Your doctor speaks II; Problems of Older People

The University of Illinois Medical Center campus in Chicago percents your doctor speaks during this series doctors in the colleges of medicine dentistry pharmacy nursing and graduate college at the University of Iowa and I will discuss the latest advances in cancer and heart research. Painless dentistry psychiatry nursing care and modern drugs. All of these and more will be presented on your doctor speaks. Your host for this series is Jack Graham a coordinator of public service radio and TV programming for the University of Illinois Medical Center campus and champagne Urbana. This is Jack Gregory our guest today is Dr Adrian a professor of preventive medicine at the University of Illinois College of Medicine. Doctor is an interesting topic we're going to be discussing today and the diseases of the people. Remember the first question I should ask you is. What are the common health problems of old people.

Well I suppose the most important health problem of all people is an effort to see that they managed to become a little older. And the three major threats to health and to life are heart disease cancer and stroke. These are the three major problems in terms of life. But there are many other minor problems and that make people feel uncomfortable aches and pains that don't threaten life. But they're around in profusion anyway. I've had three heart disease is by far the most important. I don't like to get too many dreary statistics about this kind of thing but I suppose if you were at the beginning it wouldn't be too bad. About a million Americans every year die of heart disease a million. That's right and roughly half that number of all kinds of cancer. And well over 200000 from strokes so it was a lot of problems.

When we speak of maybe I better clarify this summer Speaking of old people. What do we mean. 65 to 90 you know yeah 65 and over group and there are a fair number of people in that age group now I guess they're about 17 or 18 million people 65 and over in the United States so this is a big group. What would be considered old 20 years ago would certainly be different than today Frank I met an old 20 years ago would be 50 with and I think that that's quite true with it when people are described as young middle aged or older. Depends a lot on what time of history you're talking about. The average life expectancy even at the turn of the century was only about 30 35 years but that figure is a little bit misleading because that's an average and the reason the average is so low is that so many babies and infants were dying once you got to be an adult

in those days why your chances of going to 65 were just about as good then as they are now. But you have to get through all these childhood diseases which we're now thank God we've conquered. That's right. What is really the health of an old person let's say 70 years is used to me seems like quote unquote old. He's a really good batter. Well the idea that you can be that age and not have anything wrong with you is unfortunately a myth. I have had my my and my associates have been looking at the health of older older people for several years and there is hardly a wanton who doesn't have at least two or three troublesome annoying diseases. If that's all they have it's just as well but arthritis aches and pains and headaches and disease spells a stomach trouble trouble rocking around varicose veins these are are so common in this age group that defines

somebody who doesn't have one or another of them is a rarity. But these are not really in a sense a life threatening type of problem. I know it is annoying and they're miserable to have but it doesn't impair one's life as it is for instance as strokes or heart disease or cancer. That's quite true. The problem is that so many of these things can be helped a little bit but cannot be completely relieved. And the idea of having some nagging discomfort every day is troublesome to these people and the doctors are in a bind to try to help them. Some of those symptoms you describe sound like what I hear. Are there any particular mental problems emotional problems that all people have as opposed to young people. Well I think that there are two kinds of problems. First of all as people get older they do tend to become a little bit more forgetful. And the peculiar thing is that

they are more forgetful about what happened a couple of hours ago than they are about what happened a long time ago. For instance I have talked to an older man who could tell me exactly where the line up and the 1926 World Series and who got what kind of hits and who dropped a called third strike. But he has a little trouble remembering what he had for breakfast this kind of mental process that is common among old people. They remember pretty clearly what happened in their youth and middle age but they're kind of uncertain about what's happened in the last day or two. So this is one of the one of the problems of older people. What about what about all people themselves are they like some young people I know. Are they concerned about their health or do they just have a defeatist attitude about it or what is their general feeling baap their own makeup and health. Well actually it's a combination of being extremely

concerned and yet having the feeling that nothing much can be done. Old people have been stripped of the illusion that nothing can happen to young people. Every time I see teenagers ride a bike down the middle of the street or a start up their cars with a screech or climb some inaccessible tree or rock you're struck by the fact that young people there think nothing can happen to him now they can fall they can get hurt. They're not going to get bumped into. You have what one of my colleagues calls the immunity of IRA the it can't happen to me. Yeah. Now older people have been pretty well stripped of this they know darn well it can happen to them. And it's a little rough to live. You see your colleagues drop away and you alot of them start reading the obituary columns and they know that it's going to happen to them too

and they're quite troubled. They're very concerned about their health. On the one hand and yet on the other hand they are not so sure that very much can be done for what bothers them. And this is an uncomfortable bind I think it's one of the most unhappy problems of this older age period when that certainly would be a problem emotional problem. We hear about geriatrics disease of all people are either special type of quote unquote all doctors that take a doctor to take care of old people quote unquote. So there's this calling the doctor by the disease that he treats it's always occasion for some mild humor you know a patient to come up and say Are you with a diabetic doctor and you want to say No madam I don't have diabetes but. There are a few physicians who specialize in taking care of older people and they're called geriatricians or specialists in geriatrics or gerontology which

