Saturday, November 17, 2012

60 & Single Five Years On: Staying Physical

Gerontology (Greek for "old man" and "study of") The study of the social, psychological and biological aspects of aging. It is distinguished from geriatrics, which is the branch of medicine that studies the diseases of older adults. Gerontologists may include researchers and practitioners in the fields of biology, medicine, nursing, dentistry, social work, physical and occupational therapy, psychology, psychiatry, sociology, economics, political science, architecture, pharmacy, public health, housing and anthropology. - Wikipedia.com.
Geriatrics /ger•i•at•rics/ (-at´riks) The department of medicine dealing especially with the problems of aging and diseases of the elderly.

Today, I got back out on the road...three miles at my usual pace of 15 minutes a mile. Nothing sensational there but after spending most of my summer neglecting the physical side of my life, it was rewarding to rediscover the pleasure that comes from getting my heart rate up while breathing in fresh air and admiring the habitat as I jog along (Yes, part of the time, I break into a fast walk).
At about age 40, friends introduced me to jogging. I quickly learned that it made all the difference in my brain chemistry. I could banish a low-energy depressed mood with just 20 minutes of running and come back feeling, literally, like a different person. Exercise also helped burn up calories and manage my tendency to gain weight. So for most of the past 25 years, I've made an attempt at regular exercise. When I worked full-time at an office, running fit into my routine because I ran on my lunch hour. In retirement I should have more time for exercise, right?
Like everything else about retirement, there's no set schedule, which can be a problem for those of us who are fair-weather (on again, off again) joggers. Some mornings it's just more pleasant to sit in bed, turn on the morning news, drink coffee and read my smart phone than its is to put on the running shoes, get on the tread mill or out the door and up the road.
I turned to Dr. William Hazzard M.D., a leading expert on aging in America, for his views on aging and why exercise as well as staying mentally fit are essential for those of us over 60.
For more than 40 years, Dr. Hazzard, who lives in Seattle, has been studying the aging process. His medical textbook, "Principles of Geriatric Medicine and Gerontology" is the go-to resource for physicians worldwide who are in advanced training for the care and treatment of patients in the last phases of their lives. The book also serves as a resource for primary care doctors, internists and others who may need “instant” information for how to treat an older patient.
“People become more complex to manage as they age,” Hazzard told me in a recent telephone interview. "That diversity of care increases rather than decreases as we age. Ideally our care as we age is a team effort with the patient’s needs and welfare at the center of the discussion."
Now in its sixth edition, "Principles of Geriatric Medicine" first appeared in 1984 as Hazzard built the gerontology teaching program at the University of Washington School of Medicine. Later, he became vice department chairman at Johns Hopkins University Medical School in Baltimore where he helped establish a Center on Aging and Health.
He then spent four years at Wake Forest University in North Carolina as chairman of the Department of Medicine infusing geriatrics training throughout the school. In retirement, Dr. Hazzard serves as professor emeritus at the UW and continues to share his knowledge and views on aging.
What we need to know about the aging process
What does Dr. Hazzard say about the aging process? He describes the human organism as extremely complicated, which on the surface, functions well for most of us into our 70s.
“We (physically) peak rather early in our 20s, maybe 30s,” he said. “But there’s a long period of middle age from 25 to 75 where there’s a gradual decline in physiology but an increase in knowledge and experience that we mostly take for granted.”
We can remain in good health and stay fairly fit into our 60s, he says, as long as we stay active, don’t smoke or drink too much and have good genetics. However, as we enter our late 60s and mid-70s, diseases may start to break through.
“Our aging may become more complicated, less successful,” he said. “The closer we get to the end, we may face a crisis such as a stroke, heart attack, a fall or Alzheimer’s that changes things.”
In geriatric terms, Dr. Hazzard said these crisis points are not diseases but syndromes that make us more vulnerable as we age.
“At age 85, you don’t cure heart disease, you manage it,” he says. “We all become more complex and our (health) management becomes more complex.”
Dr. Hazzard says that even though there’s been great progress in understanding how the human body ages, researchers and physicians are only beginning to recognize the trade-offs in treatment of certain syndromes in the elderly.
For example, should a physician try to lower his elderly patient’s blood pressure with medication to a level that’s normal for a 50-year-old? Maybe not, he says.
“We know that systolic blood pressure goes up as almost a natural part of the aging process,” Hazzard said. “What’s the optimal blood pressure in a 75 or 85 year old?”
More vulnerable to our genetic weaknesses
Ideally, he said, we all find a physician who we can grow old with, who will be the captain of our care team...a physician who is sensitive to the complexities of aging and who will listen to us. Preventive care is a key part of our management program because as we age we become more vulnerable to our genetic weaknesses in terms of heart disease, Alzheimer’s or stroke.
“As a geriatrics physician, you’ve really got to love old people,” Hazzard said. “Women tend to be more gifted in that, more sensitive. She (the doctor) may have had a personal experience with a grandmother or other family member that created a positive experience.”
Factoid: According to Dean Anderson, writing at Sparkpeople.com, only 32 percent of adults 65 and older follow a regular exercise plan, and for those 45-64, the number is even lower at 30 percent.
Finding the right doctor

So how do we find a physician with geriatrics training? Using the Internet to search for doctors certified in geriatrics in your town or city is the easiest method. (AgingCare.com)  Make an appointment and do an interview. You want someone who will listen and be your advocate.
Dr. Hazzard sees geriatrics as the opposite of most subspecialties in medicine. Instead of narrowing a doctors' expertise to a specialty such as oncology, doctors trained in geriatrics should be knowledgeable in many areas intended to help older people remain mentally healthy, mobile and independent. This holistic approach doesn’t just treat current medical conditions but looks at family history with an eye to prevention or to developing a program to support the aging person as they become more frail. A doctor trained in geriatrics will help devise a “healthy aging plan” for you. The goal, Hazzard said, is not to try to have everyone live to 100, but to work to “preserve respect, dignity and comfort” for patients as they age.
Meanwhile, Dr. Hazzard’s message to healthy 65-year-olds? “Keep running and keep reading.”
Web site resources:
The Gerontological Society of America - www.geron.org.
Association for Gerontology in Higher Education -
www.aghe.org.
University of Washington School of Medicine, division of Gerontology Geriatric Medicine –
www.depts.washington..edu.geront.
American Medical Association, "Aging and Community Health, click here.
sparkpeople.com - "What You Need to Know about Fitness after 60
Get Fit Staying Fit.com
After 65, stay fit to stay healthier.

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