It pays to be thrifty, of course -- in these times especially. But if you need assistance walking, don't borrow your friend's cane or walker. And learn how to use your own. A recent study in the Journal of the American Geriatrics Society reported that 47,000 senior citizens end up in ERs each year after falling while using an unsuitable cane or walker, or incorrectly operating one.
(This strikes close to home: I don't know what wigs out me and my siblings more, the fact that my mother's walker is so rarely used or the way she operates it when she takes it out for its monthly spin, her back leaned wayyyy over, arms outstretched, the walker just a distant blur in front of her.)
In response to these numbers, the American Physical Therapy Assn. has put out a reminder that it makes sense to consult a physical therapist so that appropriate walking aids are selected and people are taught how to use them properly. (This tip is a tad self-serving, perhaps, but also seems very sensible.)
Some tips from the association's release:
The walker or cane should be about the height of your wrists when your arms are at your sides.
When using a walker, your arms should be slightly bent when holding on, but you shouldn't have to bend forward at the
waist to reach it.
Periodically check the rubber tips at the
bottom of the cane or walker. Be sure to replace them if they are uneven
or worn through.
Even the hint -- from an animal study, no less -- that a specific drug may eventually help humans extend lifespan is enough to generate considerable popular excitement, presumably among those who have an interest in living longer. But if it's longevity you want, suppressing the immune system may not be the best way to go. That's what the drug in question, rapamycin, does.
For one thing, this suppression does tend to increase the risk of disease. An undesirable side effect by anyone's standards.
Rapamycin, an antibiotic commonly given to prevent rejection of organ transplants, was given to old mice in a recent study and, yes, the animals lived longer. Lifespan was increased up to 14% for female rodents (not to belabor the point, but it's worth repeating that the study was on, yes, rodents) and up to 9% for male rodents. *
Now, more on rapamycin.
The National Cancer Institute defines it as: "An antibiotic that blocks a protein involved in cell division and inhibits the growth and function of certain T cells of the immune system involved in the body's rejection of foreign tissues and organs. It is a type of immunosuppressant and a type of serine/threonine kinase inhibitor. Rapamycin is now called sirolimus."
More on sirolimus from rxlist.com, which points out that the drug can increase the risk of certain types of cancer -- lymphoma and skin cancer, for example.
Here's a summary of the new research, published Wednesday in the journal Nature. It states: "Rapamycin may extend lifespan by postponing death from cancer, by retarding mechanisms of ageing, or both."
That's heady stuff. Here's a bit more context, in a more accessible version, from nature.com. And a blog post from the site pointing out just where the word "mice" first appeared in various media reports.
As a Forbes story clarifies, the significance here is actually what the research tells us about the biology of aging. There's a long way to go between one finding about a signaling pathway in the body and practical effects in people. A very long way.
But, of course, that doesn't mean you shouldn't try to get this antibiotic and take it as an insurance policy. Mega doses, naturally, just to be on the safe side.
-- Tami Dennis
* An earlier version of this story said the mice were all of the same type. Not so, as Mr. Miller (see comment below) was kind enough to point out.
Among the keys to longevity are telomeres, DNA sequences at the end of chromosomes that shorten as we age. When cells replicate, telomeres shorten. Thus, preserving the length of telomeres is thought to be a possible key to living longer.
A study in the new issue of the American Journal of Clinical Nutrition found that people who take multivitamins daily had telomeres that were 5.1% longer, on average, than non-vitamin users. The researchers, from the National Institutes of Health, looked at multivitamin use and nutrient intake, as well as telomere length, in 586 women ages 35 to 74. They also found a link between telomere length and intake of vitamins C and E.
How multivitamins may affect telomeres is unknown. But studies have shown that telomeres are vulnerable to oxidative stress, and some vitamins are antioxidants. But since the study is epidemiology, not a cause-and-effect study, it will take more research to know whether multivitamins really impact telomere length.
"To our knowledge, this was the first epidemiological study of multivitamin use and telomere length," Dr. Honglei Chen, of the National Institute of Environmental Health Sciences, wrote in the report. "Regular multivitamin users tend to follow a healthy lifestyle and have a higher intake of micronutrients, which sometimes makes it difficult to interpret epidemiological observations in multivitamin use." But, they added, "the results are consistent with experimental findings that vitamins C and E protect telomeres in vitro."
Technically, it's called hyperkyphosis; untechnically, it's called dowager's hump.
Whatever you call the condition -- an excessive forward curve of the upper spine often seen in elderly women -- it appears to be connected to a higher rate of earlier death in those who also have vertebral fractures.
