Gait speed and dismobility

A Diagnosis of Dismobility—Giving Mobility Clinical Visibility: A Mobility Working Group Recommendation

Steven R. Cummings, MD; Stephanie Studenski, MD, MPH; Luigi Ferrucci, MD, PhD
JAMA. 2014;311(20):2061-2062. doi:10.1001/jama.2014.3033.

Slow gait limits independence, decreases quality of life and is associated with an increased risk of disability, hospitalization, placement in long-term care, and accelerated clinical progression of many chronic diseases, including chronic obstructive pulmonary disease, diabetes, congestive heart failure, and dementia. Slow gait speed is also a predictor of all-cause mortality.


http://www.merckmanuals.com/professional/geriatrics/gait_disorders_in_the_elderly/gait_disorders_in_the_elderly.html

At age 75, slow walkers die ≥ 6 yr earlier than normal velocity walkers and ≥ 10 yr earlier than fast velocity walkers. Gait velocity slows because elderly people take shorter steps at the same rate (cadence). The most likely reason for shortened step length (the distance from one heel strike to the next) is weakness of the calf muscles, which propel the body forward; calf muscle strength is substantially decreased in elderly people. However, elderly people seem to compensate for decreased lower calf power by using their hip flexor and extensor muscles more than young adults.

I wonder if strengthening calf muscles makes any difference. Couldn't hurt.

Strengthening your calves

Tips for your pre-retirement years

• Life tips for my friends and readers who are 45-ish.
• Put away about 15% in your retirement account, above what your employer or government is contributing.
• Take good care of your relationships--they are like gold.
• Ignore all the food fads and scares; eat all the colors, eat less and move more. Just like mom said.
• Everything in moderation; especially alcohol and coffee and just pitch the cigarettes. They've never been found to benefit anything in your body.
• Don't be a pot head even if it is legal--you need every brain cell you have working at full capacity.
• Take care of your ears--turn down the music--and your teeth. Don't become a deaf senior citizen with ugly teeth--it's not pleasant. Take out the ear buds and see a dentist twice a year.
• Go to church. There are thousands of denominations as a result of squabbles that happened years ago. One should meet your needs. The world is actually more religious now than ever before--don't lose out on the benefits.
• Enjoy the many pleasures of owning a pet, but they are not family--don't kid yourself.
• Think about the benefits and responsibilities of being a citizen of the United States. It's not perfect, but it's the only one ever created with idea that the state/monarch/king/president doesn't own the people.

Music and aging

"Music, the most-studied art reviewed, has been shown to have a number of benefits [for older people]. One landmark study compared older adults who were invited to join a choir to those not invited. Twelve months after the study began, choir members showed decreases in doctor visits, falls, and over-the-counter medication use. Improvements were seen in overall health rating and number of activities performed. In a larger study that randomly assigned individuals to a choir program or a control group, the choir partisans had lower scores on a depression/anxiety scale, and higher scores on a quality of life scale. A survey of older amateur singers before and after joining a musical group showed increases in emotional well-being, social life, quality of life, and self-confidence." http://aginginaction.com/2014/01/can-music-dance-and-other-arts-programs-enhance-healthy-aging/

Inspiring, isn't it? 91 year old runs marathons

91-year-old Harriette Thompson set a new world record Sunday after she ran a marathon in San Diego in little over seven hours! Her feat, which also made her the second-oldest woman to complete a marathon in US history, is especially remarkable given that Thompson only completed her last radiation treatment for skin cancer one month ago. The grandmother of ten from Charlotte, North Carolina beat... the previous marathon record for women 90 and up by two hours and 45 minutes.

Thompson ran her first marathon at age 76 and tells people that "it's never too late" to start exercising. She has run in 15 out of the past 16 Rock ‘n’ Roll San Diego Marathons and raised over $90,000 for the Leukemia & Lymphoma Society in the process. A classically trained pianist, Thompson told WFAE that she replays pieces in her head to keep pace while running: "I usually think of Chopin etudes, the ones that are technically difficult, because usually they're pretty fast, and it stimulates me to go a little faster, and also helps pass the time."

http://ftw.usatoday.com/2014/06/harriette-thompson-marathon

http://www.people.com/article/harriette-thompson-91-finishes-marathon-in-san-diego

http://running.competitor.com/2014/06/news/record-setting-day-harriette-thompson-san-diego_104482

Guest blogger Sarah on retirement

Illness forced Sarah to retire; so she's reevaluating her life.
* * *
It's an interesting thing to retire. We all dream of it, we work for it we know that someday we will enter into that time frame of our lives when everything is supposed to be amazing. Kind of like the ultimate carrot at the end of the stick idea. However, some of us (like me) arrive at that point unexpectedly and find that we don't know how to respond to questions from loving, caring friends about, "How are you adjusting to retirement?" In the interest of reminding myself of how things are progressing, I am going to keep a journal of sorts to list out things that I am finding that I can adapt to very quickly. If that in anyway helps some of my friends as they also make this transition, all the better.

There are certainly things that are different and I'm finding that it's OK, that it's different because life was never meant to remain the same. For me, right now in this first month of official retirement, it's all about perspective. I can bemoan those changes sometimes considered losses or...I can rejoice in the changes that I consider major gains.

The first of these gains is what I am considering to be the throwing out the rulebook about time. Having to go to bed by a certain time because you HAVE to get up by a certain time because you HAVE a major responsibility to others and yourself to show up and do your job. If you are someone that doesn't necessarily sleep on a regular schedule and the pressure of HAVING to do so only makes it worse, consider this a major gain. I think in time I will figure out what my "routine" will be, for instance I just started to cook at 9 pm on a Sunday night and it doesn't matter because...it just doesn't matter. If I am up until 3 am (as I often am) then so be it. Unless I have an appointment (which I don't have very many of these days), it just doesn't matter. So the rulebook for me about going to bed and getting up and doing it over and over again until I've reached the point that it took me 2 days to recover from doing that 5 days is a row - is now over and I will be making my own rules from this point out. It is an amazing feeling of freedom which reduces the stress in my life greatly, which in turn improves the quality of my life and so it all is a process...but a process that I will be defining and making fit this new period in my life.

Stay tuned!

Follow the money--or the votes.

Seniors are not hurting.

"Sen. Tom Harkin (D., Iowa) has introduced legislation to increase Social Security benefits and build a government-run supplemental saving plan. Sen. Elizabeth Warren (D., Mass.) has so captivated progressives with her demands to raise Social Security payments that she is touted as a potential presidential candidate in 2016."

What this country needs is jobs for young people, not pandering to senior citizens. Today's retirees have been warned since their 30s that Social Security won't be there for them, and most of the couples I know have 5 or 6 streams of income, from a 403-b, or 401-k, or private investments, or annuities, or IRAs, or veterans' pension, or Social Security. There are divorced women living in “committed relationships” still getting financial support from the husband that ran off with his secretary 30 years ago. If they married, they’d lose that.

Politicians know seniors vote. Especially Democrats.

Is it too late to put it in reverse?

Oct. 20, 2013 — Scientists report in Nature they have found a novel and unexpected molecular switch that could become a key to slowing some of the ravages of getting older as it prompts blood stem cells to age.

The study is expected to help in the search for therapeutic strategies to slow or reverse the aging process, and possibly rejuvenate these critically important stem cells (called hematopoietic stem cells, or HSCs), said scientists from Cincinnati Children's Hospital Medical Center and the University of Ulm in Germany who conducted study.

http://www.sciencedaily.com/releases/2013/10/131020160654.htm

Commonly held myths about end of life issues

Some people don’t have a health care power of attorney or living will because they don’t realize how important these documents are. Others worry that such documents mean they are signing their lives away. Not so.

These powerful documents make sure that you get the treatment you would want for yourself if you couldn’t communicate your wishes. Here are a few myths that shouldn’t get in the way of creating a health care power of attorney or living will:

Myth: More care is always better.

Truth: Not necessarily. Sometimes more care prolongs the dying process without respect for quality of life or comfort. It’s important to know what interventions are truly important. It’s often impossible to know that in advance. That’s where the advice of a healthcare team is invaluable.

Myth: Refusing life support invalidates your life insurance, because you are committing suicide.

Truth: Refusing life support does not mean that you are committing suicide. Instead, the underlying medical problem is considered to be the cause of death.

Myth: If medical treatment is started, it cannot be stopped.

Truth: Not starting a medical treatment and stopping a treatment are the same in the eyes of the law. So you or your health care agent can approve a treatment for a trial period that you think may be helpful without fear that you can’t change your mind later. However, be aware that stopping treatment can be more emotionally difficult than not starting it in the first place.

Myth: If you refuse life-extending treatments, you’re refusing all treatments.

Truth: No matter what treatments you refuse, you should still expect to receive any other care you need or want — especially the pain and symptom management sometimes called intensive comfort care.

Myth: Stopping or refusing artificial nutrition and hydration causes pain for someone who is dying.

