Healthy Aging

Ask Well: Assessing Knee Supports

A while back I had gotten lax with my walking routine and found myself quite out of shape. My husband encouraged me to accompany him for a walk one day, and I did. But he was much more ambitious than I was, and we walked so far that when I got home, my right knee was a bit sore. I went to the drugstore and looked at the various knee supports available. I chose one made of neoprene that wrapped around the knee and fastened with Velcro. I wore it for a few days and my knee gradually got better.

Because of this experience I was interested in this column in the New York Times in which Gretchen Reynolds answers the question “How effective is wearing a stabilizing knee support?”

When you say “effective,” I assume that you’re asking how well a knee support can stabilize a wobbly knee or lessen the pain of an arthritic one. The answer, based on a large body of science, is that nobody really knows.

“It’s important, however, to differentiate among the types of knee supports,” she adds. She distinguishes between braces, which include rigid materials that press against the bones of the knee and offer firm external support. Soft neoprene sleeves do not offer the same support but may increase knee stability by improving the wearer’s balance. But, Reynolds says, a 2012 study found that neoprene sleeves offered no significant improvements in balance for people with knee arthritis. There is also no evidence that knee supports worn on healthy knees prevent knee injuries.

Reynolds ends with the advice that if your knees are bothering you, don’t self-diagnose. Go to a doctor, who can diagnose your problem and determine whether a knee support will help.

The knee support I used was not really a sleeve, which is a tube, but one that I could tighten or loosen with the Velcro. I wore the support and avoided any more long walks, and my knee pain did clear up within a few days. Of course the same improvement probably would have occurred whether I had worn the brace of not, but I did think that, at least initially, it lessened my discomfort.

Here’s Why You May Be Aging Faster Than Your Friends

Alice Park discusses recent research published in the Proceedings of the National Academy of Sciences that examined 18 measures of aging in people in their 20s and 30s. The markers studied mirror the biological effects of aging found in older people. The study followed 954 people born in 1972 or 1973 in Dunedin, New Zealand, from age 26 to age 38. The 18 markers measured included blood pressure, lung function, cholesterol, body mass index, and inflammation. On the basis of these measurements, researchers calculated a biological age for each volunteer. They re-examined the study participants again at ages 32 and 38 to calculate the pace at which each person was aging.

Some people were biologically older and aging faster than others, despite being the same chronological age. Not only that, but the researchers showed, by giving the 20- and 30-somethings the same tests of balance and thinking skills that gerontologists give for older adults, that these aging changes were the same as those occurring later in life.

Comparing the data of those aging more quickly with those aging more slowly should suggest some ideas of how to slow down again. Such a testing program can also provide a way to test whether a specific anti-aging treatment works.

Researchers plan to re-evaluate study participants again at age 45 to see if habits such as diet, exercise, and smoking affect the rate of aging.

Exercise can improve brain function in older adults

Here is that E-word again: exercise. New research out of the University of Kansas Medical Center suggests that older adults can improve brain functioning by increasing their fitness level.

Results indicated that aerobic exercise improved brain function, and those who exercised more saw more cognitive benefits. The intensity of the exercise appeared to be more important than the duration, so it’s important to exercise as vigorously as you safely can.

As always, check with your doctor before beginning any exercise program.

Swindlers Target Older Women on Dating Websites

This article is painful to read but could prevent some heartache. It describes scams that people employ through online dating sites to woo potential victims out of their savings.

Older people are good targets for such scams because they often have accumulated savings over their lifetime. Older women, who outnumber older men, are particularly susceptible.

Just how serious is this problem?

How many people are snared by Internet romance fraud is unclear, but between July 1 and Dec. 31, 2014, nearly 6,000 people registered complaints of such confidence fraud with losses of $82.3 million, according to the federal Internet Crime Complaint Center.

Most of the scams involve online contacts who establish a relationship with a potential victim, then began asking for money to cover situations such as medical emergencies or having their wallet stolen abroad and needing money to travel back home. And one request follows another, often adding up to significant sums:

Victims typically lose $40,000 to $100,000, said Wendy Morgan, chief of the Public Protection Division of the Vermont Attorney General’s Office. The highest reported loss in the state was $213,000.

