Family is Good for your Health

I had the good fortune this past weekend to travel to St. Louis for a family wedding. Actually, it was a wedding on my wife’s side of the family, so I am relative newcomer to the scene (17 years!). What a wonderful and joyous experience it was–even when the ceremony was interrupted by a tornado warning that forced us to evacuate the ballroom. While in St. Louis, I was also able to worship at the synagogue where I had my first rabbinic position 30 years ago, see some cousins on my side of the family that I had not seen for at least a decade, and also some dear friends who I see more often.

My parents taught me that whenever there is a Simcha (Hebrew for a “Happy Event), I should make every effort to go. There will always be sad occasions and that is not the best time or place to reconnect with loved ones. As a child we got in the car or hopped on a plane to Omaha, Minneapolis, Chicago, Wilkes-Barre, El Paso, and places in between for weddings and Bar/Bat Mitzvahs. These are the warmest memories of my childhood.

It is worth noting that when we talk about “family,” there is the family that you “get,” and also the family that you choose. I have dear friends that are family to me. My wife’s family has also become my family. There are many definitions for what family can be. In each case, I make the effort to be there when I can when there is something to celebrate–not just when something tragic has occurred.

Whenever I am at a family gathering or Simcha, I always leave feeling refreshed and energized. [This is also a product of having learned how to avoid the toxic ones in the mix.] Research shows that getting together with family for special occasions or even just for Friday night or Sunday dinner can have a positive effect on our health. In general, individuals with a strong sense of support from family and friends have a brighter outlook and are able to face adversity with greater equanimity. Conversations and interactions with loved ones also help us learn about ourselves and the world around us; these novel experiences help to build and maintain neural pathways. It is actually good for our brains! Reunions often span several generations; the mixing of ages also has a positive impact. Younger folks can learn from the older generation and vice-versa.

I know that as I grow older making an effort to be with family and friends will be all the more important. Some are close by, but many are far away. It can be costly to travel, but for me it is one of the best investments I can make in my health and welfare. I can hardly wait for the next Simcha!

Can We Ditch that Colonoscopy?

Several new outlets including NPR and AARP Bulletin, have reported that there may be an alternative to a colonoscopy in the prevention of colorectal cancer. Forty percent of adults between the ages of 45 and 75 who should be screened for the disease do not do so–many because they simply do not want to go through the process of a colonoscopy. I have blogged about this in the past; it is essential to get screened to catch the disease early. I have even blogged about my own experience with the regular testing.

The new alternative is a blood test that may prove to be a more effective form of screening since it would most likely increase the number of people willing to get tested. The new test, according to The New England Journal of Medicine, was able to detect cancer in 83% of cases. This is a similar level to those using the current methods to detect colorectal cancer. The blood test is able to indentify DNA material given off by tumors; if that material is identified, a follow-up colonoscopy can be done to make a final determination of the diagnosis.

This is great news–especially for older adults. While I am willing–and even enthusiastic–about getting my regular testing, I understand that it is not the same for everyone. I am almost 61 and in relatively good shape. A colonoscopy is a trying experience for those who are more frail. Hopefully this new blood test will be another tool in the physician’s utility belt in helping to preserve and promote good health.

In any case, be sure to communicate with your healthcare professionals about the best way for you to be screened. Early detection is your friend!

The Benefits of Travel for Older Adults

It is getting to be that time of the year; the travel season in the northern hemisphere is almost in full swing. With warmer weather comes the desire to get out and see the world–nearby and further away.

Last year when I turned 60, my aunt (who is in her 80s) told me that the 60s are the years to travel. As she explained it, the kids have already launched, (and therefore) more money is usually available, and serious health issues hopefully have not started to crop up yet. My wife (who is 9 years younger than I) and I have decided to make the most of this decade, understanding that nothing is ever guaranteed. My mom’s motto could have been “Life is uncertain; eat dessert first.” In other words, take opportunities when they present themselves because they may not reappear. Unfortunately, too many people save up for their “golden years” to travel or engage in new adventures or hobbies, but by the time they retire they do not have the capability to really enjoy these things.

The National Institutes of Health and many other organizations have studied the benefits of travel for seniors. Among the findings were “that travel has a beneficial long-term health effect. Travel within the last two years reduced the risk of death by 36.6%…. The more trips taken, the lower the risk of death. An increase in the number of trips was associated with a 13.6% reduction in the risk of death.” Sounds like more fun than exercising and eating healthy, right?

