Chapter 8 The Nitty Gritty of Aging
240818 I am one week into using a Neuronic brand photobiomodulation helmet. After watching several videos about PBM therapy, I asked the medical doctor I’ve seen about the issues around age-related cognitive decline. He is very positive about this technology and recommended this device. There’s abundant information on YouTube, etc., about how this technology works and what it does for brain health. I will update this link once I have sufficient experience to say something definitive about the results. From testimonials, two months should be long enough to see improvements in working memory and more. The following video is from the helmet developer.
Aging can be defined as the accumulation of damage, waste, and cellular errors. Loss of information. Hallmarks of aging: genomic instability, epigenetic alterations, telomere shortening, loss of proteostasis, mitochondrial dysfunction, deregulated nutrient sensing, altered intracellular communication, stem cell exhaustion, cellular senescence
Another way of looking at this is found in these numbers. The risk in overall mortality goes up by these percentages as listed by Lissa Rankin MD in her TED Talk:
Air pollution – 6% Obesity – 23% Alcohol abuse – 37% Loneliness – 45%
The Good, the Bad, and the … what were we talking about?
Let’s be honest about the challenges and the gifts of aging with an inventory of where we are. Let’s be honest with ourselves and transparent with any relevantly involved others. Let’s try to keep our sense of humor as we answer these questions for ourselves. After all, the sure cure for the issues of aging is death. So… that may be a reasonable choice to make some time. We’ve already seen a movement towards the option to end one’s life when the time feels right consciously. While we’re still alive:
What is Aging? Biological aging is generally defined as a series of functional, structural, and biochemical changes that occur throughout cells and organs, disrupting homeostasis in the body and ultimately leading to death.’
Questions to Contemplate:
How do you see your place as an elder with family, friends, and others? In the larger society? How does this review leave you feeling?
How do you feel about how you have done so far? What are you most grateful for? What do you most regret?
What wisdom have you accrued? How is it serving you?
Where and with whom do you feel valued?
Where and with whom do you feel devalued, ignored, or dismissed?
Reflecting on the aspirations of your youth, how are you doing? How realistic were they?
How would you change them if you could know what you do now?
What are your remaining life goals?
What Can We Do About the Negative Aspects of Aging?
What are you doing to reduce the negative aspects of your aging process? I’m assuming that the audience for this material will have been cultivating a healthy lifestyle for many years. However, in case you’re interested, the primary lifestyle factors that shorten lifespans are in order: smoking, alcohol abuse, lack of physical activity, economic/financial difficulties, social adversity, and negative psychological characteristics. Poor sleep exacerbates all the negative aspects of aging. Anything else? Have you researched the emerging science related to promoting a healthier old age?
Here are a few of the doctors and scientists that are really into this research:
David Sinclair, PhD head of the longevity institute at Harvard, podcaster and author of Life Span. Brad Stanfield, MD, a vocal critic of some of David Sinclair’s work, gives his take on the research and the Sheekey Science Show, among many others. David Sinclair is interviewed in a number of podcasts. The other two also have their own. Longevity scientists are learning a lot of fascinating, useful information about how and why we age. DoNotAge.com has an epigenetic bio-marker test that will rank your systems’ biological health compared to the norm for your chronological age. They also have quality, if relatively, supplements, some of which I’m using. There are, of course, other reputable companies as well.
There are two major goals. One is to boost autopathy back to its earlier robustness, which depends on a series of enzymatic actions. Autopathy is the process by which senescent, i.e., dead and dying cells, are broken down and the waste products removed from the body. This is important because those cells emit toxins that damage their surrounding cells. The other one is to reduce the deterioration of our mitochondria, the energy producers in our cells.
I have been on some supplements that research shows do these things for four months into my six-month trial. My energy is better. I sleep less, sleep more profoundly, and wake up with more get-up-and-go. I feel more resilient in stressful situations and procrastinate less. Unfortunately, my aging memory may get slightly better, but not much. We’ll see how this goes.
Currently, CognitiveNutrtion.com has started selling Live Extension’s ‘senolytic activator’ with fisetin (wax tree extract and fenugreek seed), theaflavins (decaffeinated black tea), apigenin (?) and quercetin (Japanese sophora and sunflower). $20 for 36 capsules – 3 pills once a week for three months. This is especially good for the autophagy. Many of these kinds of products are available now, and many more are on their way.
Earlier today (Feb 2022), I watched a brief Brad Stanfield podcast on Amazon about testing data on the top twenty suppliers of NMN. The results were mixed and scary: many brands had less than they claimed, and some had none! Caveat emptor.
There’s a burgeoning array of scientific research, articles and podcasts, products, and testing options. Many of us Boomers have increased in healthier aging, so the market for these substances is expanding rapidly. One issue with this is that we can’t do real human aging studies because they take too long. So mice (85% shared genes) and even fruit flies (60%) and.. uhh, bananas (44%). We know how bananas age. It’s not a pleasant model to behold.
