Elo and Preston (1992) completed a review of the literature examining the effects of early life conditions on adult mortality. Their review begins with a discussion of the epidemiologic evidence for some of the major mechanisms whereby exposures and morbidity in childhood may have health consequences for adults. Initially, they examine a number of specific infectious diseases of childhood with well-documented, long-term health effects among adults (tuberculosis, hepatitis B, rheumatic heart disease) and then look at the growing literature suggesting that a number of chronic cardiovascular and pulmonary diseases may be related to a range of risk factors beginning in the intrauterine environment (e.g., intrauterine growth retardation) and extending through disease exposures and behavior patterns acquired in childhood (e.g., acute respiratory infections, dietary consumption of fat and salt). They examine other associations including a number of studies postulating that viral infections acquired in childhood may be linked to a wide variety of chronic diseases ranging from cancer to multiple sclerosis, juvenile diabetes, rheumatoid arthritis, and presenile dementia, as well as the extensive literature linking short stature and adult mortality.
Childhood Precursors of Adult Morbidity and Mortality in Developing Countries: Implications for Health Programs
W.Henry Mosley and Ronald GrayPerinatal conditions
Low birthweight
Growth stunting, chronic obstructive pulmonary disease
Birth trauma, asphyxia, metabolic disorders
Brain damage, cerebral palsy, mental retardation
Congenital and perinatal infections
Hepatitis B
Liver cancer, chronic liver diseases
Syphilis
Blindness, deafness, paralysis, bone disease
Gonorrhea
Blindness
Infectious diseases of childhood
Tuberculosis
Tuberculosis
Rheumatic fever
Chronic rheumatic heart disease
Poliomyelitis
Residual paralysis
Trachoma
Blindness
Chagas’ disease
Heart failure
Schistosomiasis
Liver cirrhosis, general debility
Helicobacter pylori
Stomach cancer
Epstein-Barr virus
Nasopharyngeal cancer, Burkitt’s lymphoma
Nutritional deficiencies in infancy and childhood
Protein-energy malnutrition
Growth stunting, obstetrical complications, cardiovascular disease, chronic pulmonary diseases, intellectual impairment
Micronutrient deficiency
Iodine
Cretinism, intellectual impairment
Iron
Learning disabilities, intellectual impairment
Vitamin A
Blindness
Environmental hazards
Indoor air pollution
Chronic obstructive pulmonary disease, lung cancer
Lead exposure
Intellectual impairment
Friday, October 18, 2013
Sunday, September 29, 2013
Faith Leaders in End-Of-Life
Although we assume that faith leaders are experts in dealing with death, we might be surprised to find that they are not at all that comfortable with the topic. In master of science unpublished research conducted by three separate gerontology students at SDSU, we find that across all religions, faith leaders are poorly trained in end-of-life issues. Most faith leaders reported little to no formal training, and even those that have been exposed to some training admitted that they are ill-equipped to deal with end-of-life issues of their followers. And this finding was consistent for all religions studied.
We find the same story in other research. In a 2008 report by the Duke Institute on Care at the End of Life they also reported that faith healers were least comfortable and least prepared working with children, health care providers and providing grief support when death is unexpected. As you would expect, faith leaders reported being more comfortable with the rituals of their religion than with initiating discussions on end-of-life issues or training others to provide such support.
Kaye Norris and her colleagues, reported similar results from two separate 1997 studies. One is a Gallup survey which describes how people may not always receive the level of support and spiritual care they desire, which is not surprising since respondents in the survey also reported low expectations of clergy. This finding was supported by a survey from Missoula community--68 percent describing themselves as religious or spiritual--that reported that people as they near life's end, are more likely to rely for support on in order of importance; a spouse, children, immediate family members or relatives, friends and than on a faith-leader or faith community.
Faith leaders' lack of education and training about end-of-life issues and grief counseling is an obstacle that prevents them from being more effective support to the dying and the bereaved. The surprise in the research is that all faiths seem to lack end-of-life training.
But at least the issue surrounding end-of-life has entered into a discussion. Especially around the highly divisive issue of assisted end-of-life. Some religions embrace the option. Such as the Unitarian Universalist, United Church of Christ, Evangelical Lutheran Church of America, Methodists, Mainline and Liberal Christian denominations, Episcopalian (Anglican) Unitarian, Methodist, Presbyterian and Quaker movements. Even the American Baptists Churches--in contrast to the Southern Baptist Convention--support the right to decide.
It is not that we should completely eliminate religion from any discussion relating to discourse about social issues as Sam Harris crudely argues in the 2004 book The End of Faith: Religion, Terror, and the Future of Reason. We need religion because people expect their religion to console them in moments of need. The issue is that with the medicalization of death there is a passive acceptance by faith-leaders that death is a medical event rather than a spiritual journey. They need to reclaim their right. They must however first re-learn about the complex issues surrounding end-of-life.
© USA Copyrighted 2013 Mario D. Garrett
We find the same story in other research. In a 2008 report by the Duke Institute on Care at the End of Life they also reported that faith healers were least comfortable and least prepared working with children, health care providers and providing grief support when death is unexpected. As you would expect, faith leaders reported being more comfortable with the rituals of their religion than with initiating discussions on end-of-life issues or training others to provide such support.
Kaye Norris and her colleagues, reported similar results from two separate 1997 studies. One is a Gallup survey which describes how people may not always receive the level of support and spiritual care they desire, which is not surprising since respondents in the survey also reported low expectations of clergy. This finding was supported by a survey from Missoula community--68 percent describing themselves as religious or spiritual--that reported that people as they near life's end, are more likely to rely for support on in order of importance; a spouse, children, immediate family members or relatives, friends and than on a faith-leader or faith community.
Faith leaders' lack of education and training about end-of-life issues and grief counseling is an obstacle that prevents them from being more effective support to the dying and the bereaved. The surprise in the research is that all faiths seem to lack end-of-life training.
But at least the issue surrounding end-of-life has entered into a discussion. Especially around the highly divisive issue of assisted end-of-life. Some religions embrace the option. Such as the Unitarian Universalist, United Church of Christ, Evangelical Lutheran Church of America, Methodists, Mainline and Liberal Christian denominations, Episcopalian (Anglican) Unitarian, Methodist, Presbyterian and Quaker movements. Even the American Baptists Churches--in contrast to the Southern Baptist Convention--support the right to decide.