Some of the other benefits that travel can provide for seniors according to Outlook Retirement are:

Rejuvenation and Active Lifestyle. Traveling often involves walking, sightseeing, and trying new things. These help to give us a “breath of fresh air” and encourage physical activity.
Social Connections and Personal Growth. Traveling allows us to meet new people and interact in different ways with others we may know already. This is especially true for group travel. Additionally, being exposed to new places, cultures, foods, etc., helps to broaden our perspective and challenges our ways of thinking about the world.
Cognitive and Memory Boost. Being in a new environment, having to navigate unfamiliar territory, and even learning a few words in a foreign language all have healthy benefits for the brain. One of the ways that we build and strengthen neural pathways is by problem-solving. The stimulation of the brain in these ways can also help with memory.
Stress Relief and Emotional Well-being. There is an expression in Hebrew, “change your place, change your luck.” What this really means is that being in a different place can get us out of our ruts. Getting out of our everyday patterns can reduce stress and help us understand ourselves and others more clearly. Depending on where we travel, we can also see stunning vistas, great human accomplishments, or even just beautiful sunsets that can help us to appreciate the world around us.
Lifelong Learning and Cultural Enrichment. Being in new places can expose us to new ideas. We can also explore museums, galleries, neighborhoods, historical monuments, etc., that add to our knowledge of the world and history. Learning about other cultures can also deepen our understanding of diversity and ourselves.

Not everyone has the means to travel abroad, but much of this applies to places that can be no more than a few hours drive or train ride away from home. I have lived in Cleveland for less than six years and I am still discovering new neighborhoods, museums, and parks. Getting out and seeing the world is fun. We also know that it has serious benefits–health and otherwise–for older adults. Let’s hit the road!

Three Kinds of Movement

A few weeks ago I had the opportunity to sponsor a booth at the West Side Boomer Bash in Cleveland. It was an event for local older adults to interact with businesses and organizations that work with their demographic. We had some free giveaways and information, but I was looking for ways to engage in conversation with those passing by our table. I remembered the advice I learned at the 2024 IDEA & ACSM Health & Fitness Summit in Chicago; I blogged afterwards about a new way to look at the work that I do–focusing more on the term “movement” rather than “fitness.” I began by asking, “What are you doing to keep moving?” The answers were varied from “I don’t” to “I walk my dog” to “I go to the local gym several times a week.” It got people talking and gave me the chance to talk about the work that we do at At Home Senior Fitness.

A recent article on CNN.com discussed the idea of “movement” a little more in depth. The article focused on the advice of Melissa Boyd, a personal trainer and expert in the field of health and fitness. She explained that there are three kinds of movement, and that all are necessary for overall health and fitness.

The first is the kind of movement that is required by your body every day. This includes walking (which Boyd says is not really enough), bending, and stretching. Our bodies need these on a regular basis simply to allow us to do the activities of daily living.
Next is athletic movement; this is intentional exercise or movement with the aim of fitness or training for a sport. This should be done several times each week.
Last is social movement; this includes dancing and playing a sport. This is movement that allows us to interact with others and to have fun.

Unfortunately, many older adults focus only on the that first kind of movement–and for some that is a critical issue. Ideally, throughout our lives we should clear room in our schedule for athletic and social movement as well. Our bodies need all kinds of movement if we hope to stay healthy and fit as we age.

I’m Not Gonna Waste My Shot

The last week in April of this year has been named World Immunization Week by the World Health Organization (WHO). According to the WHO’s website, “The global vaccine drives of the second half of the 20th century are one of humanity’s greatest achievements. Immunization campaigns have enabled us to eradicate smallpox, nearly defeat polio, and ensure more children survive and thrive than ever before.” Unfortunately, progress on immunizations has slipped in the last few years; according to the WHO, “Growing conflicts, economic downturns, and a rise in vaccine hesitancy are some of the threats to efforts to reach…children. As a result, the world is seeing sudden outbreaks of diphtheria and measles diseases that, until now, we’d had nearly in hand.”

