The science of aging is alive and well. The challenge before us is to link the progress and the basic science of aging and clinical research to provide evidence based care for the growing number of older people.
While this article is directed towards the musculoskeletal system an example from neuroscience is necessary. While a relatively healthy musculoskeletal system is important to independence, productivity and quality of life, cognitive and emotional function is also linked to those factors.
The brain is probably the major organ of interest as people age. Simple cognitive exercises have been demonstrated in studies to improve memory. The implication of this for healthy aging is obviously enormous.
We return to the musculoskeletal system in our discussion. U.S. consumers spend more than twenty billion dollars per year on complementary and alternative medicine therapies that promise to slow the process of aging and its associated ailments. (See Online Orthopaedics Complementary and Alternative Medicine library article.)
Men and women have shown great interest in hormone therapy to slow or reverse the aging process. For men the hope that testosterone therapy might restore vitality in aging has been somewhat disappointing. For women, estrogen seemed to promise a similar ability to avoid aging, but recent studies have challenged the presumed positive effects of hormone replacement therapy for preventing heart disease and have raised other fears of breast cancer. Estrogen therapy is effective in preventing osteoporosis, but other medications have become more important in recent years. (See On Line Orthopaedics Library articles on Osteoporosis.)
So what are we to do?
Exercise. Even simple moderate activity like walking is associated with a significant health benefit.
A recent editorial in the Journal of the American Medical Association pointed out that even frail adults living at home who participate in a moderate activity program will experience distinct benefits in their physical and mental function and capacity.
In studies that evaluate approaches to reduce the functional decline in human aging, the findings repeatedly favor the positive effects of continued physical and mental activity, particularly physical activity.
Unfortunately the message seems largely unheard by both the United States population and health care providers. Exercise,
Trying to get our patients into physical activity programs and to exercise is enormously difficult. The many conveniences that do our work and our increasingly sedentary lifestyle contribute significantly to the aging process. Unfortunately, it starts early in life.
Unfortunately, physicians and their style of practice sharply focused on medical technology and pharmaceuticals do not help this problem. It would be unfair to blame this entirely on our patients and not lay some of the blame at the feet of our physicians.
Very often our complementary and alternative medicine colleagues have done a much better job in bringing to the attention of patients the need for behavioral modification.
It is horribly simplistic to reduce treatment of the aging process to one word, but here goes
EXERCISE. Simple isn't it? But how do you get people to do it? People simply don't want to take the time to do it. They have other things to do that seem more interesting to them and more beneficial.
For treatment of the aging process, NOTHING IS MORE BENEFICIAL.
Walking. Riding a bike. Treadmill. Working outdoors on a regular basis. Swimming. The list goes on and on.
I think people have heard this so often that they just tune it out.
We are not trying to make people immortal. We are trying to keep people independent and active and as healthy as possible.
There are additional benefits to exercise in that balance and strength, by being improved in the elderly, has been shown to substantially decrease the incidence of falls.
Aging seems to degrade the ability to recover and keep a slip from turning into a fall.