In this interview, Lily Sarafan, COO of Home Care Assistance and co‑author of Happy to 102, discusses the impending rise of centenarians in the United States—projected to exceed one million by 2050—and how proactive lifestyle choices can promote both a longer lifespan and a healthier healthspan. She explains that genetics account for only about one‑third of longevity, while two‑thirds are driven by lifestyle factors grouped into five pillars: nutrition, physical activity, mental stimulation, social ties, and sense of purpose. Sarafan offers concrete, everyday recommendations for each pillar—eating until 80 % full, boosting omega‑3 intake with almonds, blueberries, salmon, and tuna; engaging in consistent, age‑appropriate exercise (at least three times a week, even a simple walk for older adults); performing cognitive exercises such as Sudoku before bed; maintaining strong community and family connections; and cultivating purpose, illustrated by the Okinawan model where retirement is virtually nonexistent and age‑related diseases are rare. She emphasizes that these habits not only extend lifespan but also delay Alzheimer’s and other age‑related illnesses. The conversation concludes with an introduction to the Balanced Care Method, a caregiver training program designed to embed these longevity principles in the lives of older adults, with resources available at balancecaremethod.com and through Home Care Assistance’s nationwide caregiver network.
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You can delay Alzheimer's and other chronic illnesses just by making some simple changes. Here with some of the best-kept secrets to living a longer and happier life is one of the authors of Happy to 102. Please welcome Lily Sarafan. Hi, Lily.
Hi, Lily.
Welcome to the show.
Nice to meet you.
Nice to meet you.
Great to be here. So where did this all come about?
Well, Jim and Kathy Johnson, my co-authors, and I are fortunate to work in the senior care industry, so we already had an elevated interest in topics like aging. It was about a year and a half ago that we saw a staggering statistic in the New York Times, and that is by the year 2050, there will be over 1 million centenarians, people over the age of 100, living in the United States alone.
Wow.
So you need to find out their secrets.
That's right. And like a lot of people, we saw that and said, well, I wonder if I'll be one of those who gets to live to 100. But the more and more we looked into the lives of these centenarians around the world, we realized it's less a matter of, I wonder if I'll be one of those, and more a matter of, what will I do proactively? to ensure that I can live the longest, happiest, healthiest life possible.
And these are some simple things we can do, what, on a daily basis?
That's right.
So can you list some of the categories in your book?
Absolutely. And one thing that people might want to know is, well, most of this must be dictated by genetics. Well, they should know that scientists and researchers have determined that only 1/3 of this enviable lifestyle is based on genetics and 2/3 lifestyle factors.
Oh, okay.
And the 5 areas that we focused on Nutrition, physical activity, mental stimulation, social ties, and sense of purpose.
Okay, so give us a quick example of what we can do in each category.
Sure, so nutrition defaults to the eat until you're 80% full. Increase those omega-3s, snack on the almonds and blueberries, replace your red meats with your salmon and tuna. In physical activity, it's less about doing something strenuous and more about being consistent, and I'll speak a little bit later about how that specifically impacts Alzheimer's.
Will these nutritional changes not only extend your lifespan but improve the quality of that life? Will you still be healthy as you get old?
Absolutely, and that's what we've coined healthy longevity. It's not just about lifespan, it's also about healthspan.
Okay, so what's another category and tell us an example?
So social ties, it's about especially as people get older in the geriatric population, there's a lot of social isolation. It's about continuing those connections with community, with family that helps you maintain that positive outlook that you need to actually live that longer lifespan.
So when you feel happier, you live Absolutely, of course. Okay, and then what about your mental skills? How do you keep a sharp mind?
So everyone knows that your brain tends to shrink a little bit over time, but what they may not know is there are specific things you can do to delay the onset of dementia. So for instance, physical activity has been shown to impact the hippocampus, which is the memory region of your brain. Increasing omega-3s in your diet, exact same thing. And best of all, just by doing something simple like 30 to 60 minutes of Sudoku or memory exercises before you go to bed has been shown to have a direct impact impact on delaying Alzheimer's and dementia.
And when you say physical activity, how much are you talking about and how regularly?
So regularly, I'd say at least 3 times a week, and it's going to differ based on generation and population. Someone in their 20s and 30s can probably stand to exercise 4 or 5 times a week. For our clients throughout North America in their 80s or 90s, it can be as simple as taking a walk around the block.
Okay, just a few times a week. That will help so much.
Exactly.
So the same things that prolong your life can also delay Alzheimer's.
That's right.
That's what it sounds like. And you said that a lot of people, you said in Japan? Why, why that region?
Well, you may or may not know that Okinawa is actually home to the longest living and healthiest people in the world. So if you're going to mimic someone, mimic the best. And when you learn that it's lifestyle factors, what researchers have done is go into Okinawa and see that heart disease, cancer, stroke, Alzheimer's, what we always consider to be age-related diseases, are unheard of in Okinawa.
And it's because they're doing these simple tips that you're talking about?
That's exactly right. It's part of their lifestyle, a sense of purpose, a positive commitment, eating Healthy, and guess what? There's no word for retirement.
Huh. Is it ever too late to get started? I mean, if you're in your middle to late years, can you still turn things around?
Absolutely. In fact, that was the inspiration for all of this, is we wanted to develop a caregiver training program so that family caregivers and professional caregivers can actually instill these principles in the lives of those who are already in their 80s or 90s.
Is that what the Balanced Care Method is?
Exactly. That's the Balanced Care Method.
And then how do you participate or get involved in that?
So if people are interested in the Balance Care Method because they're family caregivers, they can learn a lot of information on balancecaremethod.com. And the caregivers that we train through Home Care Assistance across North America are also trained in the Balance Care Method.
Okay, Lily Sarafan, thank you so much. And by the way, we have some of her tips, actually a list of them, on our website. So go there.