It is not that we should completely eliminate religion from any discussion relating to discourse about social issues as Sam Harris crudely argues in the 2004 book The End of Faith: Religion, Terror, and the Future of Reason. We need religion because people expect their religion to console them in moments of need. The issue is that with the medicalization of death there is a passive acceptance by faith-leaders that death is a medical event rather than a spiritual journey. They need to reclaim their right. They must however first re-learn about the complex issues surrounding end-of-life.
© USA Copyrighted 2013 Mario D. Garrett
Saturday, September 28, 2013
Diversity and Elder Abuse
Abuse is legally defined. The law has exact definitions and boundaries about what is considered abuse. However in social settings, abuse is necessarily a relative term. But ignorance of the law is no excuse.
Older adult law in California is unique in that if the government decides that a crime has been committed against someone who is 65 years and older--whether that older adult wants to or not--the government will prosecute. Elder abuse is not different from any other type of abuse. In some instances the victim might not understand the act of abuse, in most cases the abuser—the perpetrator—is a relative of the victim, and in some circumstances the victim does not want the abuse to be exposed. What is different in elder abuse is that the victim is an older adult.
Although all elder abuse victims are vulnerable, most are just ashamed that it happened to them and that a family member whom they trusted has so wronged them. Even with the belief across most cultures that older adults, especially mothers, should be honored--which Asian cultures calls filial piety--the practice is rapidly being abandoned and becoming...old fashioned.
The problem is that we have very little information about elder abuse in general and ethnic minorities specifically. The lack of information is primarily because lawyers are weary of sharing information about their clients, or allowing their clients to be researched since any evidence that is obtained can be subpoenaed by the defense. Also some of these incidents have a long history within the family.
In the late 1970s Suzanne Steinmetz reported that half of abused children grow up to abuse their elderly parents. There seems to be a social learning component to elder abuse. If the situation at home promotes certain behaviors as acceptable then those behaviors will be reflected back at the aging parents. For lawyers, identifying that abused children are repeating learned behavior makes it that much harder to prosecute the case.
In addition, anecdotal evidence suggests that a majority of older adults have some early stage dementia, which makes them vulnerable and in some cases unable to cope with aggressive and insistent demands. How a court deals with the victims’ evidence in such cases is predictable which is why researchers and lawyers rarely collaborate.
Cultural differences bring an extra layer of consideration. Some ethnic groups, view families as a unit rather than as individuals and therefore deal with "common property" as such. There are also cultural norms in dealing with erratic behavior in families. The legal system does not acknowledge that there are different cultural impressions of what is defined as abuse. Different agencies keep different data, and reporting of abuse is not uniform across ethnicities.
Elder abuse is a growing torment in our society. It is so widespread that we fail to notice it because we ascribe such behavior to culture or, at least, to family idiosyncrasies. We also ascribe behavior as cultural, but it is likely to be a learned behavior rather than culture. There is no culture that allows for the derogation of our elders. And there is an urgency to elder abuse cases. The victims have a high--natural in most cases--mortality.
© USA Copyrighted 2013 Mario D. Garrett
Older adult law in California is unique in that if the government decides that a crime has been committed against someone who is 65 years and older--whether that older adult wants to or not--the government will prosecute. Elder abuse is not different from any other type of abuse. In some instances the victim might not understand the act of abuse, in most cases the abuser—the perpetrator—is a relative of the victim, and in some circumstances the victim does not want the abuse to be exposed. What is different in elder abuse is that the victim is an older adult.
Although all elder abuse victims are vulnerable, most are just ashamed that it happened to them and that a family member whom they trusted has so wronged them. Even with the belief across most cultures that older adults, especially mothers, should be honored--which Asian cultures calls filial piety--the practice is rapidly being abandoned and becoming...old fashioned.
The problem is that we have very little information about elder abuse in general and ethnic minorities specifically. The lack of information is primarily because lawyers are weary of sharing information about their clients, or allowing their clients to be researched since any evidence that is obtained can be subpoenaed by the defense. Also some of these incidents have a long history within the family.
In the late 1970s Suzanne Steinmetz reported that half of abused children grow up to abuse their elderly parents. There seems to be a social learning component to elder abuse. If the situation at home promotes certain behaviors as acceptable then those behaviors will be reflected back at the aging parents. For lawyers, identifying that abused children are repeating learned behavior makes it that much harder to prosecute the case.
In addition, anecdotal evidence suggests that a majority of older adults have some early stage dementia, which makes them vulnerable and in some cases unable to cope with aggressive and insistent demands. How a court deals with the victims’ evidence in such cases is predictable which is why researchers and lawyers rarely collaborate.
Cultural differences bring an extra layer of consideration. Some ethnic groups, view families as a unit rather than as individuals and therefore deal with "common property" as such. There are also cultural norms in dealing with erratic behavior in families. The legal system does not acknowledge that there are different cultural impressions of what is defined as abuse. Different agencies keep different data, and reporting of abuse is not uniform across ethnicities.
Elder abuse is a growing torment in our society. It is so widespread that we fail to notice it because we ascribe such behavior to culture or, at least, to family idiosyncrasies. We also ascribe behavior as cultural, but it is likely to be a learned behavior rather than culture. There is no culture that allows for the derogation of our elders. And there is an urgency to elder abuse cases. The victims have a high--natural in most cases--mortality.
© USA Copyrighted 2013 Mario D. Garrett
Friday, September 27, 2013
Dementia and Sex in Nursing Homes
This affair was between an older couple. He was single, a
bit of a ladies’ man in his younger time. She was still married but now
separated. They met by chance. But they gravitated towards each other whenever
they came across each other. They were often seen holding hands, and were
relaxed and mellow when they were together. This older couple enjoyed moments
of intimacy and friendship. If this was anywhere else it would elicit a
smile. But this affair occurred in a nursing home and the couple suffered
from dementia.
In this case, the nursing home was the 120-bed Windmill
Manor in Itoralville, Iowa. The man was 78, while the woman was much older at 87.
Three and a half years of private litigation ended with the elderly couple
becoming separated to different nursing homes and each died within a few years.
While the administrator and the director of nursing home were both fired.
The issue is whether they had consensual sex and how you
determine that. The woman referred to her lover as her (living) husband.
Was she confused and therefore agreed to have sex under a delusion.
The sad story here is that the law attempts to define edges.
To enumerate a black and white picture in an otherwise blurred context.
Sometimes we have to look at how unique individuals deal with such cases to
find a moral or ethical compass. The law is too clumsy a tool for us.
Supreme Court Justice Sandra Day O'Connor’s husband was
suffering from dementia and was placed in a nursing home. While there he become
romantically attached to another resident. Justice O'Connor decided that this
made him happy and sanctioned their behavior. It takes courage to understand
the disease for what it is., a disease. And sometimes how we react to people
suffering dementia is more a reflection of our fears, prejudices and moral
expectations, as much as it is about the degenerative disease itself.
