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Half of all adverse drug reactions within the US occur among older adults. 28% of all hospitalizations for older adults is because of problems with medicines. Adverse drug reaction is caused by the interaction of drugs with other drugs, alcohol, or even some foods such as grapefruit, and it seems that older adults are at special risk. What is the reason for this greater vulnerability? 

As we age, our metabolism changes. This can have a huge impact on the way in which our body processes drugs. A drug that you tolerated when you were younger may be much less tolerable in your middle or older years. And it’s not just about our metabolism. Many problems older adults have with drugs are related to overuse, underuse, or not following the guidelines that are related to the drug, i.e. storing the medicine out in the open when it should be kept in a cool, dry place, taking it on an empty stomach when it should be taken with food, taking it at the wrong time of day. The list goes on and on.

Underuse occurs when individuals split pills in half or in quarters, or skip doses because of the expense of the drugs. And it may not be just because of expense. I have an older sister who as a matter of course always took half of her prescribed dose of blood pressure medication. She also liked to mix up the blood pressure medicine with herbal remedies (God knows what the effect was on her body). Eventually she went off the prescription medicine in favor of her remedies. A year ago, she had a stroke and is still recovering from it. 

To guard against drug related problems, it is a good idea to learn all you can about any medicine you are required to take. Talk to your doctor and your pharmacist about any medicines that have been prescribed for you. It is also a good idea to fill all of your drugs at the same pharmacy, that way if there is a conflict between medicines, your pharmacist can alert you.                       

According to Forbes magazine, the following cities are the most affordable places to live after retirement. Of course retirement is more than about affordability. It’s also about family, about having access to decent health care facilities, about being close to people you can relate to, about weather, and culture … I could go on and on, but you get the picture.

Columbus, Oh

Dallas, Tx

Minneapolis, Minn

Houston, Tx

Salt Lake City, Utah

Indianapolis, Ind

Denver, Colo

St. Louis, Mo

Atlanta, Ga

Nashville, Tenn

A new study shows that caregivers have a hard time falling asleep at night. It is believed this is because of the depression that most caregivers suffer from. 

As a caregiver for my mother during the several years she suffered from Alzheimer’s before ultimately succumbing to it, I can attest to the tremendous toll caring for a dementia patient takes. Although I wouldn’t have not been there for my mother, her illness sapped everything from me until in the end the only life that mattered was her life. My life became a shell, its only purpose to care for her. The unfortunate thing about this is that it left me with no inner resources. No wonder I became so overwhelmed by depression that sleep eluded me.   

Methadone, a drug that was once associated with heroin addicts is now widely prescribed by doctors and nurse practitioners to treat assorted pain complaints, and the group most likely to die from methadone use is the middle aged. This may be because the middle aged body has had time to accumulate assorted traumas that may be resistant to traditional pain relievers. It may be also that the middle-aged are less tolerant of pain.

Methadone is a synthetic form of opium. According to an article in the New York Times

It is cheap and long lasting, a powerful pain reliever that has helped millions. But because it is also abused by thrill seekers and badly prescribed by doctors unfamiliar with its risks, methadone is now the fastest growing cause of narcotic deaths. It is implicated in more than twice as many deaths as heroin, and is rivaling or surpassing the tolls of painkillers like OxyContin and Vicodin.

Although misuse of methadone is one problem, a major problem is that many doctors are unaware of the risks associated with using this drug so overprescribe it, prescribe unsafe doses, or fail to properly monitor patients who are on the drug. Methadone use in conjunction with alcohol or sedatives may have a depressive effect on the central nervous system – the brain may forget to tell the heart to beat and the lungs to pump – therefore causing death.

Critics blame the insurance companies whose main concern is monetary cost for the increased use of methadone. For example, a one month supply of OxyContin may cost $500 compared to $35 for an equivalent supply of methadone. In these tough economic times that difference may push pain sufferers to use it over safer but more expensive drugs. Critics also blame the government for failing to recognize and confront the ignorance of physicians prescribing the drug.

Of course those most vested in current practices are the ones that are pushing back against any changes.

Reuters reports that people age 45-54 are more likely to die from prescription drug overdose than from motor vehicle accidents. Motor vehicle deaths were the No. 1 cause of accidental death, but now, according to the federal government, in 2007 nearly 7 million Americans abused prescription drugs. That’s more than cocaine, heroin, hallucinogens, Ecstasy and inhalants such as marijuana combined. This represents an 80 percent increase since 2000. 

One of the reasons ordinary Americans turn to prescription drugs is low social disapproval associated with its use, as well as the low risk of getting caught.     

Despite expectations that this would be the year in which the first disease modifying drug to treat Alzheimer’s would reach the market, that has not been the case. Just recently two widely anticipated drugs to treat Alzheimer’s failed clinical trials. That is according to the L.A. Times. 

The leading theory on Alzheimer’s is that it is caused by the sticky protein, amyloid beta. This protein clumps together in the brain and form plaque that kills brain cells.  With the failure of the latest drugs, it will be interesting to see if this theory continues to dominate research efforts.

