Aging Mythbusters

Aging 101

 
I'm too old for this!

Getting older comes with one clear benefit: you're less insecure about yourself. You're more likely to say what you're thinking and do what you want than when you were younger.

 

You may think that you’ve done your duty to you identify someone who will make medical decisions for you should you become incapacitated. But you’re asking your proxy to act FOR you, to do what they think YOU would want done in a given situation. It’s a real burden if they have no idea what your wishes are. So have the conversation. There are websites that can help you think this through, including: www.prepareforyourcare.com.

10  Naming your health care proxy is necessary,

           but not enough.

Everybody ages. It's inevitable.

Do you know anyone who looks and acts the same, decade after decade? From birth onward, life is changing, and that's a natural thing. Resistance is futile. Being in denial about aging is guaranteed to make you miserable. Creatively adapting to changes as they occur will allow you to do what matters most to you.

Brain health is heart health.

There has been a 25 percent decline in dementia over the last decade, which accompanied a significant decrease in heart attacks and strokes. Controlling your blood pressure, cholesterol, and blood glucose, optimizing your diet and physical activity, stop smoking, and losing weight can all decrease your chances of developing heart disease, a stroke, or dementia.

Some changes ARE due to "normal" aging.

Needing glasses or hearing aids, or having trouble remembering proper nouns is to be expected as you age. These changes don’t occur in the same order or to the same degree in everyone. What's "normal" doesn't mean that you will like these changes, nor does it mean that there’s nothing you can do about them.

Some changes are NOT due to "normal" aging.

Learn a lesson from my patient, Harry, who went to see the orthopedist because of pain in his left knee. When the doctor said, "What do you expect? You're 90 years old!" Harry replied, "My right knee is ALSO 90 years old, and it feels fine." 

Right-size your expectations.

Learn what to expect with aging. For example, everyone walks more slowly and loses some strength. Exercising will make you faster and stronger, but it won’t get you back to where you were at 30. All of the runners in the Boston Marathon are in top shape, but 59- to 75-year-old men finish about 1½ hours later than the 18- to 39-year-olds.

Get a doctor who knows the difference between caring for 80-year-olds versus 50-year-olds.

Regardless of how well you’re doing, there are physiologic changes that occur with age. Heart attacks can present as shortness of breath without any chest pain, certain medications should be avoided, and the benefits and risks of screening tests and procedures may differ from those for younger people.

Dose matters.

You'll become a cheaper drunk. With alcohol and many medications, you get more "bang for the buck," meaning that you will have a greater response to previously well-tolerated amounts. Medications taken at the same dose for years may begin to cause problems because of age- and disease-related changes in the way the body processes and responds to them. Your brain also becomes more sensitive to medications, affecting your memory and ability to pay attention.

Hydrate, hydrate, hydrate!

Older people run "dry." Changes in the ability to feel thirst and the kidney’s ability to concentrate urine and preserve salt puts older people at high risk for dehydration, lightheadedness, heat stroke, and confusion. But don't hydrate with alcoholic or caffeinated beverages, you'll just urinate more!

Remember to S.O.C.

When you find you can't do everything you want to do, SELECT what matters to you, OPTIMIZE by practicing and rehearsing what you are able to do (use it or lose it), and COMPENSATE by embracing alternative methods and equipment.

1  You still need 7–8 hours of sleep everyday.

It just may be harder to get! With aging, it can take you a little longer to fall asleep and your level of sleep may be lighter. Medical and/or psychological conditions may wake you up at night, after which it can be harder to fall back to sleep. 

4  There IS a magic bullet. It's called exercise!

It’s never too late to start exercising. Physical activity helps cognition, strength, endurance, and much more. Even 90-year-olds can benefit from resistance training.

5  No pain, no gain no longer applies.

You don’t need to feel pain to build strength. Studies show there's a similar gain in muscle strength and size (with fewer injuries) when you use a weight that is tolerable (not the heaviest you can lift) and raise it repeatedly until your muscles feel tired. Once this gets easier,  increase the weight or the number of repetitions.

Though there are a few exceptions, bed rest is not good for you. The less you move and the more you stay in bed, the more deconditioned and dehydrated your body will become. This is especially true if you’re in the hospital. Loss of muscle strength happens quickly, while rebuilding it can take a long time.  

2  Bed rest is good...for dead people.

7  Newer isn't necessarily better.

Newly approved medications can cause unanticipated problems in older people because there are usually few older people in the trials that show the drug’s effectiveness. This is particularly true for those who are frail or have multiple medical conditions. New medications are also often more expensive than those that are time-proven. If your medical provider or an advertisement suggests you try a new medication, ask why it’s better than the tried and true.

Getting older doesn't mean you should isolate yourself. Frequent participation in meaningful activities and relationships decreases loneliness and increases life satisfaction. Do things you enjoy and try to make some new friends.

6  You CAN make new friends.

Yes, sun causes skin cancer. But sun exposure can improve your mood, sleep quality, and bone density (by increasing vitamin D levels). Don't go out at the height of the day's sun, and if you’re going to be in direct sunlight for longer than 15 minutes, put on sunscreen and wear sunglasses.

8  Some unprotected sun exposure is beneficial.

When your medical providers suggest tests or treatments, make sure they’ve considered your life expectancy, functional abilities, and preferences. Ask if the dosage and medication are right for someone your age. Be part of the discussion. Remember: Nothing about me without me!

9  Question authority.

You still need to worry about safe sex.

Sexually transmitted diseases, including HIV, are becoming more common in the older population. Chlamydia infections among Americans aged 65 and over increased by 31 percent, and syphilis by 52 percent between 2007 and 2011. Attention to safe sex, which includes the use of condoms, remains vital as you age, especially in non-monagamous relationships. You are never too old to be at risk.

ROSANNE M. LEIPZIG, MD, PHD
Geriatrician, Professor, Author

 

Icahn School of Medicine

Mount Sinai

New York, NY

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