It is not that these moral and ethnical dilemmas exist. It
is that they are still dilemmas. In an age when the tsunami of dementia will
push us more frequently against the reality of older adults with dementia we
should have better tools than the law to deal with such radical changes in human
intimacy. For some couples coping with dementia, physical intimacy continues to
be a source of happiness. In others the dementia brings about behavioral
changes that might increase or decrease the need for physical expression and
relief. There might also be changes in sexual etiquette and expressions of
sexual urges (or not). It is difficult to separate the person from the disease.
But the disease can change the behavior of the person to such an extent that
you cannot rely on past experience in responding to them.
By the time the person is in a nursing home, there are
already noticeable changes in behavior. What this teaches us is not to rely on the law but to examine what the home will allow and what we are comfortable accepting.
© USA Copyrighted 2013 Mario D. Garrett
© USA Copyrighted 2013 Mario D. Garrett
Wednesday, September 25, 2013
Accepting Our Losses and Living Longer
Happy people live longer. Even happy countries have higher life expectancy. Scientists have even documented orangutans living longer if they are happy. It would seem that happiness is an important commodity. With older adults there is a conspiracy to be happy. Not only do happy people live longer but older adults are more likely to become happier with age.
What makes us so happy? In The Paradox of Choice: Why More Is Less, Barry Schwartz documents that the secret for happiness is not having a great choice or achieving your goals and dreams. No. Happiness comes from accepting what you have, being happy with the choices that you made. Having more choices makes us less happy. And it does not matter what those choices are. Which is why Daniel Gilbert's cheerfully engaging "Stumbling On Happiness" is so good. The argument that it is not choices that make us happy, but our acceptance of the choices we make has generated a lot of interest. In psychology Paul Baltes's model of selection, optimization, and compensation (SOC) argues that it is essential for successful development that older adults maximize their remaining capacities and minimize their losses. We do not choose to experience losses. But we choose to accept them.
In 2010 Alex Bishop and his colleagues working with the Georgia Centenarian Study found that happiness among these exceptionally older people was determined by “congruence” which was defined by three statements one of which was ‘I would not change my past life even if I could’.
"Even if I could". This is an important admission. If you are getting frailer, becoming more diminished, experiencing the loss of lovers, friends and colleagues, and facing increasing challenges you have limited options, and none of them include reversing this trend. The best utilization of your energies is to accept the changes and assume that you are destined to be here. Wherever “here” is. What psychologists call a positive character-disposition and strong adaptability to the adversities of their life. You are meant to be where you are.
And this attitude starts earlier in life, not learned when you become an older adult. Accepting “bad” choices, painful loss, forgiving people, being content with what you have in terms of money and health is how you tell your body that you are happy where you are and that you not ready to go just yet. You belong here still. Even if you could change circumstances, you would choose the same path because that is what made you.
Happiness tells your body that you are still present. That you are needed.
W.P. Kinsella in his book "Shoeless Joe" admits that "Success is getting what you want; happiness is wanting what you get." We are too concerned with success and our expression of that. What we should be looking at are vestiges of happiness. Smile wrinkles and laugh lines. Perhaps then we might stop trying to hide how we look.
What makes us so happy? In The Paradox of Choice: Why More Is Less, Barry Schwartz documents that the secret for happiness is not having a great choice or achieving your goals and dreams. No. Happiness comes from accepting what you have, being happy with the choices that you made. Having more choices makes us less happy. And it does not matter what those choices are. Which is why Daniel Gilbert's cheerfully engaging "Stumbling On Happiness" is so good. The argument that it is not choices that make us happy, but our acceptance of the choices we make has generated a lot of interest. In psychology Paul Baltes's model of selection, optimization, and compensation (SOC) argues that it is essential for successful development that older adults maximize their remaining capacities and minimize their losses. We do not choose to experience losses. But we choose to accept them.
In 2010 Alex Bishop and his colleagues working with the Georgia Centenarian Study found that happiness among these exceptionally older people was determined by “congruence” which was defined by three statements one of which was ‘I would not change my past life even if I could’.
"Even if I could". This is an important admission. If you are getting frailer, becoming more diminished, experiencing the loss of lovers, friends and colleagues, and facing increasing challenges you have limited options, and none of them include reversing this trend. The best utilization of your energies is to accept the changes and assume that you are destined to be here. Wherever “here” is. What psychologists call a positive character-disposition and strong adaptability to the adversities of their life. You are meant to be where you are.
And this attitude starts earlier in life, not learned when you become an older adult. Accepting “bad” choices, painful loss, forgiving people, being content with what you have in terms of money and health is how you tell your body that you are happy where you are and that you not ready to go just yet. You belong here still. Even if you could change circumstances, you would choose the same path because that is what made you.
Happiness tells your body that you are still present. That you are needed.
W.P. Kinsella in his book "Shoeless Joe" admits that "Success is getting what you want; happiness is wanting what you get." We are too concerned with success and our expression of that. What we should be looking at are vestiges of happiness. Smile wrinkles and laugh lines. Perhaps then we might stop trying to hide how we look.
© USA Copyrighted 2013 Mario D. Garrett
Tuesday, September 17, 2013
Fibs, Puffery, Lies and Immortality: Telomeres and Telomerase the Snake Oil of the White (Coat) Man
The University of California San Francisco's (UCSF) website is selling immortality. On September 16, 2013 Elizabeth Fernandez reports "Lifestyle Changes May Lengthen Telomeres, A Measure of Cell Aging." Reporting on a small study by Dean Ornish, Elizabeth Blackburn and eight other colleagues published in the Lancet Oncology journal. *
What the UCSF website reports is that "A small pilot study shows for the first time that changes in diet, exercise, stress management and social support may result in longer telomeres, the parts of chromosomes that affect aging." If this was true (ie valid) then it is indeed a revolutionary finding in science. Baiting all those venture capitalists to rush to the laboratory to invest their money.
Within a day the rest of the world news media started falling over themselves to report this story. Invariably ignorance and expediency did not help them from repeating the same mistake as UCSF had the day before.
"Lifestyle Changes Could Lengthen Telomeres, Life" reports the Voice of America. "Better diet and less stress can reverse cell ageing" shouted the Irish Times. "Healthy Lifestyle Changes Might Reverse Cell Aging, Study Suggests" the serious Huffington Post asserts."Lifestyle Changes Could Lengthen Telomeres, Life" Voice of America parroted. And on and on, ad nauseam.