Actually, what is listed here as TRUTH is not. You can find valid studies that state removing hydration from a dying person increases their pain.

[Truth: Unlike keeping food or water from a healthy person, for someone who is dying, declining artificial nutrition or intravenous hydration does not cause pain.]

Harvard Health Beat, Sept. 26, 2013

Doctors pressured to push Obamacare

"With open enrollment set to begin next week, enrollment groups and medical societies are hoping America's doctors can inform patients about their options for expanded coverage under the 2010 health law." Medpage.

So far, I haven't met a doctor who liked Obamacare or thought it was a good idea, so why ask them to push it? Some plan to by-pass insurance plans all together.

So I asked self, "I wonder what an 'enrollment group' is?" I looked it up, and here is one called "Enroll America."

"Enroll America is a nonpartisan 501(c)(3) organization whose mission is to maximize the number of uninsured Americans who enroll in health coverage made available by the Affordable Care Act. Enroll America is a collaborative organization, working with partners that span the gamut of health coverage stakeholders—health insurers, hospitals, doctors, pharmaceutical companies, employers, consumer groups, faith-based organizations, civic organizations, and philanthropies—to engage many different voices in support of an easy, accessible, and widely available enrollment process."

You should see the fancy website. My goodness--one of the best. Clicked all over the page, but not a peep on how it is funded (except the donate button, and I seriously doubt this staff, offices, website, training sessions, etc. are covered by donations). I bet this group didn't wait 3 years for their non-profit tax status.

Do you have a Written Income Plan (WIP) by guest blogger Jeff Gorton

“Age 85 is a bad time to go broke,” says expert retirement planner Jeff Gorton. Personal savings, various investments and, yes, Social Security may prove to be short of what you’d expected.

“Budgeting how you spend money before retirement can often be a misleading measurement of how you’ll actually spend it during retirement,” says Gorton, a veteran Certified Public Accountant and Certified Financial Planner™, and head of Gorton Financial Group (www.gortonfinancialgroup.com).

“Spending 40 hours a week at work not only earns you a paycheck, it also keeps you from spending money on more vacations, matinee screenings at the movie theater, extra trips to the mall or shopping online. You need to be exceedingly realistic in your planning, and the five years before retirement are actually the most crucial in solidifying post-employment stability.”

To prevent a rude awakening during retirement, Gorton makes certain his clients start with a written income plan (WIP). He reviews the benefits and importance of this “living document”:

• A comprehensive list of life expenses paints a clearer picture. For a 65-year-old married couple today, there is a 72 percent chance that at least one spouse will live to age 85; a 45 percent chance that one will live to age 90, and an 18 percent chance that one will reach age 95, according a recent study from the CDC National Center for Health Statistics. You may not think of listing things like pet care, yard maintenance, and regular visits to salons or spas. But if you enjoy those services now, you may want them during retirement, and you might find that you underestimated the real cost of maintaining your desired lifestyle. And, that’s not including gifts to children and grandchildren!

• The forecast of a two-legged stool. A WIP helps you appreciate the reliability of retirement income. What sources of income do you anticipate having? Traditionally, retirement funding has been viewed as a “three-legged stool,” implying a balance between Social Security, retirement plans and savings/investments. As the baby boom generation ages, Social Security benefits may decrease — and the age at which an individual can collect benefits may increase. Changes in employment may affect retirement plans. As a result, the third leg of the stool, savings/investments, may become even more important.

• Who is authoring your WIP? As with all written documents, you must always consider the source. What you may not realize is that a financial planner is liable to have a stake in selling you a financial product. Just like a retailer may have an incentive to move certain brands of products, many planners are incentivized to have you invest in specific financial vehicles from major institutions. What plan works best for you? Seek advice from an expert who isn’t trying to sell you something, such as an independent firm.

“If you don’t have a written income plan, then you’re just hoping things will work out,” Gorton says.

About Jeff Gorton, CPA, CFP®

Jeff Gorton is a Certified Public Accountant and a Certified Financial Planner™ specializing in individual tax and retirement planning. He is also an Investment Advisor Representative under Alphastar Capital Management, an SEC Registered Investment Advisor, and has a life and health insurance license. Gorton works with individuals and their families to create and protect their financial legacies. He specializes in working with retirees in the areas of tax planning, benefits, retirement planning, estate planning and safe money techniques. He received his BBA in Accounting from the University of Oklahoma. Gorton previously worked for 10 years as the Chief Financial Officer for a large retail organization, overseeing their accounting, benefits and 401(k) retirement plans.

Mild Cognitive Impairment and computer use

Don't complain if your spouse or grandpa or auntie is using the computer too much. Watch for it when they lose interest. It's a study worth looking at. . .

"In a study of 100 older people with mean age of 84 years, there was a significant decline in computer use among the eight participants who developed MCI over 43 months of follow-up, compared with the 92 people whose cognitive skills remained stable (P=0.019), Jeffrey Kaye, MD, of Oregon Health & Science University, and colleagues reported at the Alzheimer's Association International Conference in Boston."

http://www.medpagetoday.com/TheGuptaGuide/Neurology/40586

Almost, not quite, a blizzard

Central Ohio was under a severe storm warning yesterday, the day after Christmas.  We had about 4" but other counties had more.  In any case, it made me appreciate again moving to a condo in 2002.  I love hearing the trucks show up to clean the street and our driveways, or the snow shovels scraping, knowing my husband won't be bundling up to go out in the cold. But also, we have terrific neighbors, always ready to help in an emergency.

What you probably don't know about Social Security

"Taking Social Security benefits – the right ones at the right time – is one of the biggest financial decisions you’ll ever make, so you need to get it right. Getting it right on your own, however, is neigh impossible." And even checking with the specialists at the local SS office, you can get misinformation. . . the manual has over 2700 separate rules. Add to this what you don't know about Obamacare. . .

Link

College grads, start saving now!

When I graduated from college I was 21 years old and 5 months pregnant. I had other things on my mind than saving for retirement.  .  . like rent, food, graduate school, paying off the hospital and doctor bills (it was a pay as you go baby).  I put it off until I was about 48 and the children were launched.  Then I opened a tax deferred account through TIAA-CREF and started setting aside the maximum allowed.  Since I didn’t go back to work full time until about that same time, I was really behind.  If you’re starting out, don’t do what I did.

Here's how interest compounds over time: If you save $10 a day at age 25, you'll have more than $1 million by age 65, assuming an 8% annual rate of return. If you start at age 35, you'll have $445,000. At age 45, you'll only have $180,000.

http://online.wsj.com/article/SB10001424052702304432704577348052844503384.html

Retiree confidence very low compared to 10 years ago

Some people forget that G W Bush also inherited a recession. The percent of retirees in 2001 who felt very confident or somewhat confident that they had saved and invested sufficiently for retirement ranged from 74% in 2001 to 79% in 2007. In 2008, that dropped to 64% and then to 60% in 2011 as the recession ground on despite a massive influx of federal funding. Link to Research. The gloom and doom in the business community is palpable as they are hit by more and more taxes and uncertainty about health care. Expansion is mostly out of the question, unless you're a petroleum driller in North Dakota. This affects those of us who live on retirement incomes whether Social Security, or defined benefit plans or our own savings/investments. Obviously, two things jump out about those years--the current recession that started in 2007 changed the investing mix and caused retirees to reevaluate their retirement plans and spending, and the baby boomers began entering the retirement demographic.

Those of us who were born before or during WWII whose fathers fought in that war and whose parents were teen-agers or young adults during the Great Depression have a different attitude than baby boomers about saving and sufficiency. We also have benefited from stronger family safety nets and we know the difference between “wants vs. needs." The value gap will expand for Gen-Xers who were accustomed to even more “stuff” replacing spiritual and familial values. In the 1940s and 1950s even children whose parents never took them to church heard Biblical admonitions on values and thrift in school before the Supreme Court ended it in the 1960s. "Don't store up treasures here on earth, where moths eat them and rust destroys them, and where thieves break in and steal. Store your treasures in heaven, where moths and rust cannot destroy, and thieves do not break in and steal.” Matt 6:19-20

Laughing with Mary all the way to the beach

Candidates are visiting The Villages in Florida

It seems the celebrities and political candidates love The Villages, a retirement community of 85,000 residents located 20 miles south of Ocala, Florida on route 441 with a total of 504 holes of golf. Murray recently sent his e-mail list this item about their visitors. "In the past 2 years we've had Sarah Palin, Glenn Beck (twice), Bill O'Rielly, and Sean Hannity visiting us. This week we had Rick Santorum and John McCain with Newt Gingrich tomorrow and Mitt Romney Monday. Also the Tea Party Express bus will be here tomorrow." In fact, he adds, they've even had Occupiers show up to protest.

"One thing you can be sure of and that would be Obama will NOT be coming to The Villages. He already knows that The Villages special interest group is not potential supporters. They consist of the old and wise. He avoids these people plus most of the middle class that he's trying to screw and doing a dam good job of it!"