Read the stories in this article of how people were scammed. Knowing how the process works could help you avoid losing your life’s savings.

Recent News on Aging

Anti-ageing pill pushed as bona fide drug

From the journal Nature comes this article that poses a paradigm-shifting question: Is aging a natural occurrence of life or a treatable condition?

Doctors and scientists want drug regulators and research funding agencies to consider medicines that delay ageing-related disease as legitimate drugs. Such treatments have a physiological basis, researchers say, and could extend a person’s healthy years by slowing down the processes that underlie common diseases of ageing — making them worthy of government approval. On 24 June, researchers will meet with regulators from the US Food and Drug Administration (FDA) to make the case for a clinical trial designed to show the validity of the approach.

The article focuses on a clinical trial called Targeting Aging with Metformin, or TAME:

Plans call for the trial to enrol 3,000 people aged 70–80 years at roughly 15 centres around the United States. The trial will take 5–7 years and cost US$50 million.

The key to the significance of such research is that it examines a change in the way clinicians would approach aging: instead of treating conditions such as heart disease, cancer, and cognitive impairment that arise with aging, they would treat aging itself. If this were possible, aging itself would become a treatable condition instead of a natural progression of life.

Two Views of Aging While Creative

In this article for Psychology Today, Susan K. Perry addresses the question “What happens when prolific writers get old?” She contrasts two books by writers who remained creative into old age:

  • At Eighty-Two, A Journal by poet, novelist, and memoirist May Sarton, who died in 1995
  • Essays After Eighty by poet and essayist Donald Hall, recently published

About Sarton’s journal Perry writes, “Most of all I noted and appreciated her honesty about the highs and ever-more-frequent lows of her mood.” Perry contrasts Sarton’s outlook with Hall’s: “According to his new book of essays, he’s still at it in his mid–80s… . He omits nothing (or little) of the humiliations and challenges of growing old.” She continues:

Above all, Hall’s essays demonstrated to me that not all aging men and women become depressed to the point of not being able to be creative.

The 10 warning signs of Alzheimer’s

Most researchers and clinicians agree that early diagnosis and treatment of Alzheimer’s disease can help slow the disease’s progress. And if you’re at or approaching your older years, you’ve probably seen quizzes and lists all over newspapers, magazines, and the internet on warning signs you should look for.

But while early diagnosis leads to early intervention, some news out of the 2013 Alzheimer’s Association International Conference is troubling: An expert panel found 16 online tests for Alzheimer’s disease scored poorly on scales of overall scientific validity, reliability and ethical factors.

While such self-diagnosis tools may be unreliable, other people may be more accurate in recognizing these warning signs put together by the Alzheimer’s Association:

  1. Memory changes that disrupt daily life
  2. Challenges in planning or solving problems
  3. Difficulty completing familiar tasks at home, at work, or at leisure
  4. Confusion with time or place
  5. Trouble understanding visual images and spatial relationships
  6. New problems with words in speaking or writing
  7. Misplacing things and losing the ability to retrace steps
  8. Decreased or poor judgment
  9. Withdrawal from work or social activities
  10. Changes in mood and personality

But don’t try to diagnose Alzheimer’s disease at home. Visit a doctor for a thorough examination and diagnosis.

For more information see Alzheimer’s Association.

New questions about why more women than men have Alzheimer’s

Nearly two-thirds of Americans with Alzheimer’s disease are women, and now some scientists are questioning the long-held assumption that it’s just because they tend to live longer than men.

What else may put woman at extra risk? Could it be genetics? Biological differences in how women age? Maybe even lifestyle factors?

Here’s yet another article indicating that we need much more research into Alzheimer’s disease: “A recent Alzheimer’s Association report estimates that at age 65, women have about a 1 in 6 chance of developing Alzheimer’s during the rest of their lives, compared with a 1 in 11 chance for men.” Further, evidence suggests that once women develop Alzheimer’s, their condition worsens at a faster pace than in men.

Plans are underway to study both genes and hormones as possible contributors to the increased prevalence of the disease in women over men.

