Prime Time: A New Look At Aging

Preserving Domesticated Tranquility

Domesticated animals live much longer than their counterparts in the wild. Cats, dogs, even birds live two to three times longer--as long as they stay close to man.

It's true for us, too. Our lifespan began to climb dramatically as we moved further away from the 'nasty, brutish and short' lifestyles of our ancestors. As recently as 2,000 years ago, the average lifespan was about 21.

Now that the average lifespan in the developed world is pushing 80, what more can we expect? Life expectancy rose from 48 to 78 in between 1900 and 2000 in this country--is it reasonable to hope that it will reach 108 by 2100? Is it possible that that's an underestimate? Cats generally live to be 4 in the wild, but can reach 16 in captivity...

At Sage, Chris Mooney summarises recent research:

"All things being equal, these are pretty good days to be an elderly American. Not only has average life expectancy been rising steadily since 1950, but, over the past 2 decades, surveys have shown a steady decline in disability among older Americans, a trend that continues unabated. "We haven't seemed to reach a plateau yet," says Harvard University health economist David Cutler, who studies disability among the elderly. And the good news doesn't stop there: Scientists have discovered a number of ways to slow aging in creatures as different as yeast and mice. This ongoing research into aging and longevity has "immense potential to prevent late-life illnesses and prolong active life" in humans, wrote gerontologist Richard A. Miller of the University of Michigan, Ann Arbor, last November in the health care policy journal The Milbank Quarterly."

"...The discovery over the past decade of a large number of genetic changes that can prolong life in a variety of animals has spurred scientists to look deeper for explanations of what they're seeing. So far, however, there's a raft of ideas but no clear winner.

Consider just one example out of many. Martin Holzenberger of the French biomedical research agency INSERM is the lead author of a recent study showing that mice genetically engineered to respond poorly to the hormone insulin-like growth factor 1 (IGF-1), which controls growth and cell division, live 26% longer on average than do normal lab mice (see "All Together Now"). In flies and worms, related genes have a similar effect, an evolutionary commonality that researchers find intriguing."

But you may have to fight for the chance to see your second century.

"...Whether one mechanism or many drive the aging process, most scientists in the field agree that the research has already shown its medical promise and deserves better federal funding--particularly because, as Miller points out, putting the brakes on aging would also reduce the incidence of a wide range of illnesses that plague the elderly. Because of the potential payback, "it's terribly important to invest more on fundamental research in the processes of aging," says George Martin, a pathologist at the University of Washington, Seattle, who studies aging and Alzheimer's disease. "It will be very cost effective. You might not find a unitary mechanism for everything, but you might find some very important ones that you can deal with for a large segment of the population."

Despite the immense implications of new findings about the biology of aging for humans, Miller argues that basic research in this area remains drastically underfunded and neglected by policymakers. Miller notes in his piece in The Milbank Quarterly that research on aging "receives such a small proportion of government research funding that it cannot be seen in [the] pie chart." The overall budget of NIA is $1 billion a year, approximately 20% of which goes to basic research into the biology of aging, according to NIA's Warner. In comparison, the National Cancer Institute has a budget of roughly $4 billion a year. According to Warner, many promising research proposals in the biology of aging remain unfunded with the institute's current budget. But that's probably true of every part of the National Institutes of Health: "There's probably not a biomedical constituency that doesn't believe that it's underfunded," he points out.

Why does research into the biology of aging receive such a meager amount of funding? Miller has several ideas. First, he says, politicians tend to be most responsive to voter demands for research into specific diseases such as cancer and Alzheimer's, a nearsightedness shared by pharmaceutical companies. Further complicating matters is the phenomenon of "gerontologiphobia," a fear of the social consequences of life span extension that has been on prominent display by some members of the President's Council on Bioethics and particularly its chair, Leon Kass."