Is There a Retirement Crisis?

The idea of working until the end—or closer to it—isn’t new. Many of today’s retirees have enjoyed decades of relaxation financed by company pensions and Social Security, but for most of history, voluntary retirement was the exception, not the rule. “Up to the end of the nineteenth century, people generally worked as long as they could,” Munnell writes. “At the end of their lives, they had only about two years of ‘retirement,’ often due to ill health.”

Is There a Retirement Crisis? by Nicole Gelinas, City Journal Autumn 2011

Beginning a new year when you're old

Taken from “Can I Begin Again?” by J. Oswald Sanders:

“When we were younger, most of us who are Christians earnestly sought to discover God’s plan for our lives, especially when we came to the crossroads of career and marriage. Are we equally diligent in seeking his plan for our old age, or are we just drifting along with no definite aim or goal? With more time to review the past, it is not difficult to become discouraged as we recall opportunities missed; a lessening of zeal in God’s service; a mediocre prayer life; or perhaps actual sins of which we have reason to be ashamed. It is at moments of introspection that we need to turn our eyes outward and upward to our loving and understanding Father. What balm a verse like Romans 5:20 can bring! “But where sin increased, grace increased all the more.” The wonderful thing about God’s abundant grace and favor is that it is never too late to discover and follow God’s plan for the remainder of our lives, never too late to make a new start, even if we have missed his plan till the present time. To his disillusioned compatriots, the prophet Joel brought an inspiring message of hope - the hope of a New Beginning. God delights in giving his failing children a chance to begin again...”I will repay you for the years the locusts have eaten” (Joel 2:25).

Shared from cousin Gayle's weekly newsletter

Generations and the Great Recession

The generations are taking care of each other, according to the Pew Research Center.

Section 5: Generations and the Great Recession | Pew Research Center for the People and the Press

It may not be glamorous, but the retirement pay is good

The base pay for a California state prison guard is $73,728, and with overtime many guards earn up to $100,000 annually. Five years ago Los Angeles Times reported that 6,000 guards were earning more than $100,000. One lieutenant raked in $252,570. Besides generous salaries and benefits, prison guards in California can retire as early as age 50. In retirement they are eligible to receive as much as 90 percent of their income: According to the state retirement formula, guards over 50 receive a percentage of their last year’s salary equal to three times the number of years worked. The prison population is growing 3 times faster than the state population--more jobs for union guards?

The price of prison guard unions

Too Much Debt to Retire

Although you can blame the economy, this part of the article makes more sense--what was going on for the now 60 year olds in the mid-decade.

"The combination of easy credit, low interest rates and a consumption-oriented culture helped fuel a spending binge for Americans until the financial crisis. People with problems aren't just those who took subprime loans or spent foolishly on lavish lifestyles. They are people from all backgrounds, including some with six-figure incomes."

Too Much Debt to Retire - SmartMoney.com

Valuing Seniors' Lives - Investors.com

"A commercial showing granny being pushed over a cliff by a person resembling Rep. Paul Ryan, R-Wis., was recently put out by the Agenda Project, implying that the Ryan budget will kill old people by changing Medicare.

For the sake of accuracy, granny should have been dispatched by a character resembling Cass Sunstein, President Obama's head of the Office of Information and Regulatory Affairs.

The Ryan budget attempts to curb the explosive growth of entitlements such as Medicare and Social Security so they are there for granny without burdening the grandchildren with unconscionable debt. Sunstein, as was pointed out during congressional testimony last Friday, literally believes granny should be sacrificed in favor of the kids.

In testimony before the House energy and commerce subcommittees on oversight and investigations, the 56-year-old Sunstein tried to walk back comments he made in a 2003 paper, "Lives, Life-years, and Willingness to Pay," written while he was a professor at Obama's one-time home, the University of Chicago."

Valuing Seniors' Lives - Investors.com

How to travel a lot without being a millionaire | Lifecruiser

You'll find some good tips from a blogger I've followed for many years. She lives cheap at home so they can afford to travel.

How to travel a lot without being a millionaire | Lifecruiser

Your Retirement Checklist for Your 70s and Beyond

Take a look at this check-list, you might need to reevaluate. Includes a link to long term care.

Ischemic bowel disease

Just one more thing for older people to know about--I'd never heard of this condition, but apparently it does affect older people, one article I read said over 60, another over 70.
Ischemia, the noun for ischemic, means a low oxygen state due to inadequate blood flow. Bowel refers to the small and large intestine.

Ischemic bowel disease results from inadequate flow of oxygenated blood to the intestines. The extent of ischemic bowel disease can range from mild to severe based on the amount of damage from lack of oxygenated blood. This is a potentially serious condition and requires care from your doctor.

I received word that a friend was in the hospital, and when I called, I found out she has been in for two weeks, first in ICU, then step down, and she may be transferred to yet another hospital. She became ill at home with vomiting and diarrhea, called a friend to come, but had passed out by the time the friend got there. Another 2 hours delay and she would have been dead.

Read the article. Be informed.

Your Health -

Inspiring

Although I won't be doing this, it's a good idea! So go after your dream.



HT My thoughts Exactly

Public pension crisis has some bracing for worst

"A recent study of some 126 state-sponsored pension plans by the Center for Retirement Research revealed that assuming investment returns of 6%, the plans will run out of money by 2023 or 2025, depending on their framework.

Assuming an even more generous 8% investment return, the plans will run out of money in 2033 or 2041."

Should you take out your public pension funds and reinvest on your own?
Investment News
"The Ohio House of Representatives is weighing a slate of changes to the state's five public pension plans, including tying the cost-of-living-adjustment to the Consumer Price Index and capping it at 3%, instead of an automatic 3% increase.

Another part of the law would raise contributions by police officers and firefighters to 12%, from 10%, and raise the age at which employees could take their full pension to 52, from 48."

Although I retired at 60, it looks like today you should plan to work to 65 or 70, unless you've put aside other funds, as we had done. I don't regret a minute that I've had those 10 good years of activities and travel I enjoy--on the other hand, retirement is much more expensive than I imagined. I'm thankful I was able to sock away 15% in tax deferred plans, and for many years learned not to use my income which would have resulted in a more materialistic lifestyle.

Reed Krakoff set to hit fashion big-time after Michelle Obama carries $1,000 tote (and despite the price it's already sold out)

If a story looks really ridiculous, I run it through Snopes. I know. I know. Conservatives don't like this fact checking website because they say it's just a mom and pop outfit, but hey, I was a librarian for 25 years, and when I was checking facts, most of the time it was just me, by myself. Anyway, when I saw the story about Michelle Obama and the $1,000 handbag with a photo, I thought it was fake or photoshopped. First of all, it's an ugly, ugly bag,and second,it's teal and her shoes are blue. And this woman is giving "sacrifice" a bad name when she tells us to eat our carrots and she goes out for ribs. Could she really follow up that story with something this tacky? Don't know. I've always said her husband wasn't one of us, but I had hopes for her (by not one of us, I don't mean I'm a birther, because if his mother is an American, that's good enough for me).

Reed Krakoff set to hit fashion big-time after Michelle Obama carries $1,000 tote (and despite the price it's already sold out) | Mail Online

If you think this isn't a retirement story, look in your closet at all the funny looking bags you have. Or in the mirror--ha, ha.

In this case, sweating is a good sign

Recent work led by University of Iowa neuroscientist Natalie Denburg, Ph.D., suggests that for a significant number of older adults, measurable neuropsychological deficits do seem to lead to poor decision-making and an increased vulnerability to fraud. The findings also suggest that these individuals may experience disproportionate aging of a brain region critical for decision-making.

"Our research suggests that elders who fall prey to fraudulent advertising are not simply gullible, depressed, lonely or less intelligent. Rather, it is truly more of a medical or neurological problem," said Denburg, who is an assistant professor of neurology in the UI Roy J. and Lucille A. Carver College of Medicine. "Our work sheds new light on this problem and perhaps may lead to a way to identify people at risk of being deceived."

What I found interesting was that they can measure poor decision making and sweating--apparently, it's good to sweat the small stuff! "Good decision-makers display different anticipatory responses (amount of sweating) prior to a good or a bad choice, which appears to help them discriminate between the two options. In contrast, the older adults with poor decision-making abilities did not sweat more or less when deciding between a good or bad choice."

Link

Financial Health of the Cognitively Impaired May Be Forgotten

"The capacity to effectively manage one's finances is among the first things to go in individuals with emerging cognitive impairment, the authors note in their report. Patients with MCI may start by having trouble balancing their checkbook and paying bills; then, often within a year, they'll have trouble with more basic financial skills, such as counting coins and paying in cash.

"When a patient is diagnosed with MCI or mild dementia, the patient and family should be told that the patient's ability to manage their finances is going to decline probably relatively rapidly over the next couple of years," Dr. Widera said."

Financial Health of the Cognitively Impaired May Be Forgotten: Report

Save your brain--exercise!

