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A 'Dr. Spock' for the Senior Set: New Guide to Aging for Neurotics
Twenty years later I still remember walking outside our house on a bitterly cold February night carrying a heavily bundled five-month-old. My wife, a copy of Dr. Spock in hand, wouldn't let me come in. This was the famous baby doctor's prescription for croup; those days we never made a move without his baby books or, in subsequent years, those of T. Berry Brazelton. We are past the stage of having babies, but have a new care book to periodically peruse. It's for seniors-in-waiting, as well as the geriatric set, what Drs. Spock and Brazelton were to our early parenting years. "Keep Your Brain Young," is authored by two of medicine's most prestigious practitioners, Guy McKhann, professor of neurology and director of the Zanvyl Krieger Mind/Brain Institute at Johns Hopkins, and Marilyn Albert, professor of neurology and psychiatry and director of gerontology research at Harvard. This is an easy-to-understand guide about some not-so-easy worries that mark upper-middle age: What are the prognoses for grave illnesses like Parkinson's? Are memory lapses a sign of early Alzheimer's? Why is it so hard to sleep through the night? The central message is that with advances in medicine and technology, the aging process -- still no day at the beach but far better than the alternative -- is more manageable than many fear. Drs. McKhann and Albert, who have a commuting marriage, based much of "Keep Your Brain Young" on experiences with patients at Johns Hopkins and Massachusetts General Hospital. (I've never been a patient of either doctor, but when our oldest son was severely injured and hospitalized at Hopkins, a friend put us in touch with Dr. McKhann. He wasn't the treating physician but was an invaluable counselor.) Many of the most serious afflictions -- Alzheimer's, Parkinson's, strokes -- are brain related, as are everyday experiences like memory, sleep, sex and pain. A sampling of the McKhann/Albert book of wisdom and common sense: • Memory:
There may be no more typical experience in aging than so-called
"senior moments," forgetting a name, date, place, fact or
exactly where you parked the car. I still remember the 1950 Philadelphia
Phillies starting lineup, which I committed to memory when I was seven,
but forget my own computer password. Modernity doesn't make it easier. As
a political reporter 20 years ago, I knew every area code in the country;
now those 87 area codes have turned into almost 200. Chicago is no longer
just 312, it also is 773 or 847 or 630. North Carolina used to be 919; now
there are eight different Tar Heel area codes. Drs. McKhann and Albert offer encouragement: When a young person misplaces the keys for the umpteenth time, it's careless; when a senior does the same we worry it's the onset of Alzheimer's. As you age, your memory isn't as sharp, or more precisely, it takes longer to take in new information and retain it. But don't despair, say these experts on aging: It's usually not severe and there are many practical strategies -- visualizing numbers, making lists, planning ahead -- to minimize any gaps. • Sleep:
A newborn sleeps 16 hours a day and for a young adult, a rule of thumb is
an hour of sleep for every two hours awake, or about eight hours a night.
(This is as an average, so given my 15-year-old's weekend habits, somebody
out there is getting by on three hours a night.) As we age, that ratio
changes to about 45 minutes for each two hours awake, or about 6½ hours.
There are serious sleep disorders, but most problems are normal. One
constant: As you get older, you're not going to get through many nights
without a trek to the bathroom. The doctors are skeptical, however, of most alternative treatments, with one notable exception: acupuncture. They also caution that surgery should be a last resort. For seniors, much pain can be alleviated, but don't hesitate to seek help: "Pain is not a sign of moral weakness," this book notes. • Depression/Stress:
Up to 5% of the population faces a lifelong threat of clinical depression,
Drs. McKhann and Albert note. It's devastating for many, but far more
treatable than before, not just with drugs. In recent years
electroconvulsive therapy (ECT) has become safe, and an often more
effective (though usually short-lived) approach. Many more people face
stress, which clearly aggravates illness and recoveries; there is no magic
pill to alleviate stress, this book suggests, but the authors urge more
focus on relaxation techniques and social support systems. Genes, proper medical care and luck all play critical roles in one's health, these experts note. You increase these odds by not smoking, eating fatty foods or drinking heavily, and taking supplements, like vitamin E, daily. But "Keep Your Brain Young" observes three others factors characterizing those who avoid serious disease and recover better from illness: a.) they're more mentally active; b.) they're more physically active; and c.) they continue to maintain a sense of control over their lives. Indeed, Drs. McKhann and Albert hypothesize -- acknowledging lack of proof -- that one reason women live longer and are healthier than men may be because they shop more: "While shopping they are physically active...they are mentally active, comparing prices and making choices." They certainly don't diminish the tragedy of fatal illnesses like Alzheimer's, Parkinson's or Lou Gehrig's disease, for which no cures are on the horizon. Moreover, most of the drugs used to treat these diseases have side effects, and for seniors, with multiple ailments, different prescriptions clash. But if not panaceas, these vastly improved drugs prolong the quality of many lives. Their take on the drug debate won't please ideologues on either side. "The pharmaceutical companies have taken a lot of hits," Dr. McKhann states in a separate interview. "But they have enjoyed great success and they take a lot of risks." Yet, for seniors, he says, "it makes no sense for the day-to-day cost of drugs and drug management not to be covered [by Medicare]. Instead coverage is provided for highly expensive surgical procedures, many of which are of very limited value. The system is backwards." Yet Marilyn Albert and Guy McKhann abound with optimism. Over the next quarter century, they expect research will develop advances in brain injuries comparable to what's occurred in cancer over the past 25 years. For those of us who hope to be around to benefit, there is now an extraordinarily useful guidebook to serve us in the interim. FAIR USE NOTICE: This page contains copyrighted material the use of which has not been specifically authorized by the copyright owner. Global Action on Aging distributes this material without profit to those who have expressed a prior interest in receiving the included information for research and educational purposes. We believe this constitutes a fair use of any such copyrighted material as provided for in 17 U.S.C § 107. If you wish to use copyrighted material from this site for purposes of your own that go beyond fair use, you must obtain permission from the copyright owner.
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