Seniors get a boost from weight lifting

Seniors who build and preserve muscle lessen the risks of falls, diabetes, hypertension and osteoporosis. They also feel better about how they look
 
“If you can lift a weight 15 times, it’s too light,” says William Evans, a co-author of Biomarkers: The 10 Determinants of Aging You Can Control. He suggests starting at about 60 to 80 percent of your maximum lifting capacity and lifting the weight eight times or until the muscle feels fatigued. After working up to 12 repetitions, increase the weight by 10 to 25 percent and drop back to eight reps. A set of ten exercises will take about 30 minutes to complete. Before lifting, however, take a brisk walk or jog in place for 6 or 7 minutes, then stretch those muscles. Repeat this after a workout too.

When lifting, breathe out at the time of maximum exertion. Do not hold your breath or you may end up with that expression frozen on your beet-red face. Forget that saying, “No pain, no gain.” If it hurts, stop. A little muscle soreness the next day is not unusual, however. Give those muscles at least one day’s rest between workouts, but do continue your walking, swimming or biking on the alternate days.

Weight lifting is not advisable for people with high blood pressure or heart disease, and a doctor’s okay is recommended, especially for anyone with a chronic illness.
 “By helping you build muscle tissue and lose body fat, strength training revs up your metabolic rate, so you burn more calories whatever you’re doing, even when sitting and sleeping,” says Jane Brody, a New York Times columnist. “More muscle and less fat also mean fewer inches and smaller sizes, because fat takes up more room than the same weight of muscle tissue.”

 

The other ways technology helps vision

It's nice to know that science is working on improving our eyesight. But it doesn't work for everyone, and it isn't available to all, even for those for whom it would work. And useful as they are, Braille and talking books are substitutes for vision, not enhancements.

So the other trick is to make things easier to see. There are now cell phones with big buttons, websites have standards for accessibility, including options for larger typefaces, etc. Road signs can be made clearer using technology (who knew paint could be so high-tech?) and computer studies of eye movements can help us put signs in places where people actually look.

But for me, the best technology is still under construction. Head mounted displays or goggles still aren't ready for prime time. But when they get the bugs worked out, you will be able to put on something that looks like a pair of sunglasses, but will essentially open up an almost magical world, showing enhanced pictures of what's in front of you--or a normal computer screen, or television or film. It will have the capability of adding text information near the pictures, such as the name (and age, and personal details) of the person walking towards you. It will also warn you of obstacles and challenges--much like the technology that is being introduced in modern cars. And, also like in cars, it will come with maps.

Yes, it'll take getting used to and will feel wildly new and different. But that's part of the fun, right?

Trouble brews when seniors overdo booze

Ninety-seven percent of the alcoholics in America are people like your neighbors. Only 3 percent of them live on skid row. Twenty-five percent of those of us who drink become addicted, and older people are most susceptible. With age, our capability to metabolize alcohol diminishes. If we’re taking prescription drugs, it decreases even more. About 20 million Americans today are addicted.

These are among the findings of Dr. Earle Marsh. He knows the subject of addiction intimately; he is an alcoholic who beat the habit years ago. 

Seniors experience major changes that make the bottle attractive, he said. A spouse dies. Men especially feel at loose ends after retirement. Self-esteem suffers from the outward signs of aging, and chronic pain becomes too tough to bear for some.

The symptoms of increased, unhealthy levels of drinking include gulping down concoctions, hiding a bottle for secret belts, and blackouts—intervals of the night before that cannot be recalled. The alcoholic feels remorse, experiences shakes and the sweats, says Dr. Marsh, a professor emeritus at the University of California Medical School in San Francisco. The emotions may range from self-pity to delusions of God-like qualities.

As an indicator of the results of significant chemical changes caused by alcohol, he said that about 10 percent of American couples are infertile, but the rate jumps to 50 percent for couples affected by drinking. If you drink to excess your tolerance increases, which means you must drink more to achieve the same buzz as before. 

To help someone in denial, Dr. Marsh says an intervention might prove helpful. Typically, family members gather with the drinker, describe their concern for the person and define, in a kind way, the price the alcoholic must pay if he or she continues drinking. 