"Exercise training increases size of hippocampus and improves memory, "
PNAS 2011 108 (7) 3017-3022; published ahead of print January 31, 2011

In the Proceedings of the National Academy of Sciences study, "scientists started with 120 elderly volunteers who were relatively inactive but did not have dementia. Half were randomly assigned to begin walking 40 minutes a day, three days a week for a year while the remainder only stretched and performed toning exercises for the same time period. After 12 months, the group that walked showed an average 2% growth in the hippocampus compared with when they began, while the control groups suffered a more than 1% shrinkage in the same region compared with when the study started.

“If you estimate the change at an individual level,” says study co-author Arthur Kramer of the University of Illinois, “a yearlong exercise program can turn back the clock about two years with respect to the volume of the hippocampus.” "

Read more: http://healthland.time.com/2011/01/31/want-to-improve-your-memory-take-a-walk/#ixzz1Euftky36

Boomers Find 401(k) Plans Come Up Short

You have to read to the midsection or botton to see why: many boomers started too late with too little. Vanguard now recommends 15% be set aside for retirement. Also, I'm not sure who came up with that idea that retirement life requires less than your working life. It's very expensive to do the things you waited all your life to do--or in my case, didn't know you wanted to do until you got there. And no, you can't retire early if you are paying off your kids college loans, got a divorce in mid-life, still have a mortgage, or you want to go out to eat a lot and travel more. Increase your savings, decrease your want list.

Boomers Find 401(k) Plans Come Up Short - WSJ.com

Healthy Lifestyles Related to Subsequent Prevalence of Age-Related Macular Degeneration

Another reason to exercise, not smoke, and eat all the colors, just like mother said. Age related macular degeneration might be reduced as much as 3-fold.

Archives of Ophthalmology -- Abstract: Healthy Lifestyles Related to Subsequent Prevalence of Age-Related Macular Degeneration, December 13, 2010, Mares et al. 0 (2010): archophthalmol.2010.314v1

Walking reduces Alzheimer's progression, 1.5-tesla MRI shows

"With the help of 1.5-tesla MRI, researchers at the University of Pittsburgh have found that walking 5 miles per week helps reduce the progression of mild cognitive impairment and Alzheimer's disease in adults already afflicted with the condition, according to a study presented today at the RSNA annual meeting.

The findings expand upon results of a previous study released last month, which found that walking at least 6 miles per week helped to preserve brain size and prevent the onset of dementia in healthy adults."

Read more here. Lethean Cottage: Walking reduces Alzheimer's progression, 1.5-tesla MRI shows

Blood test could diagnose Alzheimer’s disease, UT Southwestern researchers find | Science Blog

"A set of proteins found in blood serum shows promise as a sensitive and accurate way to diagnose Alzheimer’s disease, researchers at UT Southwestern Medical Center have found as part of a statewide study.

An analysis of the proteins, plus a clinical exam, proved 94 percent accurate in detecting suspected Alzheimer’s and 84 percent accurate in ruling it out in people without the disease, the researchers said."

Blood test could diagnose Alzheimer’s disease, UT Southwestern researchers find | Science Blog

A new category

One of my regular reads is JAMA (Journal of the American Medical Association), and today I discovered I'm in a new health category:

"community dwelling ambulatory older adult without a prior heart failure diagnosis."

I'm so pleased.

J&J Hip Replacement Lawsuits Given to One Judge - Bloomberg

Hip replacements are no fun. First there's the pain you tolerate for years until it's intolerable; then the decision; then the surgery; and finally the rehab, and the thought, "Why didn't I do this sooner?" Imagine having one recalled!

"All pretrial proceedings in federal lawsuits against Johnson & Johnson over recalled devices used in hip-replacement surgery will be overseen by a federal judge in Ohio, a judicial panel decided.

U.S. District Judge David A. Katz in federal court in Toledo will supervise evidence-gathering efforts in cases over the ASR XL Acetabular System, which J&J’s DePuy Orthopaedics unit recalled on Aug. 26 after the implants stopped functioning properly."

J&J Hip Replacement Lawsuits Given to One Judge - Bloomberg

No, I haven't had one, but I know many who have.

Health law cut some retirement costs, but retirees will still need big savings

Even though the new health reform law will reduce some health costs in retirement for many people, retirees will still need a significant amount of savings to cover their out-of-pocket health expenses when they retire, according to a report released by the nonpartisan Employee Benefit Research Institute (EBRI). Women in particular will need more savings than men because they tend to live longer.

For instance, EBRI finds that men retiring in this year (2010) at age 65 will need anywhere from $65,000–$109,000 in savings to cover health insurance premiums and out-of-pocket expenses in retirement if they want a 50–50 chance of being able to have enough money; to improve the odds to 90 percent, they’ll need between $124,000–$211,000.

Women retiring this year at 65 will need even more: between $88,000–$146,000 in savings if they are comfortable with a 50 percent chance of having enough money, and $143,000–$242,000 if they want a 90 percent chance.

These estimates are for Medicare beneficiaries age 65 and older: Anyone retiring early, before age 65, would need even more.

The new EBRI analysis details how much savings an individual or couple will need to cover Medicare and out-of-pocket health care expenses in retirement, updating earlier EBRI simulation results from 2008. Some prior estimates have been significantly revised downward as a result of changes to Medicare Part D (prescription drug) cost sharing that will be phased in by 2020 due to the recently enacted health reform law, the Patient Protection and Affordable Care Act (PPACA).

SOURCE: “Funding Savings Needed for Health Expenses for Persons Eligible for Medicare,” www.ebri.org.

Quality of death

The United Kingdom ranks number one in quality of death. Apparently, it's a few bricks short of a load in health care, but excels in death care. The Economist Intelligence Unit was commissioned by the Lien Foundation of Singapore, a philanthropic organization, to devise a ”Quality of Death” Index to rank countries according to their provision of end-of-life care. What makes up a "good death?" "The UK has led the way in terms of its hospice care network and statutory involvement in end-of-life care, and ranks top of 40 countries measured in the Index (see Figure 1). This is despite having a far-from-perfect healthcare system (indeed, it ranks 27th on the Basic End-of Life Healthcare Environment sub-category, which accounts for 20% of the overall score). But the UK is top in the Quality of End-of-Life Care sub-category, which includes indicators such as public awareness, training availability, access to pain killers and doctor- patient transparency (and accounts for 40% of the overall score)." The link is for the summary, but there is a white paper available.

EIU.com

Clean restrooms

If it's one thing we retired people appreciate, it's clean restrooms, right? Something in our anatomy means we need the facilities more often, and being retired, we travel more than before, so we're often gazing at something growing, or going.


The loveliest public facility on an interstate just has to be Salt Kettle in Illinois, between Danville and Champaign-Urbana. It's a place you can look forward to--worth crossing your leg for 'til you get there. The photo (taken from Google) doesn't show the setting. It probably wouldn't get a Golden Plunger award, however, the setting is worth not getting back in the car so quickly and taking off. There are a lovely pond, wonderful trees, and many birds and wildlife.

The modern version of an old song

An e-mail said Julie Andrews performed this for AARP, "My Favourite Things" from the legendary movie "The Sound Of Music." Here are the actual lyrics she used:

Maalox and nose drops and needles for knitting,
Walkers and handrails and new dental fittings,
Bundles of magazines tied up in string,
These are a few of my favourite things.

Cadillac's and cataracts, and hearing aids and glasses,
Polident and Fixodent and false teeth in glasses,
Pacemakers, golf carts and porches with swings,
These are a few of my favourite things..

When the pipes leak, When the bones creak,
When the knees go bad,
I simply remember my favourite things,
And then I don't feel so bad.

Hot tea and crumpets and corn pads for bunions,
No spicy hot food or food cooked with onions,
Bathrobes and heating pads and hot meals they bring,
These are a few of my favourite things.

Back pains, confused brains, and no need for sinnin',
Thin bones and fractures and hair that is thinnin',
And we won't mention our short, shrunken frames,
When we remember our favourite things.

When the joints ache, When the hips break,
When the eyes grow dim,
Then I remember the great life I've had,
And then I don't feel so bad.

B vitamins slow brain shrinkage

Just in time. Not a minute too soon.

"Results from the double-blind controlled trial, published in the journal Public Library of Science One, revealed the annual rate of brain atrophy in subjects who took B vitamins was almost 30 per cent less than those on a placebo. Researchers involved in the 24-month trial believe the findings may be the first step in finding a way to delay the onset of Alzheimer’s."

B vitamins slow brain shrinkage - Pharmacy News

"Homocysteine-Lowering by B Vitamins Slows the Rate of Accelerated Brain Atrophy in Mild Cognitive Impairment: A Randomized Controlled Trial," A David Smith, Stephen M Smith, Celeste A de Jager, Philippa Whitbread, Carole Johnston, Grzegorz Agacinski, Abderrahim Oulhaj, Kevin M Bradley, Robin Jacoby, Helga Refsum

PLoS ONE: Research Article, published 08 Sep 2010, 10.1371/journal.pone.0012244

Easy to follow check list for estate planning and paper trail

This March 24 article in the NYT is a good reminder. It covers wills and trusts; beneficiaries; health care proxies and guardianship; titling of assets; non-marriage relationships; and perhaps most important, finding the documents when you're gone.

