Successful Aging: The MacArthur Foundation Study shows you how the lifestyle choices you make now- -more than heredity--determine your health - Rilegato

Rowe M.D., John Wallis

Rilegato

ISBN 10: 0375400451 ISBN 13: 9780375400452

Casa editrice: Pantheon, 1998

Riassunto

The president of New York's Mount Sinai Hospital and a professor of public health present the findings of a MacArthur Foundation Study, showing healthy aging is dependent on diet, exercise, and self-esteem rather than on genes. 75,000 first printing. Tour.

Su questo libro

L'autore

John W. Rowe, M.D., is president of the Mount Sinai School of Medicine and Mount Sinai Hospital in New York City. Dr. Rowe has chaired the MacArthur Foundation Research Network on Successful Aging since its inception. He lives in New York City.

Robert L. Kahn, Ph.D., is professor emeritus of psychology and public health at the University of Michigan. A member of the MacArthur Foundation Research Network on Successful Aging, and lives in Ann Arbor, Michigan.

Estratto. © Riproduzione autorizzata. Diritti riservati.

From Chapter One
BREAKING DOWN THE MYTHS OF AGING

The topic of aging is durably encapsulated in a layer of myths in our society. And, like most myths, the ones about aging include a confusing blend of truth and fancy. We have compressed six of the most familiar of the aging myths into single-sentence assertions--frequently heard, usually with some link to reality, but always (thankfully) in significant conflict with recent scientific data.

myth #1: To be old is to be sick.

myth #2: You can't teach an old dog new tricks.

myth #3: The horse is out of the barn.

myth #4: The secret to successful aging is to choose your parents wisely.

myth #5: The lights may be on, but the voltage is low.

myth #6: The elderly don't pull their own weight.

Contrasting these myths with scientific fact leads to the conclusion that our society is in persistent denial of some important truths about aging. Our perceptions about the elderly fail to keep pace with the dramatic changes in their actual status. We view the aged as sick, demented, frail, weak, disabled, powerless, sexless, passive, alone, unhappy, and unable to learn--in short, a rapidly growing mass of irreversibly ill, irretrievable older Americans. To sum up, the elderly are depicted as a figurative ball and chain holding back an otherwise spry collective society. While this image is far from true, evidence that the bias persists is everywhere around us. Media attention to the elderly continues to be focused on their frailty, occasionally interspersed, in recent years, by equally unrealistic presentations of improbably youthful elders. Gerontologists, an important group of scholars which has become prominent during the last few decades, have been as much a part of the problem as the solution. Their literature has been preoccupied with concerns about frailty, nursing home admissions, and the social and health care needs of multiply impaired elders.
That we as a society are obsessed with the negative rather than the positive aspect of aging is not a new observation. Robert Butler, a pioneering gerontologist and geriatrician who was founding director of the National Institute on Aging and established the United States's first formal Department of Geriatric Medicine at Mount Sinai Medical Center in New York, coined the term "ageism" in his Pulitzer Prize-winning book Growing Old in America--Why Survive? in 1975. Butler saw ageism as similar to racism and sexism--a negative view of a group, and a view divorced from reality. More recently Betty Friedan, a leading architect of the women's movement, wrote about the mystique that surrounds aging in America, and our obsession with "the problem of aging." The persistence of the negative, mythic view of older persons as an unproductive burden has been underlined in recent congressional debates as to whether America can "afford the elderly." Ken Dychtwald, founder and CEO of Age Wave, Inc., has consistently sounded the call for a realistic view of aging and of older persons, exhorting American corporations to become more responsive to elders' needs.
. . .
Most of us resist replacing myth-based beliefs with science-based conclusions. It involves letting go of something previously ingrained in order to make way for the newly demonstrated facts. Learning something new requires "unlearning" something old and perhaps deeply rooted. Acknowledging the truth about aging in America is critical, however, if we are to move ahead toward successful aging as individuals and as a society. In order to make use of the new scientific knowledge and experience its benefits in our daily lives, we must first "unlearn" the myths of aging. Here we present each myth with a glimpse of the scientific evidence that corrects or contradicts it. In the following chapters of this book, we will explore that evidence in greater detail and discover its implications for how long, and how well, we live.

myth #1
"TO BE OLD IS TO BE SICK"

Ironically, myth #1 could be the title of many a gerontological text. Happily, though, the MacArthur Study and other important research has proved the statement false. Still, a central question regarding the status of the elderly is, "Just who is this new breed of seniors?" Are we facing an increased number of very sick old people, or is the new elder population healthier and more robust?

