Mom was right - eat your vegetables, don't overeat and exercise, said Dr. Stephen R. Babb, an internal medicine specialist and geriatrician at American Fork Hospital in American Fork, Utah.
Speaking about physical and mental health issues facing the elderly today, Dr. Babb explained that many problems of old age are genetically acquired and have little or nothing to do with lifestyle. However, he emphasized that the way a person lives is a major factor in preventing or at least postponing many physical ailments.Positive changes in lifestyle, he continued, can help an elderly person "try to modify a risk, to lower chances, for example, of heart disease, hypertension and other long-term conditions.
"Successful aging is usually considered the ability to remain fully functional rather than severely restricted. This is becoming an ever-increasingly important consideration," he told the Church News. "Back in 1900, the average person lived 47 years. Today, a person who was 65 in 1987 can expect to live to age 82." (Please see page 6 for chart on aging trends in the United States of those over age 65.)
"Aging effectively or successfully takes an awful lot of preparation," Dr. Babb explained. "In order to age successfully, you probably have to train more and prepare more than an athlete for a marathon because everything you have done during the course of your life is going to play in the way you go through aging, and that includes all aspects of aging - health, psychological and financial." (Please see articles on social and financial issues facing the elderly on pages 6 and 7.)
In speaking of those already facing health issues incident to age, Dr. Babb added, "Health studies have clearly shown that people who are aged now can modify the quality and quantity of their life through their lifestyle."
He cited studies at the Philadelphia (Pa.) Geriatric Center, a 1,100-bed progressive care nursing home at which he worked for a year. In one study, a researcher chose a group of elderly people suffering from diabetes. The average age of participants was about 80 years old. "Diabetics are a good group to study because they get sick a lot. Diabetes affects eyes, the heart, the liver; it affects circulation. We took this group of elderly people who were diabetic and enrolled them in a low-level exercise program - mild aerobic exercise, 20 minutes a day, three days a week. This is the fifth year of this study. These people lowered their insulin requirements. They are now healthier. They are living better. They are living longer, and they feel a lot better."
Speaking of aging in general, Dr. Babb continued: "If we are lucky, we will have the opportunity to age. How we age depends on a number of factors, many of which we can affect."
The geriatrician then discussed several physical and mental challenges common to the elderly:
Heart Disease
"People who have a low cholesterol, well-rounded diet tend to have a lower risk of heart disease. Generally, the types of foods we encourage people to eat are the lower fats and complex carbohydrates," Dr. Babb explained. He defined such a diet by emphasizing the Word of Wisdom - "which includes vegetables; fruits; grains; meats in times of famine, or occasionally, and in winter. Otherwise, stick with grains, and the more natural foods."
Concerning those who already have heart disease, he added, "Studies have shown that you can get regression of the disease by changing your lifestyle."
He encouraged an active lifestyle, including regular exercise.
Cancer
"There are many cancers that seem to be affected by lifestyle, though not all. We have to make that clear. Some just happen," he said. "These types of cancers are genetic. [Regular personal and physician's exams are vital.T Other cancers, however, such as a large percentage of lung cancers, are due to lifestyle."
He noted that about 250,000 people a year die from smoking-related illnesses or complications.
He added that many colon cancers are due to dietary problems. "Societies that have the more complex carbohydrate, higher fiber diets tend to have lower incidents of colon cancer," he added.
Frailty
"Frailty is one of the biggest problems of aging, the thing that people are the most afraid of," Dr. Babb explained. "That's where physical activity comes in, being able to maintain activity and agility, muscle mass and balance.
"Generally, many aspects play into frailty. Most people will become frail because of some illness or process that causes them to become inactive or affects their strength. It can be an emotional problem that causes them to avoid contact. It can be a social problem."
Dr. Babb encouraged family, ward and community members to be aware of the needs of the elderly and help them be involved.
Visual impairment
"The two leading causes of blindness in the elderly in this country are glaucoma and diabetes," Dr. Babb said. "Glaucoma is an increase of pressure in the eye. It is called the `silent blinder.' You don't know this is happening until damage has already occurred.
"The way to avoid this is to get regular checkups with your eye doctor. He or she will check the eye pressure, and if pressure is building, eye drops will be prescribed for life-long use. If you wait until sight is already dimming, you've lost it."