Only Larry Husten in Forbes had the right title "No, Dean Ornish And Elizabeth Blackburn Have Not Discovered The Fountain Of Youth" but even he mistakes the result by reporting that “We noted a correlation between the degree of positive lifestyle change and increase in telomere length when all participants were assessed together, which supports the internal validity of this study." First of all a non random assigned study can never ever be an adequate study for causality. There is no part of this study that remotely contributes to internal validity. Not only that, but because the two groups where different to start, before the intervention took place (the control group versus those following diet exercise and yoga), completely erodes its internal validity. Two different groups will be found to be different even after nothing is done to them.
If we look at the original published paper the conclusion simply acknowledges "...showing that comprehensive lifestyle changes—or any intervention—are significantly associated with increases in cellular telomerase activity and telomere maintenance capacity in human immune system cells" (pg 1053)
Telomerase activity is very very different from telomere length. And telomere maintenance capacity is not equated with increase in telomere, it simply means that the decrease was slower. There is confusion about telomeres and telomerase in the newspaper reports. A short introduction to these two terms.
Most cell in our body have a nucleus. that contain 23 pairs of chromosome structures that hold "genes" which are a series of codes written with nitrogen-containing biological compounds. Each chromosome has two chromatid structures (left and right) connected at the center making an X. Each of the two chromatids have a special protective cap at each end called a telomere. Telomeres function by preventing chromosomes from losing base pair sequences at their ends. They also stop chromosomes from fusing to each other. However, each time a cell divides, some of the telomere is lost (usually 25-200 base pairs per division). The telomere can start off with length of 15,000 base pairs. The longer the telomeres the more times a cell can divide before it dies. Telomere maintenance is controlled by an enzyme called telomerase. Telomerase allow the telomere to maintain structure and in some cases to grow.Which is a good thing in most cases.
However, telomerase is also found in fetal tissues, adult germ cells, and also cancer cells. The connection between cancer research and immortality has not been closer. Since cancer cells are immortal (the HeLa cell lines are a prime example). Telomerase has been detected in cancer cells and is found to be 10-20 times more active than in normal body cells.
So when the authors of the article report that "...increases in cellular telomerase activity..." (pg1053) I do not think about immortality but about expedited mortality through cancer.
This is not to say that there are no benefits to exercise and low fat diet in maintaining organ health. But it is not a panacea for longevity.
There have been other promoters of the “clean living” argument. The following is a list of gurus of the clean living argument. What is unique is not only that these people are all dead (what an argument for internal validity), but that they died earlier than their life-expectancy (at the age that they started their intervention), and they died of the disease that they aimed to ameliorate through their intervention:
• Adelle Davis who often said she never saw anyone get cancer who drank a quart of milk a day, as she did.
• Nathan Pritikin after being diagnosed with heart disease, advocated regular exercise and a low-fat, high-fiber diet.
• Robert Atkins proponent of a high protein, low carbohydrates diet.
• Roy Walford a proponent of caloric restriction as a means to extending life.
• Jim Fixx who championed the health benefits of running and claimed that regular running offered virtual immunity to heart disease.
• Alan Mintz a controversial proponent of using human growth hormone—an anabolic steroid.
Francois Henri "Jack" LaLanne died in 2011 at the age of 96, due to pneumonia. He is a real hero. According to his family, he had been performing his daily workout routine the day before his death. When he was asked about the difference in public attitude between today and when he first opened his gym decades ago, Jack saw where we were going with our health kick, he said: "Then I was a crackpot and a charlatan, today I am an authority… and believe me I can’t die, it would ruin my image." His image is not ruined because through his death we have realized that mortality is not the fact that we are doing something wrong, but that there is a system of order in the world. Death is the price we pay for living. We do not need to fight death, we need to enhance our life. Exercise, diet and self awareness through meditation is an excellent way to improve the quality of our life. It might enhance our longevity because we are happier. But it will not reverse or stop aging.
The funding for the UCSF pilot project was supported by the U.S. Department of Defense among other entities.
* Dean Ornish, Jue Lin, Jennifer Daubenmier, Gerdi Weidner, Elissa Epel, Colleen Kemp, Mark Jesus M Magbanua, Ruth Marlin, Loren Yglecias, Peter R Carroll, Elizabeth H Blackburn Increased telomerase activity and comprehensive lifestyle changes: a pilot study.2011. Lancet Oncol, 9, 1048-57.
© USA Copyrighted 2013 Mario D. Garrett
What the UCSF website reports is that "A small pilot study shows for the first time that changes in diet, exercise, stress management and social support may result in longer telomeres, the parts of chromosomes that affect aging." If this was true (ie valid) then it is indeed a revolutionary finding in science. Baiting all those venture capitalists to rush to the laboratory to invest their money.
Within a day the rest of the world news media started falling over themselves to report this story. Invariably ignorance and expediency did not help them from repeating the same mistake as UCSF had the day before.
"Lifestyle Changes Could Lengthen Telomeres, Life" reports the Voice of America. "Better diet and less stress can reverse cell ageing" shouted the Irish Times. "Healthy Lifestyle Changes Might Reverse Cell Aging, Study Suggests" the serious Huffington Post asserts."Lifestyle Changes Could Lengthen Telomeres, Life" Voice of America parroted. And on and on, ad nauseam.
Only Larry Husten in Forbes had the right title "No, Dean Ornish And Elizabeth Blackburn Have Not Discovered The Fountain Of Youth" but even he mistakes the result by reporting that “We noted a correlation between the degree of positive lifestyle change and increase in telomere length when all participants were assessed together, which supports the internal validity of this study." First of all a non random assigned study can never ever be an adequate study for causality. There is no part of this study that remotely contributes to internal validity. Not only that, but because the two groups where different to start, before the intervention took place (the control group versus those following diet exercise and yoga), completely erodes its internal validity. Two different groups will be found to be different even after nothing is done to them.
If we look at the original published paper the conclusion simply acknowledges "...showing that comprehensive lifestyle changes—or any intervention—are significantly associated with increases in cellular telomerase activity and telomere maintenance capacity in human immune system cells" (pg 1053)
Telomerase activity is very very different from telomere length. And telomere maintenance capacity is not equated with increase in telomere, it simply means that the decrease was slower. There is confusion about telomeres and telomerase in the newspaper reports. A short introduction to these two terms.
