Healthy Aging— What is “Normal”?

1. Healthy Aging—What is “Normal”? Suzanne R. Kunkel Kathryn B. McGrew Scripps Gerontology Center Miami University Oxford, Ohio

2. What we’ll cover: • Physical, psychological, social, and spiritual dimensions of healthy aging • Defining “normal” aging: when are declines to disease, and not age “alone?” • When and how does the difference matter? • The good news about aging • Importance of professional, family, and community care and support.

3. Holistic Healthy Aging • Physical • Cardiovascular, musculoskeletal, lung capacity, metabolism, senses, cognitive,* “surface” aging • Psychological • Emotional, cognitive* • Social • Engagement in family and community life • Spiritual

4. Holistic Health Aging Source: National Institutes of Health, PubMed Central http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1661594&rendertype=figure&id=F1

5. Age as a risk factor, not a cause. • Aging changes • Disease • Trauma, external conditions and events • Treatment effects (e.g. medications) • A combination

6. “Normal” aging? • Hard to separate age-related changes from disease-related changes • A fuzzy line • Declines may be due to • Age • Disease • Trauma, including accumulation of trauma • Treatment effects (e.g. medications) • A combination • Hearing as an example

7. Examples of declines we think are, at least in part, “normal” aging: • Gray hair • Loss of skin elasticity, e.g. wrinkles: (affects other organs as well) • Reduced lung and heart capacity • Reduced bone density • Hearing declines • Vision declines • Some cognitive changes, e.g. learning speed

8. “Age vs. disease”: Does the difference matter? • Changes matter…. • when they interfere with daily activities • when they interfere with social roles • when they interfere with quality of life and general well-being ….whether they are “normal” aging or not • Examples?

9. Increases in life expectancy Increases in healthy life expectancy? Good news about aging…. Source: Geriatric Times November/December 2001 Vol. II Issue 6

10. Since 1973…. • Deaths due to accidental injuries declined by 60% • Maternal deaths declined by 64% • Infant deaths declined by 66% • Tuberculosis declined over 80% • An Indian child born today has a life expectancy of 75 years, due mainly to reduction in these rates Source: Dr. Charles W. Grim, D.D.S., M.H.S.A., Assistant Surgeon General Director, Indian Health Service, August 1, 2006 http://www.ihs.gov/PublicInfo/PublicAffairs/Director/2006_Statements/CHR_text.pdf

11. Concerns remain, for example…Diabetes

12. Elders can modify both “normal” changes and disease • Building strength through exercise, conditioning, and diet • Eliminating complicating risk factors • Substance abuse • Obesity • Smoking • Examples?

13. Some diseases can be prevented. • Vaccinations • Health screenings • Diet • Non smoking • Moderate alcohol use • Exercise • Falls/accident prevention • Sanitation • Environmental health • Examples?

14. Most diseases can be treated. • Medications • Diet and exercise regimens • Surgeries • Traditional medicine • Examples?

15. Chronic diseases can be managed. • Managing treatment and lifestyle • Chronic disease self-management • Disease management education and intervention programs • Examples?

16. Elders can adapt to both “normal” changes and disease • Changing expectations • Adjusting daily activities • Using assistive devices • Self care • Relying on family care and assistance • Relying on services • Examples?

17. Whether “normal” aging or disease, care and supportare important. • Family: the backbone of elder care • Community: the backup of elder care; includes elder services • Professional: trained care and support • Examples?

18. Thank you…. Suzanne Kunkel: kunkels@muohio.edu 513-529-2914 Kathryn McGrew: mcgrewkb@muohio.edu 513-529-3880