The Keys To Aging Well

By Barrie Davenport

When I think about the possibility of living to age 100, it conjures images of sitting slumped in a nursing home, wearing too much make-up with Willard Scott hovering around to mark the occasion on The Today Show.  I don’t know about you, but I don’t want to hang around too long in a withered, useless form or with a mind that exits before I do.

But would you want to live to age 100 or more if you were still active,  healthy, and respected in your community?

There is a place where that happens far  more frequently than in the United States or just about anywhere else for that matter — Okinawa. Okinawa is the largest collection of islands between mainland Japan and Taiwan. It’s in our history books because U.S. forces invaded it in World War II, and it served as a base for bomber raids during the Vietnam War. But in spite of this turbulent history, Okinawans enjoy better health and longevity than other Japanese or Americans.

Centenarians number 34 per 100,000 people in Okinawa, many living quite actively. Compare that to 5-10 per 100,000 in the United States, where more are in poor health.

So what gives with the Okinawans? Why do they live so much longer than the rest of us? Doctors have been studying the people of Okinawa for 25 years, and the results were published in The Okinawa Program (Clarkson Potter).

It’s pretty heavy reading, so I’ve summarized some of the secrets to a long and healthy life revealed in the book:

1. The Okinawan Diet. Okinawans eat an average of seven servings of fruit and vegetables a day (compared to 2-3 for Americans). They eat seven servings of grain and two servings of soy products. They eat Omega-3 rich fish several times a week and very few dairy products or  meat (about an ounce of pork or poultry a day). This diet offers protection against most diseases related to premature aging, including heart disease, cancer and stroke. Their main method of cooking is low-temperature stir frying with canola oil, a very healthy oil which is low in saturated fat.

2. Calorie Restriction. Okinawans practice something they call “hara hachi bu” — which means “eat until you are eight parts full”. This self-imposed calorie restriction contributes not only to longevity but also to long-term health. Because less food is being metabolized for energy, there is a reduction in free radicals. Free radicals (molecules without an electron) do significant damage to cells. This damage causes many of the problems that occur with the aging process. Eat less, live longer. Cool.

3. Slower Pace. During the Okinawa study, centenarians were given a personality test on which they scored low in feelings of “time urgency” and “tension” and high in feelings of “self-confidence” during the prime of their lives. They live on “Okinawa time” — nothing starts on schedule. Moderation is a key cultural value, and they have optimistic attitudes, adaptability and an easy-going approach to life.

4. Respect. In America, youth is revered and aging is something to be fought and feared. In Okinawa, longevity is respected. The elders in Okinawa are celebrated and regarded with pride and respect. Families take care of aging relatives, and they are integrated into every aspect of family life.

5. Active Lifestyle. Exercise is integrated into the lives of Okinawan elders. They enjoy gardening, tai chi, traditional dance, and light martial arts. Elder day care is subsidized by the government, and many belong to community centers where they participate in a variety of active endeavors. They play the traditional Okinawan guitar, a banjo type instrument, and enjoy activities that have a spiritual component that connects the mind and body.

6. Spirituality. A deep spirituality is profoundly important to older Okinawans, especially the women who take an active role in worship and are the spiritual leaders of their society. In addition to Western medicine, traditional shamanistic healing practices are important to the elders. Health is the theme of most prayers.

7. Genetic Component. There is a genetic component to the longevity of Okinawan centenarians, as they do have long-lived brothers and sisters. However, it appears that it is their lifestyle that determines whether or not they will live to be 100. Most of us have genes that will enable us to live to 85 or 90, but our choices related to diet, pace of life, outlook, activity, self-esteem, and spirituality will determine whether we get there healthy and active. It appears to be mostly in our own control!