Most cell in our body have a nucleus. that contain 23 pairs of chromosome structures that hold "genes" which are a series of codes written with nitrogen-containing biological compounds. Each chromosome has two chromatid structures (left and right) connected at the center making an X. Each of the two chromatids have a special protective cap at each end called a telomere. Telomeres function by preventing chromosomes from losing base pair sequences at their ends. They also stop chromosomes from fusing to each other. However, each time a cell divides, some of the telomere is lost (usually 25-200 base pairs per division). The telomere can start off with length of 15,000 base pairs. The longer the telomeres the more times a cell can divide before it dies. Telomere maintenance is controlled by an enzyme called telomerase. Telomerase allow the telomere to maintain structure and in some cases to grow.Which is a good thing in most cases.
However, telomerase is also found in fetal tissues, adult germ cells, and also cancer cells. The connection between cancer research and immortality has not been closer. Since cancer cells are immortal (the HeLa cell lines are a prime example). Telomerase has been detected in cancer cells and is found to be 10-20 times more active than in normal body cells.
So when the authors of the article report that "...increases in cellular telomerase activity..." (pg1053) I do not think about immortality but about expedited mortality through cancer.
This is not to say that there are no benefits to exercise and low fat diet in maintaining organ health. But it is not a panacea for longevity.
There have been other promoters of the “clean living” argument. The following is a list of gurus of the clean living argument. What is unique is not only that these people are all dead (what an argument for internal validity), but that they died earlier than their life-expectancy (at the age that they started their intervention), and they died of the disease that they aimed to ameliorate through their intervention:
• Adelle Davis who often said she never saw anyone get cancer who drank a quart of milk a day, as she did.
• Nathan Pritikin after being diagnosed with heart disease, advocated regular exercise and a low-fat, high-fiber diet.
• Robert Atkins proponent of a high protein, low carbohydrates diet.
• Roy Walford a proponent of caloric restriction as a means to extending life.
• Jim Fixx who championed the health benefits of running and claimed that regular running offered virtual immunity to heart disease.
• Alan Mintz a controversial proponent of using human growth hormone—an anabolic steroid.
Francois Henri "Jack" LaLanne died in 2011 at the age of 96, due to pneumonia. He is a real hero. According to his family, he had been performing his daily workout routine the day before his death. When he was asked about the difference in public attitude between today and when he first opened his gym decades ago, Jack saw where we were going with our health kick, he said: "Then I was a crackpot and a charlatan, today I am an authority… and believe me I can’t die, it would ruin my image." His image is not ruined because through his death we have realized that mortality is not the fact that we are doing something wrong, but that there is a system of order in the world. Death is the price we pay for living. We do not need to fight death, we need to enhance our life. Exercise, diet and self awareness through meditation is an excellent way to improve the quality of our life. It might enhance our longevity because we are happier. But it will not reverse or stop aging.
The funding for the UCSF pilot project was supported by the U.S. Department of Defense among other entities.
* Dean Ornish, Jue Lin, Jennifer Daubenmier, Gerdi Weidner, Elissa Epel, Colleen Kemp, Mark Jesus M Magbanua, Ruth Marlin, Loren Yglecias, Peter R Carroll, Elizabeth H Blackburn Increased telomerase activity and comprehensive lifestyle changes: a pilot study.2011. Lancet Oncol, 9, 1048-57.
© USA Copyrighted 2013 Mario D. Garrett
Tuesday, August 13, 2013
Longevity and Reilgion/Spirituality
A rare study--where a group of individuals born in 1920s were followed over several decades looking at their spiritual beliefs--reported that significant increase in spirituality was evident from late middle age (mid-50s to late 60s) to older adulthood (late 60s to mid-70s). This was irrespective of gender. Similar snapshots of people's beliefs have been substantiated by survey research and public opinion polls since the 1930s. The consistent finding is that older means that you are likely to become more religious/spiritual.
Because aging is correlated with spirituality it is not surprising to find that spiritual people are older and that older people are spiritual. Aging is correlated with spirituality. Spirituality does not, by itself, confer increased longevity. Being spiritual or religious is not a good predictor of how old you will live to, although it might tell us how old you are now. This is despite anecdotal “secrets” for longevity that people older than 85 years, gave for their good health and long life, which were "faith in God" and "Christian living." All valid responses but perhaps not accurate in this diverse society of today.
Allison Sullivan from the University of Pennsylvania published a study in 2011 showing that Jews have lower mortality than the rest of the USA. All other religions were comparable or, as with Black Protestants, had a life expectancy as much as five years lower than the average US citizen. So religion by itself is not a good predictor.
Religious affiliation follows other variables. For example, those that reported being Jewish reported lowest prevalence of drinking alcohol, were mainly women (comparable only to Catholics), were nearly exclusively White, and were the richest by a very wide margin. These are all factors that by themselves, regardless of their religious affiliation, promotes higher life expectancy. Religion and spirituality, by themselves, are not very good predictors of long life. Where religion and spirituality show distinct advantage is in coping with imminent death.
In an Australian study, which conducted detailed interviews of older adults in nursing homes and independent living homes, it was reported that religious older adults reframe memories and experiences linked with final meanings, transcend their losses and suffering, reported intimacy with God and others, and found hope. God for them was the ultimate consolidator.
Reporting religious beliefs is also associated with how your caregivers treat you. Nursing assistants who held similar beliefs as their elderly long-term clients, expressed more meaningful connections with them which resulted in better care. Which brings up the issue of what happens when societies are becoming more diverse both in terms of culture and religion and also in term of sexual preferences?
Spirituality does not confer longevity although having meaning in life does--not necessarily spiritual. Especially if you compare people’s religious participation with other older adults participating in other social events, the difference in longevity between religious and non-religious participants disappears. Being religious by itself does not promote longevity, but it might help how you are treated should you lose your independence.
Friday, August 9, 2013
Depression without Sadness
Depression is a seriously debilitating disease that increases your chances of early death. In a report that looked at twenty five separate research studies the conclusion was that depressed people are nearly twice as likely to die early when compared to non-depressed people.
Depression affects about fifteen in every hundred older adults. There seems to be less of a difference between gender than at younger ages and affects different ethnicities equally. Although these studies find that depression is less common in older age, it might be argued that we are not measuring depression correctly among older adults.
An emerging argument is that depression in older adults is more subtle and remains undetected. While on the other hand depressive symptom checklists are inflated as they include symptoms that are directly linked to a physical illness or bereavement, both of which increase in frequency with age. How good are we at identifying depression among older adults?
