The Struggle to Deal with the Presently Incurable Issues of Aging
The struggles and sufferings of the old are largely conducted behind the curtain, not talked about all that much in the public sphere. How does one manage the last phase of life for a failing, complex machine that cannot be repaired, only coaxed into a slightly slower decline? As it turns out, a fair amount of not thinking about it is involved: on the part of younger people, and particularly on the part of research and development institutions that do not wish to be burdened with the very complex, interacting nature of late life age-related diseases. New treatments and adjustments to the standard of care are rarely formally tested in the older, more frail part of the patient population.
30-40% of people hospitalized with ACS are age 75 or older. ACS includes heart attack and unstable angina (heart-related chest pain). Cardiovascular changes that occur with normal aging make ACS more likely and may make diagnosing and treating it more complex: large arteries become stiffer; the heart muscle often works harder but pumps less effectively; blood vessels are less flexible and less able to respond to changes in the heart's oxygen needs; and there is an increased tendency to form blood clots. Sensory decline due to aging may also alter hearing, vision and pain sensations. Kidney function also declines with age, with more than one-third of people ages 65 and older having chronic kidney disease. These changes should be considered when diagnosing and treating ACS in older adults.
Clinical practice guidelines are based on clinical trial research. However, older adults are often excluded from clinical trials because their health care needs are more complex when compared to younger patients. ACS is more likely to occur without chest pain in older adults, presenting with symptoms such as shortness of breath, fainting or sudden confusion. Measuring levels of the enzyme troponin in the blood is a standard test to diagnose a heart attack in younger people. However, troponin levels may already be higher in older people. Age-related changes in metabolism, weight and muscle mass may necessitate different choices in anti-clotting medications to lower bleeding risk. As kidney function declines, the risk of kidney injury increases, particularly when contrast agents are used in imaging tests and procedures guided by imaging. Although many clinicians avoid cardiac rehabilitation for patients who are frail, they often benefit the most.
As people age, they are often diagnosed with health conditions that may be worsened by ACS or may complicate existing ACS. As these chronic conditions are treated, the number of medications prescribed may result in unwanted interactions or medications that treat one condition may worsen another. Older adults differ widely in their independence, physical or cognitive limitations, life expectancy, and goals for the future. The goals of care for older people with ACS should extend beyond clinical outcomes (such as bleeding, stroke, another heart attack or the need for repeat procedures to reopen arteries).
Major step is to align (and reinforce) regular services we take for granted with those values that promote dreams, goals, and aspirations above and beyond the typically-perceived inevitable 'best practice' milestones of decline, retirement, reduced purpose, disability, mortality-acceptance, dignified-failure.
Those services could be local medical clinics, healthy insurance programs, recreational/ community facilities; i.e. the everyday lifestyle choices to monitor, rehabilitate, even improve one-self.
This is not medical innovation per se, but maybe cultural innovation.
Got this bizarre advert in a longevity e-newsletter, I periodically receive. Seems common and over-sold, but appears to have an attitude and approach (though much to be built upon) of extended future (pro-active) rather than maintenance into your declining years (re-active). See '100+ Program'. Take it as you will:
humanlongevity.com
@Jer,
Thanks,
I believe there are at least 2 others providing similar services.
Peter Diamandis has proactive medical maintenance company as well. Also Ray K with Terry Grosserman has a similar company. I believe they take numerous medical tests of you and provide advice and you come in on regular basis. Probably a great idea and probably not cheap though IMO, very valuable given our health.
@Robert,
Cheers.
I did the Mayo Clinic Executive Programme a few years ago for a pricey but not unreasonable $12 - $15k with as many Gerontology Options as I could fit into a week. They do have ongoing research into Senolytics therapies and detailed Genomic assessments. The purpose was to get as comprehensive a baseline as possible for the under 50s. Always unsure of what the best data to pursue. And, I suppose, Alcor is just up the street as a second Option.
@Jer,
Hmm, sounds like you live in Phoenix, as I believe Alcor is in Scotsdale. We just moved to Payson from California earlier this year. Thanks for the information, trying to get nerve up for comprehensive testing.
I drive to Phoenix twice a week to my gym ( heading there now) and once a week using my own at home.
@Robert,
Glad to hear that there is someone in the vicinity to keep us all apprised of what is likely to be one of the hot spots of anti-aging research, therapies, and clinical assessments. Unfortunately, I live and did fly in from out of state, in the cold North. But, at the time, was thrilled to see Frank Lloyd Wright School, Grand Canyon, and the Observatory tours in the south of that state.
I highly recommend Mayo for such as assessment. Since they ask for your input about which tests and assessments to undertake (though they have a list of typical), this is an excellent opportunity to research other such 'long life maintenance program/ clinics' (or ask the crowd of contributors and readers here) to customize your approach. Establishing a Baseline with as much relevant data seems to me to be an excellent early step at seeing advanced age healthy success. Best,