Alcoholics Anonymous helped him turn his life around, and he recommends the program. “If someone in your house has a problem, write AA," he says."They’ll send you information in a plain brown wrapper with no return address. Then you might place it where someone else can pick it up and make use of it.”

 

Technology and vision

One of the most rapidly evolving areas of technological progress is in optics. It's happening for a variety of reasons--companies want to make better computer games, the military wants to provide better equipment to its soldiers, movie makers are working on 3D technology to get people back in the cinemas, and virtual reality may change the way we experience the world.

So it's no surprise that the number of patents filed in optics is growing at 5% a year, which is really robust. But what are the likely ramifications for seniors?

Stem cell experiments improved the vision of elderly, umm, rats in experiments. The aim of the research is to combat macular degeneration, the most common cause of blindness for people over the age of 55.

The principal reason seniors abandon driving motor vehicles is deteriorating eyesight. So cars that drive themselves (yes, really) may help mobility for seniors, and improved parking technology and cameras replacing mirrors might go even further.

Audio books can be a bit bothersome, but text to speech software allows you to choose what you want to listen to. It works both ways, if you're tired of writing--or even tired of hitting computer keys.

And the world of implants continues to improve and expand. More and better retina implants will help millions.

Seniors a big target when it comes to scams

Seniors make up about 13 percent of the population but fall victim to more than half of the telemarketing schemes perpetrated in the U.S. And it’s people with money, education and know-how who pay much of the billions of dollars telemarketers pocket yearly.

Crooks rip off seniors who need new driveways, long-term care insurance, reverse mortgages, love and affection. On the love front, for a 65-year-old San Francisco man it began when a young woman stepped on his toe while they were in line. She insisted on buying him a cup of coffee in atonement.
The friendship that followed prompted him to lend $5,000 to the woman’s sister for a beauty parlor. More money went to the woman’s brother, a man, it turned out, who was actually her husband. It ended up with her dropping the victim off at the hospital, his entire net worth of $180,000 gone.

A more dangerous version, known as the foxglove case, found gypsies pulling the sweetheart scam on lonely old men. The men ended up marrying younger women, then rather rapidly died of heart attacks. Police, after some urging, investigated, exhumed several bodies, and discovered the men died from eating foxglove plants, which produce symptoms much like heart disease.

The M.O. often finds a team that picks a man of modest means who owns a home that has appreciated in value over the years. A favorite pickup line of the women is, “Don’t you remember me? My mother used to bring me over to visit you.” There follows a bit of hanky panky, so when she pops the question, he feels he should do the right thing.

 Keep in mind these tips on avoiding swindles:

 1. Don’t sign anything until you thoroughly understand the whole document. Make the seller describe every detail.

2. Don’t be influenced by scare tactics, such as, “If this furnace isn’t repaired now it’s going to cause a terrible fire.”

3. Avoid buying or signing if someone demands money
up front.

4. Be careful whenever a company contacts you first. Check it out.

5. Don’t make a purchase on the first visit to, say, a car dealer. Take time to talk about it with friends or relatives.

Making our senses work better--technology and hearing loss

Since I elected to spend 5 years cutting down trees bent over a chainsaw with my ear three inches from the chainsaw motor, I am pretty used to saying, What? or more commonly, Huh?

Close to a third (29%) of seniors are hearing impaired, and that percentage rises as they get more senior, reaching 47% for those over age 75. But how much of a difference does that make in day to day living?

The NIH Senior Health site lists some: "People with hearing loss have trouble fully participating in everyday life. They may mistake words in a conversation, miss directions or warnings, or leave a ringing doorbell unanswered. Older people who can't hear well may become depressed or withdraw from others to avoid feeling frustrated or embarrassed about not understanding what is being said.

"They may become suspicious of relatives or friends who they believe "mumble" or "don't speak up" on purpose. Hearing loss can cause older people to become more isolated and can even put them in harm's way if they are unable to respond to warnings or hear sounds of impending danger.

