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Jul. 30 2010 — 11:49 pm | 40 views | 0 recommendations | 0 comments

Chilling out for August

Sunrise over a lake near Leybourne. Sunrise ov...

Image via Wikipedia

When today’s boomers, not to mention today’s pre-boomers (the new-chic word for geezer) were young, stress had not been invented. Oh, moms got frazzled with everything, dads (and occasionally moms too) came home bushed after a long hard day at the office, office buddies groused about too much work for too little pay – but nobody had figured out that Stress was messing with our lives.

Now we know.

Over on the PositScience site – this is a company that follows such things – Karen Merzenich reports on a Wired magazine article by Jonah Lehrer; it’s not online yet, but parts have been on Lehrer’s own blog. Lehrer has found, in talking with primatologist Robert Sapolsky, that stress is bad for one’s health even if one happens to be a baboon

Throughout decades of research studying baboon populations in Africa, Saposkly noticed that low social position created stress and poorer health in some of the baboons. Studies in humans have shown much the same thing. Specifically, things like having a mean boss or not having any control over your work contribute to a sustained stress response in your brain which negatively affects health and longevity. To paraphrase, Lehrer essentially says that stress doesn’t make you sick- but if you are sick, it will make it worse.

This news comes not long after an article in Psychology Today, by Howard Fillit M.D., about stress and its long-terms effects:

Over the course of a lifetime, the effects of chronic stress can accumulate and become a risk factor for cognitive decline and Alzheimer’s disease. Several studies have shown that stress, and particularly one’s individual way of reacting to stress (the propensity to become “dis-stressed” often found in neurotic people for example), increases the risk for Alzheimer’s disease.

For boomers, pre-boomers, elders and geezers, if stress has been accumulating all these years, it’s probably a good time to change. Perhaps, just chill out. Chilling out is something else that wasn’t invented until after stress was… but it is a handy response for these days.

Happy August from Boomers and Beyond.

Jul. 30 2010 — 8:53 am | 3,198 views | 0 recommendations | 21 comments

Moving Mom & Dad — Abroad

Scotney Castle, Lamberhurst,  Kent

Image by Lincolnian (Brian) via Flickr

Retirement village? Assisted living? Co-housing? Age-restricted or aging-in-place communities? Inter-generational cooperative? This space has explored many of the growing varieties of housing choices for boomers and elders when the time comes to downsize, rightsize, clear out or economize. Here’s a new one that’s making the news: think global.

Even with (and sometimes because of) today’s grim economy, increasing numbers of Americans are choosing senior housing overseas. Some are returning to former homes in countries with lower costs or better health care, some are finding bargain housing in inexpensive areas where they have friends or a support community.

But many are just making housing in another country life’s last great adventure.

According to Boomers Abroad, an ambitious online community/social network, the number of Americans and Canadians living abroad, already about 7 million, is expected to double and then some within the next 10 years — and you’re invited to join them. The site links to the top five locales listed in the just-released September/October issue of  AARP The Magazine the best of what Mexico, France, Panama, Portugal and Italy have to offer—”castles, palm trees, rain forests, grilled lobster—in their unique and unparalleled retirement experiences. ”

Jul. 29 2010 — 1:20 pm | 113 views | 0 recommendations | 1 comment

New studies on staying fit, living long

Staying fit in summertime — you know, those steamy days when lying on a raft in the middle of the lake seems a proper choice for the strenuous life — isn’t always easy. But as it turns out, new studies indicate it’s both doable and critical. Plus, it can keep you alive. According to a newly published study, just getting off the raft and walking around a bit can reduce your risk of early death. This just in from Science Daily:

A new study by researchers from the London School of Hygiene and Tropical Medicine (LSHTM), Cambridge University and the Karolinska Institute in Sweden has found that even light or moderate intensity physical activity, such as walking or cycling, can substantially reduced the risk of early death.

The study, published in the International Journal of Epidemiology, combined the results from the largest studies around the world on the health impact of light and moderate intensity physical activity. It showed that the largest health benefits from light or moderate activity (such as walking and cycling) were in people who do hardly any physical activity at all. Although more activity is better — the benefits of even a small amount of physical activity are very large in the least physically active.

The good news from this study is that you don’t have to be an exercise freak to benefit from physical activity. Just achieving the recommended levels of physical activity (equivalent to 30 minutes daily of moderate intensity activity on 5 days a week) reduces the risk of death by 19% [95%confidence interval 15% to 24%], while 7 hours per week of moderate activity (compared with no activity) reduces the risk of death by 24% (95% CI 19% to 29%).

