Earth: The Gray(ing) Planet

Published in Woonsocket Call on April 17, 2016

Last month, a National Institute of Health funded U.S. Census Bureau report was released announcing that the world’s older population is growing dramatically at an unprecedented rate. According to the newly released federal report, “An Aging World: 2015,” 8.5 percent of people worldwide (617 million) are aged 65 and over. This percentage is projected to jump to nearly 17 percent of the world’s population by 2050 (1.6 billion).

The new 165 page report, released on March 28, 2016, was commissioned by the National Institute on Aging (NIA), part of the National Institutes of Health, and produced by the U.S. Census Bureau.

“Older people are a rapidly growing proportion of the world’s population,” said NIA Director Richard J. Hodes, M.D. “People are living longer, but that does not necessarily mean that they are living healthier. The increase in our aging population presents many opportunities and also several public health challenges that we need to prepare for. NIA has partnered with Census to provide the best possible data so that we can better understand the course and implications of population aging.”

“An Aging World: 2015” is chock full of information about life expectancy, gender balance, health, mortality, disability, health care systems, labor force participation and retirement, pensions and poverty among older people around the world.

“We are seeing population aging in every country in every part of the world,” said John Haaga, Ph.D., acting director of NIA’s Division of Behavioral and Social Research. “Many countries in Europe and Asia are further along in the process, or moving more rapidly, than we are in the United States. Since population aging affects so many aspects of public life—acute and long-term health care needs; pensions, work and retirement; transportation; housing—there is a lot of potential for learning from each other’s experience.”

A Look at Some of the Details

The report noted that America’s 65-and-over population is projected to nearly double over the next three decades, from 48 million to 88 million by 2050. By 2050, global life expectancy at birth is projected to increase by almost eight years, climbing from 68.6 years in 2015 to 76.2 years in 2050.

In addition, the global population of the “oldest old”—people aged 80 and older—is expected to more than triple between 2015 and 2050, growing from 126.5 million to 446.6 million. The oldest old population in some Asian and Latin American countries is predicted to quadruple by 2050.

The researchers say that the graying of the globe is not uniform, “a feature of global population aging is its uneven speed across world regions and development levels.” The older population in developed countries have been aging for decades, some for over a century. “In 2015, 1 in 6 people in the world live in a more developed country, but more than a third of the world population aged 65 and older and over half of the world population aged 85 and older live in these countries. The older population in more developed countries,” says the report.

Meanwhile, the researchers report that in the less developed world, “Asia stands out as the population giant, given both the size of its older population (617.1 million in 2015) and its current share of the world older population (more than half).” By 2050, almost two-thirds of the world’s older people will live in this continent, primarily located in the eastern and northern hemispheres. “Even countries experiencing slower aging will see a large increase in their older populations. Africa, for instance, is projected to still have a young population in 2050 (with those at older ages projected to be less than 7 percent of the total regional population), yet the projected 150.5 million older Africans would be almost quadruple the 40.6 million in 2015, notes the report. .

The Graying of the Ocean State, Too

AARP Rhode Island State Director Kathleen Connell says that statistics gleamed from a new interactive online tool, the AARP Data Explorer, detailed by blogger Wendy Fox-Grage, a senior strategic policy advisor for AARP Policy Institute, suggests that Rhode Island for some time, has had the highest per capita 85 plus population of any state. But “Data Explorer also shows that Rhode Island was surpassed in 85 plus per capita in 2015 – second now to Florida by 1/10,000th of a percentage point. Interesting, by 1260, we are projected to rank 14th.

“Nationally, from 2010 to 2060, the 85-plus population will more than triple (260 percent), the fastest growth of any age group over that time period,” she says.

Connell says, “AARP Data Explorer clearly shows that the age 65-plus population will grow much faster than younger age groups. All three older age groups (65-74, 75-84 and 85-plus) will more than double between 2010 and 2060, while the younger age groups (0-17, 18-49, 50-64) will increase only slightly.”

“The growth of the age 85-plus population will significantly outpace all other age groups, once Boomers begin turning 85 in the 2030s,” adds Connell, noting that “This phenomenon will have significant impact on every aspect of society, ranging from our health care system to the economy.”