When we think about vaccinations, we usually think about two things: babies and children, and the COVID-19 vaccines. Immunizations are not just for these two reasons. According to the Centers for Disease Control (CDC), there are vaccines that are especially important for older adults. Those aged 50-64 should be up to date on COVID-19, Flu, Shingles, and Tdap (Tetanus, Diptheria, and Whooping Cough). Others that might be recommended by a physician in this age cohort include Hepatitis B, MMR (Mumps, Measles, and Rubella), as well as RSV (Respiratory Syncytial Virus). Those older than 65 should add in the Pneumococcal vaccine. Depending on your lifestyle, there may be other important precautions to take; for example, last year I traveled to South America and the parts of Argentina and Brazil where I visited necessitated Yellow Fever and Malaria immunizations.

Some people worry that vaccines are dangerous. A report from the National Institutes of Health (NIH) last year concluded the following: “Vaccines play a crucial role in reducing mortality rates in the elderly by preventing severe infections and associated complications. Any vaccine-preventable infections, such as pneumonia, meningitis, and certain respiratory and bloodstream infections, are commonly associated with antibiotic use. By vaccinating older adults against these diseases, the incidence of infections can be reduced, thereby potentially decreasing the need for antibiotics and reducing the selection pressure for antibiotic-resistant bacteria. Older adults may be more susceptible to antibiotic-resistant infections due to factors such as weakened immune systems, higher rates of healthcare-associated infections, and more frequent antibiotic use. Despite these positive effects, vaccine resistance is observed specifically in the elderly population. Age-related changes in the immune system, the individual’s immune response, and the individual’s overall health status often limit vaccine efficacy. Certain medical conditions, such as immunodeficiency or chronic diseases, may impair the immune system’s ability to mount a robust response to vaccines. As a result, the level of protection provided by vaccines may be reduced in these individuals. Despite these factors, vaccination remains crucial for older adults as it can still provide significant benefits in terms of reducing the risk of severe illnesses, hospitalizations, and complications.”

In other words, the benefits outweigh the risks–especially as we age–since we are often less able to fight off infections. Even though the immunizations may be less effective due to a number of factors, the benefits are still there.

On a personal level, I did not get the immunization for shingles after I turned 50. My wife got shingles when she was 49. I saw how horrible it was and how much pain she was in. We both wondered how much older folks could possibly bear shingles, especially when you factor in other medical issues. The next day I made my appointment for my first shot. At my annual check-up, I make sure to review my immunizations with my doctor. I would rather be safe than sorry.

Observe World Immunization Week by checking with your health care providers. To paraphrase the musical, Hamilton, don’t waste your shot!

Can Friends Keep You Healthy?

One of the greatest challenges facing older adults is loneliness. When we are younger, we are often surrounded by partners, children, and friends. As we age, though, spouses and friends may no longer be with us, and in our highly mobile society, children often move away from where they grew up. Being surrounded by loving and supporting people might be something we unfortunately take for granted in our younger years, but it becomes more and more precious as time passes.

Loneliness can also have an adverse effect on physical health. A recent article from AARP, highlights the way that friendships can influence our physical well-being. The article notes that a “new study of older adults finds that even momentary social interactions with friends reduce fatigue and stress. It follows a wealth of earlier research showing that friendships later in life forestall dementia, Alzheimer’s and physical decline.” Social interactions are thought to stimulate the brain much in the same way that some puzzles do: activating thinking, remembering information, and being mentally nimble. Lack of social interaction can be worse than the effects of obesity, smoking 15 cigarettes a day, and physical inactivity.

How can loneliness be counteracted? The answer is particular to each individual. Introverts may actually fare much better than extroverts in this regard; there are those who simply get more stimulation and fulfillment from reading a book, watching a movie, or going for a walk alone. For older extroverts, however, the need to be with others can be complicated. We make most of our friends at work, at school, through our children, and by being out and about; these opportunities are often limited as we age. The COVID-19 pandemic showed us, though, that even folks who have a hard time getting out of their homes can still find ways to meet new people. Those who do not have mobility issues or have better access to transportation can get involved in senior groups at houses of worship, community centers, or libraries. Many find new friends at the local gym, in adult education classes, and in group travel. It requires some effort, but ultimately there is a positive payoff.

Nobody wants to be lonely. Humans are social beings. Not only can strengthening and creating friendships be good for our emotions and spirits, but we should not forget that it can also impact the way we feel and how we age in a healthier way.