The unforgettable Glen Campbell

David Wild discusses watching CNN’s film Glen Campbell … I’ll Be Me:

Like a lot of people around the world, I have been listening to and loving the extraordinary music of Glen Campbell all of my life. Yet it was only this week that I could emotionally bring myself to see “Glen Campbell … I’ll Be Me,” the very beautiful, very musical and even more moving documentary directed by James Keach that quite rightly received an Oscar nomination for Best Original Song.

Especially take a look at Wild’s list of the 10 most unforgettable of Glen Campbell’s songs.

The Best Ways to Survive a Stroke | Next Avenue

10 warning signs, plus what to do to save someone’s life — or your own

via The Best Ways to Survive a Stroke | Next Avenue.

Too Many Open Browser Tabs

Whenever I find an interesting article, I leave it open on my browser because I just know it will form the basis of a spectacular blog post. I’ve always done this, but in the past I would finally just close everything and start over again because the web is, after all, an infinite source of riches. But since I challenged myself to write a blog post a day in 2015, I’ve been less eager to close all those tabs down. What if I face a day when I can’t think of anything to write about?

My browser has now become so bloated that I have to do something to make my system work faster. Instead of just closing all those tabs, I’m resorting to a collection of the very best ones here. Because I have lots of wide-ranging interests, this is quite an eclectic collection. But every one of these articles is worth attention. I guarantee it.

The Moral Bucket List

New York Times op-ed columnist David Brooks writes here about some special people:

ABOUT once a month I run across a person who radiates an inner light. These people can be in any walk of life. They seem deeply good. They listen well. They make you feel funny and valued. You often catch them looking after other people and as they do so their laugh is musical and their manner is infused with gratitude. They are not thinking about what wonderful work they are doing. They are not thinking about themselves at all.

Brooks distinguishes between two types of virtues, the résumé virtues and the eulogy virtues:

The résumé virtues are the skills you bring to the marketplace. The eulogy virtues are the ones that are talked about at your funeral — whether you were kind, brave, honest or faithful. Were you capable of deep love?

He goes on to say that a while back he set out “to discover how those deeply good people got that way.” In the rest of the article he describes what he found out.

It’s a good article, and I encourage you to read it. But I’ve left this browser tab open for a while now because this article reminded me of a former friend of mine. She could, at times, act caring and loving, but I always detected the tiniest disconnection between her inner workings and her outer behavior. For example, one day after she had spent a long time describing how each of her three children had recently hurt her feelings, she paused for a second while looking at me, then asked, “How’s your daughter?” During that second I could see the gears working inside her head: “I’ve talked about my kids, so I should now ask about hers.” I knew she wasn’t truly interested, so I said, “She’s fine” and left it at that. She visibly exhaled with relief.

This women always blamed other people for any problem in her own life. Everything was always the other person’s fault. She even developed a convoluted philosophy of life—it involved a person’s True Center of Pure Being (her caps)—that allowed her to avoid having to take responsibility for her own actions. When one of her children made her feel down on herself, she would explode and scream at me, trying to make me feel just as bad about myself as she felt about herself. When I told her, several times, how hurtful her behavior was to me, she said that I should understand that she was under a lot of pressure. “I’m not what I do,” she said.

This woman is the opposite of the people David Brooks describes. One can’t simply invoke one’s True Center of Pure Being. She is what she does. We all define ourselves by what we do and say. And this is why she’s a former friend, not a current one.

Sex, Dementia and a Husband on Trial at Age 78

This article brings up one of those issues that’s so complex and deeply personal that I have trouble figuring out what I think about it. In Iowa, Henry Rayhons, age 78, has been arrested for having sex with his 78-year-old wife, who had severe dementia, in a nursing home. The couple was married in 2007 after each had been widowed.

The top-level issue is whether Mrs. Rayhons was capable of giving consent for sex. But the lower-level issue is the question of who gets to decide whether Mrs. Rayhons was capable of giving consent: her husband, nursing home administrators, her doctor, her children?

This case suggests that someone must take the initiative in setting guidelines:

Sex is one of the most ambiguous areas in the scientific understanding of Alzheimer’s. While there are established methods of measuring memory, reasoning and the ability to dress, bathe and balance checkbooks, no widely used method exists for assessing the ability to consent to intimate relations.