Inventory
Social Life Humans are, by nature, social creatures. I recently saw a chart listing the significant factors predicting longevity. Surprisingly, diet and exercise were in the middle. The top factor was one’s intimate relationships and social life. Social isolation (a lack of social connections) and loneliness (feeling alone regardless of social ties) take us down; sadly, they are epidemic in our society.
Social isolation is a primary, often neglected health concern among the aged, who are more prone to it due to physical isolation, hearing and visual issues, and the loss of friends and family members. It increases the risk of all-cause mortality, depression, cognitive decline (up to a 50% increase in dementia), obesity, cancer, high blood pressure, heart disease, stroke and more. It also weakens the immune system, reducing our ability to deal with various diseases and environmental assaults. Its adverse effects are on par with smoking, physical inactivity, and obesity. And then there’s the additive effects of these together. Approximately one-third of people over 45 feel lonely, and one-fourth of people over 65 are thought to be suffering from social isolation. As of this writing, Covid has been with us for two years, exacerbating this problem.
Structural issues such as living in more crime-ridden or impoverished neighborhoods, lack of access to social services, limited transportation, and the resources needed for daily life contribute to even more hardships for older adults. There are also inheritable components that may increase or decrease the adverse effects of loneliness.
The reverse is true. Elders who engage in productive activities with others, stay mentally stimulated and creative, and find meaning and purpose in their lives tend to be happier and live longer.
Sleep How well do you sleep? We’re beginning with sleep because good sleep is vital to our overall health and well-being. Sam Harris had a fascinating podcast with Matthew Walker, PhD, a sleep researcher and the author of the best-selling book Why We Sleep. (#267, Nov 10, 2021 – The Kingdom of Sleep) They talked about the importance of good sleep, the evolution of sleep, sleep in different species, types of insomnia, things that harm healthy sleep, ways to improve sleep, etc.
Poor sleep is associated with all-cause mortality. It is a significant predictor of death. This is true for too much and too little sleep. It contributes enormously to the increased likelihood of getting cancer, diabetes, Alzheimer’s and other dementias, heart disease, obesity, depression, anxiety, etc. Even brief episodes, e.g., disturbing a healthy subject’s sleep for just four days, put them into a prediabetic condition.
Pharmaceutical sleep medications work by increasing the neurotransmitter GABA, which reduces the activity of neurons in the brain. While these can bring on sedation, they interfere with healthy sleep patterns.
There are many popular remedies. Along with the limited scientific evidence of their efficacy, the supplement industry must regulate them more to determine their purity and potency. Some popular ones are:
– Melatonin is the best known. It is a hormone produced in the pineal gland. There is evidence of its effectiveness in helping bring on and sustain sleep. My holistic physician has found hops tincture to be very effective. I tried it once, and it seemed to help
– Valerian has been traditionally used for reducing anxiety and help with sleep.
– Chamomile, usually taken as a tea, seems to have many benefits in calming various systems.
– Kava kava is an herb long used in its native Pacific islands that has an avid following in the U.S. It has soothing and mildly euphoric effects. Some heavy users develop an addictive relationship with it. There is concern that prolonged use of time can harm the liver.
– Some non-psychoactive cannabinoids can help restore and support the natural restorative sleep cycle. CBD tends to be a stimulant in low doses while promoting sleepiness at high doses. Delta 9 cannabinoids, especially CBN, are also helpful in this way.
Some people use psychoactive strains, especially indicas. People respond differently to sativa (more stimulating) and indica (sedating) dominant strains. I like Andrew Weil’s observation in his A Natural Mind: “Marijuana is an active placebo. It doesn’t do anything in particular, but it does something.” That explains a lot about the difference in people’s responses to it.
Recommendations for improved sleep include Keeping to a regular schedule. This includes resisting going to bed earlier if you slept less than usual the previous night. Don’t hang out in bed before your bedtime. Get up soon after you’ve awakened. All of these are about programming your brain for a regular sleep cycle.
One particularly interesting point because of its broad impact is how disruptive of healthy sleep evening alcohol use is. It is a sedative for some but not all people. What it does do is disorganize the normal curative stages of sleep. They also talk about strategies for improving sleep patterns.
Most interesting of all, however, for me was his talk about how, while sleep researchers have known for a long time that all mental illnesses are associated with problematic sleep issues, they are now finding evidence that sleep disorders are not so much a product of mental illness as a causative factor. This is very important because it opens new and hopefully more effective ways to help treat these disorders.
Another interesting thing he said was that the immediate stimulating effects of coffee or caffeinated tea in the morning are not due to caffeine but to the hot liquid raising the body’s core temperature. I started drinking a cup of hot water some days soon after arising. It does seem to do something mildly stimulating.