is a branch of medicine dealing with the health of older people. But in general older people can be taken care of by general practitioners by internists by surgeons. There are certain kinds of operations which need to be done almost exclusively on older people and so that some surgeons tend to pretty well limit their practice to older people but this doesn't need to be the case at all. We don't have a clear cut specially of taking care of all people like we do for taking care of kids for instance like Pediatrics so that this is really not a clear cut thing but it's you think it would come to that something because of the factors so many were reaching this particular age group and so many old people. I don't know it's funny when you look at the way in which the practice of medicine is divided it's curious and in part time it's divided according to what part of the body you take care of. You know some doctors take care of the eyes. Some take care of

yours nose and throat. Others take care of the chest so that the practice of medicine is divided by part of the body and it's also divided by the kind of treatment whether you give pills or whether you weer the scalpel you know. So now it may be starting to be divided by the age of the patient and we'll Pretty soon have a crazy quilt of different kinds of divisions of medical practice that would be a whole nother subject and topic we can get out of the way. You were mentioning about the emotional problems that people have in the fact that when I get to that particular age and they have seen their friends and colleagues pass away and they kind of just marking time you know and I've as you indicated is a big emotional problem. What can know what can I hope people do to stay in reasonably good health. Both from a physical standpoint both from an emotional and mental standpoint. Well there are three important things that I think they can do and one of them we're going to be talking about a few weeks later.

I think it's very important that all people have a doctor or a clinic. Which they attend regularly. It's important that even though some of the things that cause them trouble may not be entirely treatable but they do maintain regular contact with a doctor or with a medical facility because a lot can be done to keep people in reasonably good health and prevent trouble. The second recommendation I would make is to avoid any big change for some reason. It's been shown again and again that when older people leave a neighborhood or leave a town particularly when they don't have close family that they run into health problems. I think it's better to stay put not to move if you can avoid it not to change your dwelling area not to leave your familiar neighborhood. If you can and any way avoid it

and the third thing. Is that the more interested you are in something outside of you and the less interested you are in what goes on inside your skin the better your morale and possibly the better your health will be I think it's important for older people to try to get interested in something and the best kind of interest is an interest in something that you know will go on after you're gone. I see a monument to yourself is it worth study or do some going to research or something which would. Continue this process after. Well if you're fortunate enough to be involved in something that you know will continue to have some value after you're gone. By virtue of your work I think that's desirable but it seems to me that there are many things interest in children and in a neighborhood that projects our interest in other people the more you can concern

yourself about others and the less you can concern yours just with yourself the better you do. That's good advice for all of us I think. Young and old we hear a lot about the President's Council on Physical Fitness and the fact that our youth is in flabby shape. Quote unquote somebody said this and and you know we're all in bad shape and nobody exercises enough and so forth and so on. It is an exercise actually good for old people should they be doing exercise. Well this question has received a lot of attention recently. Does exercise help you to prevent the development of certain kinds of diseases especially heart disease and disease of blood vessels. I would say that Old age is no time to make a major change in physical activity. There seems to be a kind of a sharp division of older people. Some are very sedentary they don't move around much at all and others are quite active. We have had to talk to older

people who are walkers and who quite literally spend most of the day on their feet walking around the neighborhood stopping to sit on a bench for a few minutes and then walking more. There doesn't seem to be anybody in between. I have the impression that those who are quite active are in better health but I can't say that the activity causes the improved health obviously those who are in good shape are going to be able to move around more and those who are not won't be. It seems to me that the best thing to do during this period a life is to try to continue that kind of activity pattern you've had before if you've been rather quiet and sedentary before this is no time to start doing pushups if you're able to do it. It's better just to maintain things as they happen. What about the sexes. Is it true that do females are really the stronger sex What about the older women are they in better shape physically health wise and men older men.

Well this is one of the curious problems of old age that we understand very little about and we're going to have to understand more about because we are rapidly getting a large number of the widow women 65 and over. It's quite true that women live on the average of about seven years longer than men. And if you leave out those diseases which only women can get. The only major illness I know of that causes more disease and more trouble in women and in men is diabetes. Men have more difficulty with heart disease more difficulty with all forms of cancer and more difficulty with stroke more difficulty with T.B.. Then do women. This is quite important and we don't know why. It may be that women have a small excess of a certain.

Well I'm trying to avoid giving the fancy name for it. That's how a certain complex kind of protean that's in the egg and sperm when when when people are conceived. Women have a little bit more of that complex protean material in man about 2 percent more now there's that make that difference we don't know. Is it that women don't have a quite the occupational stress and strain in the responsibility that men do. I don't know men would like to think so. I don't know whether women would like to think so or not but the difference is there and it's tremendous and it's increasing. I was wondering a question that comes to mind you're talking about the some of the reasons or possible reasons why women. You know I have better physical health than men do. And you mentioned maybe it's because men have been all strained at the office and things of this nature and in the competitive world.