Source: http://liveboldandbloom.com/03/health/the-keys-to-aging-well

The War on Doctors and the Destruction of Healthcare

Walking the hospital corridors, it often amazes me many of the comments I overhear patients and others speaking about doctors. On this day, I took notice to the conversation of two elderly women who were none too happy with doctors, whom they stated only cared about their computers these days and not about their patients.
Upon hearing this, I wanted to scream out that nothing is further from the reality of what doctors truly feel. In fact, many days, a burning desire to toss my computer out the second floor window consumes me, but I rein it in. Doctors abhor spending time during the patient visit on their computers, documenting in the electronic chart. This decision was foisted on us by governmental mandates much against our wills. EHR (or electronic health record) technology was forced upon us as well as its antecedent meaningful use requirements. If we do not comply, we will be financially penalized so we have little choice. I have published many articles on the topic.
Patients do not see this, however. They want our time, they need our eye contact, they need to know we care about their health. They do not want us keyboarding away while they open their hearts to us. It makes them feel insecure. It lets mistrust sneak in. This lack of trust is very harmful to the doctor-patient relationship in many ways. Perhaps, the most important is that patients are less likely to follow our medical advice when the trust is not there. And, this can lead to unfavorable medical outcomes.
Reading or watching the media now exemplifies the anti-doctor culture now prevalent in the US. Even in a State of the Union Address, our own POTUS Obama made the suggestion that doctors perform procedures for profit. He completely disregarded the integrity of most doctors who work long hours, studied for many years, and take great strides to give patients our very best care. The media clamors for us to be transparent about our charges, while many of us close our doors because we can no longer afford to practice. We see the stereotype the media portrays of us: greedy doctors driven for profit. Yet, how many of those journalists volunteered to visit our practices or even talk to us and see what it is like in the exam room and what we deal with on a daily basis? Far easier just to perpetuate a stereotype than to investigate the reality. Sure, there exist some greedy doctors out there. But, the truth is, the majority of doctors despise them because they give us all a bad name and cast us in an unfavorable light. Does anyone want to know what the average doctor is like? Or do we just want to hate them all in the same way because it pleases us this way?
The war on doctors flames in board rooms across the country, as healthcare executives discuss how to profit off of our work. They place no value on our expertise, but rather calculate how they can reduce our reimbursements and get us to practice medicine in the way they desire to reduce costs and maximize their revenue. Doctors are not judged by clinical skills but rather by how much money they saved for the insurance company. I receive these analyses quarterly from many of the insurance companies that I contract with. If I prevent my patients from going to the ED to obtain medical care or only prescribe them the cheapest medications, I earn a higher rating. Do we really want to be treated by doctors who know how to cut costs the most, or by those with the best medical skills and knowledge? Sure, we all need to be conscious of healthcare costs, but not by sacrificing the best care for our patients. Insurance companies see their bottom lines. I, and most physicians, see a patient in front of us in the exam room that we want to help, to cure, to heal, to prevent a bad outcome from happening. But, all too often, the insurance company often over-rides our medical decisions in order to save costs, not lives. How has the system lost its priority like this?
And the government is no ally to doctors either. All too often in recent years, laws and mandates have poured forth from the halls of the Congress and Senate putting more restrictions on doctors. These mandates do little to improve patient outcomes. There is no evidence available that they do yet doctors are forced to comply with these regulations or face financial penalties. In fact, if you look further into these new laws, for example MU, PQRS, PCMH, it seems that these systems are just a way for the government to have an easy way to harvest more data about our patients. Do we really want that? And why is the government turning patients into data? In the future, doctors will be paid if patients meet certain clinical outcomes, like target LDL cholesterol levels, BP readings, and many more. Shouldn’t we be worried about the person and their health and not aiming for a specific target number? The governmental mandates are changing all this. And, to make matters worse, the government is the one establishing these guidelines. Do we really want our politicians deciding what is best for our health more than doctors do? Isn’t it time politicians removed themselves from practicing medicine unless they have earned a medical degree?
Unless, we stand up and demand changes, we are facing a future where the doctor no longer has much input into your medical care. They will be forced to follow guidelines established by those without any formal medical training. And patients will be the biggest losers in this new medical world. They will no longer be a player in their own healthcare decisions. They will be relegated to what their insurance companies allow them to receive, based on cost alone. There will be no more private doctors or small practices. Patients will only be able to see doctors, if they are lucky, in large systems or hospital groups. They will no longer have a personal relationship with their doctor, who will now just be a cog in the wheel, signing off only on what he is allowed. The patient will become a number, like at the deli counter: patient in, patient out. And the patient will leave dissatisfied because they had to pay for the visit because of their high deductible. And they were not able to receive any medications or tests they needed because the insurance company denied them……and they were too expensive to pay out-of-pocket. The doctor will be burnt out and the patient disgruntled. And the government will have the data they need because the burnt-out doctor is forced to submit it under financial penalty. And the insurance company maximized their profits, with their CEOs and other administrators making annual salaries in the tens of millions of dollars (as already happens in the present day).
These are historic times for the US healthcare system. We are watching it destruct before our very eyes. The days of Marcus Welby type medicine long gone
Yes, these are historic times in medicine as the curtain closes on the way we have trained and learned to practice medicine. The doctor is no longer center stage, unless you are watching a puppet show. We are now the supporting cast. Patients no longer have center stage either. The stars are the CEOs, the administrators who are raking in the big bucks and determining company guidelines and what doctors can and cannot do. The co-stars are the politicians, who issue mandates for their own gain, to push their own agendas and to line their own pockets.
The war on doctors is flaming. The American healthcare system is being destroyed.
Are we going to fight back? Or are we going to watch history unfold?
Source: http://drlinda-md.com/2015/05/the-war-on-doctors/