“People age 85-plus are the group most likely to need long-term services and supports (LTSS) to help them with everyday tasks. They not only have higher rates of disability than younger people, but they are also more likely to be living alone, without a spouse or other family member to provide them with assistance,” observes Connell.

Over the years, the Rhode Island General Assembly has enacted legislative changes in the way it delivers and funds aging services and supports for older Rhode Islanders and their family caregivers, says Connell.

According to Connell, early last year, AARP Rhode Island released, “Raising Expectations 2014: A Report Card for Rhode Island Long Term Services and Supports System Performance.” The report assessed the LTSS Scorecard and recommended policy goals.

Connell says that the results revealed that Rhode Island showed strengths. With the subsequent passage of key legislative proposals that included caregiver paid family leave and the CARE Act, the state has moved in the right direction, she says, stressing that “the policy report pointed to areas for improvement that state leaders should not ignore.”

“With the reauthorization of the Older Americans Act through 2019, and continued backing from Governor Raimondo, Rhode Island seniors and caregivers are benefitting from a host of home- and community-based programs,” says Director Charles Fogarty, of Rhode Island’s Division of Elderly Affairs. “A top priority for the agency is strengthening of those services so everyone can make it in Rhode Island. We are proud to partner with hardworking older Rhode Islanders and advocates; we are constantly listening to their suggestions which are helpful in providing direction on development of effective programming and policies,” he says.

Fogarty noted that during Governor Gina Raimondo’s first two budget cycles (FY 2016 enacted and FY 2017 proposed budgets), more than $1 million in additional general revenue funding has been allocated for programs such as Meals on Wheels, senior centers and other home and community care services. Seniors can remain in their homes with a high quality of life for as long as possible through the provision of affordable and accessible home and community-based services and living options preventing or delaying institutionalization.

Connell says a the nation’s population ages, Rhode Island now has an opportunity of showing other states, with growing age 85 plus populations what it takes to care for an aging population.

Rhode Island, too, can also teach the world community a thing or two about providing programs and services to their older citizens.

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Beware of Health Scams

Published in Pawtucket Times, December 19, 2014

Like millions of older baby boomers and seniors, some nights you just can’t get to sleep. It’s very late and you begin channel surfing. Does this sound familiar? Many TV viewers may ultimately find themselves, usually from 2:00 a.m. to 6:00 a.m., watching an infomercial announcer pitch a health product or service, always claiming your health will improve, or that the aging process can be stopped or reversed, if you just purchase that bottle of dietary supplements, weight loss product, baldness remedies or sexual enhancement supplements, that home exercise machine, even register for a memory improvement course. The lists of products pitched on these paid commercials are endless.

The Vancouver, BC-based International Council on Active Aging (ICAA), a nonprofit group that supports professionals who develop wellness facilities, programs and services for adults over 50, calls on older consumers to beware of false promises and products with little health benefit. “Unfortunately, as people over 50 pursue this goal, many succumb to what one industry insider calls graywashing – claims that chip away at older adults’ retirement nest eggs with dubious promises of renewed youth and health,” says Colin Milner, CEO and founder of ICAA, who coined the term, graywashing.

There is No Fountain of Youth

According to Milner, there is no shortcut to improving your health. “Yet, people spend billions of dollars a year on products that claim there is,” he observes. “Many products also say they will turn back time,” he says, noting that the research shows these claims to be unsubstantiated.

Milner points to a statement by the National Institute on Aging (NIA), one of 27 Institutes and Centers of the National Institute of Health, which states: Despite claims about pills or treatments that lead to endless youth, no treatment has been proven to slow or reverse the aging process.” Be aware, warns Milner, as health fraud scams are abundant.

According to NIA’s Age Page, “Beware of Health Scams,” health product scams offer viable “solutions that appear to be quick and painless.”

As to dietary and weight loss supplements, American consumers spend a small fortune on potions claiming to help shed pounds, many sold over the counter. Be careful. Some supplements contain hidden illegal drugs and other chemicals that could cause serious harm.

