Never Quite “Old”

Recently the New York Times ran a piece which once again addresses the question of what constitutes being “old” in America.  The writer, who is 61, says that the question of “what is ‘old,’ anyway?” is very much on his mind and is on the minds of the 70 million Baby Boomers who are older than 50.  He adds, by way of illustration:  “Dinner conversations are now hyper-focused on how to stay young or at least delay old.”

active-seniors-bicyclingThose sound like pretty damned boring dinner conversations!

It seems like we see these articles with regularity, as we Baby Boomers fight desperately to avoid association with “old age.”  The article linked above, for example, quotes a researcher who says that somebody who is 60 years old today is “middle-aged” and true “old age” doesn’t occur until men hit 70 to 71 and women hit 73 or 74.  Wanna bet that those numbers move back even farther as the bulge of the Boomer generation moves closer to the dreaded “old age” cutoff, to the point where, in a few years, people are saying 80 is the new 50?

It’s pretty ridiculous — and kind of pathetic — when you think about it.  Some people in the Baby Boom generation have always seemed more focused on how they are perceived than how they feel about themselves.  Now that they are aging, and they don’t want to be seen as “old,” they struggle to convince everyone that a different definition should apply. But the efforts aren’t working, and people still use the same criteria to define who is “old” — things like whether you’ve got gray hair, or for that matter any hair, and whether you’re approaching retirement at your workplace.  If you have enough of those criteria, you’re going to be seen as “old,” whether or not some researcher argues that advances in longevity really should change the definition.

If all Baby Boomers were really as rebellious as they like to think they are, they wouldn’t care about public perception.  If you’re seen as old by others, so what?  The key is what people think about themselves, not the labels assigned to them by others.  Baby Boomers would be better off if they stopped talking about “being old” at dinner conversations, and started focusing more on what they personally still want to do with their lives.

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My Doctor’s Questionnaire

My doctor is one of those incredibly capable health care professionals who is always acquiring information in order to provide the best possible medical advice.  He uses the information obtained from a questionnaire as deftly as surgeons use a scalpel or GPs use a rubber tomahawk on your knee to test reflexes.

Recently, though, I’ve noticed a change in the tenor of the questionnaires I’m getting from my doctor.  No longer are they just focused on allergies, or muscle strains, or my diet, or how much exercise I’m getting.  Now the questions seem a lot more, uh, pointed.  In my most recent visit, the very first page of the questionnaire I was given to complete was the “Duke Activity Status Index.”

img_5859“Can you take care of yourself (eating, dressing, bathing or using the toilet)?”

“Can you walk indoors such as around your house?”

“Can you walk a block or two on level ground?”

Can you climb a flight of stairs or walk up a hill?”

Hey, wait a second!  Exactly what kind of questionnaire is this, anyway?  Why are the busybody nerds at Duke wondering about whether I can walk a single block on level ground, or eat without assistance?

I’m guessing the “Duke Activity Status Index” is not given to 25-year-old patients.

And then the very next page in the questionnaire packet is the “Burns Depression Checklist,” and one of its questions is:  “Poor self-image:  Do you think you’re looking old or unattractive?”

Well, to be honest with you, I really wasn’t focused on the subject until I started to read this questionnaire!

Destination: Jimmy Durante

Yesterday I ran across a discouraging article.  It pointed out that whereas most parts of the human body have stopped growing when an individual reaches adulthood, there are two uniform exceptions to that rule: your ears and your nose.

589dbf1913f52__george-burns-and-jimmy-durante(FYI, apparently fat cells around the midsection are not considered a separate “body part.”)

The article explains that in most parts of the human body, growth stops because cells stop dividing — although the cells themselves can expand or shrink.  The ears and nose are different from other body parts because they are soft tissue encased in cartilage, and the soft tissue cells keep growing, and growing, and growing — forever.  And when I call up the mental images of the two of my grandparents who lived well into their 90s, I realize with a start that they did end up with pretty big schnozzollas, now that I really think about it.

This is discouraging news, because I don’t know of anyone who desperately desires to have a bigger nose or more prominent ears.  The nose is already one of the dominant features of the face.  It’s not exactly an attractive, expressive feature, either.  If a facial feature has to continue to grow, why couldn’t it be the eyes?

And, if like me, you already have a considerable, if noble, nose, and ears that look like the twin handles of a Roman vase, you wonder just how big the darned things might get.  I’m afraid I’m ultimately headed to Jimmy Durante territory.

What The Pop-Up Ads Are Telling Me

I have an app on my phone that allows me to play “Spider Solitaire,” which helps me kill time on the road.  Because I’m a cheapskate, I downloaded the free version of the app, which means I have to endure, and promptly delete, an advertisement before I can play a new game.

hqdefaultIn the past, the ads were almost exclusively for other time-wasting game apps, which almost always featured smiling and frolicking animated creatures, or happy magic elves, or popping cubes, or a classy English butler who was part of a secret society trying to find hidden objects on the screen.  Lately, though, the ads seem to be sending a darker, more targeted message:  Hey user!  We’ve somehow figured out that you’re old, and since you’ve never responded positively to an ad with adorable, starry-eyed tap-dancing pandas, we’re going to bombard you with obvious age-related products instead!