How to Build a Bolder Brain With Age

Sandra Bond Chapman, Ph.D.

Cognitive neuroscientist; Founder and Chief Director, Center for BrainHealth, University of Texas at Dallas

In advance of National Older Americans Month this May, the Institute of Medicine (IOM) issued a report titled "Cognitive Aging: Progress in Understanding and Opportunities for Action." The report details changes in cognition -- essentially, brain functions such as memory, attention, decision-making and problem-solving -- as we age that affect our lives. The report also identifies positive steps we can take to counter these losses to promote cognitive health.

We are all aware of the physical changes that occur as we age: graying hair, wrinkles, and a tendency to gain weight. Less well understood, but of greater concern to our ability to live long, healthy lives are age-related changes in our brains. According to a recent AARP survey, staying mentally sharp is important to 93 percent of Americans, but few know how to maintain or improve brain health. Until recently, cognitive losses in healthy adults were viewed as an inevitable consequence of living longer causing alarm since our life expectancy has increased steadily over the years.

The Institute of Medicine report confirms the results of scientific research showing that cognitive aging is a natural process that affects everyone, to varying degrees, with both positive and negative effects. However -- and here is the good news -- each of us has the ability to strengthen our cognitive abilities throughout our lives, and to prevent, slow or even reverse cognitive decline, given the right interventions and adoption of healthy habits.

The report details three scientifically-supported actions we should take to protect our cognitive health as we age:

-- Make time for physical fitness: Regular aerobic exercise (three times a week for 50 minutes) will not only enhance physical health but also brain health, boosting blood flow to the memory center for the brain.

-- Reduce cardiovascular disease risk factors (including hypertension, diabetes and smoking)

-- Manage medications effectively

Through decades of research at the Center for BrainHealth at The University of Texas at Dallas, we have identified a specific approach to brain training that involves nine thinking strategies. We found that the brain training strategies not only improved cognitive performance, but also induced beneficial physiological strengthening of brain systems as well as real life changes.

Higher-level thinking skills -- decision-making, planning and judgment -- are controlled by the frontal networks, the brain's command operation. Frontal lobe fitness is key to our ability to thrive personally and professionally no matter what generation we are in. To stave off cognitive decline, it is important to stimulate these higher-order thinking skills throughout life.

Here are a few tips for keeping your brain (or your teen's brain) healthy and performing at a high level:

Teens and Young Adults -- Our education system emphasizes rote learning and memorization at the expense of higher-order thinking skills. Parents and teachers should encourage young people to develop their own unique interpretations of movies, and political discussions and to look for multiple possible solutions to problems rather than one "right" answer.

The greatest risk this young group faces is becoming addicted to distractions due to the enormous volume of information, stimulation and interruption coming from their smartphones and other devices. It is crucial to establish boundaries around use of technology and to encourage them focus on one idea, problem or task at a time.

Age 25 - 45 -- Key to success for this age group is being able to block extraneous information to focus on the ideas that are the most important. The notion of multitasking -- that we can do two or more things at once -- is a myth, and a dangerous one. The brain can only perform one task at a time. Far from making people more productive, multitasking exhausts the mind, decreases effectiveness and creates damaging levels of stress.