The NIA fact sheet also claims that most dietary supplements are not fully tested by the Federal Drug Administration, a federal agency charged with protecting the public’s health. In 2014, FDA issued 63 Warning letters to companies that cited unapproved or unsubstantiated claims, tainted products or other health-fraud-related violations.

So, think carefully before you purchase that item. It is important to talk with your physician before you begin taking a supplement or using a health product remedy.

The NIA Fact Sheet notes that arthritis remedies, using Magnets, copper bracelets, chemicals, special diets and electronic devices, oftentimes unproven, can be quite expensive, potentially harmful, and unlikely to help. There is no cure for some forms of arthritis and rest, exercise, heat and some drugs, are the best ways to control the painful symptoms.

Health scams oftentimes target very sick people, especially those afflicted with cancer, in an attempt to trick people who are desperate for any remedy they can find. Buzz words to beware of include: “quick fix,” “secret ingredient” or “scientific breakthrough,” says NIA’s Fact Sheet.

Furthermore, weight loss, sexual enhancement and bodybuilding “supplements” are especially suspect, too, warns the NIA Fact Sheet. Some vitamins may help, but some supplements can harm people taking certain medicines or with some medical conditions. In particular, avoid those supplements claiming to shrink tumors, solve impotence or cure Alzheimer’s. There is no cure for Alzheimer’s Disease at this time.

Milner urges older Americans not to be swayed by personal testimonials featuring “real people,” or “doctors,” often times played by actors who claim amazing cures. These testimonials are no substitute for real scientific studies, and can tip you off to a scam. In general, never purchase or start taking a medical treatment without first talking to your healthcare professional, particularly if you already take other prescribed drugs, recommends Milner.

Don’t Become a Victim of Scam

Be knowledgeable about the health care products you buy, suggests Milner, noting that the NIA Fact Sheet recommends that a person question what he or she sees or hears in ads or online. Always ask your physician, nurse, pharmacist or other healthcare provider about products you’re thinking of buying. Most important, avoid products that “promise a quick or painless cure.” Beware of claims that a health care product is made from a “special, secret or ancient formula” or it can “only be purchased from one company.”

Also, be wary if the infomercial claims the product can cure a wide variety of medical conditions or even successfully treats a devastating disease like Alzheimer’s or chronic arthritis. Put your credit card away and hang of the phone if you are required to make an advance payment or there is a very limited supply of the product.

“Science may be getting closer to a Fountain of Youth, says Milner, but, “we’re not there yet. “The pillars of healthy aging are simple. They include a sensible diet, regular exercise, good sleep habits, meaningful relationships, and engagement in life,”

A Final Note for Rhode Island’s AG…

The Consumer Protection Unit at the Office of Attorney General receives very few consumer complaints about deceptive health and beauty products, because most of these products are regulated on the federal level. The best advice they can offer consumers is to file a complaint with the federal Consumer Financial Protection Bureau, or CFPB. Although these types of products are not regulated by individual states, and therefore the Attorney General has no jurisdiction over the sale of such products, Attorney General Peter Kilmartin reminds consumers that the age old tip applies when considering a purchase, “if it sounds too good to be true, then it probably is.”

One way consumers can protect themselves, says Kilmartin, is to “ask for medical documentation backing up the claims and to ask and understand the refund policies before making a purchase. Another way to protect yourself is to pay by credit card, not debit card. Many credit card companies will allow you to dispute payment if the product or service doesn’t match up to its claims.”

For more information about the National Council on Active Aging go to http://www.icaa.cc/.

FDA s created a new website (www.fda.gov/ForConsumers/ConsumerUpdates/ucm278980.htm) to help consumers protect themselves from fraudulent health products and schemes.

Herb Weiss, LRI ’12, is a Pawtucket-based writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.

Prominent Oncologist’s Death Wish at Age 75

Published in Pawtucket Times, December 12, 2014

Dr. Ezekiel Emanuel, MD, Ph.D., a nationally-recognized oncologist and bioethicist, definitely marches to a different drummer.  While millions of older Americans pop Vitamins and supplements like M&M Candy, regularly exercise at their local gym, religiously jog and carefully watch what they eat to increase their life span, the chair of medical bioethics and health policy at the University of Pennsylvania, says living past the ripe old age of 75 is not on his bucket list.  We would be doing both society and our loved ones a favor by agreeing with this belief, he says.