For years, I slept an average of 5 ½ hours a night. I’d be sleepy at 9, and then around 10, I’d get this burst of energy and be up to 1 or 2. Then, when I woke up at 6 or 7, I’d stay awake. I was okay with that. Then a scientist friend, Jim Oschman, PhD, told me about Earthing products. From almost the first night I started sleeping on earthing sheets, I slept closer to 7 hours or more. If I woke up early, I could fall asleep earlier and get back to sleep. Go to earthing.com for their products and more information. I’ve recommended it to many Rolfing clients. About half notice the immediate benefits of sleeping, and the others don’t. More about this under ‘inflammation’ below.
Night Cramps at night or early morning become increasingly common with aging. I tried supplementing with … NOTE: I deleted what was here because there is great, i.e. more effective advice in the book
Food and Fasting Several experts in healthy aging I’ve studied say that the most important thing you can do to enhance your aging process is to eat less.
Unfortunately, good longevity studies in humans aren’t practical, so rodents, similar to us, and fruit flies, which share 70% of our age-related genes, are the usual subjects.
NOTE: Since I wrote the following, many former advocates have changed their minds, saying it produces skinny, soft bodies.
The main approaches to enhance health and aging used along with a good diet are intermittent fasting (IF) and calorie restriction (CR). Don’t eat so often and don’t eat so much. Don’t eat and snack all day long and don’t eat until you feel over stuffed.
Intermittent fasting is becoming increasingly popular because it is effective at enhancing health and the tangible experience of well-being. It is often combined with calorie restriction. The most common recommendation is to only eat during an 8-hour window and then fast for 16 hours. I have begun doing that; it isn’t as difficult as it might sound.
Time-restricted feeding (TRF) is a newer approach because it is easier. One eats and fasts in 12-hour windows and doesn’t bother with calorie restriction. Some experts suggest regular, longer-term fasting. One version is a five-day fast monthly, etc.
Some systems include a cheat day to make the process less demanding for people who need more yummies to feel good. Interestingly, body types play into this. Our bodies can be divided into the skinny, stringy ectomorphs, the meaty mesomorphs, and the softer, rounder endomorphs. Ectos tend not to go to food for comfort, while endos do, and mesos are in between. When I lived in an intentional community sharing food and other resources, the relevant people knew this. So, even in times of scarcity, we tried to get the endo families some extra goodies like cocoa powder. They just needed it. It wasn’t about them being more indulgent or less disciplined. Those cravings were hardwired in. I’m more into it, and when I used to get depressed, I quit eating.
The rationale is that fasting stresses the cells, which counterintuitively is good for them so long as it isn’t taken too far. The premise is that when cells are stressed, they quit putting energy and resources into reproductive strategies and put it into fortifying themselves. The animal studies data on increasing lifespan are robust.
Calorie restriction has been seriously studied in animals for over a century now. It’s been found to slow or prevent the onset of some age-related diseases and bio-markers for muscle and gut tissues. These lifestyle adaptations help reduce obesity, kidney and liver disease, diabetes, and cancer and increase longevity while enhancing physical functioning. It is essential to have the fasting start earlier in the evening so its effects occur while sleeping. There is a natural circadian rhythm to autophagy, which is the breakdown of old and dead cells, i.e., senescent cells in the body. This is important because these cells secrete toxic chemicals—the metabolic enzyme pathway for autophagy declines in effectiveness with age. There are supplemental approaches to help with this, which are discussed below.
At a ncbi.nlm.nih.gov site, scientists Hwangbo, Lee, and Min say CR and fasting appear to extend lifespan by both partially overlapping common mechanisms such as the target of rapamycin (TOR) pathway and circadian clock, and distinct independent mechanisms that remain to be discovered. We propose that a systems approach combining global transcriptomic, metabolic, and proteomic analyses followed by genetic perturbation studies targeting multiple candidate pathways will allow us to understand better how CR and fasting interact to promote longevity—got it?
Re diet: The only wholly accurate statement I know about a healthy diet is that no one diet works for everyone. There is abundant evidence that various nasty, poisonous, and hormone-disrupting chemicals in our food are not suitable for us. New information for good and bad is coming out all the time.
Inflammation is the most common and persistent source of problematic body reactions. There are some times when it is good. It helps our immune system work against invading pathogens and helps heal and recycle damaged tissue issues. Otherwise, it increases asthma, rheumatoid arthritis, diabetes, obesity, blindness, heart disease, bowel problems, cancer and more. Inflammation in the brains of pregnant women is associated with an increased likelihood of schizophrenia and autism in their children. Almost anything you can do to reduce the chronic inflammation in your body is good for you. Many are simple and obvious. A low-inflammation diet, especially low sugar levels, exercise, weight loss when appropriate, time in nature, healthy sleep, and reduced stress.
If you’re curious, there is the simple, inexpensive blood test for your C-reactive protein (CRP) levels, which is a marker for the level of inflammation in your body.