Although we normally associate depression with sadness, studies are now showing that older adults are generally less likely than young adults to report sadness--dysphoria--when they are depressed. Joseph Gallo from John Hopkins University and colleagues reported that in a number of different studies older adults were less likely to report being sad than younger persons. And this seems to be an aging effect rather than to a particular generation. People who might have expressed sadness with depression when they were young, as they get older they are less likely to express sadness with their depression. Depression among older adults is related more to listlessness and lack of interest in life rather than sadness.
It could be that older adults are better at separating sadness from depression. However studies show that older adults are not very good at identifying facial expressions showing anger, fear, happiness, and sadness. And it is the more subtle expressions of emotions that older adults have trouble with. Andrew Mienaltowski and his colleagues in Bowling Green, Kentucky show that in general, older adults have more difficulty discriminating between low intensity expressions of negative emotions than did younger adults.
The issue is that older adults not only do not express sadness with their depression but that they are less likely to see sadness in others. With health care professionals getting older, it is not just depressed older adults that we need to be concerned about but also their physicians. If older physicians are less likely to see sadness then they are less likely to notice depression. Depression without sadness is not only difficult to detect by physicians it is also a silent killer. In a 13-year follow-up, older adults who reported depressive symptoms without dysphoria--nondysphoric depression--were at increased risk for death, functional limitation, cognitive impairment and psychological distress. Among suicide victims 55 and older, 58 percent visited a general physician in the month before the suicide. In fact, 20 percent see a general physician on the same day and 40 percent within one week of the suicide.
Depression among older adults is a serious issue and it is not part of the aging process. The lack of expression of sadness and the diminished ability by others of perceiving sadness further hides this silent early killer.
Depression affects about fifteen in every hundred older adults. There seems to be less of a difference between gender than at younger ages and affects different ethnicities equally. Although these studies find that depression is less common in older age, it might be argued that we are not measuring depression correctly among older adults.
An emerging argument is that depression in older adults is more subtle and remains undetected. While on the other hand depressive symptom checklists are inflated as they include symptoms that are directly linked to a physical illness or bereavement, both of which increase in frequency with age. How good are we at identifying depression among older adults?
Although we normally associate depression with sadness, studies are now showing that older adults are generally less likely than young adults to report sadness--dysphoria--when they are depressed. Joseph Gallo from John Hopkins University and colleagues reported that in a number of different studies older adults were less likely to report being sad than younger persons. And this seems to be an aging effect rather than to a particular generation. People who might have expressed sadness with depression when they were young, as they get older they are less likely to express sadness with their depression. Depression among older adults is related more to listlessness and lack of interest in life rather than sadness.
It could be that older adults are better at separating sadness from depression. However studies show that older adults are not very good at identifying facial expressions showing anger, fear, happiness, and sadness. And it is the more subtle expressions of emotions that older adults have trouble with. Andrew Mienaltowski and his colleagues in Bowling Green, Kentucky show that in general, older adults have more difficulty discriminating between low intensity expressions of negative emotions than did younger adults.
The issue is that older adults not only do not express sadness with their depression but that they are less likely to see sadness in others. With health care professionals getting older, it is not just depressed older adults that we need to be concerned about but also their physicians. If older physicians are less likely to see sadness then they are less likely to notice depression. Depression without sadness is not only difficult to detect by physicians it is also a silent killer. In a 13-year follow-up, older adults who reported depressive symptoms without dysphoria--nondysphoric depression--were at increased risk for death, functional limitation, cognitive impairment and psychological distress. Among suicide victims 55 and older, 58 percent visited a general physician in the month before the suicide. In fact, 20 percent see a general physician on the same day and 40 percent within one week of the suicide.
Depression among older adults is a serious issue and it is not part of the aging process. The lack of expression of sadness and the diminished ability by others of perceiving sadness further hides this silent early killer.
Wednesday, August 7, 2013
Painful Religion at End-Of-Life
In the United States nearly eight out of every ten hospital deaths have no formal pain management. More than eight out of every ten older long-term care facility residents experienced untreated or under-treated pain at the time of death. While seven out of ten people on Medicare who are dying, regardless of their age or where they died, received inadequate amount of pain management. People in the United States are dying in pain.
Most Americans--three of every four--do not fear death as much as we fear being in pain at the time of death. Despite these clearly stated and seemingly universal preferences, too many of the 3 million Americans who die in health care settings each year suffer needlessly in pain at the end of life.
Persons dying from prolonged illnesses can, and should, experience a “good death”. And we know exactly what that means. For most of us a good death consists of dying at home, surrounded by family, and free from pain and suffering. And our preference to die in such a dignified manner is consistent regardless of one’s age, gender, ethnicity, or religious background.
However, by following Christian and Protestant fundamentalist beliefs people who are dying are less likely to have access and select methods for hastening the process of dying. In the United States, approximately 25% of all U.S. deaths occur in the long-term care setting, and this figure is projected to rise to 40% by the year 2040.
The belief in an afterlife--and the support from caregivers who share the same belief--must contribute to the fact that being religious is negatively associated with fear of death. But there is also the worry that some religious beliefs, because of their emphasis on natural death, preclude you from pain medication that might hasten death and taking control over what for most of us will be a painful final passage through life.
Although religious doctors were significantly less likely than their non-religious colleagues to provide treatment with at least some intent to shorten life, when religious doctors did provide such treatment they were significantly less likely to have discussed this with their patient. And this is the unspoken secret of hospitals.
Physicians prescribe pain medication that hastens the final passage of death in a clandestine manner. We live (or die) in an atmosphere of silent favors to alleviate pain.
The Universal Declaration of Human Rights: Article 5 “No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.” The renowned physician Jack Kevorkian’s final push to bring this issue to the Supreme Court--where it should be legitimately decided and which they arrogantly refused to hear—only resulted in pushing him into jail. Because of religious self-censoring we are not approaching the issues head-on. We are therefore resigned to repeating the same mistakes. Older adults in the United States will continue to die in pain.
As Susan Imhof and Brian Kaskie have argued, “we can only conclude that public policies will fall even further behind the advancement of evidence-based pain-policy guidelines, and the number of Americans who continue to suffer needlessly in pain at the time of death will only increase.”
© USA Copyrighted 2013 Mario D. Garrett
In memory of Uncle Freddie who died after a protracted illness.
Most Americans--three of every four--do not fear death as much as we fear being in pain at the time of death. Despite these clearly stated and seemingly universal preferences, too many of the 3 million Americans who die in health care settings each year suffer needlessly in pain at the end of life.
Persons dying from prolonged illnesses can, and should, experience a “good death”. And we know exactly what that means. For most of us a good death consists of dying at home, surrounded by family, and free from pain and suffering. And our preference to die in such a dignified manner is consistent regardless of one’s age, gender, ethnicity, or religious background.