Being Awed

I was fortunate today to share a once-in-a-lifetime event with my family: the solar eclipse of 2024. Living in suburban Cleveland, we were in the path of totality. I knew the experience would be cool, but nothing prepared me for the overwhelming awe of those 3 minutes of totality. Within a half hour of the beginning of the eclipse, it began to cool down (it was an unseasonably warm day); as the totality approached it began to get darker and darker–almost like the moments after sunset. At the moment of totality, we took off our glasses and were treated to the most amazing Ring of Fire. As long as I live, I doubt I will ever forget the sights, sounds, and feelings of those moments. It was chilly. It was quiet. The wind stilled. The moon and sun put on a spectacular show.

Of course, eclipses occur quite rarely–and total eclipses even less. Nevertheless, there are awesome things around us all the time; by “awesome,” I do not mean in the slang use, but rather in the traditional meaning of inspiring awe. Our world is filled with many terrible things, but there are also many amazing things. Watching cardinals hatch in a nest in the small wild hydrangea in front of our house was awesome. Being there for the birth of each of my children was amazing. Having the opportunity to travel and see man-made wonders (the pyramids of Egypt, the skyscrapers of New York City, Machu Picchu, and the magnificent city of Jerusalem) and natural ones (Iguassu Falls, the Grand Canyon, a Resplendant Quetzal in Costa Rica, and huge tortoises in Galapos) has made me appreciate how much there is to inspire awe in our world. While there are many horrible acts committed in the world, there are also acts that humans perform that fill me with wonder: donating blood, adopting children, fighting for justice.

When we recognize the awesomeness in our midst, hopefully we begin to cultivate a practice of gratitude. As I have blogged in the past, developing a sense of thankfulness can result in positive health outcomes–both physically and emotionally. We may not only be thankful to a higher power for the marvels of the natural world, but also to the positive accomplishments of our fellow humans. We can also be better at showing how grateful we are to those around us.

The eclipse had a profound effect on me. I hope that it will inspire me to bring more wonder into the world through my actions, and to better appreciate the awesome things and people around me.

Why Are Rates of Alzheimer’s Disease in the US Dropping?

The most recent issue of AARP Bulletin (March, 2024) has a cover story on Alzheimer’s Disease. It reports that, for the first time in close to 20 years, new drugs are being approved for the treatment of the disease. Not only that, there may soon be better ways to diagnose it–including a simple blood test. The focus among researchers has shifted as well from only looking at the plaque which is found in the brain of those with Alzheimer’s Disease to also looking at neural connections and inflammation. The article is full of information and definitely worth a read.

What I found most compelling was the surprising news that Alzheimer’s Disease diagnoses are actually on the decline. From 2000 to 2016, the rate dropped 30% in the United States according to a 2022 Rand Corporation study! What accounts for this stunning trend?

As noted above, it is NOT because of any new drugs. Instead, researchers believe that the focus placed on heart health over the last 20 years has paid dividends in other areas such as dementia. According to another 2022 study–this one from the University of Minnesota–“41 percent of Alzheimer’s and related dementias were attributed to a dozen modifiable risk factors, of which high blood pressure, obesity and physical inactivity had the most impact.” In other words, we can change our behaviors and lower our odds of getting dementia.

A sidebar in the article pointed out a number of behaviors that can prevent Alzheimer’s Disease.

Don’t smoke! Enough said.
Keep blood pressure and blood sugar at healthy levels. Hypertension and Diabetes increase the risk of memory and thinking problems by 41%.
Get regular exercise. Get moving and lower your risk for all dementias by 28% and Alzheimer’s by 45%.
Eat more healthy foods. A diet limited in red meats, saturated fats, and added sugars that is also high in produce can lower your chances of getting AD and dementia by 48%. Berries and spinach are thought to protect brain cells.
Take a multivitamin. Multivitamins cannot replace a good diet but they have been shown to have a beneficial effect on the brain.
Care for your ears and eyes. A University of Toronto study in 2022 showed that hearing and/or vision loss increase the risk for cognitive problems by 20-50%. Hearing aids and vision care can help.
Be attentive to mental health issues. Stress, depression, anxiety, and loneliness over time can contribute to cognitive decline. Seek help for these conditions.
Get quality, regular sleep. Sleeping is what allows our brains to clear out waste; sleeping problems can prevent that from occurring. Take appropriate steps to improve sleep.