Earthing, i.e., grounding your body with the earth’s energy like the ground rod for a house does, is a proven way to reduce inflammation. My CRP plunged after using them.
It turns out that there is a current of electrons streaming through the earth’s surface wherever there is any moisture. It is created by the 2000 or so lightning storms occurring at any given time. These electrons enter our bodies when our skin is in touch with the earth or when a semiconducting material is between this current and our skin. An earthing product connects a semiconducting sheet or pad to the earth through a ground rod or by clicking them to the ground in an electric outlet. James Oschman, Ph.D., has a section on Earthing in the Energy Medicine in Daily Life Your Life chapter in his brilliant, groundbreaking book Energy Medicine: the Scientific Basis, 2nd Edition. You can find more about this in my The World We Live In chapter.
I’ve been using earthing sheets and pads since about 2008. I was curious after sleeping on them for a couple of years, so I checked my C-reactive protein. There are two different scales; on one, one is perfect, and the lower, the better. Mine was 0.26! My doctor was stunned. He had never seen one that low.
Our Physical Systems
Muscle-Skeletal-Connective Tissue – There is an age-related reduction in muscle mass and function. They are reducing strength and power. There are hormonal and neurological factors involved. This posture tends to be more flexed forward, and the gait length is shortened. Seniors tend to have less sensation in their lower but not upper bodies. The reduction in reflex speed, coordination, and balance combined with bone loss can become a severe problem for seniors as it increases the likelihood of more serious injury. One of my Rolfing jokes goes: “Adult human beings bounce about as well as ripe watermelons.” Ouch!
So – how does your body feel? Do you have chronic aches and pains? Limited mobility? Are you stiff in the morning? How’s your physical endurance? Trouble going up and down stairs? Can you turn your head to look out your car’s rear window? One measure of the health of your aged body is: Can you get up off the floor without using your arms and hands? I can do it now, but it sure isn’t easy. I watched a video of me doing a presentation on Bucky Fuller’s Synergetics math (more about that in The World We Live In section) when I was 32. At one point, I was sitting on the floor cross-legged. I watched in awe as I saw my younger self seem to uncurl and rise to standing magically. Oh well!
As we’ve aged, we’ve accrued more time being pulled towards the earth’s center by gravity. The Ida Rolf Institute once had a contest for a T-shirt slogan. The one they chose was Rolfing – Quality You Can Feel. Blah! I think mine was better:
Make Friends with Gravity It Always Wins in the End
I read in a kinesiology textbook that if an average-sized human’s head is just one inch forward of the midline of their body, they put an extra 30 pounds of stress on their shoulders, upper back, and neck. That’s a lot! That’s a little more weight than one of those gray cement construction blocks. This is one primary reason why getting Rolfed is a good idea. The goal of the Rolfing series is to align the body better vertically so that gravity becomes a more supportive and less destructive force in our daily lives.
In my Rolfing practice, many people come in wanting more flexibility. I explain to them that while that’s fine, it isn’t enough. One can be flexible and goofily uncoordinated, and how much flexibility do we really need? To pick up something, we don’t need to be able to bend over and touch the floor with our palms while not bending our knees. We can bend over while flexing our knees or squat.
Another important thing, along with flexibility, is fluidity. Fluidity lets us move with grace as multiple body parts move in harmony. At Rolfing school, we watched old Fred Astaire movies. OMG – His dancing! The way he could glide across the floor is almost unbelievable. And as some women point out, Grace Kelly could do everything he could but backward and in high heels. Still, even with that, he was exceptional in a subtle manner that she wasn’t. Then there’s Michael Jackson.
Along with flexibility and fluidity, there’s stability. People with one or both above may sway back and forth like a blade of grass in a breeze.
A few decades back, there was a fascinating article in Science News magazine titled ‘Gauging Aging’ about how to determine the actual biological age of older humans. I don’t remember where it said they got their data. We now have much more advanced science to do this. These add to but do not do not invalidate earlier insights. Science News is a reputable professional journal that reviews the newest science research across multiple disciplines.
I laughed as I read it. The first was the appropriately named ‘vital capacity.’ It was called that by an early 19th-century British surgeon, John Hutchinson. He must have been a keenly perceptive man. Vital capacity measures the total volume of air we can expel in a breath from a fully inflated lung. He concluded that this was a measurement predicting longevity. The article said there is no known way to improve it, including exercise.
Well, in most cases, Rolfing does that. It is easy to measure and has been with Rolfing clients. It isn’t magic. It is straightforward. Ask almost any reasonably educated person what is involved in the breathing process. They’d surely mention the lungs, the diaphragm muscle, maybe the ribs. There are the nerves and supply, too. Any other major thing that I’m missing so far? Yes. Fascia is the tough, fibrous, taffy-like electro-gelatin that surrounds all of our cells and then bundles of cells out to wrap individual muscles, groups of muscles, whole limbs, etc. This, of course, includes the torso. Loosen the layers of fascia winding in complex patterns around the torso, and you get more vital capacity.