Age 46 - 65 -- Whereas this age group is losing capacity to process new information quickly and to store and retrieve data, the potential to think broader, deeper and from a higher perspective actually increases with age. Years of accumulated experience means those of us in this phase of life can easily identify what is important to know and what to ignore when presented with a huge amount of information. This ability can efficiently compensate for memory deficits. As we age, it is important to prioritize our to-do lists and take the time to filter large amounts of information and synthesize it into the most important ideas.

Over 65 -- Our cognitive perspective gets more positive as we age. Seniors tend to be happier and remember events and happenings in a positive light. Their accumulated wisdom allows them to make better decisions and solve conflicts more easily than younger generations. Seniors must continue to engage in complex mental activities to keep from losing ground in their cognitive capabilities.

I am grateful to the Institute of Medicine for publishing this report, which will enhance our understanding about this relatively new area of science. For thousands of years, people have searched in vain for the Fountain of Youth to stay young. However, science is pointing the way to a Fountain of Youth, which paradoxically is to embrace the continued potential of our aging mind. We retain tremendous power to strengthen and heal our brain's health throughout life.

Source: http://www.huffingtonpost.com/sandra-bond-chapman/aging-brain_b_7235990.html?utm_hp_ref=tw

Nutritious, delicious and easily digestible: Japan innovates to feed elderly population

Companies and care homes in Japan are finding new ways to feed the country's elderly population well. 

 

TOKYO: The Japanese government estimates that by 2060, 1 in 4 of its citizens will be over 75. So it is no surprise to learn that food tailored specifically for the elderly is a fast growing market in Japan.
At the Minami Oi Care Centre, three types of meals are served up for its elderly residents: Regular meals; dishes that retain their original form but are softened; and meals with a jelly-like texture.
Meals are thus prepared with care to ensure they are at the right texture to make it more digestible to some of the residents. When salted mackerel is served, some portions need to be mashed up and reshaped.
The process begins by adding the fish into a mixer with some broth. The mixture is then moulded into shape, put into the refrigerator to set, then seared just before serving, to make the mashed-up fish look like it has been grilled. This meal is for those who have difficulty swallowing food. A problem many elderly experience.
“Meals that have been blended in a mixer is common in Japan; but you don’t know what you’re eating,” said Sachiko Inoue, chief nutritionist at Minami Oi Care Centre. “And many don’t finish their meals, because they do not look delicious. I wanted customers to know what they are being served and that the meals looked and tasted delicious.”
Residents at the care centre enjoyed the variety of meals on offer. “I don’t have any teeth,” said a 92-year-old woman. “Everything is soft and delicious.” For the kitchen staff, fixing a meal that looks mouth-watering, yet one that is nutritious and satisfying, is no easy task.
“This is an elderly home - so keeping to the standard for the texture and the size is what makes the task difficult,” said chef Kunio Yamada.
The silver segment of Japan’s food industry is increasing by double digits. In 2011, it was estimated to be worth US$835 million. Today, its potential value, on the back of a fast-ageing society in Japan, is believed to be about US$23 billion.
A manufacturer, which already supplies the Minami Oi Centre, is capitalising on this potential. “We plan to build a new factory next year and focus on food products for those with dysphagia (difficulty in swallowing) - which indicates how much we expect this industry to expand,” said Shouku Yokoyama of Nutri NOTE. “I think we will spend about 1.5 billion yen (US$12.5 million).
Many other food manufacturers are taking this same path. One product being put out by several manufacturers is a type of powder that can be mixed into liquid to form a jelly-like substance. This prevents the liquid from going down the wrong way.
The trend for customised food products for the elderly is set to grow, especially now, with Japan's government calling for them to be looked after at home, rather than in facilities.
Source: http://www.channelnewsasia.com/news/asiapacific/nutritious-delicious-and/1840940.html

Old Age Doesn’t Have to Be a Shipwreck

Rabbi David Wolpe

David Wolpe is the Max Webb Senior Rabbi of Sinai Temple in Los Angeles.

A few years ago, after my father died, my brothers and I gathered in Philadelphia for her birthday. We took my mother out to dinner at a local restaurant. After the meal, my brothers and I pulled out our wallets. My mother looked at us with scorn, and loudly said, “No!” We were shocked. Surely she didn’t think that we would let her pay for us? But she seemed emphatic, so dutifully, we put our cards away. My mother looked at us again, and crowed triumphantly, “Dessert!”