Are there any figures or any just mistakes in regard to for instance now before the 1800s it was almost unheard of for women working as they are but nowadays a good majority of women are competing with men in jobs and I was wondering if there's any that this stick to show with you know it's women's health it's gone down or paralleled men because of the fact they're competing with men and you know various jobs and employment and so forth orders. You know this is this is. An extremely important point that you bring up. I think it will be able to be able to answer this question after a while. But the trouble was at the turn of the century again. Women died in childbirth so often that women lived appreciably less than men and in the space of about 50 years it's been completely reversed. There are many other peculiar reversals a disease pattern also or was largely a disease of women in the early 1900s and now it's completely flip flop.

Yes was this was stated by some to be due to their tight undergarments in the Victorian era but I find it difficult to believe that an actor I know that you were engaged in a study here in the city of Chicago dealing with the health of old people. Could you tell us about the study. Well for about three years a little more than three years we've been concerned with gathering information that would lead to intelligent programs of improving the health of older people gaining the kind of information that would enable doctors and hospitals to keep older people in better health keep them alive longer and either prevent or delay the occurrences of heart disease and stroke particularly and keeping mental functions intact as long as possible. Now we've been working with the Chicago Heart Association and with the Cook County Department of Public again in the study

we've already talked to and examined briefly about 3000 older people and we are in the process of spending much more time with another group of 3000 persons. And as a matter of fact if you're 65 and over and living in Cook County there's a reasonable possibility that you may one day find a letter in your mail saying that doctors at the University of Illinois College of Medicine would like to talk to you about your health and check you over briefly. All of this information will be made available to your doctor or your clinic or to you if you want. And we're spending about half a day with these people. We have two doctors with us we have people who are specialists and keeping track of records and data. We have medical technicians. We have people who can do.

Determinations on blood and to see how well certain chemicals in the blood are doing a lot of people and there are a large group of us working together and we'll be as I say the chances are that if you're 65 or over in good beyond that you may may hear from us and we hope that you work with us and there's nothing like writing about this and will know this. There is no no new or experimental aspect of it. So essentially these people will get the kind of checkup that you would get if you went to a little doctor's office and forked over $100 or so if you're getting a real advanced and the best type of treatment really that you can one can get. Well you he did it we don't we're not actually trying to treat or not treat. But but that I mean if that's right I guess the best diagnostic work up there that is not available. And actually we're doing some additional things that it would be hard to put together in any one doctor's office you have to go to three or four to get all the answers. But this is one of one area in

which you're doing all that quite right. And we've deliberately stayed away from anything that would cause discomfort that would trouble people. Still we're finding that so many of the older persons are so concerned about what's going to happen and when the minute they walk in the door we can tell that they're upset and they're wondering about what's going to happen. And I wish this wasn't so. But I don't really know what to do about it. All we know is that when they leave they're feeling fine and they're very pleased that they came. I suppose that there always is some concern that the doctor's going to turn up something that you wish he you don't want to know about. And that's always a value. That's right. And most of the people that we're seeing a grew up at a time when a lot of these conditions were just hopeless. But and of course because they grew up and learned during that time they still think that that's the way things are now they don't know how much can be done. Now you're ready you're studying mainly what the problem strokes is it's trying to determine or get some heart

disease and also the mental deterioration that occurs in this age period we're trying to find out why some people get it and why others don't. And what can be done to keep people from getting or at least to delay these things for several years. Can you briefly in the time that we have left say some things that you do know about. Let's take heart trouble with some things one should avoid like smoking. I always hear that that well that's true. Unfortunately it seems to do so little good to keep pointing out the risks of cigarette smoking. It certainly is a problem. And yet cigarette sales continue to soar. Cigarette smoking certainly is a problem. If blood pressure stays up over periods of time it should be lowered with with with medication and almost invariably it can be if a person has too much a certain fatty substances in the blood cholesterol that you hear about. Physicians ought to make attempts to lower their sometimes

diet will lower it. Sometimes a program of physical activity will lower it. The main point that I want to make is if we know we can pinpoint the man most likely to run into this with a heart to heart attack any little way we can do it as a middle aged man to a lesser extent in middle aged women. But this has not been done for older people and we've got to extend it to older people. We've got to take better care of our older people and this you also hope to get some findings as far as strokes Yes mental deterioration right. Exactly the same kind of plan for these other two diseases. Well we hope that one of our listeners who I would think this particular program possibly might be contacted not to be fearful of this particular project that you are engaging on cooperate with you people hope so. Doctor thank you very much for being on and talking about a most interesting topic that is diseases of old people and what is being done to help these people. Our guest has been Dr. Adrian Ostrow professor of preventive medicine at the University of on

our College of Medicine. You have just heard another in the series your doctor speaks produced by the University of Illinois Medical Center campus in Chicago in cooperation with this station. During this series such topics as cancer and heart research painless dentistry psychiatry nursing care and modern drugs will be presented on your doctor speaks to your host for the series is Jack Gray camera coordinator a public service radio and TV programming for the universe their own II Medical Center campus and Champaign Urbana. Your doctor speaks is produced and directed by Mr. Reagan. This program was distributed by the national educational radio network.