The second criterion is even more humorous from my Rolfer’s point of view. It concerns how increasingly dry and inelastic the fascia has become around the cells. It isn’t just that we get more wrinkled, stiff, and stooped over. As the blood is moved into the tiny finest tubules, they don’t connect to the cells. They end in the fascia near the cells. Everything the cells need, the oxygen, sugars, nutrients, enzymes, hormones, and whatever else is essential, must migrate through the fascia to get to the cells. The metabolic waste products migrate through the fascia to enter the lymph and veinous return systems.
None of this works as well as in a more hydrated fascial environment. What, if anything, can we do? I don’t know if this has ever been tested.
With age, our reflexes become slower. The refresh rate with nervous system stimulation becomes slower. This shows up in many ways. You can see it on a bumping subway ride. Younger people can bounce longer and mostly compensate for the swaying by shifting their bodies accordingly. Older people, however, with slower reflexes, are more likely to have to hold on to something.
Vertigo must be a scary, frustrating condition to have. Instances of vertigo increase with age. It occurs two or three more times in women than men. A brief Google search found one source saying that by age 60, dizziness and vertigo affect 30% of people. Another one said that by age 65, they affect 70%. The elderly have many reasons for having poorer balance. They are weaker. Muscles, deteriorating spines, brittle bones, circulation problems, poorer vision, and perhaps medicines that aggravate the whole thing.
In my Rolfing studies, we were told that the sense of orientation that helps us maintain our balance is threefold. There’s our inner ear function, the feeling of our feet on the floor, and our vision on the horizon. You can try this experiment. Standing on one leg is much more challenging if your eyes are closed.
I saw an ad for a device that would be useful to us. It looks like a bathroom scale. It has a motion sensor aimed along the floor and a light that shines on the floor. So, if someone gets out of bed to go to the bathroom in the dark, it lights up the floor. This simple device could have prevented a lot of falls, which are especially dangerous as we age.
Falls are the leading cause of accidental injury-related deaths for those over 65.
A Test: One predictor of longevity is the sitting-rising exercise. It was designed to predict mortality in middle-aged and older people. The test is to sit cross-legged on the floor and get up again without using your hands, knees, arms, or sides of your legs. If you can do those without using any of those, you’ve scored a perfect 10. You lose a point for each use of one of those joints or appendages. In a Brazilian study, the mortality rate of those with a 0-3 score was 5-6 times higher than those with an 8-10 score. Claudio Araujo, the author of the study, said: “It is well known that aerobic fitness is strongly related to survival, but our study also shows that maintaining high levels of body flexibility, muscle strength, power-to-body weight ratio, and coordination are not only good for performing daily activities but have a favorable influence on life expectancy.”
Skin – How is your skin looking and feeling? This is a sensitive and challenging issue for many elders, especially women, given the youth bias in contemporary culture that I discuss at length in this work. The skin care market is a $100,000,000,000+ industry and growing. Cosmetic surgery is a $50,000,000,000+ industry and is growing. Increasingly, men are accessing it as well.
There is a widely-ranging genetic component to how our skin ages, independent of how much we exercise, stretch, and what we eat and drink. Yes, a healthy lifestyle helps with our skin and everything else, yet we’ve inherited what we’ve got. As a Rolfer for over 40 years, I’ve had someone stand up in front of me in their underwear or an equivalent outfit over 25,000 times. I’ve seen and touched a lot of skin. I know there are 80+ year-olds with firm, smooth, glowing skin. There are people with extremely healthy lifestyles who have sagging wrinkly skin beginning in their 40s.
The ability to feel light touch does not degrade with age. What should be more remarked upon is how really good aged skin feels to the touch. Those micro wrinkles and large pores have more surface area, so stroking them and/or having them stoked can be more sensual than stroking younger skin. Let’s all be open to changing our perceptions of this.
One fascinating and sometimes troubling aspect of our skin is its origin. We all start with one kind of cell, which early on, as the embryo develops, becomes three kinds of cells – the mesoderm, endoderm, and ectoderm. Each of these then develops and further differentiates. This is called gastrulation.
The mesoderm gives rise to the skeletal and smooth muscles, adipose tissue (fat), blood vessels, bones and connective tissues, and the heart and urogenital organs.
The endoderm becomes the colon, stomach, intestines, lungs, liver and pancreas.
The ectoderm becomes the nervous system’s spinal cord, peripheral nerves, brain, linings of the mouth, anus, nostrils, sweat glands, hair, nails, tooth enamel, and skin.
So, the skin is related to the nervous system and not the meat part of us. Skin is an extraordinary material we usually take for granted until there’s a problem—more about this under ‘touch’ below. Medically speaking, skin issues are highly diverse. There are hundreds of skin rashes, and with all medical progress, things like eczema, psoriasis, rosacea, etc, are often problematic to treat.