At the same that efforts to find a cure are taking a setback, technology to detect Alzheimer’s is advancing rapidly. But there is no way to halt or reverse the disease. The five medicines currently available treat symptoms disease such as confusion and memory problems and not the disease. And their effect on the lives of Alzheimer’s victims is so minor that many find that the drugs are not worth the cost and side effects. 

Despite these setbacks, some researchers remain hopeful that a cure will be found. 

Now for the good stuff. For those of you not wiped out by the current economic slowdown, Reuters reports on a study that shows that laser treatment can be very effective in removing wrinkles. Although side effects such as lightening or darkening of the skin is associated with the procedure, these side effects always clear up.

Carbon dioxide laser treatment, the gold standard of laser treatment, works by vaporizing mater molecules in and surrounding the cells. The body responds by producing more collagen, which fills in the wrinkles.

Laser treatment allow doctors more control than procedures such as chemical peels and dermabrasion. It has been around for awhile and has been proven to be effective.

A new report by the US EPA shows that the poor, the elderly and children will suffer the most from global warming. The cause of global warming is the release of greenhouse gases in to the atmosphere from fossil fuel burning. Experts predict that by the year 2050 global temperatures will rise by about 2 degrees and by the end of the century temperatures will rise by about 7.5 degrees.

Global warming is expected to bring about worse heat waves, drought, worsening air quality and flooding. Accompanying these changes will be increases in the number of diseases spread by tainted food, bad water and bugs.  The elderly are considered to be at increased risk because of their already frail health and limited mobility.  

All of us are familiar with the stiff gait of the old. There is a look of uncertainty on their faces as they attempt even the most minor walks. Their legs are stiff and seem unable to bend, and there is no hip action. Will I make it? they seem to wonder. Of all the declines that accompany aging, it is the one to avoid at all costs. That’s why a cold chill went through me recently when I noticed signs that I might be losing some of my flexibility.

Upon rising off the floor, instead of bending my knees before coming to a full stand, I noticed that I was avoiding putting pressure on my knees. Was this the beginning of the end? Then, what can I do to avoid becoming a stiff, frail woman? The answer for me and anyone well into their middle years is to regain flexibiliy and balance. As we age, there is a natural loss of balance. This can cause us to fall and stumble. It only gets worse with each passing year.

For people 65 and over, about one-third can expect to fall each year. Falls are the leading cause of injury death among elder Americans. They are the most common cause of nonfatal injuries and hospital admissions for older adults. At least 90% of hip fractures each year are the result of falls.

Falls can also decrease quality of life as elder adults become more careful in their movement to reduce chances of falling. Limited mobiliy and curtailment of activities can lead to depression.

To combat this natural loss of balance, some people turn to balance training classes. Studies show that there are exercises people can engage in to regain balance.

1. Standing on one leg for 60 seconds
2. Leaning forward over a stable base as far as possible without taking a step
3. Walking heel to toe
4. Standing up from a sitting position and sitting down while maining correct posture.

You can also join exercise classes that provide balance training. Tai chi, yoga and weight training are good examples of training that can help balance. One study of different type group exercises showed that tai chi was the most effective in maintaining balance. The study showed that those who participated in tai chi classes for one hour a week for 16 weeks had a 50% reduced risk of multiple falls. To preserve balance requires a continuing commitment. Balance exercises must be done on a regular basis, at least two to three times a week.

For more info read the L.A. Times 5/26/08 Life with more balance.

By 2015 those 50 and older will represent 45 of the American population. Increasing numbers of these older Americans are choosing to live in age segregated housing where at least one member of the household must be at least 55 and no one under 18 is ever allowed to live there. Estimates are that 12 million Americans will live in age segregated communities in the next decade. This marks a drastic change in the way our society organizes itself. 

Even as the housing market continues to implode, adult communities remain popular. These communities create their own reality. Residents spend their time golfing, line dancing, card games and other social activities.  In the larger more expensive ones, residents get around on carts fixed up to look like expensive cars. Little time is devoted to problems that face the larger world. Even though some communities offer extension classes, these are shunned in favor of more fun activities.

When age segregated communities first came on the horizon no one believed they would take off. But they turned out to be immensely popular. There are a number of reasons why people are drawn to them. One is lower taxes. A far greater reason is that suburbs are alienating and are built around a car culture, which makes it almost impossible to age in place. And because of the large amount of moving Americans engage in (on average, Americans move 12 times during their lifetime), it’s hard to develop a sense of community in the suburbs. There is also the factor of our youth centric culture. 

One of the problems with segregating ourselves from the larger community is that it reinforces negative stereotypes. It also encourages selfishness. In a recent article I read, Sun City, a large older adult’s community defeated 17 school bond measures in 12 years before they de-annexed from the school district. Having raised their own children, they no longer had an interest in the rest of the children in the country. This type of selfish disregard for the needs of the larger community can have disastrous consequences for our country.

These types of conflicts can be dealt with if the residents of age segregated communities are able to find ways to balance conflicting needs even if it means they have to make a sacrifice.