Joy . . . or Pain?

he/longevity. Stock Photo/Getty Images. One time Use Only. Senior woman in infinity pool, laughing, close-up. (Adam Pretty - Getty Images)

"There are no health benefits to smoking," said David Reuben, chief of the division of geriatrics at the University of California, Los Angeles (UCLA). "The only benefits lie in quitting."

We know, we know: Quitting smoking is one of the toughest acts in the personal health business.

If you're ready to try again, or just considering it, you can find help at the "How to Quit" site of the Centers for Disease Control and Prevention ( http://www.cdc.gov/tobacco/how2quit.htm ), the "Guide for Quitting Smoking" of the American Cancer Society ( http://www.cancer.org/ , click on "quitting smoking," then click on "kick the habit," then on "quitting smoking") or the National Cancer Institute's site ( http://www.smokefree.gov/ ).

Challenge Your Brain

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Ever thought about volunteering at a local school? Finally learning to speak Portuguese? Plowing all the way through "Finnegan's Wake"? If living long and well is your goal, it may be time to act. A growing body of research suggests that keeping your brain engaged on challenging tasks appears to help stave off cognitive decline, dementia and Alzheimer's disease. All three of these can lead to premature death and a poor quality of life.

The NIA conducted a seminal study in this area, published in 2002 in JAMA. Researchers divided 2,800 healthy seniors into three groups: One practiced strategies for remembering lists of words and details in stories. The second worked on reasoning skills, detecting patterns in information and using them to solve problems. The third group tried to boost processing speed by practicing such tasks as looking up telephone numbers, reading directions on prescriptions and responding to traffic signals. Each group showed improved cognitive ability, compared with baseline, at the end of the 10-week training and again two years later. A control group that received no training experienced no such improvement.

But after you challenge your brain with, say, a word puzzle, it's important to go out and have fun. A 2003 New England Journal of Medicine study linked participation in leisure activities like playing musical instruments, dancing, reading and playing board games with a reduced risk of dementia among 75-year-olds. Researchers theorized that such activities stimulate pleasure-oriented neurotransmitters, forming new connections in the brain.

Likewise, a three-decade-long study published in 2003 in the Annals of Internal Medicine examined 678 Catholic nuns, ages 75 to 107. Researchers found that those who regularly engaged in games and crosswords were more likely to remain mentally alert until death. Nuns who performed more menial tasks, such as housekeeping or kitchen work, did not tend to live as long.

Work With Your Doctor

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According to Bob Gleeson, medical director of Northwestern Mutual Life Insurance Co. and author of "What Healthy People Know and the 7 Things They Do to Stay Healthy and Live Long" (Classic Day Publishing, 2005), most of us are born with the genetic wherewithal to live to 85. The challenge, he says, is to prevent premature disease from taking us down before that.

Outside of living the healthiest life possible per the kind of steps outlined in this article, the best way to do that, he argues, is to know which diseases you may have a higher risk for, discuss those with your doctor and schedule the appropriate screening tests for them.

There is no magic list of screens (yet) precisely tailored to your age, family history, environment and lifestyle. You've got to develop that with your doctor. For instance, does osteoporosis, the bone-thinning disease, run in your family? Your doctor may order a bone-density test, which the U.S. Preventive Services Task Force recommends for women 60 and older who are at increased risk; he may ascertain that you're getting enough calcium and weight-bearing exercise. At increased risk for heart disease or stroke? You and your doctor may want to discuss complementing lifestyle measures such as diet and exercise with statins -- cholesterol-lowering drugs -- or anticoagulants.

Want to have a sense of your risks before you consult your doctor? Some online tools can help you guesstimate your risk for diseases including heart attack, cancer and diabetes. See, for example:

· The National Heart, Lung, and Blood Institute's risk calculator, http://www.nhlbi.nih.gov/guidelines/cholesterol (click on "10-year risk calculator").