Saturday, June 24, 2017

Lifespan Differs from Health span

Photo by Quinn Dombroski.
Because I am a gerontologist, people often talk to me about their desire for longevity.

But is this wise?

I spent three years volunteering in a multi-level care center, observing the difference between lifespan (how long a person lives) and health span (how long a person lives without disability).

The all-too-human desire for longevity reminds me of the Greek myth of Tithonus.

He was a mortal who was the beloved of Eos, the Titan goddess of the dawn. She asked Zeus to bestow eternal life upon Tithonus. Zeus did so.

But Tithonus did not receive eternal youth. Instead, age transformed him into a grasshopper.

And that problem--immortality vs eternal youth--has been exaggerated in the 21st Century as people in industrialized nations are living several years longer than their great grandparents.

Advances in sanitation, health education, preventative medicine and curative medicine has allowed more and more people to live into late adulthood, more into their 80s, 90s, and 100s than ever before.

See the post Life Expectancy vs Life Span for definitions and statistics. 

Many people are enjoying good health through much of their late life. However, not all people of advanced age live without disability and disease.

The National Institutes on Aging (NIA) explains the difference between lifespan and health span in the online publication Biology of Aging.  The chapter, "Living Long and Well" notes the important differences.

NIA hopes that continued research can help close the gap so that people have very few years of disability in advanced age.

A lot of research about the aging process is conducted with insects and animals. However, longitudinal studies are bearing great fruit.  Also, there is an increase in the number of studies of the oldest old: centenarians and supercentenarians.

Other related search terms include compression of morbidity, disability-adjusted life-years (DALY), Healthy Life Years (HLY), healthy life expectancy (HALE), and disability-free life expectancy.

It is exciting to read this research and to adopt healthy lifestyle choices advocated by a variety of medical experts.  But still the question remains: Is it wise to petition Zeus, God, or the medical community for immortality?

I don't have an easy answer for how to close the gap between life span and health span. Even if I accept the existence of "the gap," I don't have an easy answer for how to live gracefully for months, years, or even a decade with poor health.

And avoidance isn't a great option.  Every time I see a grasshopper, I'm reminded that the Greeks' cautionary tale, appropriate even for our modern era: there will probably always be a difference between immortality and eternal youth.

Related:

Leisure World Cohort Turning 90







Monday, June 19, 2017

Big Fish: Film Review

Released: December 10, 2003.
Big Fish (2003) ranks as one of my all-time favorite films.

Yes, it contains themes related to aging.

However, many elements of the film are pertinent to people of all ages:

parent-child relationships (particularly father-son conflicts), courage, family legacies, truth vs illusion, coping with illness--and more.

The bottom line: WATCH THIS FILM!

I rewatched this film on Father's Day weekend with one of my teens.

What was my takeaway this time?

Big Fish illustrates this phenomenon: family members each hold their own version of reality.

My past viewings were informed by my decades of work in English departments.  In 2013, I earned a gerontology degree.  Between my new paid work and upcoming life changes, I'm looking less at the artistry and more at the family roles.

I'm now a midlife person who is launching a young adult son while offering (pitifully inadequate) long-distance support to aging parents.

(Young Edward from birth through childhood is played by more than one character, but the greater portion of the flashbacks are portrayed by Ewan McGregor; late-life Edward is played by Albert Finny. The adult son is portrayed by Billy Crudup.)

Tuesday, April 25, 2017

Modern Death: Book Review

Published February 7, 2017.
Modern medicine has increased the average life expectancy of people living in industrialized nations.

However, modern medicine has also decreased the health span.

In other words, people are living longer, but many are living in a state where their quality of life is very low while managing numerous chronic diseases and sometimes--for years--a terminal disease.

Particularly salient are Warraich's questions about how to balance extending life with quality of life during end-of-life care.

Haider Warraich, a fellow in cardiology at Duke University, provides a thoughtful exploration of issues surrounding end-of-life care in his book Modern Death: How Medicine Changed the End of Life

His book is one of more erudite on the topic. The academic register is a bit high.  And one of the earlier chapters discusses death at a cellular level, which I found very challenging. 

Nevertheless, Warraich includes a number of case studies to balance out the history, philosophy, statistics, and evidence-based research.  These stories help illustrate the complex and difficult situations that patience and their support team of family members and health care professionals face. 

Friday, April 7, 2017

The Luckiest Old Woman Around: An Elder Tale


Photo by Paul Downey.
Once long ago in Northumbria near the village of Hedley, there lived an old woman.

She earned a living by doing chores and errands for the local women.  They would pay her with some fire wood here, some tea, sugar, and flour there.

It wasn't much, but she made do.

This post is part of a series on elder tales. An elder tale features an older adult who relies on strength of character and wisdom to solve problems. This contrasts with tales about younger heroes who often rely on riches, magic or a mentor to help them solve problems.  

One afternoon she was headed home and spotted a black iron pot by the side of the road. She hadn't seen anyone else on the road for a while, so how would she find the owner?

She thought to herself, "Perhaps it has been cast aside on purpose. Maybe it has a hole in it?  Still, I could make some use of it as a flower pot."

Even though it was a smallish sort of pot, the old woman discovered it was quite heavy. She opened the lid and saw, to her great astonishment, that it was full of gold coins.

"Oh, I am the luckiest old woman around. But how will I carry this home?"