However, by following Christian and Protestant fundamentalist beliefs people who are dying are less likely to have access and select methods for hastening the process of dying. In the United States, approximately 25% of all U.S. deaths occur in the long-term care setting, and this figure is projected to rise to 40% by the year 2040.
The belief in an afterlife--and the support from caregivers who share the same belief--must contribute to the fact that being religious is negatively associated with fear of death. But there is also the worry that some religious beliefs, because of their emphasis on natural death, preclude you from pain medication that might hasten death and taking control over what for most of us will be a painful final passage through life.
Although religious doctors were significantly less likely than their non-religious colleagues to provide treatment with at least some intent to shorten life, when religious doctors did provide such treatment they were significantly less likely to have discussed this with their patient. And this is the unspoken secret of hospitals.
Physicians prescribe pain medication that hastens the final passage of death in a clandestine manner. We live (or die) in an atmosphere of silent favors to alleviate pain.
The Universal Declaration of Human Rights: Article 5 “No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.” The renowned physician Jack Kevorkian’s final push to bring this issue to the Supreme Court--where it should be legitimately decided and which they arrogantly refused to hear—only resulted in pushing him into jail. Because of religious self-censoring we are not approaching the issues head-on. We are therefore resigned to repeating the same mistakes. Older adults in the United States will continue to die in pain.
As Susan Imhof and Brian Kaskie have argued, “we can only conclude that public policies will fall even further behind the advancement of evidence-based pain-policy guidelines, and the number of Americans who continue to suffer needlessly in pain at the time of death will only increase.”
© USA Copyrighted 2013 Mario D. Garrett
In memory of Uncle Freddie who died after a protracted illness.
Tuesday, June 25, 2013
Last Will and Testament
Legacy: an enduring gift after death. It has often been the
vision of humans to become immortal. Apart from science fiction, the
reality is that the only way to become immortal is to leave something behind
that endures--in what the philosopher Karl Popper referred
to as “World 3.” These are items
that are shared in the world after we are gone: articles, prose, paintings, music,
inventions, buildings, policies, social transformations. For all others that
have not had a chance for such Popperian creativity, there is the last
will and testament to ensure that after their death, their estate is left to those that they choose.
But sometimes, people have left some weird and wonderful requests. The notoriety
of these requests are perhaps more of a legacy than the distribution of the wealth itself.
One such area of puzzlement has been the bequeathing of large sums of monies to dogs and cats.
Leona Helmsley the "Queen of Mean" established a
$12 million trust to her Maltese dog while leaving $5 million each to her grandsons. Meanwhile Eleanor Ritchey, enriched by the Quaker Oil State Refining
Corporation business, left about $14 million to her 150 stray dogs. A California
prune rancher Thomas Shewbridge's left all shareholder rights of his estate to his
two dogs, who regularly attended stockholders' and board of directors'
meetings. The British singer Dusty Springfield left instructions stipulating that her cat was to be fed imported baby food and serenaded with Springfield's
songs. Increasing the cat's romantic ambience by also arranging for the cat to marry his new guardian's pet cat. While Doris
Duke heiress of the American Tobacco Company—and founding of Duke University--stated
that $100 million was to be secured in a pet trust for her dogs.
While some final instructions are not ultimately upheld in a
court of law, they have redefined our meaning of legacy. Perhaps there is a deeper message. One impression from
these last wills and testaments is how inconsequential money is and that the best way to transmit this message is by giving it away to pets that do not understand its value. Perhaps there are better ways of transmitting such a message. But is there a better way?
In 2005, a study by Allianz found that leaving a legacy (an emotional inheritance) was far more important to peoples than leaving an inheritance, and that 77% of both “baby boomers” and their parents rated “values and life lessons” as the most important legacy they could receive or leave. Would it be better to write an "ethical" will? A parent’s insight, knowledge and wisdom to transfer to younger generations.
The importance of writing down one's innermost concerns is demonstrated in an old study--which has been repeated many times since--by James Pennebaker from the University of Texas. He found that when people--who had experienced significant trauma--wrote about their experience, they showed positive effects on blood markers of immune functions, and that this continued for six weeks.
Ethical wills are valued by the recipient as well as being beneficial to the writer.
We need to include ethical wills as part of Popper's World 3. What better way to leave the world but to transmit the knowledge that you have gained so that future generations can stand on your insights and reach higher ideals. For most of us, that is all we have to transmit, and it might not be such a poor option.
In 2005, a study by Allianz found that leaving a legacy (an emotional inheritance) was far more important to peoples than leaving an inheritance, and that 77% of both “baby boomers” and their parents rated “values and life lessons” as the most important legacy they could receive or leave. Would it be better to write an "ethical" will? A parent’s insight, knowledge and wisdom to transfer to younger generations.
The importance of writing down one's innermost concerns is demonstrated in an old study--which has been repeated many times since--by James Pennebaker from the University of Texas. He found that when people--who had experienced significant trauma--wrote about their experience, they showed positive effects on blood markers of immune functions, and that this continued for six weeks.
Ethical wills are valued by the recipient as well as being beneficial to the writer.
We need to include ethical wills as part of Popper's World 3. What better way to leave the world but to transmit the knowledge that you have gained so that future generations can stand on your insights and reach higher ideals. For most of us, that is all we have to transmit, and it might not be such a poor option.
Saturday, May 4, 2013
Gerontocracy, Plutocracy, Oligarchy and the Aging Revolution
The 111th Congress, which took office in 2009, was the oldest in USA history. While the average age in the Senate was 59 in 1945, it was 63 in 2011. Similarly with the Senate, the average age of representatives at the House rose from 53 in 1945 to 57 in 2011. Although the 112th Congress was slightly younger by a few months, the trend is unmistakable. We have a pattern where the average American is more than 20 years younger than the person who represents him or her in Congress.
When the novelist Richard K. Morgan wrote the Takeshi Kovacs series, he imagined a world in the 25th century where an incredibly wealthy elite rules the world. Although this is the situation today, the difference is that the series of novels envisaged a technology so advanced that it granted these wealthy rulers effective immortality and unfathomable wisdom through the ability to transfer the accumulated knowledge of human minds. These individuals are known as "Meths". Referring to Methuselah the longevity icon from the bible. A world that is governed by a combination of gerontocracy (ruled by older adults), oligarchy (ruled by a few) and plutocracy (ruled by the wealthy.)