Dr. Babb explained that diabetes is another frequent blinder. But, he added, proper treatment of diabetes under a doctor's care, and a proper diet, can prevent potential blindness.
He added that many other potential blinders can be treated with such things as dietary modifications.
Hearing impairment
"Hearing loss is more environmental," Dr. Babb noted. "It's what we're exposed to in the work place. Because men tend to be exposed to more high frequency noises, they tend to experience more hearing loss at an earlier stage."
Dr. Babb suggested getting regular hearing tests, possibly getting hearing aids, and, when exposed to high frequency noises, using appropriate ear protection.
Nutrition
"Malnutrition is a huge problem among the elderly," Dr. Babb said. He explained this is mainly due to financial problems, limitations in getting to a store or preparing the food, poor oral hygiene and loss of taste.
"The elderly don't feel as hungry; they don't feel as thirsty," he said. "Caretakers of the elderly need to be aware of nutrition. That's one of the reasons I do house calls. I look at everything. I look in the refrigerator, and I look in the cabinets."
Living conditions
"The environment has to be safe," Dr. Babb counseled. "We have to be sure it's free of obstructions that could predispose a person to injury. We want to avoid throw rugs. We want to maintain stairs and make sure they are properly lighted. We have to make sure fire detectors are installed and functioning."
Hygiene
"Hygiene is so important," he explained. "That's one of the first things you tend to notice."
Although good hygiene involves personal care, Dr. Babb exhorted family members and others to watch for poor habits. He pointed out that poor body hygiene can result in such things as foot fungal infections. He emphasized regular checkups with physicians, and, for the feet, the use of lotions and good-fitting shoes. He added that swelling in the feet can be caused by heart problems or an inactive lifestyle. In the case of inactivity, blood may pool in the feet. Again, he suggested regular, moderate physical activity under a physician's direction.
In speaking of good oral hygiene, Dr. Babb encouraged proper brushing, flossing and regular visits to the dentist.
Dementia
"There are many kinds of dementia, of which Alzheimer's disease is one. At our current stage of knowledge, we don't know how to prevent it, and we really don't have good treatments once it has occurred. There are some promising looking medications that are in development," Dr. Babb related.
He explained that one of the main problems in dementia is the pressure on the primary caretaker, who is usually a spouse. "It is a 36-hour-a-day job taking care of the afflicted one," he said. "So often for the caretaker, there is such a mixture of emotions. He or she is just exhausted."
He encouraged family, ward and community members to help relieve the primary caretaker when possible.
Depression
"Aging tends to be characterized by loss," Dr. Babb said. "We tend to lose many things - independence, friends, spouses, homes. In our society, we tend to deny depression. We seem to feel it's a character weakness. That's absolutely untrue. Very often, it's a chemical problem."
He added that severe depressions can be treated with professional therapy and proper medications. For mild depression, he encouraged regular activity, good relationships with family members and others, and service.
Dr. Babb emphasized that "how we deal with aging is to a large extent a state of mind. It depends on what we do with it."
ADDITIONAL INFORMATION
Be a partner in your health care, physician advises
Anne Nicol is in partnership with her physician - in her own health care, that is.
The 79-year-old member of the American Fork 21st Ward, American Fork Utah East Stake, trusts her geriatrician, Dr. Stephen R. Babb, but she seeks to understand her medications and treatments.
"I read a lot," Sister Nicol said. "I volunteer at the information desk at American Fork Hospital. At the desk are various information sheets and things like that. I also get a health letter through the mail."
Dr. Babb said his patient is an "informed consumer. She doesn't take everything we push over at her without any questioning."
Continuing, he emphasized the importance of the patient and physician working together. "You need to ask me questions," he counseled. "You need to ask me why I'm doing what I'm doing. Why am I prescribing a particular medication? How does that medication interact with other medications? What do you need to avoid while you're on this medication? Are there alternatives?"
In speaking of patient participation, Dr. Babb also spoke of living wills and a "special power of attorney." Through these legal means, a patient can decide, or have a proxy decide, what kind of - if any - life-sustaining procedures would be used in the event of debilitating injury or illness.