We laughed, of course. But the contrast of her force and her limitations is painful. The diminishment of a person is a fearsome and often tragic thing to see. I am at an age when my contemporaries are taking care of and often burying their parents. It is not unusual for death to be preceded by a steady and sometimes painful decline. As a rabbi, I visit old-age homes and hospitals and have to remind myself that this is the fate of everyone who lives long enough. Once the people who are slow, burdened with brittle bones and fading faculties, were children, teenagers, adults, bursting with dreams. They, too, could not imagine being in their current state.

The nuclear family is not kind to the aged. Once most people lived with multiple generations all together in the same house. Institutions have taken the place of families, and the old-age home and the college dorm epitomize our social structure—the old live with the old, and the young live with the young. Except for worship services and sporting events, it’s rare to see intermingling of generations in our society. We pay homage to the wisdom of age, but our culture does not seem to believe it. In a time when technology continually changes the landscape, it’s the younger generation who are likeliest to know how to navigate the world. Teenagers will fix your cellphone and connect your AppleTV. Startups are often created by those who are starting out.

Still, it is our great loss that we disregard the generations who preceded us. Although the elderly represent the past, they are in fact our future. They are where we are headed. Not only do they carry the vividness of personal memory about the years before we were born, but they also carry the immediacy of what it means to be further along on the journey than most of us are now. One day, if we are lucky, we will be old. What will life feel like for me in 20 or 30 or 50 years?

Old age, Charles de Gaulle once said, is a shipwreck. The first sense of that remark is the wreckage of one’s body, once so reliable and now so painful in rest and burdensome in motion. Yet if you think of the storm and gales, emotional, physical, even historical, that so many of the elderly have had to endure, the image of a shipwreck makes a new kind of sense as well. Just as we rush to interview the survivors of any difficult experience, for we know there is an insight born of survival itself, we should look to those who are older not only for the wisdom of living, but also for the wisdom of aging.

Everyone is ultimately headed to the same place. Care for the aged is a mandate of compassion to be sure, but it is also a way of understanding the human condition, including our own. The Psalmist pleaded thousands of years ago, “Do not cast me aside when I am old” (71:9). All of us need to reflect on how well we heed the Psalmist’s cry.

Source: http://time.com/3846825/old-age-shipwreck/

7 Habits of People Who Age Well

Exercise, diet—even attitude—can be as important as genetics when it comes to growing old gracefully. "Old age," as Bette Davis once said, "is no place for sissies." But that doesn’t mean you need to chicken out. Sure, growing older affects nearly every part of your body—including your hair, skin, heart, muscles, and more—but aging well may be as simple as adopting these (mostly) easy everyday habits.
By Abigail Wise
1 Maintain a positive attitude.

Photo by Sean Malyon/Getty Images
You are what you think you are when it comes to aging. Seniors who think of age as a means to wisdom and overall satisfaction are more than 40 percent more likely to recover from a disability than those who see aging as synonymous with helplessness or uselessness, according to The Journal of the American Medical Association.
2 Watch what you eat...

Photo by Carlos Daniel Gawronski/Getty Images
Nutrition plays a major role in how your body ages. “The latest research shows that a low-glycemic diet high in fresh fruits and vegetables, whole grains, and lean protein is healthiest,” says Dr. Jeffrey Benabio, Physician Director of Healthcare Transformation at Kaiser Permanente Primary Care. One great example is the Mediterranean diet, rich in plant-based foods, whole grains, nuts, and red wine (in moderation!). It also involves eating fish twice each week and cutting back on salt. Research shows that this type of diet may help you age better by warding off heart attacks, strokes, and premature death, according to Harvard Medical School. An added bonus: Benabio says that foods rich in Omega-3 fatty acids, such as walnuts, salmon, and flaxseed, help your skin manufacture the essential oils it needs to protect itself and can help skin look younger. In contrast, sugary, carbohydrate-heavy, and fatty foods—think, chips, soda, and white bread—can speed up the aging process, says Benabio. “So, when shopping or dining out, opt for whole grains and natural sweeteners,” he says.
3 …And how much you eat.

Photo by Cultura/BRETT STEVENS/Getty Images
Overeating may lead to a shorter life span, cardiovascular disease, and type 2 diabetes, according to the NIH. To age well and live longer, it’s best to stick to a balanced diet that consists of about 2.5 cups of vegetables, 1.5 to two cups of fruit, six ounces of grains, three cups of dairy, and five ounces of protein each day.