Alzheimer’s Disease and other dementias are frightening–to those who receive the diagnosis and for their loved ones. It is reassuring to see that progress is being made in research for diagnosis and treatment. What is most exciting to me is knowing that our own actions can have a positive impact. It is not just a crapshoot (or even based solely on genetics). We can (up to a point) help prevent cognitive decline as we age!

Working Out with Chronic Conditions

While the gentlemen in this picture look hale and hearty, I am willing to guess that if they are still alive today, they are probably dealing with one or more chronic health conditions. The CDC defines chronic health conditions as those “that last 1 year or more and require ongoing medical attention or limit activities of daily living or both. Chronic diseases such as heart disease, cancer, and diabetes are the leading causes of death and disability in the United States.” At Home Senior Fitness works with clients who are 55 and older, and nearly all of my clients deal with such conditions. How does it affect the way that we train and what results can be expected?

At the 2024 IDEAfit / ACSM Health and Fitness Summit in February, I took a course offered by Dr. Carol Ewing Garber entitled, “Prescribing Exercise to Clients with Chronic Diseases: A Cast Study Workshop.” Garber is Professor of Movement Sciences and Education and Chair of the Department of Biobehavioral Sciences at Teachers College (which is incidentally two blocks from where I attended Seminary in New York). The course looked at different hypothetical cases of individuals of various ages and backgrounds living with different chronic conditions. We worked together to determine the best course of action for training the individual to bring them to greater levels of fitness and health.

Over the years as I have worked with older adults, I have found myself in the same kind of “workshop,” just not in a large hotel with dozens of other people. It is, rather, a one-on-one with myself figuring out what would be most effective and what to avoid. I have had clients come to me with long-time diagnoses like atrial fibrillation (A-fib), dementia, and Parkinson’s Disease. I have also had clients come to me with new diagnoses like epicondylitis and camptocormia (look both of those up!). When we aware of such diagnoses, it is necessary to take into account how not to worsen a condition as well as what exercises might improve it. Many of these conditions I learned about when I was studying to become a personal trainer, but others required me to do research. I have even reached out to a client’s physical therapist on occasion for guidance. These chronic conditions cannot simply be ignored.

Garber’s class was a good reinforcement for me. It reminded me of the importance of understanding where my clients are (not just physically either) so that I can meet them there and then make a difference. If you or someone you loved is diagnosed with a chronic condition, make sure your fitness professional knows about it, knows what it is, and knows how to work with it. Personal trainers can be allies with doctors and therapists in building a better quality of life while living with a long-term condition.

Just for the Women

This is my third report on the IDEA/ACSM Health and Fitness Summit in Chicago at the end of last month. The third session I attended was entitled “Everyday Strength for the Older Female Client;” the instructor was Keli Roberts. I was very interested in this class because approximately half of my clients are older women. Over the years I have learned a lot about the needs of older adults, so I was looking forward to finding out what particular issues women face as they age.

In all honesty, most of the class really applied to older adults of any gender. We talked about different categories of aging: chronological, functional, biological, psychological, and social. Each contributes to the overall picture of a person’s health and fitness, and helps to determine the needs of the client and how best to meet them as a personal trainer. The class was mostly aimed at group or small-group fitness strategies; nevertheless, there was a lot to be learned.

There are a number of issues that relate directly to women. Because women have often been caregivers, it may mean that they did not have the time or opportunity to take care of themselves in the past; the result is that there may not be a history of exercise and other healthy habits. How do we create new patterns of behavior? Women may also be less likely to avail themselves of health services or have access to them in the first place. Some women, then, may not even be aware of the health conditions particular to themselves. All this needs to be taken into account so that an exercise program can be successful.

Older women may experience heart disease, diabetes, obesity, stroke, cancer, anxiety, and other mental health challenges. These are mostly shared with men. Osteoporosis, however, is much more prevalent in women. Osteoporosis a medical condition in which the bones become brittle and fragile from loss of tissue, typically as a result of hormonal changes, or deficiency of calcium or vitamin D. Research has shown that women can benefit from resistance exercises that involve weight bearing and weight lifting. This can be done safely and effectively as long as all the other co-morbidities are taken into account.

I have already put some of my newfound knowledge into practice with my clients and my exercise class. Roberts made me more aware of areas of weakness for women and how to compensate for them. My main takeaway is that while all older adults share much in common when it comes to fitness, women have their own unique sets of circumstances that cannot be ignored. I will definitely be more aware in the future.