The gastrulation process gets more complicated; for instance, all three layers create our eyes.
ADD: Two common issues with older men are weakening of the urine stream and more frequent and urgent urination due to the enlarging prostate’s pressure on the bladder. Finasteride reduces the size of the prostate, as well as helping to reduce the incidence of prostate cancer, which is the second most common cancer in men. Tamsulosin can relax tension around the bladder to help increase urine flow. Ask your doctor.
Urogenital – Lots of uhh… interesting, i.e., embarrassing, uncomfortable, challenging things for elders.
The Urinary: Urinating urgency and urine leakage issues are bothersome and embarrassing. You can research causes and remedies such as they are online. There are obvious and maybe not so obvious similarities and differences between genders. Valves and membranes lose their integrity as bladders age. In men, pressures can build with prostate enlargement. This leads to leakage issues.
The market for adult aids has surged with the Boomers’ aging. It’s approaching $20,000,000,000 a year. The forbidden word in marketing is ‘diapers.’ Underwear and pads are okay. Gotta call them something. For men, the Depend brand has HealthDri briefs and Dignity boxer shorts plus ‘guards’ and ‘pouches.’ One company has tubes that the penis slides into and secures with a velcro strap or something. That seems like it would work better for small leakages. I had to laugh, wondering: “What would happen if the man had an erection?” Bladder leakage is a common result of prostate surgery. For women, there are Silhouette briefs, Fit-Flex underwear and Night Defense. You’ll have to ask someone else about them.
I am 77, and the urgency and minor leakage issues have become an increasing hassle. I keep some empty yogurt cups in the car and occasionally use one. (Not while driving! You’re safe on the road if driving near me. Well, my vision and reflexes aren’t what they used to be, but that’s another story.) I’ve begun researching the products and will find out what it’s like to use them. My Primary Care Physician (PCP – sounds like a new recreational drug) recommends the prescription drug Flomax (sounds good) for reducing the size of the prostate gland if there’s a BHP issue. (Wasn’t that the company that spilled all that oil into the Gulf of Mexico?) Ohh – Benign Prostatic Hyperplasia. Sorry!
On a more serious note, prostate cancer is the second most common cancer diagnosis in men and the fifth leading cause of death. As of February 2022, Brad Stanfield has a podcast about a treatment to help prevent prostate cancer. It is the drug Finasteride. In a trial of 18,000 men, it led to a 25% reduction in prostate cancer rates. It blocks the conversion of testosterone to dihydrotestosterone, which in adulthood causes prostate enlargement and male pattern baldness. With Finasteride, there was an 18% vs 24% risk of prostate cancer. At the 18-year follow up 30% reduction with it. Check out the current research status of it. For men, prostate cancer is the second leading cancer diagnosis and the fifth leading cause of death. Finasteride not only shrinks the prostate, which helps with urinary functioning, but it also reduces the incidence of prostate cancer. Flomax (Tamsulosin) also helps urinary functioning by relaxing the muscles in the prostate and bladder. I’m not a fan of a lot of prescription drug use, but in this case, I prefer it to the alternative of not treating these issues.
A sad note is that a doctor told me that urinary incontinence is the main reason elders get sent to assisted care. I get that it’s hard to live with having to change a bedridden adult’s diapers and then the odor of urine. If I’m to that point, I think that I’ll decide to check out of the scene for good.
I was talking to an older woman friend about the whole aging thing. She laughed and told me about how recently, at a family gathering, they had a few drinks, a little pot for some of them, and were playing some game that got them laughing so uproariously that she wet her pants and had to change. Three times! And she’s still able to laugh about it. That’s a good sign.
With Japan’s especially large old-age population dynamics, a company, Super Faith, has created a way to turn them into a clean energy source.
The Sexual The multifaceted sexual issues again have similar and different gender issues. The erectile dysfunction drugs have dramatically altered older men’s and women’s sexual lives. I include them in my Life Enhancing Substances section. There’s a lot of popular joking about the STI (Sexually Transmitted Infections is the newer term since they aren’t diseases.) rates in senior citizen centers, so quite a lot of activity must be taking place. I haven’t got there yet. It could be fun, especially for the guys, since the women outnumber the men there. I’m not going to say more about sexuality and aging here because there is much about this in other sections.
Digestion and Elimination are also areas tending to lack charm as we age. The digestive system doesn’t age as other systems do because it is affected by other systems. Decreasing muscle function causes all sorts of problems throughout the body.
Nervous System and Cognition For almost everyone, there are cognitive declines with aging. These result in slower and worse word recall, poorer multitasking, shorter attention span, slower processing speed, and worse fluid intelligence, i.e., short-term memory, spatial orientation, etc. Depression is more common in the elderly. There can be both anatomical and cultural causes.
There are often positive changes, such as semantic memory, i.e., more extensive vocabulary, crystallized intelligence, i.e., recall of earlier events, accumulated knowledge, and perhaps wisdom.
