Tuesday, February 19, 2008

Successful aging

My 79 year old patient Ms. H was in yesterday to discuss her hip pain. She'd just returned from a cruise down the Nile and a visit to the Great Pyramid of Giza.

"Paley," she advised (my only patient, incidentally, who calls me by my last name), "Travel while you're still young."

Her Giza gripe was that she'd been unable to enter the pyramid because the entrance passageway was too short to allow a normal height individual to walk through but rather required a virtual duck walk to navigate. And her arthritic hip completely precluded such a maneuver. Still more aggravating to her was the ease with which an 88 year old traveling companion duckishly negotiated the cramped walkway.

But all in all, Ms. H declared the trip "fabulous." While her duck-walking friend can certainly be dubbed the 'remarkable elderly,' Ms. H more than qualifies as resilient in her adjustment to a painfully arthritic hip and her willingness to take it on tour.

I'd declare them both successfully aged. What constitutes successful aging and how we can advise our patients to achieve same is a matter of much research and publishing in the medical literature. Certainly, the best advice is to choose your ancestors carefully as studies suggest that the offspring of remarkable elderly on average go down the same road even if they don't eat sprouts and drink green tea.

For those of us who trusted the luck of the draw in parentage, here's good news from The Netherlands. Researchers on the Leiden 85-plus Study* sought out the Leidenian octagenarians, evaluating the success of their senescence from two points of view. Using standardized scales for physical, social, and psychocognitive functioning, they found that a mere 10% of the participants could be labeled successful from an overall functioning point of view.

When they interviewed the subjects, however, on their views about growing old, successful or not, they found most of them viewed aging well as "a process of adaptation rather than a state of being," valuing "well-being and social functioning more than physical and psychocognitive functioning."

Coping, adjusting, redirecting, and staying resilient even if not necessarily upright or duck-walking may be the secret to gilding the golden years.
*von Faber, M, et al. Successful aging in the oldest old: Who can be characterized as successfully aged?, Arch Intern Med. 2001 Dec 10-24;161(22):2694-700.


Ruth said...

I hope I can visit the Nile when I am 79 or 88! Great to hear about those successful agers. I tend to see more of the ones who haven't done as well

JeanMac said...

I can just hear that older lady referring to your by last name.Kind of a familiar/sweet thing. Reminded me of my Mom -she said all the nurses in her days referred to each other by last names.May we all be travelling at 79!

KGMom said...

I haven't reached my 80s (just turned 63) but I am hoping to age gracefully. And I am also hope to travel more.
But I must say, the aging bones don't always treat one kindly. I went out the other night to try to photograph the lunar eclipse--bent down to steady my camera and then thought--oh crap, how am I going to get back up without whacking the camera! Finally made it, but I was most annoyed at the less than limber body!

Mauigirl said...

Great post. I think if I asked my mother if she feels she is aging successful she'd say she is, even though she is a bit wobbly and can't walk very far. She still enjoys her life and does what she wants and we always go on vacation to Cape Cod with her every year as she's done since her childhood.

My aunt might be less optimistic about it even though she is just as healthy as my mother. It's all about attitude.

I think as long as I can blog I'll be happy in old age! I just hope my hands don't become too arthritic to type! Of course by then maybe it will all be voice recognition!

Femail doc said...

MG and others: I think we're lucky to enjoy the Internet as part of our lives. My mom could never really learn to use it, yet the easy access to the world without ever leaving one's home will enrich our lives even when we are 'less than limber.'

Ruth, in my mom and others, I've noted how hard it is for old ladies to learn to use canes properly. Along with computers, maybe we should learn to use canes and walkers while we're mentally nimble enugh to do so.