Furthermore, dementia symptoms fluctuate. What may be appropriate on one day may not be appropriate on another day. Even more confusing, what may be appropriate in the morning may not be appropriate in the afternoon of the same day.

I’m glad I’m not sitting on the jury for this case.

Parsing Ronald Reagan’s Words for Early Signs of Alzheimer’s

Lawrence K. Altman, M.D., reports:

Now a clever new analysis has found that during his two terms in office, subtle changes in Mr. Reagan’s speaking patterns linked to the onset of dementia were apparent years before doctors diagnosed his Alzheimer’s disease in 1994.

The findings of the study by Arizona State University researchers were published in The Journal of Alzheimer’s Disease. Altman points out that these findings “do not prove that Mr. Reagan exhibited signs of dementia that would have adversely affected his judgment and ability to make decisions in office.”

But the findings do suggest that alteration in speech may one day be used to predict the development of Alzheimer’s and other neurological conditions long before clinical symptoms appear. Earlier detection could lead to earlier treatment, which in turn could help reduce or at least slow damage to the brain.

This research used the same computer algorithm that other researchers have used to analyze changes in writing by novelists, which I have written about here:

Canadian researchers have reported that analyses of syntax in novels by Iris Murdoch and Agatha Christie indicated early signs of dementia (Ms. Murdoch died of Alzheimer’s; Ms. Christie is suspected to have had it.) The same analysis applied to the healthy P. D. James, who died at 94 last year, did not find signs of dementia.

Scientists not involved in this study caution that much more research is necessary before analyses such as this can confidently be used in examining for Alzheimer’s disease.

Diabetes Prevention That Works

It’s Week 5 of the Diabetes Prevention Program, and however commonplace the conversation, the results can be impressive. In 2002, a large national clinical trial showed that among adults at risk for Type 2 diabetes, this “lifestyle modification program” and resulting weight loss reduced the incidence of the disease by 58 percent in 1,000 subjects participating in the program, compared with those who did not — and by an even more substantial 71 percent in those over age 60.

So the Centers for Disease Control and Prevention began rolling out the National Diabetes Prevention Program in 2012. Now, 527 organizations around the country — health care providers, community groups, employers, colleges, churches — offer it in every state, often at multiple sites. Several providers are experimenting with online versions. The Y.M.C.A., the largest single organization involved, enrolls 40 percent of participants nationally.

via Diabetes Prevention That Works – NYTimes.com.

Did you know that nearly 26% of people over age 65 have Type 2 (sometimes referred to as adult-onset) diabetes? Here’s news about a program aimed at helping us make lifestyle changes to decrease our likelihood of developing the disease.

Many YMCAs across the country are offering this program. There’s a link here to help you find out if your local Y is among them.

Coverage for End-of-Life Talks Gaining Ground – NYTimes.com

Five years after it exploded into a political conflagration over “death panels,” the issue of paying doctors to talk to patients about end-of-life care is making a comeback, and such sessions may be covered for the 50 million Americans on Medicare as early as next year.

via Coverage for End-of-Life Talks Gaining Ground – NYTimes.com.

This article offers balanced information on the question of whether doctors should be reimbursed for discussing end-of-life directives with patients. These discussions not only help doctors fulfill patients’ wishes but also relieve families of having to make crucial medical decisions in emotional, stressful situations.

Some private insurers already cover the cost of end-of-life discussions, so it’s important to check your coverage if you have supplemental insurance.

Hospital Charges Surge for Common Ailments, Data Shows – NYTimes.com

Charges for some of the most common inpatient procedures surged at hospitals across the country in 2012 from a year earlier, some at more than four times the national rate of inflation, according to data released by Medicare officials on Monday.

While it has long been known that hospitals bill Medicare widely varying amounts — sometimes many multiples of what Medicare typically reimburses — for the same procedure, an analysis of the data by The New York Times shows how much the price of some procedures rose in just one year’s time.

via Hospital Charges Surge for Common Ailments, Data Shows – NYTimes.com.