Paper Trail

I'll take what they're having

Congress has wonderful health care--they have choices. Lots of them. Apparently, that works for them.

The current US senate turns out to be the oldest on average of any senate in history. It makes a good selling point for young challengers, but it’s really a side effect of increasing longevity. The Senate Historical Office reports that the average age of senators at the start of this, the 111th congress, was 62.7 years. The average in the first congress, over 200 years ago, was a mere 47. Blog, Prospect Magazine

"As soon as members of Congress are sworn in, they may participate in the Federal Employees Health Benefits Program (FEHBP). The program offers an assortment of health plans from which to choose, including fee-for-service, point-of-service, and health maintenance organizations (HMOs). In addition, Congress members can also insure their spouses and their dependents. . ."

Read more at Suite101: Health Care for U.S. Congress: Politicians Receive the Country’s Best Care - at Taxpayers' Expense

Here come the Boomers

"By 2029, all of the baby boomers (those born in the post World War II period 1946–1964) will be age 65 years and over (1). As a result, the population age 65–74 years will increase from 6% to 10% of the total population between 2006 and 2030 (data table for Figure 1). As the baby boomers age, the population 75 years of age and over will rise from 6% in 2006 to 9% of the population by 2030 and continue to grow to 12% in 2050. By 2040, the population age 75 years and over will exceed the population 65–74 years of age." Health, United States, 2008 Chartbook section

Heard you were retiring

Dear Cousins,

I see by your Christmas cards and letters of 2008 and 2009, that you both have retirement plans--now or soon. Congratulations if that has actually happened. I retired in 2000 and have really enjoyed it. I’m doing a lot of things I had on my PEP list (post employment plan), but the most time consuming, blogging, wasn’t around then. I’ve been a blogger since 2003, and now have 12 blogs. I’m out of control, obviously. But writing and writing workshops were on my list.

My biggest worry about retirement (other than money, of course) was that I had no hobbies. Like my dad in that respect. And we have no grandchildren, which seems to take up the time of most of our friends. But, time certainly hasn’t been a problem. About a year before I retired, I kept a note book in my purse and jotted down things from the local paper that looked interesting. Then, being a librarian, I organized them, and guess what? Everything I liked to do as child floated to the top: writing, drawing/art, reading/research and animals! Whoddathunkit? One of the very last things on this list was “bird watching,” and my colleagues had even given me binoculars for a retirement gift in 2000 when they saw it. But this past summer at Lakeside I joined the bird watching group and volunteered for the Midwest Bird Symposium in September and just loved it. Boy--are those folks committed!!

Together we started an art ministry at our Lutheran church, and I just finished up 10 years with that, but he’s stayed with it. I did take a few years of art lessons, and do participate in art classes during the summer, but that’s been pretty slow. I’m a better artist than most people who try it, but not good enough to suit me! He paints much more than I do, and sold 11 paintings last year.

We have traveled much more than I ever imagined--we go with U. of I. Alumni groups when we can because of the educational component, but have done some on our own too, like an Alaska cruise, Amtrak to California and back, Finland and Russia, and local U.S. stuff with some architects.

Finding a good balance for volunteering hasn’t been easy. I do quite a bit at the church, and served lunch at the senior center and used to visit nursing homes, but I tend to be somewhat of a loner--not much into committees, task forces and groups. So I help out where I can--I don’t think God is keeping a check list of approved agencies--plus, laws are so strict now on what volunteers can do. Just keep a casserole in the freezer, and take it out when needed. No license needed to be neighborly.

I also joined a book club--so I am forced to read fiction, which I rarely did before, although we do all types. I visited a horse show which was on my list, but only one. Those are expensive, but I did get to pet some noses. Genealogy--I’m a dabbler. I need the names and dates of your grandchildren for the database.

So let me know how it’s going--you can always catch up with me at my blog http://collectingmythoughts.blogspot.com

The halt and the lame

Today we were communion servers at first service (8:15). I try to be presentable--those parts that show. We wear neck to ankle white robes with a tie belt. I don't wear open toe shoes or sandals, because people are at the communion rail looking down--just about 2' from my shoes. I make sure my fingernails are clean and manicured, nails trimmed. Not much perfume or cologne. OK.

Friday night we were both injured. On our hands. I was getting ready for bed and somehow, while removing a piece of underwear, something that had both elastic and a little metal slider slipped lose and smacked the knuckle of the middle finger left hand. Ow, that hurt. Then I looked at it and within seconds it began to swell and turn blue. Must have been some sort of delicate blood vessel close to the surface. But I turned on the TV and climbed into bed. It was warm on Friday and I was enjoying having the windows open, perhaps for the last time of the season, listening to the insects and the train whistle in the distance. My husband came in the room and in the dark began to bring the storm window down. I asked him not to, but he insisted it was going to get cold. What's the temperature, I asked. 72. Please leave it up, I'm enjoying it--it's NOT cold. Just then the half raised very heavy storm fell on the tip of his middle finger. He screamed and writhed on the floor. I thought I might have to call the squad. For all I knew his finger could have been out on the patio! (It was dark.) Blood was squirting, I kid you not. He rushed into the bathroom and rinsed it while I searched for a band-aid. He's OK, but couldn't paint yesterday and is wearing a band-aid to protect it.

Today the bruised (my finger is purple) and bandaged Bruces offered the blood and body of our Lord and Savior Jesus Christ to other clumsy but redeemed sinners.

You need really deep roots

during this time of life.

Wednesday afternoon at Lakeside on Lake Erie I attended a lecture about trees. The speaker told about the importance of a lot of water early in their growth; about the wrong way to mulch (volcano instead of donut--the roots will girdle the tree and strangle it); the danger locally of the Emerald ash borer; how to prune; invasive species (Norway Maple, Tree of Heaven); and the problem of the silver Maple. Our speaker said they grow fast, but their life expectancy is about the same as a human. Also, they require a lot of care. One specie I wasn't familiar with was the Chinkapin Oak, or Chinquapen. He said the leaf was similar to a chestnut and that it was urban tree of the year.

However, Thursday evening we had a terrific wind storm in southern Michigan and northwestern Ohio, and we lost power--some for several hours, others for 2 days. When I walked around the grouds, I saw many damaged and fallen trees, a number were silver Maples. One huge tree on the lakefront had fallen on another and sheared limbs off of that one. At 2nd and Plum at that park, it looked like another fallen silver Maple.

But up on 7th street (7 blocks from the lake) a saw a huge tree had fallen in the yard of the old Danbury school (now boarded up). The root circumferance was huge, maybe 7 or 8 ft., sheared off almost at ground level, but the depth of the roots was very shallow because it was growing on rocks. There have been quarries around here even before the town. Trees perhaps are like people. You can get so far, but if the wind really starts to blow, you'd better hope your roots of faith go really deep. I brought a leaf home; I think it is a Chinkapin Oak.

Aging in Place

The Kiplinger Connection at AIArchitect says:

Lifestyle Trends

Remember when retirees headed in droves to the Sun Belt? No more.

Recent retirees seem to prefer aging in place, caring less about the weather and more about staying in their homes, close to their friends, family and community. City dwellers are also reluctant to give up cultural and entertainment opportunities. Overall migration from large cities fell on average by over 40% from 2007 to 2008. The recession is likely to compound the trend, but it’s far from the biggest factor.

The change presents problems for cities and states in some regions. Many aren’t equipped to provide the housing and services that older people need. Look for a realignment when the economy picks up, creating business opportunities from retrofitting homes so they’re senior friendly, to leisure and health care services.

Do you suppose it was all those hurricanes?

Exercise is important

In the 1980s I took a Jackie Sorenson Aerobics class. Eventually, I lost 20 pounds and really was in the best condition of my life. Here's a photo of my friend Nancy and me (I'm on the right) when the class was doing a Blues Brothers routine. We're not sure, but we think it is 1986.


I had to lose that same 20 pounds again in 1993, the late 90s, and again in 2006. Seems to want to hang around. Doesn't come off as easy as it used to.

Four Pensions

I talked to a retiree today who is having no problem in "this economy." He and his wife between them have four pensions--two social security and two defined benefit programs. Of course, those benefits are invested in the stock market, so he'd better pay attention. Or maybe not--he'll sleep better. He says they live on one pension and save the other three. Their home has been paid for for years. He drives a Prius and loves it. Their other car is a 1996 something with under 70,000 miles.

Good news for coffee drinkers

"Midlife Coffee and Tea Drinking and the Risk of Late-Life Dementia: A Population-based CAIDE Study." Marjo H. Eskelinen, Tiia Ngandu, Jaakko Tuomilehto, Hilkka Soininen, Miia Kivipelto. Journal of Alzheimer's Disease, Vol 16, No 1, January 2009 (in press). Link.