Circulatory: With age, our heart, arteries, and veins change. Heart muscles and the walls of blood vessels thicken and become less elastic.
Some of this is normal, and generally, more than other systems, some harmful ones can be mediated by lifestyle for better or worse. High blood pressure, diabetes and obesity. Regular exercise helps maintain more elasticity.
Epigenetics, Neuroplasticity, and Neurogenesis are relatively new areas of multi-disciplinary research and study with many important implications for our health and well-being.
– Epigenetics is how your environment and behaviors can affect the expression of our genes. The genes are not changed, but how they are expressed is. It changes how our cells read our DNA. This is a complicated area. There are different kinds of epigenetics. Some pathogens use epigenetics to weaken the host’s immune system. Some cancers are more likely to occur with specific epigenetic changes. A mother’s nutrition during pregnancy can create epigenetic changes that predispose their children to certain illnesses, etc.
– Neuroplasticity is about how the environment and behaviors can change the structure of our brains.
Our Senses
Vision deteriorates with age, generally most noticeably after age 40. A major cause is the lens’s decreasing flexibility, which leads to poorer visual acuity, less ability to distinguish between colors like blue and black, longer for the eyes to adapt to changes in lighting, less sense of color contrast, and poorer depth perception.
There are also neurological changes that affect vision. If you are driving and looking down at the dashboard, it takes longer to focus on and integrate what you are looking at. Then, when you’re looking back at the road, the same thing happens. Thinking about driving, I once wondered what miles per hour are in feet per second. It’s almost 1 ½ feet per second. Going 30 mph sounds slower and less threatening if I hit something than going 45 fps. Something about inertia: if you are cruising down the highway at 70 mph, you’re going over 100 fps. A lot can happen in a second or two at that speed.
The medical establishment recommends a dilated eye exam every year or two for vision and early signs of other possible problems for elders.
Common aging issues are:
– Dry eyes, especially for women. Counterintuitively, excess tearing may be a sign of dry eyes. OTC lubricating eye drops work well.
– Macular degeneration harms vision, especially the sharp central vision necessary for daily activities.
– Diabetic retinopathy can, to some extent, be reduced with lifestyle changes that help with other consequences of diabetes.
– Cataracts may only become a minor problem as the lens gets cloudy. More severe cases can be corrected with surgery.
– Glaucoma is caused by a buildup of fluid in the eye. It was one of the first medical conditions for which cannabis was prescribed.
An interesting historical anecdote is that in the 1500s and 1600s, European nations wanted from China, and the Chinese wanted only a little from Europe, which they considered an uninteresting backward culture. They did love eyeglasses and bought a lot of them. The old scholars were able to read their scrolls again! The clever Europeans were not to be denied. They asserted themselves with the philosophy of The Divine Right of Free Trade. No country could refuse to open its borders to trade. The traders needed something more to give them, so they initiated the importation of opium. Eventually, the Chinese government got tired of this plague and banned opium. The traders had a solution: Send in their gunboats and shoot up the Chinese ports. These were the mid-19th century Opium Wars. The Chinese lost. They haven’t forgotten.
Hearing – High-frequency hearing loss is common. That may have been made worse by past loud noise exposure. This primarily affects the hearing of consonant sounds and all speech in noisy environments. Hearing aids help with these but do not help with slower auditory signal processing, which can decrease the ability to understand and remember spoken information. Tinnitus becomes more common.
Hearing loss can lead to multiple misunderstandings, humorous and not depending. Recently, my partner asked me to adjust the bandana that mutes our bedside lamp, and I thought she asked me to “address the banana.” What! The same evening, I was talking about how men are the more sensitive gender when it comes to feeling inside of our bodies, how we feel pain and itching more, and she thought I said, “How we feel pain and chickens more.” Uhh… maybe, but not right now!
Taste and Smell are intimately related in our experience. The sense of smell significantly deteriorates after age 70 due to the loss of nerve endings and less mucus, which helps hold odors longer in the nose to be detected. The ability to discriminate among smells also decreases. The capacity to smell is unique among the senses in that stimulation of it doesn’t necessarily generate a cognitive response. This olfactory function declines more than our sense of taste.
The number of taste buds also diminishes with age. Smoking and alcohol use cause even further reduction in these organs’ sensitivity. This loss with aging may contribute to a decrease in appetite and eating. It may also contribute to anxiety and depression. Loss of these senses is more acute with dementia.
Touch is more complicated. There are three kinds of touch receptors, and each has subtypes plus nerves for painful stimuli. Touch lets us feel pain, temperature, pressure, vibration, and body position and movement. Our skin, muscles, tendons, ligaments, and bones sense their environment. Touch serves three major functions: exteroceptive, for stimuli originating outside our body; interoceptive, for stimuli originating inside our body; and proprioception, the perception of our position in space and movement.