4 Exercise regularly.

Photo by Paul Bradbury/Getty Images
Staying active is a vital part of aging well. The average woman can lose 23 percent of her muscle mass between ages of 30 and 70, says Fabio Comana, a faculty instructor at the National Academy of Sports Medicine. You lose muscle more rapidly as you age, but exercise—resistance workouts in particular—can increase mass and strength, even well into your 90s, says Comana. Staying fit may also reduce age-related memory loss, according to a study published in the journal Frontiers in Aging Neuroscience. Plus, Alzheimer’s disease accounts for approximately 60 to 70 percent of all dementia cases, says Comana, adding that increasing physical activity can decrease this statistic by 25 percent. That’s because exercise strengthens the hippocampus, the region of the brain associated with learning.
5 Stay social.

Photo by Courtney Keating/Getty Images
Friends and relatives can help you live longer. Those of us with strong social ties were shown to have a 50 percent higher chance of living longer than those with poor or insufficient relationships, according to a study published in the journal PLoS Medicine.
6 Protect your skin from the sun.

Photo by Photo Alto/Frederic Cirou/Getty Images
Too much time in the sun can cause wrinkles, not to mention cancer. But wearing sunscreen can help prevent your skin’s aging. And while the sun’s UV rays do trigger vitamin D production, which is essential for bone health, that’s hardly a good reason to expose yourself. “Here are the facts,” Benabio says. “After a few minutes of sun, your skin stops making vitamin D…and starts making skin cancer.” Most people get plenty of Vitamin D, but if you think you’re not, try eating more salmon or even eggs (don’t skip the yolk).

7 Get plenty of sleep.

Photo by Rafael Elias/Getty Images
You probably know that you should snooze for seven to nine hours each night, according to the National Sleep Foundation. But did you know that not sleeping enough may mean a higher risk of obesity, heart disease, and diabetes. Plus, naps can improve memory and even help make up for missing nightly Zzs. And it turns out that “beauty sleep” isn’t a myth. During sleep, your body releases a growth hormone that helps restore collagen and elastin, the essential building blocks of young, healthy skin, says Benabio. Recent studies have also shown a connection between insomnia and accelerated aging of the brain, Benabio says. In other words, chronic lack of sleep adversely affects your brain’s function and speeds up the aging process. “Too many of us treat sleep as a luxury instead of a need,” says Benabio. “If I could encourage people do make one healthy change this year, it would be to sleep more.”

Source: http://www.realsimple.com/health/preventative-health/habits-of-people-who-age-well

For the Aging, Mobile Technology is the Most Freeing

by ORION JONES

File this one under The Fruits of Technology, especially for the aging.

Older people, 65 and older, are the most likely to reap the emotional benefits of smartphone technology. More than any other age bracket, they consider a smartphone to be "freeing," rather than "a leash," according to the Pew Research Center. On the other hand, 18- to 29-year-olds are the most likely to consider smartphones a leash.

The elderly also felt more strongly than any other age group that smartphones are "connecting" devices, as opposed to "distracting." Again, 18- to 20-year-olds were the most pessimistic: 37 percent considered their phones to be more of a distraction than a device that served to connect them to friends and family.

"For young adults, smartphones are often the device through which they filter both the successes and annoyances of daily life — which could help explain why these users are more likely to report feeling emotions about their phone ranging from happy and grateful to frustrated or angry during a weeklong survey."

Researchers suggest this is a result of how different ages use their phones differently. Younger generations are more likely to rely on their devices for social networking and viewing media content. Older generations use more basic functions like telephone calling, texting, and email. One reason younger generations may find their phones less satisfying is they serve as a way to actually avoid the people around them, rather than be open to naturally occurring conversation.

The takeaway here is to not presume seniors are "too old" or automatically "uninterested" in emerging technology just because there is a learning curve. As Bill Novelli, CEO of AARP (formerly the American Association of Retired Persons) explains, different generations share the same needs and values, meaning that everyone stands to benefit from technologies that brighten our lives.

Read more at the Pew Research Center.

Source: http://bigthink.com/ideafeed/for-the-aging-mobile-technology-most-represents-freedom