Once, turning 65 typically meant retirement, Medicare and the inevitable onset of physical decline. It also often signaled the need to search for a geriatrician, a doctor who specializes in caring for the complex medical problems of the elderly.
But many of today’s older Americans are healthy, vigorous and mentally sound, with no urgent need to change doctors. They aren’t afflicted with age-related diseases or functional impairments. This raises interesting questions about when — and whether — those 65 and older need to make that switch.
Seeing a geriatrician “should never be age specific,” says Nir Barzilai, a longevity researcher at the Albert Einstein College of Medicine. “Biological age and chronological age are not the same. Asking what age to start seeing a geriatrician is not the right question. The right questions are: What conditions do you have? Are you mobile? Are you starting to get frail? Are you losing weight, or not walking well? Can you shop? Can you get to your apartment? Can you live by yourself?”
Researchers at Boston Medical Center found that frequent, persistent back pain is associated with earlier death in a study of more than 8,000 older women who were followed for an average of 14 years. After controlling for important sociodemographic and health factors, women who reported frequent, persistent back pain had a 24 percent increased risk of death compared to women with no back pain. Published in the Journal of General Internal Medicine, the study is the first to measure the impact of back pain persisting over time on mortality. The researchers also found that disability measured after back pain helped explain the association.
Back pain is the leading cause of disability worldwide, and women aged 40-80 years have the highest prevalence of back pain. Also, women report more frequent and debilitating back pain compared to men. The proportion of adults over the age of 65 is increasing rapidly in the United States, and optimizing physical health in order to extend life for older adults is a well-documented public health goal.
“To our knowledge, our study is the first to measure disability after measurement of back pain. This allowed for a prospective analysis of back pain that persisted over time and later rates of disability, which may help explain the association between back pain and mortality,” said Eric Roseen, DC, MSc, a research fellow at Boston Medical Center and leading author of the study. “Our findings raise the question of whether better management of back pain across the lifespan could prevent disability, improve quality of life, and ultimately extend life.”
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My grandmother, Bella, a former nurse in the Ukraine, moved to the United States to help raise me when I was 7 months old. She was diagnosed with Alzheimer’s disease last year.
There was nothing to do to prevent her inexorable loss of memory and independence, her Massachusetts General Hospital memory specialist told our family, except to take a drug called memantine that slightly improves cognition in Alzheimer’s patients, but does not treat the underlying disease.
IT STARTS OUT SLOWLY, almost imperceptibly. The misplaced keys. The forgotten birthday or anniversary. Using the wrong word or losing the thread in mid-conversation. These are often dismissed as typical signs of aging, but in some people, they may be the earliest signs that something bigger is at work – the development of dementia or Alzheimer’s disease. When a doctor diagnoses dementia or Alzheimer’s in your loved one, you should be sure to ask a lot of questions to make sure you understand your loved one’s current state of being and so you can appropriately prepare for how this progressive disease could change over time.
1. Is it Alzheimer’s or another kind of dementia?
There are several types of cognitive decline people may experience. “Dementia is simply an umbrella term,” says Dr. Susann Varano, a geriatrician at Maplewood Senior Living, a Westport, Connecticut–based senior living residence company. “If a physician says, ‘you have dementia,’ it’s the same thing as saying, ‘you have cancer.'” She says it’s critical to pinpoint exactly which type of dementia it is. “Is it Lewy body dementia? Is it vascular? Is it a frontotemporal disorder? Is it mixed dementia? Is it Alzheimer’s disease?” Although all dementias affect the brain and cognitive function, “each of those types of dementias have a different path. Some accelerate more than others and some have different presenting symptoms, so it’s very important to get the actual diagnosis of dementia.”
I never wanted to be a concussion expert. I know some of the world’s leading authorities on head injuries and I’m certainly not one of them, but “expert” is a relative term. My expertise comes from personal experience.
During my two decades behind the wheel as a full-time Nascar driver, I suffered more than a dozen concussions. For a long time, I managed to keep most of them a secret, but then my symptoms got too severe to keep up the charade and I was forced to get help. My battle with head injuries has given me a wealth of firsthand knowledge of the causes, symptoms, and types of concussions, and their treatments.
Racers get every injury you can think of, from broken legs to cracked collarbones. But it was concussions, not fractures, that forced me to retire as a full-time Nascar driver in 2017. Twice I was pushed out of the driver’s seat because of concussion-related symptoms, missing two major races in 2012 and an entire half-season in 2016.
ALMOST HALF OF WOMEN and more than one-third of men will develop Parkinson’s disease, dementia or suffer a stroke after age 45.
A new study published Tuesday in the Journal of Neurology, Neurosurgery & Psychiatry examined 12,102 people aged 45 and older from 1990 through 2016 to observe their lifetime risk of these diseases. Researchers found that 1,489 people were diagnosed with dementia, 1,285 had a stroke and 263 were diagnosed with Parkinson’s disease.
Women are more likely than men to experience any of these conditions. A woman’s lifetime risk for any one of the three is 48.2 percent, compared to 36.3 percent for men. Among the participants, 438 of them, 14.6 percent developed multiple conditions, with women more likely to suffer from disease co-occurrence. Women were nearly twice as likely as men to suffer both a stroke and to be diagnosed with dementia – 2.9 percent of women compared to 1.9 percent of men.
A report newly published by the Centers for Disease Control and Prevention estimates that the burden of Alzheimer’s disease and related forms of dementia in the United States will double by the year 2060.
About 5.7 million individuals in the United States are living with Alzheimer’s disease, according to the Alzheimer’s Association.
This neurodegenerative disease is one of the leading causes of disability and the sixth-leading cause of mortality in the U.S.
With annual healthcare costs of more than $250 billion, the disease also puts a significant strain on the nation’s healthcare system.
USC scientists say Alzheimer’s could be diagnosed earlier if scientists focus on an early warning within the brain’s circulation system.
That’s important because researchers believe that the earlier Alzheimer’s is spotted, the better chance there is to stop or slow the disease.
“Cognitive impairment, and accumulation in the brain of the abnormal proteins amyloid and tau, are what we currently rely upon to diagnose Alzheimer’s disease, but blood-brain barrier breakdown and cerebral blood flow changes can be seen much earlier,” said Berislav Zlokovic, the Mary Hayley and Selim Zilkha Chair in Alzheimer’s Disease Research at the Keck School of Medicine of USC. “This shows why healthy blood vessels are so important for normal brain functioning.”
In a new review article in the Sept. 24 issue of Nature Neuroscience, Zlokovic and his colleagues recommend that the blood-brain barrier, or BBB, be considered an important biomarker — and potential drug target — for Alzheimer’s disease. Because Alzheimer’s is irreversible, and not fully understood, understanding the first step in the disease process is a critical step in fighting it.
THE SHARE OF AMERICANS with Alzheimer’s disease and related dementias is expected to more than double by 2060 as people increasingly survive into older adulthood, according to a study from the Centers for Disease Control and Prevention.
An estimated 5 million older adults had Alzheimer’s or a related dementia in 2014, and by 2060 that figure is expected to rise to 13.9 million, or about 3.3 percent of the U.S. population, according to the report, which evaluated health claims data for more than 28 million Medicare beneficiaries.
Alzheimer’s – the fifth-leading cause of death for adults 65 and older and the sixth-leading cause of death for Americans overall – destroys memory and cognitive functioning and poses a greater risk as people age.