Doctors Share Advice - How to Stay Golden

Doctors Share Advice - How to Stay Golden

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Doctors Share Advice - How to Stay Golden

Albuquerque Journal

05-23-05

There's something about the age of 50. Maybe you don't consider yourself over the hill yet, but you're sure getting a clearer view of the other side.

That could mean it's time to think about the steps you can take to go gently into old age. What you do now could make a big difference in how you feel in another 20 or 30 years, according to a couple of Albuquerque physicians.

Carla Herman, chief of the division of geriatrics at the University of New Mexico, and Barry Ramo, a cardiologist at the New Mexico Heart Institute, talked to the Journal about key considerations in making your senior years golden.

While Herman has focused her practice on health care of the aged, Ramo has made an avocation of interviewing some of his older patients and acquaintances to see what has led them to a vibrant old age.

"So much of what happens to us depends on how we behave, how we take care of ourselves," said Ramo. "Our fortune is not just tied to genes and good luck."

Good diet and regular exercise do a lot more than help us feel and look good now.  They also help prevent metabolic syndrome a condition sometimes thought of as "pre-diabetes" that is marked by high blood pressure, an unfavorable cholesterol profile, a big belly and insulin resistance, he said.

Those conditions in turn lead to a host of chronic diseases that lead to disability, he said.

So avoid that syndrome now and you may not have to worry as much about kidney failure, heart disease, failing eyesight or diabetes later.

Herman said she tells her patients to exercise three to five times a week and that includes exercises that increase your aerobic capacity, strengthen your muscles and enhance your flexibility, she said.  "Exercise lowers stress levels in older folks," she said. "It can improve cardiovascular disease and prevent falls."

She also advises seniors to make sure they're getting adequate vitamin B6, B12 and folate, a naturally occurring B vitamin, and get at least 1,200 milligrams of calcium and 400 to 800 units of vitamin D daily.

The mind can play a big role in people "acting old." Ramo said one study showed that a person's view of aging was the major determinant in how long he lived.  Too many people, he said, have a negative view of aging.

Ramo said he has talked with 50 to 75 people from their 70s to 90s he's thinking about writing a book titled "Living to 90 Begins at 50" and has found one common denomimator:  "They all have such a positive view of life."

People age well when they maintain a sense of connectedness to the larger world, whether through participating in activities at a senior center, volunteering in the community or pursuing a personal passion, he said.

Both he and Herman mentioned a book "Successful Aging," by John W. Rowe and Robert Kahn (1998, Random House Inc.) that spells out findings of a MacArthur Foundation study.  Lifestyle choices, including the food you eat and the activities you enjoy, determine how well you age, it found.

"That book did a nice job talking about the issue of social support," Herman said, noting that people do better when they are married, engaged in social activities, or involved in a church, for example.

"Rowe also talks about how people want to feel they have a role, and be valued and recognized for that," she said. "In traditional societies, elders had the role of knowledge-giver ... We don't really have that in our society."

Yet one-quarter of people over 60 still are working; 30 percent volunteer in some activity; 40 percent are helping their children or grandchildren; 20 to 25 percent are providing some form of caregiving, she said.

"But that's not recognized (as valuable) in our society," Herman said, wondering if the baby boom generation will change that image.

Doctors' own views about aging need to change, Ramo said. Too many of them think it's all right for an older person's vital signs or test results to fall outside the ideal as they age. "They say, 'Your cholesterol is high. Your blood pressure is high.  But that's OK you're getting older.' '' Ramo said.  "That's not OK."

Herman has set up a Senior Mentor Program that pairs medical students with people 65-plus who can help future doctors understand and communicate with older people, as well as see models of healthy aging.

Healthy aging also means catching problems early.  "People don't want to find out what's wrong with them," Ramo said.  "It's unrealistic to expect to live to be 90 and not have a serious illness ... You have to get it early or manage it as much as possible."

That means regular checkups and health screenings, along with taking medications that are prescribed, he said.  But, it also means taking into account whether some symptoms might be caused by your medications, he added.

Herman said she often recommends that her patients bring in all the medications prescribed and over-the-counter drugs and supplements to be reviewed for possible interactions.

Women 65 and older should have an annual mammogram and clinical breast exam until they turn 80, she said. Starting at 50, people should get a colonoscopy every 10 years, she said.  Screening for cervical canc usually stops at age 65 if a woman has had a history of normal results, she added.

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