Aging Gracefully - Marist

Aging

GracefullyJodi Friedman, MD

Medical Director

Center for Healthy Aging

Northern Dutchess Hospital

April 3, 2019

1

April 4, 20192

This lecture is not

for sissies either.

What is Aging??

The progressive decline and deterioration of functional properties of the body, at multiple levels, that lead to decreased ability to adapt to internal or external stimuli and increased vulnerability to disease and mortality.

April 4, 20193

What is Successful Aging?

“A favorable outcome as perceived by the

individual, and his [or her] ability to cope

or adapt to the cumulative changes

associated with the passage of time, while

experiencing a sense of meaning or

purpose in life.”

M. Flood, “Successful Aging: A Concept Analysis,” The Journal of Theory Construction & Testing, 6(2), (2002): 105-108.

Disrupting Age

https://www.aarp.org/disrupt-

aging/stories/ideas/info-2016/what-is-old-

video.html

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Objectives

Describe normal aging and

misconceptions that go with it.

Review the major health domains and

how they impact aging.

Explore things we can do every day to

improve our experience of aging.

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What are we NOT doing?

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Health Domains

Physical

EnvironmentMental

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SUCCESSFUL

AGING

Health Domains:

Physical

Chronic diseases

Approx 80% of older adults have at least one

chronic disease, and 77% have at least two.

Mobility and gait

Cognitive

Sensory

Nutrition

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Aging Quiz-1

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1. The majority (>50%) of older adults will become senile during old age.

2. Declines in all five senses normally occur in old age.

3. Physical strength tends to decline in old age.

4. The vast majority of older adults will at some point end up in a nursing home.

5. Pain is a natural part of the aging process.

1. F

2. T

3. T

4. F

5. F

Normal Aging

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Prevention: Medicare Annual

Wellness Visit

April 4, 2019

innovations.ahrq.gov/profiles/physician

practices use software facilitated system

complete medicare annua lwellnessvisit

GanguliI, Souza J, McWilliams JM,

MehrotraA. JAMA. 2017 Jun 6;317(21):2233-

2235

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Medicare started covering preventative services for seniors only since 2011.

In 2014…

Only 7% of older adults receive all recommended preventive services

Only 16% of Medicare recipients had an Annual Wellness Visit

Going to your doctor:

screening Cancer screening:

Mammograms Pap Smears, Prostate exams Colonoscopy

Other: Blood Pressure Osteoporosis –Not just for women! Diabetes Mellitus Depression

Aortic aneurysms: family history, smoking

Vaccines: stay up to date: pneumonia, zoster, tetanus, pertussis

Cognitive Screening

Ageism in Healthcare

1. Potential for over-treatment.

2. Potential for under-treatment.

3. Improper communication during

medical encounters.

4. Patients attributing symptoms to old age.

5. Institutionalized ageism.

April 4, 2019

http://www.asaging.org/blog/not-doctors-

only-ageism-healthcare

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April 4, 2019

https://www.ncoa.org/news/resources-for-

reporters/get-the-facts/healthy-aging-facts/

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Exercise for Prevention:

What does exercise help with?

Insulin sensitivity

Body composition

(muscle vs. fat)

Blood pressure

Cardiovascular

function

Pulmonary function

Lipid profile

Bone mineral density

Muscle strength

Cognitive function

Chronic inflammation

Balance/falls,

Insomnia

Depression

Mobility

April 4, 2019

APTA of MA Geriatric Special Interest Group,

2010

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73 YEARS OLD

AGES 79 AND 76

Age 90 and 94

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Harriette Thompson: Finished

the Suja Rock ‘n’Roll Marathon

at age 92.

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Exercise:

Getting Started

Check with your doctor?

Start easy but make it a habit.

Pedometer, park farther away, 1-2

strengthening a day.

Increase by small amounts ever week or

so.

If you are sore, assess the situation.

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Types of Exercise

Poly-pharmacy

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Cognitive

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Reducing Risk of Cognitive

Decline:

April 4, 2019

The National Academies, Preventing

Cognitive Decline and Dementia (2017).

Institute of Medicine, Cognitive Aging (2015).

Baumgart, et al., Alzheimer’s & Dementia

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Cognition 2

April 4, 2019

N Engl J Med 2016; 374:523-532February 11,

2016DOI: 10.1056/NEJMoa1504327

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In 2016, NEJM,

looked at

Framingham data

over 3 decades:

Found a decrease in

the incidence of

dementia!!!!!

