What to expect as you age, and how to fight back
Keeping the Mind Sharp
In terms of cognition, the good news is that people over 60 show an improvement in “world knowledge,” which includes vocabulary, creative
thinking and problem solving, according to Molly Wagster, a neuroscientist at the National Institute on Aging. That said, almost all of us will experience some age-related deterioration, says Wagster. “Even from our 20s through our 50s, we show steady decline in memory and learning,” she says. The difference lies in the degree of impairment, as well as how quickly it sets in.
1 in 4 women over 65 have osteoporosis
The three areas most prone to deterioration are the ability to multitask, “attentional focus” (which affects short-term memory) and “word production,” which you might call “tip of the tongue syndrome.” This happens because, as we age, the insulation around our brain cells (neurons) wears down, affecting mental processing. It’s like when the plastic coating of a wire – or your cell phone charger – slowly becomes stripped, and it no longer makes a full, steady connection.
But there’s a lot we can do to fight back. A recent study found that just four factors – socialization, a healthy diet and both physical and brain exercise – can improve our mental skills as we age. Even more important, research shows, is enjoying those things!
Social interaction is beneficial for emotional and cognitive function, and without it, people become isolated and depressed, conditions that are sadly epidemic among older adults. In one landmark study, older folks with the highest levels of social activity — from visiting friends to attending church to going to parties — showed significantly less cognitive decline than less active peers.
Wagster adds that “busyness” in and of itself is advantageous, as is mindfulness meditation and having a purpose, whether that’s being in a relationship, having something to look forward to or feeling needed. A great way to accomplish all three: volunteering.
The jury is out on games and puzzles – except in that they do improve one’s skills at those particular tasks. When it comes to the brain, many researchers subscribe to the “use or lose it” theory. “Any complex interpersonal exchange could promote or help maintain efficient neural networks,” says Bryan James, lead researcher on the socialization study. Some experts recommend using mnemonics, or systems for improving and assisting the memory, like making visual associations or word plays on names or places.
The primary difference between health care for people in their 60s and those in their 80s is the value of diagnostic testing, says Dr. David Chen, an internist at Aurora Health Care in Hartford. “If people get prostate screening, colonoscopies or mammograms in their 60s, they’re likely to live long enough to benefit from any necessary treatment,” he says. “But we wouldn’t want to put a 75-year-old through the trauma of surgery.”
A serious risk for seniors is osteoporosis, or loss of bone density, which is a leading cause of deadly falls. One in four women over 65 has the condition, but it often starts to become an issue decades earlier, as protective estrogen levels drop. In a perfect world, women would begin building up calcium stores in their 20s, but that doesn’t always happen.
Arthritis is also prevalent among older folks; in America, almost 55 million suffer from it. While some types are genetic and not easily prevented, the risk factors of other types are modifiable. Things that combat arthritis are good overall recommendations anyway: maintaining a healthy weight, not smoking, doing appropriate exercises, not wearing high heels and following a diet that’s low in sugar and alcohol and high in foods that fight inflammation.
Age per se doesn’t raise the risk for heart disease, high blood pressure, certain cancers and diabetes, but poor diet and a sedentary lifestyle do. And the longer we live like that, the more likely our risk for chronic disease is to increase. Therefore, maintaining an optimal weight is just as important as you get older, says Chen. Unfortunately, he notes, Milwaukee has a very high rate of obesity. Excess weight is a contributing factor to the more than 1 million hip and knee replacements performed in the United States every year, because every extra pound is the equivalent of an additional three to four pounds of stress on the knee.
Other things diminishing with age are hearing and vision. But because they can decline slowly and we naturally adapt, we don’t always realize how much we’ve lost, Chen says.
“People fear memory loss but don’t realize the connection between it and hearing loss,” he says.
Also, since risk for eye diseases such as glaucoma, macular degeneration and cataracts grows with age, Chen advises people to see their ophthalmologist and audiologist at least once every two years.
A Place to Call Home
How to assess whether a residence is right for you
The best way to choose the right facility for you or a parent is to visit! While you’re there, use this checklist to help you decide:
- Notice the “vibe” or “soul” of the place: Is it friendly? Do staff members greet you? Do residents seem engaged and happy?
- Remember that this is a decision of the heart, so note – and trust – your emotional reactions.
- Make sure the noise level is satisfactory.
- Check for odors in the halls, private rooms and especially bathrooms.
- Pay attention to the surrounding neighborhood. Are residents allowed outdoors? Do you feel safe?
- Look for maintenance issues indoors and out: peeling paint, broken rails or light fixtures.
- Schedule a visit for around 4 p.m. on a weekend. If there are staffing issues, this is when you’re likely to see them.
- Ask to see the inspection certification and make sure it’s up to date.
- Observe what residents are doing – and how well-groomed they are. Look for a lot of activities in the public areas and for smiling, engaged people.
- Inquire what kind of support they offer for dementia and Alzheimer’s patients.
- Eat a meal there. Is it enjoyable?
Types of Residences for Seniors
Supportive Care Residences: Owners rent one or several apartments and hire and supervise caregivers. This offers freedom but no oversight.
Residential Care Apartment Complex (RCAC): Another “aging in place” option, these offer privacy and independent living and an on-site staff. Residents can purchase the level of care they need.