I first noticed this theme when I started to see ads for pharmaceutical products, like an ad for a drug that is supposed to deal with type 2 diabetes.  Geez, I thought:  That’s a pretty serious topic for a pop-up ad on a free game app.  But then the next ad was for $350,000 in life insurance, with no age or health limits, that would allow your family to bury you and give you peace of mind that they would be provided for after you went into the Great Beyond.  And since then I’ve seen ads for new mattresses so I can get a better night’s sleep, ads for prostate and urinary tract medications, and ads for retirement communities featuring smiling seniors out on the golf course.  What’s next? Ads for Sansabelt slacks, Geritol, and early bird specials at the MCL Cafeteria?

It’s getting so that playing a few games of Spider Solitaire has become kind of a downer.  Hey, can we go back to those ultra-cute tap-dancing pandas?

 

Sleepless, But On Guard

Everyone knows that, as you get older, your sleep patterns change and, for the most part, get worse.  A lot worse.

The arc of sleep goes from the totally out like a light sleep of the very young to the 12-hour power-sleeping capabilities of college students, but it’s all downhill from there.  By the time you’re in your 40s, 50s, and 60s, the realities of shrinking bladder capacity and ever-present concerns about developments in your career and family life combine to make sleep a fitful exercise, with lots of tossing and turning mixed in.  There’s not much REM sleep to be had.

neanderthalerScientists think there is an evolutionary reason for this unfortunate trend — one that goes back to caveman days.  They say older folks sleep less soundly because their role in the tribe was to be alert for potential predators, attacks from warring clans, and other lurking disasters.  In caveman days, the blue-haired set would go to bed earlier than the rest of the tribe.  Then, with their lighter sleep habits, they would be roused by the sounds that a nocturnal animal would make upon entering the cave and could give the alert, so that the more youthful members of the tribe could help to fight the predator.  And the sleepless oldsters would also be first up in the morning, to get that all-important fire going and be ready to deal with any unwanted intrusions by bears or wolves or sabertoothed tigers.

It’s nice to know that there’s an exciting explanation for experiencing poorer, less satisfying sleep as you get older, and that in the dawn of humanity a codger my age would be quickly roused to alertness in order to grapple with cave bears and save the tribe.  I’d still trade it for a solid seven hours of sound sleep.

Rethinking Alzheimer’s

Alzheimer’s disease has been a known condition since it was discovered, in 1906, by a German doctor, and it has been the focus of lots of attention and research for decades.  It ranks as one of the top causes of death in the United States and is the third leading cause of death among people 60 and older, just behind heart disease and cancer.

So, after more than a hundred years, why haven’t we figured out how to treat this dread and deadly disease that robs people of their minds and personalities and leaves them empty shelves of their former selves?  Why, for example, have doctors and drug companies been able to develop effective treatments for HIV and AIDS, but not Alzheimer’s?

alzheimer_brainIt’s not that the scientific and medical community isn’t trying — but identifying the real cause of Alzheimer’s, and then devising a meaningful treatment, is proving to be an incredibly elusive challenge.  A brain with Alzheimer’s is like a car crash with no witnesses, where the accident reconstruction expert tries to find clues from the physical evidence.  Do those skid marks indicate that the driver was going too fast, or do they suggest that the driver was distracted, or was the driver paying attention when something like a deer unexpectedly came onto the road?  In the case of Alzheimer’s the brain is mangled and distorted and physically changed, both chemically and structurally.  Are those changes what caused the disease, or are they mere byproducts of the active agent that does the real harm?

For more than a quarter century, Alzheimer’s researchers and drug companies have been focusing on the “amyloid hypothesis,” which posits that an increase in amyloid deposits causes the disease, and have worked to develop drugs to target amyloid.  The hypothesis was devised because Alzheimer’s patients have an unusual buildup of amyloid in their brains, amyloid buildups have been found to be harmful in other bodily organs, and people with a genetic history of Alzheimer’s in their families also have been found to have mutations in the genes responsible for amyloid production.  With this kind of evidence, it’s not surprising that amyloid production has been the focus of treatment efforts.

Unfortunately, though, the trials of drugs that address amyloid production haven’t been successful — and after repeated failures, some scientists are wondering whether the amyloid hypothesis should be scrapped, and the disease should be examined afresh.  The amyloid hypothesis remains the prevailing view, but a minority of researchers think that the focus on amyloid buildup is like trying to close the barn door after the livestock have already escaped.  And they wonder whether the amyloid hypothesis has become entrenched with so many people, who invested so much time and money in developing amyloid-based treatments, that work on alternative approaches is being undercut.

It’s a classic test for the scientific method.  Over the years, there are countless examples of instances where prevailing views on medical, or physical, problems were overturned in favor of new approaches that turned out to accurately identify cause and effect.  The scientific method is supposed to objectively find the right answers.  For Alzheimer’s disease, maybe it is just a matter of tweaking how to develop the right treatment for the amyloid build-up — or maybe it’s something else entirely.

Those of us who have dealt with Alzheimer’s in our families hope the scientific and medical community put aside preconceived notions, dispassionately assess the evidence, and explore every avenue for developing a successful treatment.  This disease is just too devastating to go unaddressed.