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.


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?"

Sunday, March 26, 2017

Creatinine Clearance: Biomarker of Health & Longevity

Photo of nephrons by eLife Journal.
What lab tests can signal signs of longevity?

The Dunedin longitudinal study showed that research participants with higher creatinine clearance levels had better health overall.

Nevertheless, kidney function does slow down a little as we age.

However, not every older adult is destined for kidney dialysis.

This post is part of a series on biomarkers of health and longevity.

Monitoring kidney function is important.

[Note: This post does not offer medical advice; its purpose is only to increase awareness. If you have any concerns about your kidney health, please see a licensed medical professional.]

Friday, March 17, 2017

Org Chart for Administration on Aging

Click on the image to enlarge.
This week, the President released his "Skinny Budget."

As a result, there's a lot of buzz about potential funding changes to a variety of federal programs.

Several programs affect older adults.

Meals on Wheels (MoW) is just one, and only a portion of their funding comes through the Administration on Aging under the U.S. Department of Health and Human Services.

Read MoW's press release about their funding sources. 

(Not all government programs benefiting older adults are affected by the President's proposed budget. For example, Social Security and Medicare are not part of the President's budget.)

It's difficult to monitor all programs available to older adults.

The enormity of the task discouraged me from looking at details. However, I feel as though it's time to start paying more attention to various programs that benefit our mature citizens.

So I'm getting my head out of the sand and looking at programs one at a time.

Where to start?

Friday, March 10, 2017

APA Using NCD not Dementia

Photo by Keoni Cabral.
If the Sapir-Whorft theory is to be believed, the language we use shapes our reality.

For this reason, the American Psychological Association (APA) scrutinized the origins of "dementia"-- which is tied to "madness" -- and introduced a new term.

Neurocognitive Disorders

"Neuro" refers to the physical brain.

"Cognititive" refers to the thought processes within the brain.

The term "disorder" recognizes that there is a medical cause for problems residing in the brain or thoughts.

Furthermore, disorders are categorized as "major" or "minor" NCD.

This term took shape in 2008 as a result of an APA workgroup.

However, neurocognitive disorder did not become formally recognized until the May 2013 publication of the APA's DSM 5 Manual--one of many changes.

Friday, February 24, 2017

On Living: Book Review

Published Oct. 25, 2016.
Kerry Egan draws on her experience as a hospice chaplain to share stories about how illness and dying highlight people's values.

Some might expect her to offer sermons about the place of religion in people's lives. She doesn't do that.  Instead, she demonstrates the healing power of narrative.

Egan observes that chaplains do the following work:

"We listen to the stories that people believe have shaped their lives. We listen to the stories people choose to tell, and the meaning they make of those stories."

Those who are sick and dying often find great insight in telling the story of their life. Egan focuses on maintaining an attitude of love and compassionate listening as people work to make meaning of their lives by sharing stories.

People talk about their childhoods, their life's work, their families, and most often their desire to love and be loved.

Saturday, February 4, 2017

Motherhood: Lost and Found: Book Review

Published December 4, 2013.
Ann Campanella experienced a decade of tension about her mother's failing health and her difficulties carrying a baby full term, which she chronicles in her memoir, Motherhood: Lost and Found (2013).

As an award-winning poet, Campanella brings her creative abilities of insight and turn of phrase to her work.

She generously shares her tender feelings and insights about her mother and her pregnancies, which may serve as a great comfort to people facing one or both of these challenges.

At the start of her book, we watch as Campanella's mother grows increasingly distracted and emotional.

Her mother, Elizabeth (Betty) Williams, has trouble driving, keeping track of time, and remembering what city she's in. She even fails to recognize family members and grows more dependent on others to help her dress, eat, and use the bathroom.

But the changes to memory and bodily function are not the only symptoms of Alzheimer's Disease. Betty grows more emotional, alternating between being confused, angry, depressed, paranoid, and hurt.

In time, the doctor's describe Betty's symptoms as those consistent with Alzheimer's Disease.  While this does give the family some answers, a diagnosis of a disease with no cure doesn't remove the affiliated difficulties.

Friday, January 27, 2017

Tinkers: Book Review

Published January 1, 2009
Paul Harding won the Pulitzer Prize for Fiction in 2010 for his novel Tinkers, a story about three generations of men from New England.

We meet George Crosby, a clock repair man.  From the start, the novel focuses on time, memory, and perspective.  George is suffering from delirium as a mature man in his last six weeks of life.  This leads to some shifting perceptions between past and present, reality and fantasy.

This is a book that I read slowly, wanting to live in the moments that he creates on the page.

Readers are next introduced to George's father, a salesman. Every fall and spring, Howard stocked up a wagon full of goods and traveled through back roads with his mule, selling to impoverished country people and making very little profit.

Howard is a poet at heart, but between the demands of providing for his family and the difficulty of dealing with his epilepsy, he lives a far less elegant life.

Friday, January 13, 2017

White Blood Cell Count: Biomarker of Health

Photo by keepingtime_ca.

Most people know that having a high white blood cell count is most likely a sign that the body is fighting an infection.

Also, having a low white blood cell count can be a sign of a problem.

White blood cells play a central role in the body's immune system. These cells constitute about 1% of human blood. They are small, but they are mighty.

Until doing research for this post, I had no idea what values constituted a healthy range for white blood cell count (WBC).

Depending on the source, healthy ranges for WBC are listed somewhere between 4,000 to 5,000 per microlitre on the low end or normal and between 10,000 and 11,000 per microlitre on the high end of normal. 

This post is part of a series on biomarkers of health and longevity.

Sunday, January 1, 2017

Happy 5th Blogoversary to TGAM

Image by Nick Lee.
Today marks the fifth anniversary of this blog on aging.

Initially, this was a place for me to record my observations as a graduate student in a gerontology master's program.

Since then, I have taught gerontology classes at Wichita State University before moving to Indiana, where I currently teach part time for University of Southern Indiana (USI).

One of my primary identities is "Life-long Learner."  The blog gives me a place to share book reviews, research notes, and film critiques.

Here are the 20 posts that have accrued the most views over the last five years. 

In ascending order...

20. Quotes about Aging (April 25, 2016)
19. New Home for an Emptying Nester (March 14, 2016)
18. Midlife Ennui (March 7, 2016)
17. The Lie of One-and-Done Caregiving (January 21, 2016)
16. Books about Alzheimer's (June 5, 2014)