"Sometimes older people are mistakenly thought to be confused, unresponsive, or uncooperative just because they don't hear well."

As a techno-optimist, it didn't take me long to find examples of how technology is addressing those with differing levels of hearing loss. Hearing aids are getting smaller, more powerful and more intelligent--but a lot more is going on, as well:

(From the American Speech-Language-Hearing Association)

What are Assistive Listening Devices?

An assistive listening device (ALD) is any type of device that can help you function better in your day-to-day communication situations. An ALD can be used with or without hearing aids to overcome the negative effects of distance, background noise, or poor room acoustics. So even though you have a hearing aid, ALDs can offer greater ease of hearing (and therefore reduced stress and fatigue) in many day-to-day communication situations. Hearing aids + ALDs = Better listening and better communication!

What are examples of ALDs?

Personal frequency modulation (FM) systems are like miniature radio stations operating on special frequencies assigned by the Federal Communications Commission. The personal FM system consists of a transmitter microphone used by the speaker and a receiver used by you, the listener. The receiver transmits the sound to your hearing aid either through direct audio input or through a looped cord worn around your neck.
Personal FM systems are useful in a variety of situations such as listening to a travel guide or book review, in a classroom lecture, in a restaurant, in a sales meeting, or in a nursing homes or senior center.

FM systems are also used in theaters, places of worship, museums, public meeting places, corporate conference rooms, convention centers, and other large areas for gathering. In this situation, the microphone/transmitter is built into the overall sound system. You are provided with an FM receiver that can connect to your hearing aid (or to a headset if you don't wear a hearing aid).

Infrared systems are often used in the home with TV sets, but, like the FM system, they can also be used in large settings like theaters.
Sound is transmitted using infrared light waves. The TV is set at a volume comfortable for family members. The infrared system transmitter transmits the TV signal to your receiver, which you can adjust to your desired volume. Thus, TV watching as a family becomes pleasurable for all. While it is not too loud for family members with normal hearing, the volume is just right for you because it is adjusted by you through your individual receiver.

Induction Loop Systems are most common in large group areas. They can also be purchased for individual use.
An induction loop wire is permanently installed (perhaps under a carpet) and connects to a microphone used by a speaker. (In the case of individual systems, a wire loop is laid on the floor around you and the speaker.) The person talking into the microphone creates a current in the wire which makes an electromagnetic field in the room. When you switch your hearing aid to the "T" (telecoil/telephone) setting, your hearing aid telecoil picks up the electromagnetic signal, and you can adjust its volume through your hearing aid.

One-to-one communicators. Sometimes in a restaurant, nursing home situation, or riding in a car, you want to be able to easily hear one person. Or perhaps you are delivering a lecture or running a meeting and a person in the audience has a question. You can give the person a microphone to speak into. The sound is amplified and delivered directly into your hearing aid (or headset if you don't have a hearing aid), and you can adjust the volume to your comfort level. When using the one-to-one communicator, the speaker does not have to shout, private conversations can remain private, and, when in a car, your eyes can remain on the road!

There are many, many other ALDs such as telephone amplifying devices for cordless, cell, digital, and wired phones; amplified answering machines; amplified telephones with different frequency responses; paging systems; computers; wake-up alarms.
Your audiologist can provide you with additional information on ALDs.

Are there communication devices besides those that assist listening?

Yes, there are visual systems that can be used alone or in combination with listening devices and hearing aids. Persons who are hard of hearing or deaf, or even persons who have no hearing loss, can benefit. There are also alerting devices that signal you when a sound occurs. For example, there are doorbell, knock-at-the-door, or phone alerting devices; fire alarm/smoke alarm devices; baby-crying devices or room-to-room sound alerting systems; vibrating clock alarms; vibrating paging systems; and vibrating watch alarms. Many use strobe light or conventional light to alert you; others use vibrating systems to alert you.