The first clue comes in the prevalence of diseases. Throughout the century there has been a shift in the patterns of sickness in the aging population. In the past, acute, infectious illness dominated. Today, chronic illnesses are far more prevalent. The most common ailments in today's elderly include the following: arthritis (which affects nearly half of all old people), hypertension and heart disease (which affect nearly a third), diabetes (11 percent), and disorders which influence communication such as hearing impairment (32 percent), cataracts (17 percent), and other forms of visual impairments including macular degeneration (9 percent). When you compare sixty-five- to seventy-four-year-old individuals in 1960 with those similarly aged in 1990, you find a dramatic reduction in the prevalence of three important precursors to chronic disease: high blood pressure, high cholesterol levels, and smoking. We also know that between 1982 and 1989, there were significant reductions in the prevalence of arthritis, arteriosclerosis (hardening of the arteries), dementia, hypertension, stroke and emphysema (chronic lung disease), as well as a dramatic decrease in the average number of diseases an older person has. And dental health has improved as well. The proportion of older individuals with dental disease so severe as to result in their having no teeth has dropped from 55 percent in 1957 to 34 percent in 1980, and is currently approaching 20 percent.

But what really matters is not the number or type of diseases one has, but how those problems impact on one's ability to function. For instance, if you are told that a white male is age seventy-five, your ability to predict his functional status is limited. Even if you are given details of his medical history, and learn he has a history of hypertension, diabetes, and has had a heart attack in the past, you still couldn't say whether he is sitting on the Supreme Court of the United States or in a nursing home!

There are two key ways to determine people's ability to remain independent. One is to assess their ability to manage their personal care. The personal care activities include basic functions, such as dressing, bathing, toileting, feeding oneself, transferring from bed to chair, and walking. The second category of activities is known as nonpersonal care. These are tasks such as preparing meals, shopping, paying bills, using the telephone, cleaning the house, writing, and reading. A person is disabled or dependent when he or she cannot perform some of these usual activities without assistance. When you look at sixty-five-year-old American men, who have a total life expectancy of fifteen more years, the picture is a surprisingly positive one: twelve years are likely to be spent fully independent. By age eighty-five, the picture is more bleak: nearly half of the future years are spent inactive or dependent.

Life expectancy for women is substantially greater than that for men. At age sixty-five, women have almost nineteen years to live--four more than men of the same age. And for women, almost fourteen of those will be active, and five years dependent.

It is important to recognize that this dependency is not purely a function of physical impairments but represents, particularly in advanced age, a mixture of physical and cognitive impairment. Even at age eighty-five, women have a life expectancy advantage of nearly one and a half years over men and are likely to spend about half of the rest of their lives independent.

There are two general schools of thought regarding the implications of increased life expectancy on the overall health status of the aging population. One holds that the same advances in medical technology will produce not only longer life, but also less disease and disability in old age. This optimistic theory predicts a reduction in the incidence of nonfatal disorders such as arthritis, dementia, hearing impairment, diabetes, hypertension, and the like. It is known as the "compression of morbidity" theory--in a nutshell, it envisions prolonged active life and delayed disability for older people. A contrasting theory maintains just the opposite: that our population will become both older and sicker.

The optimistic theory may be likened to the tale of the "one-horse shay" by Oliver Wendell Holmes. Some sixty-five to seventy years ago, when one of us (RLK) was reluctantly attending the Fairbanks Elementary School in Detroit, students were required to memorize poetry. One of Robert's favorites was a long set of verses by Oliver Wendell Holmes entitled "The Deacon's Masterpiece or The Wonderful One-Horse Shay." (A shay was a two-wheeled buggy, usually fitted with a folding top. The word itself, shay, is a New England adaptation from the French chaise.)

The relevance of all this to gerontology becomes clear early in the poem. The deacon was exasperated with the tendency of horse-drawn carriages to wear out irregularly; one part or another would fail when the rest of the vehicle was still in prime condition. He promised to build a shay in which every part was equally strong and durable, so that it would not be subject to the usual breakdowns of one or another part. And he was marvelously successful. The shay showed no sign of aging whatsoever until the first day of its 101st year, when it suddenly, instantly, and mysteriously turned to dust. The poem concludes with a line that stays in memory after all the intervening years. It is the poet's challenge to those who find the story difficult to believe. Since every part of the shay was equally durable, collapse of all had to come at the same moment: "End ...

Dettagli dell?edizione

• Editore: Pantheon
• Data di pubblicazione: 1998
• ISBN 10: 0375400451
• ISBN 13: 9780375400452
• Rilegatura: Copertina rigida
• Lingua: Inglese
• Numero edizione: 1
• Numero di pagine: 265