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Live Life On Your Own Terms

Growing older doesn’t have to mean growing frailer

frailer optAccording to a 2015 John Hopkins University study, about 15 percent of adults 65 and over are frail.

And according to Dr. Linda Fried, geriatrician, dean of Columbia University’s Mailman School of Public health and a pioneer in the medical study of frailty, this means that they live with at least three of the following conditions:

  • Low physical activity
  • Weak grip strength
  • Low energy
  • Slow walking speed
  • Non-deliberate weight loss

Another 28 to 44 percent of older adults, with two of these markers, are pre-frail, according to Dr. Fried and colleagues’ research.

Chronic conditions including diabetes, heart disease, lung disease and stroke can double the risk of frailty, while dementia can multiply it tenfold.

Coronavirus or not, keeping these four health appointments is Important.

keeping health appointments optIf you subtract the statistics from just three states – New York, New Jersey and Massachusetts, which account for 10% of the population but 42% of COVID deaths – the remaining 47 states’ death rates are about as low as Luxembourg’s and Macedonia’s. But while the coronavirus may be less fatal than thought, it’s still every bit as scary.

Maybe this is why so many Americans have been putting off screenings and other health appointments they’d be better off keeping.

As of mid-April, the number of colonoscopies was down 90% from 2019. Mammograms and Pap tests were each down 94% compared to the 2016-2019 average. And the CDC estimates that there were a million fewer emergency room visits each week from March through mid-April.

For most people worried about COVID infection, putting off screenings and blood tests won’t do much harm over the short term. But the short term has a nasty way of turning into the long term. And over the long term cancers can grow to the point where they’re harder and more invasive to treat. A neglected cavity in a tooth can lead to a root canal. Blood coagulant levels can change from one week to the next.

That’s why it’s a good idea to keep these kinds of appointments:

Why experts are of two minds about the value of cognitive screening. 

2 mindsAlmost 6 million Americans have Alzheimer’s disease, and just about everyone over 65 has at least some fear of getting it.

The first step in finding out if any dementia – and Alzheimer’s is a terrible form of dementia – is a cognitive screening.

Cognitive screenings, such as the Mini-Cog, Memory Impairment Screen, General Practitioner Assessment of Cognition, Mini-Mental Status Examination, and the Montreal Cognitive Assessment, take five to ten minutes. They involve doctors asking patients with no obvious symptoms of mental decline to recall words, draw a clock face, spell a word backward, remember a sequence of words, and similar tasks.

Since seniors have a higher risk of Alzheimer’s, memory or thinking problems, or other cognitive impairment, does periodic cognitive screening make sense? The answer depends on which experts you ask.

The Problem with Too Much Medical Care

elephantWhile only 7.3% of adults aged 18 to 44 have Multiple Chronic Conditions (MCC), almost nine times as many 65 or older do (61.6%). And that can lead to something straight out of John Godfrey Saxe’s 1872 poem, The Blind Men and the Elephant.

That’s because Multiple Chronic Conditions usually call for multiple medical specialists, and, like the blind men in the poem, too many focus on their own areas of specialization and fail to see the whole elephant. This narrow view can produce wide-ranging consequences.

“Once you get three, four or five and six diseases, several things happen,” says Dr. Mary Tinetti, chief of geriatrics at Yale School of Medicine. “[A]lmost guaranteed, trying to get one of those diseases under control is gong to make one of the other diseases worse.”

Be safe at congregational worship

worshipAs Virginia’s reopening continues, churches, synagogues and mosques are reopening their doors – and that’s good for seniors who’ve been self-quarantining for months.

Seeing and talking in person with friends from your congregation is good for psychosocial and mental health. So is the sense of joining them in connecting to a higher power.

But if you’re over 65, you’re still at higher risk of Coronavirus infection.

That’s why it pays to make sure your place of worship and you yourself are following the CDC’s Guidelines for Communities of Faith.