There are separate touch receptors for low-level touch (innocuous to pleasant) and high-level mechanical touch (unpleasant to harmful).
The good news for the aged is that as the skin thins, it becomes more sensitive to low-level touch.
The problem is that reduced sensitivity to temperature and pain may lead to injury. As our reflexes slow, the moving away from painful stimuli will also slow.
An interesting gender difference in touch is that, generally, males have a higher level of interoceptive awareness than females. We feel our bodies more. For instance, if they stop and focus, most men can feel their pulse without touching the artery in the wrist. Most females can’t. So, males are the more sensitive gender. Hah! Although, in women’s speak, when it comes to pain, we’re a bunch of wimps.
END OF LIFE
Euthanasia is becoming an increasingly common option with the increasing arrival of Boomers at the end of life. If one is really near the end with no chance of recovery and experiencing a low quality of life, they may choose to end it. One painless method is to quit eating. You lose your sense of hunger and only need a little liquid. It usually takes two to four weeks to fade away peacefully. A more rapid path is to take a compassionate brew that puts you to sleep for the final time. Another is to get a canister of helium from a party supplies store and a mask to inhale. There’s no suffering.
Clinical trials using strong doses of psychedelics with terminally ill stage 4 people to see if that experience can reduce their anxiety around death have been very successful. The movie A New Understanding – the Science of Psilocybin interviews some researchers and patients before and after their journeys. It’s fun to hear their stories.
Are you dealing with the Body? Various states are increasingly permitting less regulated funerals and burials. Lucinda Herring’s Reimagining Death: Stories and Practical Wisdom for Home Funerals and Green Burials is an excellent resource. As is Liz Rothschild’s book Out of the Box: Everyday Stories of Death, Bereavement, and Life.
What’s Next? There are a wide variety of theories about the afterlife. I don’t entirely trust them—all the various takes on heavens and hells. People seem to have to have stories to explain or comfort them or whatever. It is a great mystery of life. There are the ever-popular Heaven/Hell dichotomies. The fundamentalist Christian’s view of Heaven as living forever in a big park with all of their relatives with God and Jesus sitting on the sidelines sounds hellishly dull. There’s the Letting Go is Hard to Do video And a Twilight Zone episode (?) about a guy who dies, wakes up in a beautiful house surrounded by beautiful women, and can have everything he wants. “Wow – I’m in Heaven?” After a while, he finds it boring, and later really boring, and eventually so boring that he can’t stand it any longer, so he asks Peter to send him to the other place. To which Peter responds, “This is the other place.
There are the stories of near-death experiences (NDEs) that Raymond Moody’s 1975 bestselling book Life After Life introduced to the culture. But they were only dead for a few minutes. I’m waiting for one who’s been dead for at least a week or more. I have an interesting NDE story: In 1977, the fellow who introduced me to my first wife was dying of cancer. We went to visit him in the hospital, where he was in a coma. The nurses were acting as tho he was gone. We had read Moody’s book the previous year, and it said that hearing is the last thing to go, so we talked to him. I read a sample NDE story from the book where the dying person is going down a dark tunnel with light at the end and is greeted by people who have died before. He slowly opened his eyes and softly said, “Yes, that’s what I’m experiencing,” and went back out again. There are lots of other stories and books about this.
And the reincarnation theories. If someone tells you they believe in reincarnation, it may be helpful to ask them what kind. The Hindu one has your current life status dependent on your previous one. So if you were born into a high caste family, you deserve the perks, and if you are in a low caste family, that’s what you deserve. This is an awful system that justifies extreme classism. I’ve heard that in many rural areas of India today, a high-caste person can abuse or kill a lower-class person with impunity. I believe that in Mahatma Gandhi’s ashram, the only weddings they would conduct were between people of different castes.
I prefer the Tibetan Buddhist version I heard; the only things that go on are our level of spiritual wisdom, the knowledge of emptiness, and our degree of compassion. That sounds right to me. In the My Story section, I describe the psychedelic journey that convinced me we have an eternal soul. However, what ‘eternal’ means if there’s an end to the Universe in 100 billion years is beyond me. And there’s the scientific materialist’s ‘nothing.’
The Liftoff I Had a Dream (nice way to start a speech) is a very brief, maybe 10-15-second snippet of a dream. In it, I was sitting in a side seat at the end of a long table with others. Everything had a ghostly misty sense, a fleeting image almost bereft of color. I was barely aware of the others at the table except for the person to my right at the end. It was my lover in this life. We all knew we were there to die for some higher purpose. I wasn’t thinking about what that was. There was no angst, just a peaceful neutrality. We were present together.
She started intoning in a language I didn’t understand. As she did that, everything became even paler. I laid my upper torso and head down on the table for a moment and then rapidly raised, arching my back and lifting my head and hands over my head as I faded away, lifting off. And then I awakened. It was soaringly beautiful. I‘m going to use the term liftoff sometimes when talking about death.