(Of course, if you get off the raft and jog around the lake, the benefits rise. Who knows, there could be a further reduction in the risk of death, as long as you aren’t jogging in traffic. Over on his Coloradoan blog, senior runner Jon Sinclair points out that runners of a certain age — Sinclair introduced this writer to the “pre-boomer” designation — have been at it long enough to have proved this point: “Everyone stand up. All of you that began running after 1976 can sit down. Those that still are standing can smirk proudly at those sitting. I’m sure there aren’t many of you standing. For us ‘pre-boomers,’ or pbers, the current state of running is amazing and we should all feel happy about it.”)

But the best news of all, especially for those drawn to summertime laziness, is just in from the SportsGeezer. It is the suggestion that if you invite a bunch of friends to join you on the raft, possibly planning for cocktails and dinner later, you might do just as well skipping the walk/jog altogether:

More powerful than exercise, better than giving up smoking, extensive social networks have been shown to increase longevity by 50 percent. The Scientific American reports on research conducted at Brigham Young University that reviewed the results from 148 studies—which included a total of 308,849 participants—going back to the early 20th century. Most studies assessed survival in contrast to mortality from all causes. Sciam reports that the analysis also assessed what kind of studies best predict a person’s survival. Questionnaires that had asked participants at least a few in-depth questions about various social connections (such as, “To what extent are you participating or involved in your social network?” or “To what extent can you count on other people?”) were more effective at pinpointing a person’s overall risk of mortality from all causes than those that simply determined if a person was single or married or lived with at least one other person. The researchers found that when the questions delved deeper, complex social networks increased survival rates by 91 percent.

Prospects for a pleasant summer and a long life just went up.

Jul. 25 2010 — 1:14 pm | 83 views | 0 recommendations | 0 comments

Preventable diseases=health care costs

Public health in the U.S.? “It would be difficult to spend this much money and do worse,” says Thomas R. Frieden, Director of the Centers for Disease Control and Prevention. It is the ‘prevention’ issue on which we get an F: tobacco, obesity, teen pregnancy and motor vehicle accidents, all preventable, are where our health care dollars go, Frieden says; and if we would shape up, literally and figuratively, there would be savings in the millions of lives and billions of dollars.

Frieden, who also serves as Administrator of the Agency for Toxic Substances and Disease Registry, is in a position to understand all this. A physician with training in internal medicine, infectious diseases, public health and epidemiology, he has spent the past several decades combating disease and advocating for preventive measures across the U.S. and around the world. He took over as head of CDC in June, 2009.

Speaking to an audience of health professionals and community members at San Francisco’s Commonwealth Club recently, Frieden launched his remarks with a story of treating one patient, a few years ago, who had multi-drug resistant tuberculosis (TB is on the rise these days.) Cost of treatment? Over $100,000. Cost of prevention, had this one man been vaccinated? $10.

High on the list of largely preventable diseases, Frieden said, is cardiovascular disease. Simple measures like quitting smoking, cutting down on (or eliminating) trans fats and losing weight would lead to huge reductions in expenditures on treatment of cardiovascular disease, not to mention longer, healthier lives. He also cited the $200 billion cost of tobacco-related disease, which currently claims some 1200 lives per day.

Other preventable health care costs come from teen pregnancy and motor vehicle accidents, Frieden said, citing the dollars that are saved when these don’t happen. But he came down hardest on obesity. “It is epidemic in the U.S.,” he said. “And in the next 30 years obesity is expected to double in adults and triple among children.”

One audience question (OK, it was submitted by this writer/agitator) went unanswered in the Q&A session following the talk: How can the exorbitant costs invested in often-futile end-of-life treatment be reduced? But that question may have been buried in the substantial pile of other questions posed in relation to the above, and other issues such as:

Can CDC spread some money around to states and local governments for health care? “In a word, no.” And what about the catastrophic Deepwater Horizon oil spill? Its effects will be with us for a long time, Frieden said, but CDC’s primary concern right now is with health and safety of workers and others on the scene. CDC is involved with a number of other agencies addressing the human and environmental impacts of the disaster.

The event was introduced by California HealthCare Foundation Director of the Chronic Disease Care Program Sophia Chang, and moderated by University of California San Francisco Chancellor Emeritus and Global Health Institute Director Haile Debas.