Abstract: Caffeine stimulates central nervous system on a short term. However, the long-term impact of caffeine on cognition remains unclear. We aimed to study the association between coffee and/or tea consumption at midlife and dementia/Alzheimer's disease (AD) risk in late-life. Participants of the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study were randomly selected from the survivors of a population-based cohorts previously surveyed within the North Karelia Project and the FINMONICA study in 1972, 1977, 1982 or 1987 (midlife visit). After an average follow-up of 21 years, 1409 individuals (71%) aged 65 to 79 completed the re-examination in 1998. A total of 61 cases were identified as demented (48 with AD). Coffee drinkers at midlife had lower risk of dementia and AD later in life compared with those drinking no or only little coffee adjusted for demographic, lifestyle and vascular factors, apolipoprotein E ε4 allele and depressive symptoms. The lowest risk (65% decreased) was found in people who drank 3-5 cups per day. Tea drinking was relatively uncommon and was not associated with dementia/AD. Coffee drinking at midlife is associated with a decreased risk of dementia/AD later in life. This finding might open possibilities for prevention of dementia/AD.

Happiness

If in your domestic life you would be supremely happy you must not forget the old adage: "The husband must not see and the wife must be blind." The Gospel Messenger, December 18, 1888.

New Year's Problem Solving

The only item that applied to me in the New Year's Day "How to fix your life in 2009" article in the Wall Street Journal was this one. And many retirees need to be on the alert--especially if you live in the the mid-west.

Problem: You work indoors, live in a cold climate and wear sunscreen to protect your skin -- and you wonder if you're getting enough vitamin D.

Solution: Have your vitamin D level checked. Experts think many people aren't getting enough these days, and that can put you at higher risk for a variety of problems, including osteoporosis, heart attacks, high blood pressure, multiple sclerosis, macular degeneration, mental illness, chronic pain and many cancers. Your doctor can check your D level with a blood test, which costs about $100 and is usually covered by insurance. Make sure the test measures 25-hydroxyvitamin D, not 1, 25-dihydroxyvitamin D. A concentration of less than 20 nanograms per milliliter is considered deficient, and more than 30 npm is healthier.

If you are low, you can boost your level with inexpensive supplements. Current U.S. guidelines call for 200 international units per day from birth through age 50; 400 IUs from 51 through 70 and 600 IUs from age 71 on. Many medical organizations now think that's too low. The American Academy of Pediatrics says children should have 400 IUs a day, and the National Osteroporsis Foundation thinks adults over age 50 should have at least 800 to 1,000.

In most of the U.S., being in the sun for at least 20 minutes a day can boost your D level nicely but also raise your risk of developing skin cancer.

—Melinda Beck

I was tested for Vit. D levels about 2 years ago as part of my annual exam, and must say, I failed miserably. I'd never heard of "low vit. D" but my wonderful internist, Dr. Bill Wulf is always ahead of me.

Double whammy if you're 70 and a half

President Bush has signed legislation that will temporarily suspend the penalty for seniors who fail to take the required minimum distribution from IRA and employer retirement accounts in 2009, but you’ll still need to do the required distribution for 2008--and that’s based on your fund balance at the end of 2007. Not good, folks, not good. Imagine this (and I know you can with little trouble). Congress just had to rush through that horrendous September bailout which was supposed to create more credit from banks so they could help business. At least, that’s the way we were told it would work. But so far, all that’s happened is a run on the government for more bailouts, from the auto industry to universities to home builders. And the lending institutions have continued to give their year end bonuses and perks. But those mental midgets we elected just couldn’t figure out a way to rush through a plan to change the wording in the 2008 requirement--the year a lot of us lost 40-50% of the value of our accounts. How tough would it have been to change 70.5 to 71.5 or 72.5? I'm not sure this is the best source, but I'm going with it now because it doesn't require registration. Full text of HR 7327 here, but use your "find" command (control F) with the word "retirement" to get to the correct section.

Wants not needs

Christmas is a tough time for us retirees. The kids, spouse, sister/brother, buddy asks, What do you want for Christmas, and you can't think of a thing. I've been married 48 years, I'm 69, and if there's anything I need or want it's usually pretty small (Clariton, new pair of hose, mittens) I just buy it. But just let me walk through Macy's at the before 1 p.m. sale on a Friday, and all of a sudden, I'm standing at the "Take another 50% off" sale rack. It's not that I believe the "originally was" tag--clothes are never that. But when it's new and costs less than I could get it at a resale shop (my favorite is Discovery cancer shop here in Columbus), I do stop and push around the merchandise. Yesterday I bought this little jacket--full of bright colors and patterns--with western detailing and metal buttons. Not me, but $9, from the "original" $58, and I'm as big a sucker as the next mama.

Media hype wrong again

Cross posted at Collecting my Thoughts

So much for all the gloom, doom and disaster the media were promoting. Who are their sources? The people went out on Black Friday and increased spending by 3% over last year. And for once I'm glad. The jobs they saved may be their neighbors or their own. Now we'll get all the qualifying stories from the journalists and consultants who got it wrong. The "yes, but," excuses.

Anyone in retirement years can see we're heading for a bad time, just open your latest statement. It's not like 2004 when the Kerry/Edwards campaign continually bad mouthed the economy for over a year, Bush, new jobs, etc. and the media chimed right in. It's not 2006 when the Democrats took over Congress by campaigning on the bad economy (that wasn't) and then rode it into the ditch by making no corrections the president wanted. The week after the 2004 election it was all good economic news again. Because we don't have time for it turn around like it did in the late 80s, and the late 90s and after 9/11, it's going to be a challenge for retirees--especially if they don't fix that 70.5 age for drawing down IRAs based on Dec. 31, 2007 balances. People my age didn't grow up expecting everything, so we are probably better off than the younger boomers who thought life would always be a bigger house, or a new leased car every other year, or a vacation in Aruba.

Does Retirement Kill You? No.

Didn't think so. All the retirees I know are too busy to die. Now, retirement accounts. That's another matter.

Abstract:
The magnitude of the effect that health has on the retirement decision has long been studied. We examine the reverse relationship, whether or not retirement has a direct impact on later-life health. In order to identify the causal relationship, we use unexpected early retirement window offers to instrument for retirement behavior. They are legally required to be unrelated to the baseline health of the individual, and are significant predictors of retirement. We find that there is no negative effect of early retirement on men's health, and if anything, a temporary increase in self-reported health and improvements in health of highly educated workers. While this is consistent with previous literature using Social Security ages as instruments, we also find some evidence that anticipation of retirement might also be important, and might bias the previous estimates towards zero.

"Does Retirement Kill You? Evidence from Early Retirement Windows"
by Norma B. Coe, Maarten Lindeboom
(November 2008) IZA DP No. 3817

Cross posted at Collecting My Thoughts

Think Again Grants

I saw an article in the Columbus Dispatch that Columbus State has $3 million in grants for older, new students but can't find them. Columbus State, which was just a tiny, little thing when we moved here now has 24,000 students. The $1,000 grant is for tuition, for a new (or almost new) student taking at least 6 hours, spread over 3 quarters. Maybe now is the time for you to think about taking that college credit class?

What's wrong with this picture?

Reading through this LA Times article, you see that the current down turn is not the problem. These retirees had too much debt and were taking too much risk. All bubbles burst. There were recessions in 1973-75, 1981-82, 1990-91, and I personally know what was happening to my investments in 1999, and we know what happened after 9/11. So why does any retiree think the next 20 or 30 years will be different than the past?

“Three refinancings have left Dale Campbell and his wife owing $485,000 -- more than their Whittier home is worth. The interest rate on their mortgage is due to reset in November, and the payments will more than double to $3,800 a month. The 77-year-old retired truck driver figures it's just a matter of time before the bank sends the couple packing.

"We don't want to leave here, but we can't afford the payments," said Campbell, who spent the proceeds from the refinancings on home improvements.

The Campbells aren't alone. Homeowners ages 50 and over account for an estimated 28% of all delinquencies and foreclosures in the current crisis, according to a report released last week by AARP, the nation's leading senior citizens lobby. That translates into 684,000 older people who have lost their homes or are in danger of losing them. Many experts believe there are a lot more on the way.

The bad news doesn't end there. A separate AARP study found that, over the last decade and half, Americans 55 and older have experienced the sharpest increase in bankruptcy filings than any other age group, accounting for nearly a quarter of all filers last year.

Los Angeles bankruptcy attorney Scott Bovitz has noticed the graying of his clientele.

"In prior years, it was rare for me to hear from a grandma," he said. "Now we're talking to people 55 and older every day." "
The golden years have lost their glow

Testosterone therapy for men

Testosterone therapy: Can it help older men feel young again? According to MayoClinic.com (one of the Mayo Clinic's three main Web sites which provide health information and tools) the jury is still out on testosterone therapy for older men.