When I am 75…

Why not age 80 or even 85?  Emanuel admits that his 75th birthday day was just a randomly chosen number, but the year was selected because scientific studies indicate that increases in physical and mental disability occur around this age, as well as a decline in both creativity and productivity.

The renowned 57-year old breast oncologist is at the top of his professional game.  Emanuel has received dozens of awards from organizations such as the National Institutes of Health and the American Cancer Society, including being elected to the Institute of Medicine (IOM) of the National Academy of Science, the Association of American Physicians, and the Royal College of Medicine (UK). Hippocrates Magazine even selected him as Doctor of the Year in Ethics.

Emanuel is a prolific writer, editing 9 books and penning over 200 scientific articles. He is currently a columnist for the New York Times and appears regularly on television shows including Morning Joe and Hardball with Chris Matthews.  .

The prominent physician, is also considered a key designer of the Affordable Care Act (commonly called Obamacare).  At a personal level, he has two well-known brothers, Chicago mayor Rahm Emanuel, former White House chief of staff, and Hollywood agent Ari Emanuel.

With this prominence, Emanuel’s death wish to die at 75, (the year 2032) before the onset of Alzheimer’s disease and other dementias, and decreased physical stamina (it’s harder to walk a quarter of a mile, even to climb 10 stairs) is drawing the ire of critics who charge that he advocates for health care rationing and legalized euthanasia.

But Emanuel claims that these charges are not true.  Setting his death at 75 is just his personal preference, he says, leaving his mortal coil. In his writings and media interviews he notes that setting the age when he hopes to die just drives his daughters and brothers crazy.

Last October, at the BBC Future’s World-Changing Ideas Summit in Manhattan, Emanuel’s prop, a full-page AARP ad from a newspaper, featuring an older couple hiking above a line of text that read, “When the view goes on forever, I feel like I can, too. Go long.”  Reinforcing his point, Emanuel is not buying AARP’s message pushing the positives of living an extended life.  For him, he doesn’t buy it and most definitely, seventy is not the new 50.

Sharing a Death Wish on the Air Ways

On Dec. 7, on CBC Radio Canada’s Sunday Edition, Emanuel, discussed his controversial October 21, 2014 article published in the The Atlantic, “Why I Hope to Die at 75.”  His Sunday interview detailed his unconventional and controversial stance, especially to AARP, the nation’s largest aging advocacy group, and aging organizations who strongly oppose this type of thinking.

Throughout the 28.12 minute interview with Michael Enright, Emanuel, he warns listeners, “Don’t focus on years, and focus on quality.”

“A good life is not just about stacking up the years and living as long as possible. People need to focus on quality of life,” says Emanuel, noting that “Setting an actual date for a good time to die helps you focus on what is important in your life.”

“It is really about what you are doing to contributing and enriching the world.  I want people to stop focusing on just more years, focusing on quality,” he says.

Emanuel says that you need to be realistic on living forever, your body and mind doesn’t  go on forever.  You should just be satisfied with living a complete life, he says.

By age 75, people will have gone through all stages of life, says Emanuel.  As a child you begin to develop skills and figuring out your place in the world. You go to college, raise a family, work to hone your skills and talents. At the later stages of your life you give advice and mentor people, he says, noting that in your mid-seventies, physical deterioration and mental slowing along with loss of creativity, begin to be felt.

During his radio interview, Emanuel claimed he is very active, recently climbing Mount Kilimanjaro with is two nephews, stressing that he is in relatively good health and doesn’t have a terminal illness and has no plans to commit suicide.   As a matter of fact, the physician even condemned physician-assisted suicide and euthanasia, in a 1997 article published in The Atlantic, a policy allowed in the states of Oregon, Vermont and Washington.  His philosophical view of ending one’s life is to allow the body to age naturally, he stresses.

