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Monday, August 20, 2018

At What Age Do We Peak?

Posted By: Advancing Care

A Westchester Medical Center Health Network expert explains that good health starts with a state of mind.

By Richard Klin

There’s a simple answer, and a more complicated response, to the question above, according to William Frishman, MD, Director of Medicine at Westchester Medical Center, flagship of the Westchester Medical Center Health Network (WMCHealth).

The simple answer, says Dr. Frishman, is that our bodies peak in our 20s and 30s. The more nuanced response, however, is shaped by how we deal with reduced vigor and energy as we age, as well as the depression that can set in as we realize we’re not as invincible as we once were.

“Yes, the body ages and slows down. And there isn’t much variance to this,” says Dr. Frishman. “In essence, it’s all about the body’s supply and flow of adrenaline, which supports immune response, cognition and can even block pain.” The key, he says, is not to resign ourselves to a stereotypical view of old age, but to maximize what we have — at any age.

Physical Strength

The 20s and 30s are peak performance periods the apex of physical competence. “Elite athletes are mostly in their 20s and 30s,” Dr. Frishman points out. “As hardy as we may feel as teens, that’s not the age of best-ever health. How many 16-year-old professional baseball players do you see? And, on the other side of the spectrum, a pro athlete still active in his  40s is a rarity.”


Reflexes also peak in our 20s and 30s. To illustrate this, Dr. Frishman suggests watching the game show Jeopardy! “There are few — if any — much older contestants who compete. It’s not because the older one is, the less one knows; in fact, it’s just the opposite. It’s just that as you age, the speed-coordination combo gets slower. You can still know the answers to Jeopardy!; you just can’t buzz in as quickly.”


“It’s easier for women to get pregnant at 20 than at 40,” says Dr. Frishman, “because of hormonal changes that occur with age, even before menopause. However, thanks to an array of fertility treatments and technologies, women giving birth in their 40s is more common than ever.”


While cognition also peaks during the decades of the 20s and 30s, it doesn’t evaporate. Barring a catastrophic condition, such as a stroke or Alzheimer’s disease, cognitive strength can sustain during one’s lifespan. Short-term memory declines; long-term memory remains intact. The ability to learn takes a little longer. But “you still can do what you’ve always done — only at a slower pace,” Dr. Frishman says.

Losing a Step

“Athletes, as they age, refer to ‘losing a step,’” Dr. Frishman says. “But that  doesn’t mean someone is hampered or damaged. You can still do what you used to do, only not as fast, not as often and perhaps not as well. A 90-year-old typically can’t run sprints. But a 90-year-old can run a marathon. This is where the mind-body connection kicks in. You can choose to mourn the aging process. Or you can work with it.”

In sum, says Dr. Frishman, diminished physical capacity need not mean a diminished life. “My job as a physician,” he observes, “is to maximize what the patient can do.”

A respected clinician, Dr. Frishman is a prolific writer and scholar whose background encompasses, among other things, medical support for many of the nation’s chief executives, beginning with the Nixon administration. He’s also an expert in an overlooked slice of history: the study of presidents’ health and the physicians who cared for them.