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Nutrition

April 4, 2019

https://www.ncbi.nlm.nih.gov/pubmed/1969

9838

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Nutrition

Micronutrients: older adults often

have deficiencies.

Protein: Increase to prevent

decrease of muscle mass.

More evidence on specific diets for

specific diseases: low carb for

Alzheimer’s disease

Aging Quiz

April 4, 2019

http://faculty.webster.edu/woolflm/myth.ht

ml

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1. Most older adults have no desire or capacity for sex.

2. Most older adults have difficulty with adapting to change; they are set in their ways.

3. The majority of adults say they are happy most of the time.

4. The majority of older adults say that they are lonely.

1. F

2. F

3. T

4. F

Psychological Issues

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Ageism

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Changes that

come with aging

are seen as

negative, so we

hide them.

Leads to lack of

treatment,

isolation.

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Emotional Intelligence

Ability of individuals to identify different emotions in themselves and others . Use emotional information to guide thinking and behavior. Adapt and manage emotions to achieve goals.

Studies indicate a that this increases with age.

April 4, 2019

Dictionary of Psychology

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Aging and Creativity Book, “The Creative Age” explores how to

awaken your potential in the second half of life.

Betty Friedan, author and feminist, wrote “The Fountain of Age” at age 72 and “Beyond Gender: The New Politics of Work and Family” at age 76.

Nelson Mandela, became president of South Africa at age 75.

PD James, British mystery writer, published her last book at age 91.

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Aging and Creativity:

Inventors

April 4, 2019

https://www.nytimes.com/2015/04/18/your-

money/more-older-adults-are-becoming-

inventors.html

39

“Older inventors bring valuable skills to their work, many experts say, like worldly wisdom and problem-solving abilities that can give them an advantage over younger inventors.”

Psychology: An Attitude of

Gratitude

Gratitude is an affirmation of

goodness in the world and the

recognition that the sources of

this goodness exists outside of

individuals.

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“

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A 2015 article in Scientific American reported that, out of 24 strengths, including love, hope, kindness, and creativity, the single best predictor of good relationships and emotional well-being was gratitude.

Dr. Huffman, psychiatrist at

Mass General.

Psychology: An Attitude of

Gratitude

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DECREASES

Fat consumption

Stress hormone

(Cortisol)

Blood pressure

INCREASES

Sleep quality for

people with

chronic pain

Sleep quality for

people with

difficulty sleeping

Athletic activity

Let’s Take a Body Scan

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Sleep

April 4, 201944

Psychological:

Get Enough Sleep

Sleep changes in older adults

DEEP sleep

in REM sleep

Sleep requirements

Medical problems and Medications

Sleep if you are tired

Use non-pharmacologic methods first

Good sleep hygiene

EnvironmentPOLICY

COMMUNITY

FAMILY AND OTHER

CAREGIVERS

HOME

SELF

April 4, 201946

Home Environment:

Aging in Place

Aging in place means being able to live in

the home of your choice for as long as

you are able, while being able to get any

assistance you require as your needs

change.

April 4, 2019

https://ageinplace.com

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Home

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Social Support

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The Future….

https://www.youtube.com/watch?v=WTj

CYutcGjw

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Social 2: Advanced Directives

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Community:

Rhinebeck@Home

Serving and Staying In Place (SSIP):

Kingston and 209 have websites, New

Paltz

Exercise classes

Senior Centers

Day programs

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Review: The Top 10

1. Participate in disease prevention.

2. Address problems when they arise.

3. Be your own advocate in your

healthcare.

4. Beware of ageist attitudes.

5. Make gratitude part of your lifestyle.

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Top 10 Continued

6. Plan ahead.

7. Take advantage of community

resources and participate in policymaking.

8. Learn something new.

9. Eat right.

10. EXERCISE!!!!

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April 4, 201955

Resources https://go4life.nia.nih.gov/

713/ref=sr_1_1?ie=UTF8&qid=1509831626&sr=8-1&keywords=the+creative+age

https://www.ncoa.org/healthy-aging/chronic-disease/better-choices-better-health/

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/AWV_chart_ICN905706.pdf

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Resources

https://www.drnorthrup.com/goddesses-

never-age-best-years-ahead/

https://ageinplace.com

https://www.aarp.org/livable-

communities/network-age-friendly-

communities/

https://www.acpdecisions.org/

http://www.compassionandsupport.org/

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