In eighteen years, Emanuel pledges to refuse all medical procedures and treatments, including taking medications such as statins, cholesterol lowing drugs, and antibiotics that could prevent life-threatening illnesses or extend his life.  He notes that his last colonoscopy will be at 65, to screen for cancer.  No more colonoscopies after 75.  And, he’ll only accept palliative care after that milestone age, too.

“I’m not suggesting people kill themselves at 75 but, rather, let nature take its course,” Emanuel says.

How Others See it

Emanuel’s personal preference not to seek medical procedures or to use medications at age 75 that might lead to his death is not the same as physician assisted suicide, says Rev. Christopher M. Mahar, S.T.L., of the Providence Catholic Diocese, noting that this choice has always been respected by the Catholic Church.

“He is not actively choosing to take his life, and as long as he is not rejecting any of the ordinary means necessary for the preservation of life, such as nutrition and hydration, and is not intentionally destroying his body, he is free to decide for himself, says Mahar.

As Emanuel says, there is a downside to aging.  My 88-year-old mother died after a 14 year battle with Alzheimer’s disease.  At age 89, my father, whose quality of life declined over his later years, died suddenly, by having a pulmonary embolism.

For me, 89 is the year I choose to meet my maker, hanging up my spurs.  Yes, I will let nature take its course, but I will most continue to take Vitamins and antibiotics, even my Lisinopril, for high blood pressure.  I will not turn my back on medical procedures or technology that might enhance the quality of my life, even lengthen it.

I agree with the statement of late Actress Betty Davis stated, “Old age ain’t no place for sissies.”   There is no alternatives, you can only hope for nature to ultimately take its course, and it will.  And so, we all are inclined to pick our own magic number.

Herb Weiss, LRI ’12, is a Pawtucket writer who covers aging, health care and medical issues.

TV Celeb Valerie Harper Calls for More Funding for Cancer Research

Published in Pawtucket Times, May 12, 2014

With a growing population of aging baby-boomers, the U.S. Special Committee on Aging held a hearing on Wednesday to put the spotlight on how decreased federal funding to support cancer research is derailing the nation’s successful efforts on its fight against cancer and to detail treatment advances. .

In Dirksen Building 562, Chairman Bill Nelson (D-Florida) addressed the packed room on how innovative cancer research has tripled the number of survivors during the last 40 years, while continued federal cuts to balance the nation’s budget are having a severe impact on biomedical research.

But, despite significant advances in medical treatments over the years, cancer still is a major medical condition for the national to confront. About 1.6 million Americans—the majority of them over age 55—will receive a cancer diagnosis this year, and more than 585,000 will die from the disease.

Putting Cancer Research on the Public Agenda

In his opening statement, Nelson stated that “As a result of the sequestered cuts, Francis Collins, director of the National Institutes of Health (NIH), had to stop 700 research grants from going out the door.” Federal funding support has “accelerated the pace of new discoveries and the development of better ways to prevent, detect, diagnose, and treat cancer in all age groups,” he says.

Cancer research has been put on the radar screen of the Senate Aging panel because “little is known about the impact of cancer treatments on the body as it ages,” added Nelson.

Nelson notes that although many cancer survivors are in remission because of ground breaking advances in research, there still remains a large percentage of people with cancer across the nation who are still dependent on their next clinical trial, or even the next NIH research grant to keep them alive just a little bit longer. This is why Congress must be committed in its war against cancer, he adds, noting that the best place to start is to renew the federal government’s role and commitment to innovative research that is taking place at universities, oncology centers and hospitals, where much of the federal funds are being directed by NIH.

Dr. Harold Varmus, director of the National Cancer Institute, said more research is needed to fully understand how cancer is linked to aging. “Because most types of cancer-but not all-are commonly diagnosed in older age groups, the number of people with cancer is rising [with the world’s population rapidly aging], and continue to rise, here and globally.”.

“For people of any age, the first line of defense against cancers and their damaging consequences is prevention,” states Varmus.

Dr. Thomas Sellers, director of the H. Lee Moffitt Cancer Center and Research Institute, made his views quite clear about the federal government’s “irreplaceable role” in funding medical research. “No other public, corporate, or charitable entity is willing or able to provide the broad and sustained funding for the cutting edge research necessary to yield new innovations and technologies for cancer care of the future,” he says.