Examples of visual systems include the following:

Text telephones, which allow phone conversations to be typed and read rather than spoken and heard
Computerized speech recognition which allows a computer to change a spoken message into a word processed document
Closed-captioning TV, which allows text display of spoken dialogue (All TVs with screens of at least 13 inches diagonal measurement must have built-in captioning.)
Note taking, which allows a hard of hearing person to concentrate on listening and watching a speaker while a trained person takes notes (This has been used in schools not only for students who are deaf or hard of hearing but also for students who are unable to write.)

But who will do the laundry? Robotics and aging, continued

Japan is one of three countries that focus on robotics--the other two are South Korea and the U.S. Here in the US we specialise, and focus on military uses (which later get adapted for civilian use). South Korea does heavy industry and some domestic robotics.

But Japan--Japan! Oh, what they are doing, and oh how we will use it.

"New household robots in Japan are not only capable of pouring a drink, but of cleaning up the dishes afterward. Japanese inventers are now taking on the challenge of creating a robot that is even capable of cooking. The International Food Machinery and Technology Expo in Tokyo this week revealed prototype robotic chefs flipping Japanese pancakes, serving sushi, slicing vegetables and performing various tasks in the kitchen."

"As home to one of the world's fastest aging populations, Japan is experiencing a boom in robotic developments. With the increase in need for assistance for their elderly, a growing number of companies are investing heavily in the future of household robotics, many of which are designed to assist daily life for the elderly as well as the infirm – a job that many young people are unwilling to take."

"Tomio Sugiura, president of Sugiura Kikai Sekkei, which manufactured the vegetable-slicing robot, envisions a robot in every home in the near future. He says, "Nowadays, almost every family has a car. In the near future, every family would be having a humanoid robot that can help out various things at home.”

Choreograph your happiness level

Dr. Howard Liebgold places a large hourglass on the table he’s behind. “What do these grains here at the bottom represent?” he asks the workshop audience.

We quickly determine those grains represent the past. “You can’t change the past,” he declares with a wiggle of his 18-inch-tall wizard’s hat, which he’d donned at the opening. “You can’t go back.” But we can do something about the grains of sand flowing through the chute now—the present—he says.

When kids, we heard, “Keep your nose to the grindstone,” and “Don’t you ever laugh in church.” Our brains take this data in. Thus, “Many of us are programmed to not be happy.” Before it starts, kids of 4 and 5 laugh and giggle 325 times a day, one study showed. A typical adult? About 15 times a day. By the age of 18, we’ve received 180,000 negative comments from parents, teachers and others, the doctor estimates. “We have a right to be happy, but no one teaches us how.”

 Here are some steps he offers to boost your level of happiness:

1. Focus. Ask someone to find the color blue and within seconds he or she will spot the color in a book cover, a scarf,  the sky overhead. It’s all around us. The same principle holds true with humor. “When you focus on it, you find it,” Dr. Liebgold says.

 2. Treat yourself.  “When I went on vacations,” he recalls, “I enjoyed some apricot nectar. Finally, it occurred to me that for about ten cents I could drink some every morning.” Sounds simple except that the doctor, like so many of us, grew up in the Great Depression, so treats didn’t come easy at first.

 3. Schedule humor into your life. As the former head of Kaiser’s Chronic Pain Management team, Dr. Liebgold asked chronic pain sufferers to do a gratitude exercise. This requires giving thanks for what works and doesn’t hurt first thing in the morning. In other words, don’t let the pain take control.

 4. The activity comes first. Mrs. Leibgold enjoys sleeping in, so early in the morning, he heads for his special room where he might enjoy jazz, yodeling, weight lifting, playing tunes with spoons and juggling. “I come out feeling high,” he says, adding that humor and doing what we enjoy creates endorphins—chemical brain boosters about 200 times more potent than morphine.