On the good news side — which was a slim side of the room, no pun intended — Frieden cited progress in efforts to promote biking and walking as an alternative to the automobile (currently costing $4 million in emergency room visits and $200 billion overall annual costs; “$12 billion could be saved by seat belts”) and in HIV prevention (treatment for one person: $400,000; cost of a condom, five cents.)

This reporter stood briefly at the back of the near-capacity crowd before the talk started and counted 24 audience members who would qualify as obese. It’s easy to feel righteous when you’ve never had a major weight problem and you got to the event on foot and on Muni bus. It’s hard to feel unsympathetic when you can’t seem to lose those 3 or 4 pounds you could really do without, when you smell the french fries while passing every fast food joint on Market Street and you know how many people don’t have access to good public transportation.

Public health is, indeed a public problem. Dr. Frieden has his work cut out for him.

Jul. 20 2010 — 5:28 pm | 72 views | 0 recommendations | 0 comments

Early cancer tests, surgeries questioned

Was this mastectomy necessary? It’s a question few breast cancer survivors want to ask, and one that few are likely to answer absolutely. But after years of aggressive emphasis on early diagnosis and treatment, some previous imperatives are being called into question. Noting that breast biopsy has long been considered the “gold standard,” a report in today’s New York Times addresses the new rethinking:

As it turns out, diagnosing the earliest stage of breast cancer can be surprisingly difficult, prone to both outright error and case-by-case disagreement over whether a cluster of cells is benign or malignant, according to an examination of breast cancer cases by The New York Times.

Advances in mammography and other imaging technology over the past 30 years have meant that pathologists must render opinions on ever smaller breast lesions, some the size of a few grains of salt. Discerning the difference between some benign lesions and early stage breast cancer is a particularly challenging area of pathology, according to medical records and interviews with doctors and patients.

Diagnosing D.C.I.S. “is a 30-year history of confusion, differences of opinion and under- and overtreatment,” said Dr. Shahla Masood, the head of pathology at the University of Florida College of Medicine in Jacksonville. “There are studies that show that diagnosing these borderline breast lesions occasionally comes down to the flip of a coin.”

Much of the current finger-pointing is toward pathologists, where their money comes from, whether they are ‘certified’ or not and in general, how good a job they do.

In 2006, Susan G. Komen for the Cure, an influential breast cancer survivors’ organization, released a startling study. It estimated that in 90,000 cases, women who receive a diagnosis of D.C.I.S. or invasive breast cancer either did not have the disease or their pathologist made another error that resulted in incorrect treatment.

After the Komen report, the College of American Pathologists announced several steps to improve breast cancer diagnosis, including the certification program for pathologists.

For the medical community, the Komen findings were not surprising, since the risk of misdiagnosis had been widely written about in medical literature. One study in 2002, by doctors at Northwestern University Medical Center, reviewed the pathology in 340 breast cancer cases and found that 7.8 percent of them had errors serious enough to change plans for surgery.

This space has argued occasionally for reconsideration of yearly mammograms and for longer, stronger consideration of other options before a mastectomy is performed. Especially in the case of older women.

Would I insist on further studies or opt for less radical treatment if I were diagnosed with breast cancer today? Probably. Can I undo the mastectomy I had at 72? Not exactly. Second-guessing is beside the point for someone who is healthy and fit, but asking questions won’t ever hurt.

Earliest Steps to Find Breast Cancer Are Prone to Error – NYTimes.com.

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    About Me

    I’ve been a writer since probably before you were born: newspapers, magazines, trade publications and websites beginning with Beliefnet.com’s start-up issue. Working as a hospice volunteer and with AIDS groups led to a 1999 book Dying Unafraid (still in print and apropos) and more involvement with end-of-life causes. This is how to end any cocktail party conversation: “I write a lot about end-of-life issues.” So with Boomers and Beyond I’m working backwards and sideways and wherever concerns of these generations lead. I grew up in beautiful downtown Ashland, VA) and migrated through Atlanta eventually to San Francisco where I live with my final husband, Bud (my college Senior Dinner Dance date before we lost track of each other for 37 years.) Manhattan/Asheville/Atlanta kids, parents of my five flawless grandchildren, keep me attuned to Boomerhood. Full rather braggadocio disclosure: the Manhattan daughter Sandy is married to T/S super-contributor Miles O’Brien.

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