Sellers warns, “Without increased funding now, the spectacular advancements we have witnessed in the past will not be there in the future.”

Star Power to Make a Point

One of the nation’s most prominent lung cancer survivors, Valerie Harper, who rose to fame on the “The Mary Tyler Moore Show” and “Rhoda,” “Valerie,” and more recently on “Dancing with the Starts, advocated at the May 7 Senate panel for increased funding for cancer research. Harper, detailed her own battle with cancer, reminiscing about her initial diagnosed with lung cancer in 2009, later finding out last year that her cancer had spread to the lining of her brain.

Through the eyes of an entertainer Harper explained her fight with cancer. “Cancer reminds me of a very bad but tenacious performer, who although no one wants to see, insists on doing an encore, having a return engagement, making a comeback and worst of all, going on tour,” she said.

According to Harper, more than two-thirds of all lung cancers occur among former smokers or those who never smoked, the majority being former smokers.  Second hand smoke, air pollution and radon, a colorless, tasteless and odorless gas, can cause lung cancer. But, one’s genes can play a role in developing lung cancer, too, she says.

Seventy four-year old, Harper, a cancer survivor of four years, admitted she never smoked, but was exposed to secondhand smoke for decades. As to family, her mother developed lung cancer and later died from it. The actress believes that her lung cancer might be traced to two risk factors, second-hand smoke and genetics.

In her opening testimony, Harper claimed that 75 percent of all lung cancers are often times discovered too late, in the later stages when the disease has already spread. The vocal cancer advocate called for Congress to put more funding into finding better ways for early detection of the disease.

Harper notes that research can also identify new treatment options for lung cancer when it is detected in stages 3 and 4 and finding promising ways to personalize chemotherapy, by testing genetic markers, making the treatment less toxic and more effective against specific tumors.

Others on the Witness List

In 2012, Chip Kennett, 32, a former Senate staffer, remembers passing his annual physical “with flying colors.” Weeks later, a nagging, blurry spot in his right eye would lead to a PET scan that showed he had cancer “everywhere.”

Looking back, he expressed to the Senate panel the shock of being diagnosed with having cancer. “There are really no words to describe what it feels like to be told you have an incurable disease that will kill you,” he said.

Now 18 months post-diagnosis, Kenett, who is now living with an as-yet incurable form of State IV lung cancer, is now in his fourth targeted treatment, the clinical trials have allowed the young man to lead a relatively normal and productive life. “Research saves lives and I am a living example of that. The drugs that have kept me alive for the past 18 months were not available just seven years ago,” he says.

Other witnesses at the hearing included Mary Dempsey, assistant director and cofounder of the Patrick Dempsey Center for Cancer Hope and Healing in Lewiston, Maine, who shared her experience of taking care of her mother, Amanda with her Brother, nationally renowned actor Patrick Dempsey seen on “Grey’s Anatomy.” Over 17 years since the mother’s initial diagnoses in 1997, she had a total of twelve recurrences and just recently died in March.

“My mom lived this experience, and I shared it with her as her primary caregiver,” notes Dempsey said. “In this role, I experienced first-hand the impact cancer had on every part of my life. For me, it really became a full-time job, navigating resources, understanding the medical world, and coping with the profound changes in our lives.”

A Call for Increased Cancer Funding

Hopefully the Senate Aging Panel’s efforts to put medical research on the short list of the nation’s policy agenda will get the attention of GOP lawmakers who over the years have attempted to balance the nation’s budget by slashing NIH funding.

Cancer touches every family. Everyone knows of a family member, colleague or friend who has died from cancer or is a cancer survivor. Americans must send a strong message to their Congressional lawmakers, “no more cuts to medical research.” If the nation is truly at war with cancer, it is shameful to not give the nation’s medical researchers the adequate funding necessary to defeat it once and for all.

Herb Weiss, LRI ’12, is a Pawtucket based writer who covers aging, health care and medical issues. He can be reached at hweissri@aol.com