Community-Based Residential Facility (CBRF) offers communal dining, activities and a nursing staff, with some degree of oversight.
Adult Family Homes are run by private individuals and can be ideal for difficult- to-place people. These might have just one to three beds or house hundreds.
Practice Good Maintenance
Strong exercise and nutritional habits are your best bets for optimum health
Choose the Right Fuel
While nutritionists agree there’s no perfect “one size fits all” diet, most support a healthy, balanced diet that emphasizes fresh produce, healthy fats (oils from olives, nuts, seeds, avocados and coconuts) and wild-caught fish, especially salmon and other deep-water fatty fish that are high in essential omega 3 fatty acids. Other foods that are high in omega 3s include avocados, coconuts and coconut oil, nuts and seeds. Everything else should be kept in moderation. One model that meets those criteria is the Mediterranean diet.
But not all fruits and veggies are created equal. You’ll get the most nutritional bang for your buck with antioxidant-rich foods like blueberries, strawberries, beets, spinach, broccoli and dark leafy greens. Those last (green) veggies – particularly kale, collards and spinach (in moderation) – are also high in calcium, necessary to build strong bones and fight osteoporosis and osteopenia, a less severe condition.
For women who’ve been diagnosed with one of those conditions or are at risk, Chen recommends supplemental calcium, magnesium and vitamins D and K – and to not smoke. Discuss your risk, and whether to supplement (and how much) with your doctor.
Some experts believe chronic, uncontrolled inflammation is the “gateway” to many other conditions, including arthritis, cancer, heart disease, diabetes, depression and, some experts believe, Alzheimer’s. Combat it by eating an anti-inflammation diet, such as the one recommended by Dr. Andrew Weil (got to drweil.com). This approach puts the emphasis on fresh vegetables and fruit, whole grains, beans and legumes, with two to six servings of fish and seafood per week and very little animal protein.
A balanced diet is fundamental to weight management; excess weight and obesity are factors in almost every serious disease and condition.
Use it or Lose it!
Keeping fit is a key factor to staying healthy as you age. Regular workouts help you control your weight and reduce the risk for the leading causes of death. Exercise lowers cholesterol; strengthens muscles and bones; improves circulation, mental health, mood and sleep; and boosts energy and confidence. For older adults, it helps prevent falls and increases chances of living longer.
“Inactivity leads to overall physical decline,” Chen says. Working out regularly also reduces your risk for stress, he says, and that is an underlying factor in most major diseases.
“After age 30, we lose 1 to 3 percent of muscle mass every year,” adds Eric Pampuch, fitness program coordinator at Interfaith Older Adult Programs in Milwaukee. This is especially problematic as people age, because that attrition is often accompanied by other losses, such as balance and flexibility, says Pampuch.
The main problem areas for people over 60 are lower back, knees, shoulders and elbows. Knees, especially, take the brunt of our weight and mobility. Pampuch, who leads seniors well into their 90s through strengthening and stretching programs, says you don’t necessarily have to change your workouts as you age – “but you must use the right form,” he stresses. “Lifting wrong… actually increases your risk for injury.”
Pampuch recommends 150 minutes of cardiovascular exercise per week. The secret is finding a schedule you can integrate into your lifestyle.
Weightlifting or other strength training at least twice a week is essential to fight the loss of muscle mass. Aim for 20 to 30 minutes per session, ideally with a professional who’ll make sure you’re not setting yourself up for injury. Be sure to rest in between days to give the micro-tears a chance to heal.
Don’t be afraid to lift three-, five- or even eight-pound weights, he adds. When you lift, the muscles are forced to tug on the bone, which increases density. “I have a 91-year-old male client who uses five- and eight-pound weights, and a 90-year-old woman who does plenty of repetitions with three-pounders.”
Falls are the leading cause of both fatal and non-fatal injuries for Americans over 65. That’s a grim enough statistic. But this one is even more alarming: Wisconsin leads the nation in its death rate due to falls – at 135 per 100,000 senior residents. That’s why fall prevention should top every senior’s to-do list. Jennifer Lefeber, evidence-based health-promotion programs coordinator at Milwaukee County’s Department on Aging, encourages people to take a class before they feel it’s needed. “That’s why we call it ‘prevention,’” she says. The department offers free classes; for information, call 414-289-6352.
Wisconsin’s death rate due to falls: No. 1 in the nation
“People think you have to exercise – and you do,” says Lefeber. “The best approach is multi-factorial and has at its core increasing confidence.” She says a good falls-prevention program includes:
- Exercise that focuses on coordination, balance and strength, especially in the lower body
- Learning to recognize fall hazards (slippery floors, area rugs, cords, clutter and pets) and then modify them. Only 6 percent of falls occur in bathrooms, she notes.
- Vision testing
- Medical reviews, especially of prescription drugs that can cause drowsiness, dizziness or blurred vision
- Evaluating the need for assistance, such as a cane or walker or grab bars in the bathroom
- Home lighting inspection, including night lights in the bedroom and bathroom
- Physical therapy, if needed, to assess and improve gait
- Discussion of proper footwear, which should fit well and securely, have good treads and approximately a one-inch heel ◆