In The Republic, Plato wrote: “it is for the elder man to rule and for the younger to submit”. The sensationalism is lost when we realize that this has been the trend since the inceptions of societies--with minor but significant exceptions. While the ancient Greek city state of Sparta was ruled by a flat out gerousia--a council made up of members who had to be at least 60 years old and who served for life, most variants of gerontocracy are less prescriptive. In addition, all theocratic states and organizations--in which leadership is concentrated in the hands of religious elders--are traditional gerontocracies, as with the Holy See, Islamic State and Mormonism among others. And as we have seen, our Congress is becoming increasingly gerontocratic.
Although traditionally it was assumed that some skills—for example, mathematics--drastically decline with age, political life was observed to nurture older adults. However, a new study in 2012 of British civil servants by the French epidemiologist Archana Singh-Manoux shattered this conception. The study shows that cognitive skills such as memory and reasoning start declining as early as 45. Except for vocabulary. Political spin it seems remains a forte of gerontocracy.
Such age-related decline is detrimental. But with increasing age of politicians comes other more serious diminishment that sometimes accompanies older adults. Ron Reagan contends that his father, President Ronald Reagan, showed signs of Alzheimer's disease three years into his first term. President Reagan went on to serve two 4-year terms in office.
The greatest of Roman orators, Marcus Tullius Cicero, had some insights: "Nothing is so unbelievable that oratory cannot make it acceptable." The "great communicator"--as President Reagan was known--might increasingly be the way of emerging gerontocracies. Where the power of oration trumps a prudent government. Cicero again had this to say ” The budget should be balanced, the treasury should be refilled, public debt should be reduced, the arrogance of officialdom should be tempered and controlled…”
Mario Garrett, Ph.D., is a professor of gerontology at San Diego State University and can be reached at mariusgarrett@yahoo.com
When the novelist Richard K. Morgan wrote the Takeshi Kovacs series, he imagined a world in the 25th century where an incredibly wealthy elite rules the world. Although this is the situation today, the difference is that the series of novels envisaged a technology so advanced that it granted these wealthy rulers effective immortality and unfathomable wisdom through the ability to transfer the accumulated knowledge of human minds. These individuals are known as "Meths". Referring to Methuselah the longevity icon from the bible. A world that is governed by a combination of gerontocracy (ruled by older adults), oligarchy (ruled by a few) and plutocracy (ruled by the wealthy.)
In The Republic, Plato wrote: “it is for the elder man to rule and for the younger to submit”. The sensationalism is lost when we realize that this has been the trend since the inceptions of societies--with minor but significant exceptions. While the ancient Greek city state of Sparta was ruled by a flat out gerousia--a council made up of members who had to be at least 60 years old and who served for life, most variants of gerontocracy are less prescriptive. In addition, all theocratic states and organizations--in which leadership is concentrated in the hands of religious elders--are traditional gerontocracies, as with the Holy See, Islamic State and Mormonism among others. And as we have seen, our Congress is becoming increasingly gerontocratic.
Although traditionally it was assumed that some skills—for example, mathematics--drastically decline with age, political life was observed to nurture older adults. However, a new study in 2012 of British civil servants by the French epidemiologist Archana Singh-Manoux shattered this conception. The study shows that cognitive skills such as memory and reasoning start declining as early as 45. Except for vocabulary. Political spin it seems remains a forte of gerontocracy.
Such age-related decline is detrimental. But with increasing age of politicians comes other more serious diminishment that sometimes accompanies older adults. Ron Reagan contends that his father, President Ronald Reagan, showed signs of Alzheimer's disease three years into his first term. President Reagan went on to serve two 4-year terms in office.
The greatest of Roman orators, Marcus Tullius Cicero, had some insights: "Nothing is so unbelievable that oratory cannot make it acceptable." The "great communicator"--as President Reagan was known--might increasingly be the way of emerging gerontocracies. Where the power of oration trumps a prudent government. Cicero again had this to say ” The budget should be balanced, the treasury should be refilled, public debt should be reduced, the arrogance of officialdom should be tempered and controlled…”
Mario Garrett, Ph.D., is a professor of gerontology at San Diego State University and can be reached at mariusgarrett@yahoo.com
Wednesday, April 24, 2013
Geography of Aging
If aging occurred as a random event, unaffected by external variables, the distribution of older adults would be equal across geography regardless of what individuals do or how they live. But we do not see that.
Instead, what we find are distinct clusters of older adults. Wealthy countries have proportionally more older adults than poor countries, Blacks and minority groups have lower percentages of adults living to older ages. Educational levels and income increase longevity, long-lived parents have long-lived children, happy healthy people live longer, obese people die earlier. Taller people die earlier, women who give birth later in life live longer and have longer-lived children, long-lived people escape diseases, and women outlive men.
Michelle Poulain a demographer who identified the "Blue Zones" while marking communities of centenarians on a map with his blue pen, has come up with a number of clusters. And they are all related to geography. The only clusters of extreme long-lived older adults are found in natural environments in traditional cultures within a confined geography. These "Blue Zones" are places of exceptional longevity.
Recent advances in genetic manipulation in animals which increases life expectancy by 30 to 50 percent is overshadowing studies of geography that show similar improvements in life expectancy of similar magnitude.
Where we live is just as important in promoting longevity as biological manipulations. For example some Black inmates in prison live longer than their peers living in the community. Our environment can protect us from harm, but can it also promote health? Numerous studies have shown that both monks and nuns living in religious orders live much longer by a margin of 11 to 31 percent. And we all live in segregated communities.
Rich people live in rich neighborhoods and poor people live in poor neighborhoods. And it seems that being in a place where we belong promotes health. Researchers found that low-income older adults living in high-income neighborhoods had poorer physical functioning, more functional limitations, worse self-rated health, worse cognitive ability, and were lonelier than low-income adults who lived in low-income neighborhoods. Being in a high-income neighborhood did not confer an advantage because they did not belong.
The process whereby the feeling of belonging is translated into a longer life is turning out to be simple. Researchers are exposing the role of how genes have a capacity to switch on and off according to the internal environment in our bodies. Epi-genes, as they are known, can be switched on and off, allowing for the expression or suppression of our genetic information.
The environment can trigger epigenetic changes. In addition, how we feel about our community changes our internal chemicals which affect our epigenetic makeup. How we feel about where we live changes how our body expresses our genes.
Which might explain why it is that the only clusters of extreme long-lived older adults are found in natural environments in traditional cultures within a community that they belong to. The feeling of belonging translates into our bodies being contented and not ready to shut down. If we understood the body better we would not need to know the brain.
Mario Garrett, Ph.D., is a professor of gerontology at San Diego State University and can be reached at mariusgarrett@yahoo.com
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