctor (153). The message from the author is that now is the time for medicine ‘to bring it all together and tackle the body’s integrated system, with all its complexity, to target the remaining challenges in medicine – those that pivot around inflammation and degeneration. Common pathologies, which target the whole body, need this integrated approach’ (158).
This book will certainly pique the interest of the older woman because of the title but I doubt that women in their 40s and 50s would be thinking much about ageing. Yet this book is vital for them to read as it is in these years when changes need to be made.
I found this an interesting book and am sure it will advance the knowledge of medicine particularly for women.
Melbourne University Press