What are the risks of testosterone therapy?

Not enough study has been done to determine the risks of testosterone therapy in men with normal testosterone levels. In theory, a higher than normal testosterone level could increase a man's risk of prostate cancer or an enlarged prostate (benign prostatic hyperplasia). But studies haven't determined whether testosterone therapy could cause these complications.

Studies show testosterone therapy can cause sleep apnea in some men. This condition causes you to continually start and stop breathing as you sleep. Testosterone therapy may also cause your body to make too many red blood cells (polycythemia), which can increase your risk of heart disease.

Consider the list of pros and cons when evaluating testosterone therapy that are included in the article.

Arthritis and exercise

It may seem counterintuitive, but a recent study confirms that people with osteoarthritis can improve mobility and enhance their quality of life with modest levels of exercise. Take a look at the summary at the Johns Hopkins Health Alert Good News about Exercise and Arthritis

No senior discount here

There are some retirement places, like this one in Plano, Texas, where folks aren't worried about senior discounts or flat stock accounts.

Song of the Other Sister

Glucosamine chondroitin
maybe some ibuprofen
Viactiv with calcium
fish oil and Senior Centrum.

Ohioans need some D,
build those bones for all to see;
Stretch and bend, wear socks and shoes,
Take a walk after the news.

Breathe deeply, now in and out,
wave to your friends give a shout,
life is good we can't complain,
but we'd settle for less pain.

Summer poem

Bikes and grass and summer things
Tea with ice, a thought that clings--
Yellow roses, gray blue eyes,
Summer romance--a young girl's sighs.
Hot rod cars, loud and steamy,
Didn't we think they were so dreamy?
Now we smile and say good-bye,
while watching rain clouds in the sky.

Glucosamine chondroitin

On my last check up I mentioned to my doctor that I've developed some hip pain, that goes away within a few minutes after moving around. "Arthritis," he said, and suggested I try Glucosamine chondroitin.

"Osteoarthritis is the most common form of arthritis in the United States and has a major effect on the health-related quality of life. In 2004, the estimated direct and indirect medical costs associated with all forms of arthritis exceeded $86 billion. Glucosamine and chondroitin sulfate are the most widely used dietary supplements for osteoarthritis, with estimated sales in 2004 approaching $730 million."

This study looked at its use, but decided stricter standards were needed before a final decision could be made.

Time to Talk campaign

The National Center for Complementary and Alternative Medicine (NCCAM), part of the National Institutes of Health (NIH), has launched Time to Talk, an educational campaign to encourage patients—particularly those age 50 or older—and their health care providers to openly discuss the use of complementary and alternative medicine (CAM). CAM is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine, such as herbal supplements, meditation, naturopathy, and acupuncture. Read more

Fat grandmothers

I had none. I'm so fortunate that I had both my paternal and maternal grandparents in my life, and my great-grandparents lived just a few doors away when I was very young. My grandmothers weren't fat, or even plump or curvy. If your grandmother is a member of my generation, you probably can't say that.

Today I was reading "Aging, adiposity, and calorie restriction," by Luigi Fontana and Samuel Klein in the March 7, 2007 JAMA. It's a very cautious and conservative review of the literature from 1966 through December 2006 in PubMed (the largest and most famous medical literature database) which concludes from all the studies done on calorie restriction in the last 40 years that calorie restriction in adult men and women causes beneficial metabolic, hormonal, and functional changes, but (and here's the cautious part) the precise amount of calorie intake or body fat mass associated with optimal health and longevity in humans is not known. And after laying out all this fabulous research (139 citations), the authors take a buy-out and decide that because calorie restriction is difficult to maintain long-term, we might have to turn to a pharmacological agent for a solution. Cha-ching. There's no money in eating less, moving more.

That's what got me thinking about my grandmothers, both of whom lived to their late 80s. One was born in 1876 and the other in 1895, young enough to be the other's daughter (my great grandmother was born in 1873), a time when life expectancy at birth was about 45. Their generations benefited from better hygiene, but I doubt that either ever had a vaccination. It's possible that very late in life they might have had an antibiotic. I don't know much about their early lives, but given the times, I'm sure they were both breast fed by non-smoking mothers. They didn't give birth in hospitals. They both lived their childhood and early married life on farms a few miles from each other, but didn't work in the fields. Housework, however, was much more physical in those days. I use Grandma Mary's pressing irons as book-ends--they were heated on the cookstove and weigh 10-15 lbs. Water was pumped outside and carried in to be heated either in the stove or on it. Grandma Mary was wealthier than Grandma Bessie and did have a German woman as household help, but they would've worked side by side. And both gardened (potatoes, carrots, cabbage, tomatoes, beans, turnips) and raised chickens for meat and eggs. Root crops could be stored, and beans and tomatoes were canned for winter, but table fare was pretty bland and boring. Both women baked their own bread. Beef was not on the table in either household. Grandma Mary rarely served meat, except chicken occasionally, and Grandma Bessie would have only had fatty pork, sausage, or a tough old chicken, too old to lay. Cows were for milk (cash crop) and butter (for cooking), and when you think about it, they were much more difficult to butcher for a single family than a pig or chicken. There wasn't even much in the way of fruit, maybe a few apples, grapes for juice or berries.

According to the authors, the first calorie restriction study was done in 1935 when it was discovered that limiting calories in lab rats increased their life span by 30-60%. Food shortages during WWII in some European countries were associated with a sharp decrease in coronary heart disease, and although this article didn't mention it, I've seen reports like that on breast cancer. Again, the authors use cautious language, but say "population studies suggest that lifestyle factors, such as sedentary lifestyle, dietary intake, and adiposity, are responsible for up to 70% of chronic disease and are a major contributor to reduced longevity. . . data suggest that a BMI at the low end of normal (18.5-24.9) is associated with optimal metabolic and cardiovascular health."

Cross posted at Collecting My Thoughts.

Reduce need for drugs with massage

The Wall St. Journal on March 10 had an article about the Providence Rest nursing home which caters to retired nuns. A licensed massage therapist has cut the home's use of antipsychotic drugs for agitated patients from 30% down to 2 or 3%. Read the story here.

Don't forget your nap

Retirees can enjoy the health benefits of a nap. I was browsing my sign-in at JAMA and the archives today, and noticed this at Arch Intern Med. 2007;167:296-301, "Siesta in Healthy Adults and Coronary Mortality in the General Population." They don't have much evidence for women because very few died during the study, but for men it is clear: the habit of a regular mid-day nap lengthens their lives.

How this study was done: This study involved 23,681 men and women in Greece between the ages of 20 and 86 who volunteered to take part in the European Prospective Investigation into Cancer and Nutrition (EPIC). All those in the study were asked whether they took a midday nap and, if so, how long they napped. They were divided into groups: those who never napped, those who took naps of 30 minutes or more at least three times per week and those who took midday naps occasionally or whose naps lasted less than 30 minutes. The researchers also asked about their levels of activity and diet. The study excluded those who had previously had heart disease, stroke or cancer.

What was found: Of those in the study, 792 died, and 133 of those died of heart disease. The researchers found that the risk of dying from heart disease was 37 percent lower for those who took naps of 30 minutes or more at least three times a week than for those who took no naps. Occasional napping did not have an effect on the risk of dying from heart disease. It appeared that the effect of napping was stronger in men, and in particular, men who worked. The authors said that findings are consistent with the fact that occupational stress can increase heart disease risk. Summary

Five Healthly Resolutions for Women

Five Healthy Resolutions for Women appeared at WebMD. I've added my own comments, and not lifted large sections to post, so pop on over and read the whole article. We've heard it all before, but January 2008 is a good time to renew your resolves of 2007.

Eat, but don’t pig out. All or nothing approach will kill your resolution. When I lost 20 lbs. a year ago, I had a list of things I would avoid, like French fries and cheese, but I allowed myself my favorite restaurant meal on Friday nights--Philly Cheese steak with Fries--which had just about everything on the list!

Jump outside the box. Most workout intentions fall by the wayside by February. Like the diet, don’t be unrealistic. If you hate exercise or you aren’t athletic (like me), you won’t get there by resolving to be different. It’s just you. Park further away. Take the stairs. Take dance lessons. Volunteer to walk a neighbor’s dog. Wear a pedometer.

Guard against the bone thief. Women and osteoporosis. For postmenopausal women 1,000-1,500 milligrams daily if on menopausal hormone therapy. Exercise helps the bones too, as does good nutrition. Smoking and alcohol have to be watched too. To paraphrase Ben Stein, nothing you overindulge in when you're young is worth being disabled or an invalid when you're older.

Get an A+ in taking health exams. Mammogram. Bone density. Pap smear. The colonoscopy is the only exam we have that actually can prevent cancer--find a polyp and have it removed before it causes trouble all during the exam. Colon cancer is so nasty--and so preventable.

Take care of the caregiver. Stress can really lower your immune system. Moms and daughters seem to always be looking out for someone else. Take the time to assess your situation. Who'll take care of everyone else if you're laid up?

