When I was a kid, old people regularly annoyed me with a mantra they used as a catchall comment to discussions of even the mildest difficulties: “As long as you've got your health.” they repeated. “As long as you've got your health.”
Now that I'm old, I understand. A simple cold feels more like a flu these days and lasts longer too. We all know, or know of, someone whose broken hip sent them permanently to a care home or worse, who died without recovering (20 percent of elder fall victims, within a year).
Our sleep goes out of whack, foods we've enjoyed all our lives now give us gas, stairs become problematic, our stamina is gone with the wind we used to have.
And that's just for the healthiest among us. Eighty percent of people older than 65 have at least one chronic disease and many have more than one.
What else most of us have in common, however, is a determination to do what we personally can to maintain our health, to take responsibility for it ourselves.
The difficulty emerges from the plethora of advice and information available nowadays via the internet. There is way too much that is too often contradictory and it takes too long to sort out what is useful and what is not, what is true and what is false.
Now, however, along comes a guidebook for healthy living just for old people written by a husband and wife team. Mehrdad Ayati is a physician board certified in family medicine and geriatrics. He's also an assistant professor of medicine at Stanford University School of Medicine and has a slew of other impressive credentials.
His wife, Arezou Azarani holds a degree in physiology along with fellowships in molecular biology and genetics.
Paths to Healthy Aging is a deceptively short “workbook,” as Dr. Ayati calls it, with just five chapters: Nutrition, Mental Health, Frailty, Overmedication, How to Find a Geriatrician. It is packed with useful, common sense information with easy-to-understand explanations about how we age and how that affects our health.
What is most neglected in treating the medical needs of elders, says Dr. Ayati, is someone who will actually listen and pay attention to their concerns. (I don't know about you, but my primary care physician spends more time looking at a laptop screen when I'm with him than at me.)
”The next thing that is of most interest to patients,” writes Ayati in his introduction, “is valid, up-to-date information on how to prevent, treat or live with diseases. They want to grasp complex medical issues in a comprehensible format...
“My goal here is to...simplify the journey. Based on my experience of what has worked best for my patients to achieve meaning, joyful and healthy lives...”
And that is exactly what he does throughout deceptively simple little book.
Each of the chapters begins with a set of questions to ask yourself that can be used then as a reference and comparison as you read through the information.
In nutrition, for example, he discusses loss of taste buds in old age, the need to keep up dental care, the importance of companionship (perhaps at lunch together each day) and why fad diets that rely on emphasizing or de-emphasizing certain nutrients lead to unwanted results and poorer health.
Since most people I know have a problem keeping their weight down, I was surprised at how much time Dr. Ayoti spends discussing weight loss in old age but as he explains,
”Data indicate that even the loss of a small percent of weight over a three-year period is associated with multiple negative health outcomes such as frailty, fatigue, a higher risk of infection, delirium (confusion) and an increased death rate in the elderly.”
He follows with an impressive section on many ways of overcoming loss of appetite or interest in food and eating.
The chapter on mental health is equally wide-ranging, easy to understand and, as you would expect, covers physical activity, stress reduction and staying engaged by choosing a variety of activities that, he notes, aren't very useful unless we enjoy them.
I know from my own reading that Dr. Ayati is up-to-date on the latest findings. I appreciated the pithy section on blood pressure that explains why systolic pressure of 135-140 over diastolic of 70-90, which might be considered high for young people, is normal for elders.
The frailty chapter includes a good selection of easy exercises anyone can do at home without special equipment to help maintain strong bones and muscles, balance and independence.
Each chapter ends with a “take home message” list summarizing the most important parts of the information along with an “action plan” you can fill in to track what you want to change and a long list of studies he has consulted in writing each chapter.
Although I won't attempt to summarize, the chapter on overmedication is important with extremely useful explanations of the reasons it can be a problem and how you can help control it with your physicians. And I like this funny cartoon he includes on the topic:
Throughout the book, Dr. Ayati reminds readers that it is not intended as a substitute for medical advice from your own doctors. Generally, at this blog, I ignore medical advice books as most of them have a particular axe to grind, usually on the order of “drink six cups of green tea a day while standing on your head and you'll live to be 147 without a single wrinkle.”
Oh, all right, I made that up but you know what I mean. Paths to Healthy Aging, however, is the opposite - filled with common-sense information you can trust, written by a friendly geriatrician whom I wish could be my own. He genuinely likes and understands the health needs of old people.
By the way, the one place where I part company with Dr. Ayati is his chapter on finding a geriatrician. He acknowledges that there are too few, but that it is good to see a trained expert in aging health once a year.
I don't disagree but I spent nearly two months calling and emailing local geriatricians when I moved here trying to find one who would see me.
It wasn't that I would need to wait several months as Ayati acknowledges can happen with the geriatrician shortage in the U.S. It was that they all gave me, politely, some version of we're not taking on new patients at this time.
That doesn't mean it is futile to try, but it's really hard.
You can read more about Paths to Healthy Aging at the website and it is available online at several of the most popular booksellers.