 5. Don’t delay. Friends of the Liebgolds kept saying that they were going on a hot-air balloon adventure “when we get around to it.” A fatal illness ruined that plan. Dr. Liebgold had to deal with his own mortality after discovering he needed carcinoma surgery. He compared it to being hit on the head by a piano. “Man is the only animal who knows in advance that he will die some day,” he says. “How can this knowledge help? It adds an urgency to life. Do whatever it is that you most want to do.”

He recommends Harold Kushner’s books When Bad Things Happen to Good People for coping with tragedy and When All You’ve Ever Wanted Isn’t Enough if mired in the concept that “I’ll be happy when the kids go to college” or “when I get a raise” or “when I retire” instead of enjoying the moment.

He stays aware of what’s going on in the world, but Dr. Leibgold doesn’t tune in on the news (“It’s practically all bad”). Since his retirement, he’s written three books and created a variety of audio- and videotapes about dealing with phobias, improving self esteem and assertiveness. 

During his presentation, Dr. Liebgold switches from his wizard’s hat to a top hat and winds up with a towering headpiece straight out of Dr. Seuss. They offer additional evidence he takes his subject but not himself seriously.

The coulda, woulda, shoulda game

One perk of advancing years is our accumulation of toppers. Let’s face it, three score and ten provides us so many wrong turns, bum relationships and general screw-ups we can excel when playing coulda, woulda, shoulda.

You won’t find the rules for this one in any game book. Masochists probably rate as the masters of it because it boils down to admissions of really dumb moves or the painful results of inertia.Younger people run out of things to lament just as we’re warming up with tales of misspent youth or lousy career decisions. The problem is they tune out or walk away about the time we hit our stride.

The longer we live the louder we can voice the thoughts of one friend: “I shoulda spent more time smelling the flowers and I shoulda trusted my instincts more, taken more chances, laughed more, cried more, loved more.”

One regret I hear and frequently echo: “If I’d stayed in the chair and finished just one page a day, I coulda written 35 books by now.”

When the area behind my ears was still damp, a fellow I knew found employment as a runner for a stockbroker. “There’s this company I bought a couple of shares of stock in,” he said. “You might be interested. It’s called International Business Machines.” But I didn’t even know that stock was a kind of flower, let alone a share in a business venture.

My misadventures in financial arenas could fill a book—and might someday if I could only stay glued to the chair long enough. There was the place we rented in Lafayette by a small creek where posh homes had blossomed nearby It had served as a rustic summer get-away. We’d just arrived in California from the Midwest. The owner in mid-1963 wondered if we’d like to buy the place, but that $10,000 seemed like a bundle for a house on one-third of an acre. Now it’s probably worth $450,000.

Some people believe they might have found contentment by enrolling in est, marrying someone else or becoming a follower of Buddha. On the other hand there’s Calvin Trillin. He said, “Maybe humans aren’t meant to be content. Americans seek Nirvana and inner peace and all that stuff, but I don’t think it’s in our American genes. If you want to be contented, you should be a dog.”

Shoulda’s, however, get sticky when you’re throwing advice. In fact, if you’ll permit me to offer this suggestion: Forgo the advice altogether. As Oscar Wilde put it: “It is always a silly thing to give advice, but to give good advice is absolutely fatal.”

One of the sad shoulda’s often comes after age hoists one over the AARP divide: “We shoulda taken that cruise when we first talked about it. Now Myron’s too sick to travel.” You must admit the tennis shoe maker got it right with the slogan, “Just do it.”

America’s most memorable shoulda, coulda scene came during “On the Waterfront,” when Marlon Brando in his role tells his brother, “You shoulda looked out for me. I coulda been a contender. I coulda been somebody.” He won an Oscar in 1955 for his performance.

Some people get stuck in a coulda, woulda, shoulda rut. A constant focus on past peccadillos, problems or perversities makes Jack or Jill a very dull monomaniac indeed. They forget that they’ve made some pretty good decisions along the way, whether it be in real estate, departing a stultifying relationship or a job change. They shoulda remembered Samuel Johnson’s view: “The habit of looking on the bright side of every event is worth more than a thousand pounds a year.”