Besdine's Boomers

Dr. Richard Besdine uses the mnemonic "Besdine's Boomers" to remember these mid-life strategies for healthy aging.

Blood pressure -- get screened at least once a year and treat appropriately if high
Exercise -- keep the mind and body as vigorously active as possible
Smoking -- stop as soon as you can; the benefits accrue immediately
Driving -- have a physician evaluate you for driving risk
Immunizations -- get a flu shot every year and a pneumococcal vaccine once
Nutrition -- proper nutrition is critical, especially for cardiovascular health
Environment -- keep your home environment safe with smoke and carbon monoxide detectors; get rid of toxic substances under the sink
Screen for cancer regularly -- Colon cancer screening as recommended by your physician; skin should be evaluated by a physician once a year; for women a mammogram annually and a pap smear as recommended by your physician

Booze -- avoid excessive alcohol; alcohol and smoking accelerate bone loss
Osteoporosis -- women and men should get a minimum of 1500 mg. calcium a day; one-quarter of all hip fractures in the elderly occur in men
Oral health -- healthy teeth and good dentures are important for proper eating; see your dentist annually
Mobility -- stay as active as possible
Emotional health -- too little attention is paid to stress reduction in old age, when events such as the loss of work and the death of friends and spouses can cause stress and emotional upheaval
Rx drug safety -- beware of taking outdated and conflicting medicines
Social Networks -- important for stress reduction and overall emotional health

Richard W. Besdine, M.D.
Professor of Medicine and Director,
University of Connecticut Center on Aging,
University of Connecticut Health Center

Seen at Alliance for Aging Research

Unbelievably good deals

This is a terrific little reference book. "Unbelievably good deals and great adventures that you absolutely can't get unless you're over 50" by Joan Rattner Heilman, 2007-2008 edition, McGraw Hill, 2007, will set you to dreaming about what you're going to do with all that free time when you are retired. There are 19 chapters on travel, education, sports, shopping, etc. Chapters 2-12 actually deal in some way with travel--lodging or airfares, tours, cutting costs, etc. This author doesn't want you to pay sticker price for anything. Always ask about a senior discount.

If you are a single man over age 45 and a great dancer, consider being a "host". You can cruise for (almost) free, working 3-4 hours a day. All you have to do is not get romantically involved with any of the passengers.

This summer at Lakeside I met a kite-flying teacher who was wildly enthusiastic about the Evergreen bed and breakfast club, which is featured in this book. It's for people over 50, has 3,500 members and 2,000 host locations. A couple pays $15 for each overnight stay. The club dues are $60 (single) and $75 (couple). Check www.evergreenclub.com.

Recommended automobiles

Jonathan Welsh of the WSJ recommends the following cars if you've had a knee replacement: 4 door Ford 500 (Taurus), Chevrolet Impala, Buick Lucerne and Dodge Charger or Chrysler 300. Can't imagine trying to get into a Charger with bad or stiff knees.

More stuff, more stress

A few years ago, a well-heeled girlfriend told me that her 80-something mother was living in a tiny trailer in Arizona with a minimum amount of furnishings. She'd told her family, "When I die, just push it over the cliff." She wasn't poor; but she'd learned what most of us do after awhile--your possessions own you, not the other way around. In an article, about "Stressed out Moms" Ingrid Schlueter writes,

One factor seems to be expectations going into marriage. Newlyweds of my parents’ generation had very modest expectations financially. My parents started out in a basement apartment in Des Moines, Iowa that didn’t have much in the way of amenities. They graduated to a studio apartment later and then to a three bedroom flat where my brother, sister and I spent our early childhood years. From there it was a very simple, three-bedroom Milwaukee bungalow. No family room, one bathroom, old, basic kitchen and bath. The carpet when we moved in was the original and that goes for the linoleum as well. Mom made it all comfortable and homey, and we kids didn’t know that we lacked a thing. That’s where my parents lived until I was married.

Today, few newlyweds start out this way. Home ownership is seen as essential for many, even if it requires both husband and wife to work outside the home. It’s a dangerous way to begin because once the couple starts relying on two incomes to live, it is very hard to stop when a baby comes. Then the couple begins the stressed out years of trying to find and pay for exorbitant childcare, while strangers get the privilege of caring for their baby. Add a couple more children to the picture, and you have a lot of outgo for that same two-income couple and the race to meet all the demands begins."

That's exactly the same thing our Irish bus driver John (50 and the father of 5) said about the younger Irish generation setting up homes and getting mortgages. It's not a local problem. [See my Ireland trip log]

Cross posted from Collecting My Thoughts

Adorable baby gifts

If I had to buy a baby gift, here's where I'd go on the internet.

Thirty years ago

Thirty years ago I would have never dreamed that topics like retirement, 401-k plans, osteoporosis, nutrition or exercise could become so interesting. My reading tastes have changed completely--in fact, on Thursday I think I'll tell you 13 things about JAMA.

Cross posted from Collecting My Thoughts.

Saved by a case of poison ivy

We've known each other about 40 years--were neighbors when we were both apartment dwellers in 1967. At an art show this morning she told me she'd had a cervical something-ectomy, didn't get the exact term. She's an avid tennis player, but had called her doctor for some poison ivy treatment, and in passing mentioned that she had a tingling in her neck--sort of felt like little bugs crawling around. He told her he would schedule an MRI, which sort of surprised her. Well, she had bone spurs on her spine, but had felt no pain except the tingling. One wrong move on the tennis court or a fall, and she might have been paralyzed. She immediately had the surgery and was recuperating most of last summer. Now she has two small rods supporting her neck, but everything is fine, and she's back to making her art work and playing tennis.

I looked up "bone spurs + tingling + neck" and learned that, "In persons 60 and older, bone spurs are common. Only a little more than 40% of the population will develop symptoms that require medical treatment as a result of bone spurs." She really had no significant pain. Pay attention to those tingles, and Thank God for poison ivy!

Sex and the sixty year old

The February 14 issue of JAMA has an article on the sexual difficulties of a 60 year old woman, just in time for Valentine's Day, but I didn't see it until April 1. It seems that Ms. B has diabetes, hypertension, hyperlipidemia, and asthma now, and when she was younger she had endometriosis, bladder suspension surgery for incontinence and a hysterectomy for uterine fibroids. As might be expected, she takes a lot of medication, has back pain, and is allergic to some of her meds. She doesn't smoke or drink, and works as a psychologist. Oh yes, she didn't go through menopause until 58, so she dates her complaints to decreased desire and less stimulating sex to that. The author isn't specific, but says Ms. B. has some "body image" issues. One of the comments about obesity and sexual issue made me suspect that might be the problem.

I would be out of the mood just listing her health problems, so I can imagine trying to live with them. The article lists all sorts of reasons for sexual dysfunction and what life style or medical changes can be made. However, I found the very last paragraph quite instructive--almost humorous.

PHYSICIAN: How should I bill for a sexual health consultation in order to be reimbursed?
DR. POTTER: . . . Examples of reimbursable ICD-10 diagnoses include: lack or loss of sexual desire (F52.0), failure of genital response (F52.2), menopausal and female climacteric states (N95.1), postmenopausal atrophic vaginitis (N95.2), dyspareunia (N94.1), and orgasmic dysfunction (F52.3).

There are 122 references in the bibliography.

The old to extremely old ratio

There's a proposal to reexamine the health care of the elderly, and not so elderly. It used to be that there were a lot of people in their 50s and 60s to help care for those in their 80s and 90s. For instance, my parents were in their 50s when my mother's parents died, and 70s when my father's died. They were there for errands to the doctor, taking in food, helping with home chores, taking them to church, supervising medications, and visiting them for companionship. And they had brothers and sisters, cousins, nieces, nephews and grandchildren also available. People today are living longer (although in my family we always had people living into at least their 80s it seems in every generation), having children later or none at all, and when they do have families, they are smaller. This will have an impact as the boomers age.

"They estimate that in Switzerland, the oldest old support ratio has fallen from 139.7 in 1890 to 13.4 in 2003. They predict that these oldest old support ratios will decrease to 3.5 in Switzerland and 4.1 in the US by 2050." Seen at Medscape.com

Late in life divorce

"One woman in her eighties, married for fifty-three years, woke up after transplant surgery and announced to her husband: 'I don't know how many years I have left, but I do know I don't want to spend them with you.' "

That's probably a bit drastic but Calling it Quits author Deirdre Bair says it's happening. And often it's the ladies making the move.

New treatment for wrinkles

Possibly you were too busy over the holidays developing wrinkles while buying gifts and anticipating bills to notice that the FDA has approved a new treatment for those deep lines--something that lasts longer than Botox and Restylane. It's called Radiesse and is produced by BioForm Medical Inc.

And if you don't care about lines and wrinkles, you might use it to plump your retirement portfolio. Sales are expected to rise 15% annually through 2010--just 3 years away-- to $935 million.