In a study published in the May 19 issue of Annals of Internal Medicine, researchers at UCLA found that the greater the curvature, the higher the risk of death within the study period. This held true regardless of age, the problems caused by the basic spinal osteoporosis or the severity of the fractures.
basic information about the condition from osteopenia3.com;
and a blog, Dowagers Humps, that though not especially active, does appear to target folks looking for practical solutions and support.
As for what women can do to improve their quality of life, a small unrelated pilot study, also from UCLA and published in the American Journal of Public Health a couple of years ago, found that yoga might help produce better posture in women with hyperkyphosis.
Those researchers said such improvements could have included "increased strength and flexibility (attested to by improvements in physical function measures) and heightened attention to alignment (as reflected in women’s diary entries)."
Photo: Yoga seems unlikely to hurt, and it might provide some benefits.
Occasionally we get letters from readers asking for fitness advice, and when this came across the electronic transom we decided to post a response here, thinking a number of people could benefit from it. A reader named Patrick writes:
"I am a 60-year-old male. I keep to a stringent exercise regimen, with weight training every other day and aerobics on a treadmill every day. I also eat well, keeping my weight close to what it was when I was 18. However, whatever I do and regardless of how hard I work out, I am unable to tighten the skin in the mid section (for six-pack abs). Can you tell me if this is just age, or if there is something else I can do?"
Let's dispense with the bad news first -- the stuff you can't do much about. Some of that sagging may be loss of skin elasticity due to the normal aging process -- the same one that makes our faces wrinkle. Loose skin can also be chalked up to genes, and if that's the case, please feel free to blame your parents. But blame yourself if you've spent copious time in the sun, since that can prematurely age skin, making it head south.
Now for the things you can change. We spoke with Pete McCall, an exercise physiologist with the San Diego-based American Council on Exercise, who suggests examining your diet first. You mentioned that you eat well, but how your diet breaks down is important. You should include some good fats in your diet, since they contribute to skin health, fueling production of collagen, a protein found in the connective tissue that helps keeps the skin smooth, taut and wrinkle-free. Good sources of polyunsaturated and mono-unsaturated fats are avocados, nuts, seeds and olive oil.
As for your workouts, McCall says those may need some tweaking as well. If you're doing the same strength training workouts week in and week out, you're not taxing your musculeoskeletal system and not building new muscle. That's especially important as we age, since starting around age 40, men lose about 1% of their muscle mass a year. "Doing more intense weights and explosive training will help the body create more testosterone, which produces muscle growth," says McCall. "That could help fill out the skin and create that tightness. If you're just lifting the same weight every time, you're not stimulating any muscle development."
Because power lifting requires lifting heavier weights and specific lifting techniques, you might want to get some help from a personal trainer to learn the ropes before embarking on a program.
We understand that not seeing the results you want is frustrating, but there is a point at which vanity might need to take a back seat. Or maybe stay in the front seat, but be very quiet.
"What I try to get people to think about," says McCall, "is that if you train for the mirror, you're never going to be happy. When I work with clients I ask them what is their performance goal -- do they want to run, ride a bike? I tell them to train for function, and then form follows function. The type of training they do will produce a good body."
Sports such as swimming, soccer, martial arts or basketball typically work the entire body, with the muscles performing in unison, not in isolated bouts as with weight training. If sports aren't on your roster, you might want to check out some masters programs, such as U.S. Masters Swimming and USA Track & Field.
If you try any of these ideas, please let us know the outcome.
Fear isn't always protective -- sometimes it can create a self-fulfilling prophecy of poor health. Yoga might help. Pets might not.
Recent research at Oregon State University suggests that older adults who are worried about their health are less likely to have active lifestyles. Such inactivity is then linked to more trouble walking. And that trouble, as we know, can make controlling weight, blood pressure, blood sugar and cholesterol more difficult -- in short, creating more health worries. (Rather than belabor the benefits of exercise, we'll refer you to the Mayo Clinic's quick tutorial.)
Similarly, walking difficulties can cause a fear of falling. And less physical activity can increase the likelihood of falls. Indiana University researchers have found that some older adults who are afraid of falling can be helped by yoga. In their small study, a 12-week class ratcheted down participants' fear a bit and significantly increased their lower-body flexibility.
Perhaps greater flexibility could also increase the chances of surviving a pet-related accident unscathed. A recent CDC report has detailed the fall-related risks posed by pets, pet-walking and pet-related accessories (such as food dishes) and found that, though such injury-related accidents are rare, older people are more likely to sustain them.
(To be fair, there's no breakdown on whether small barking dogs are more likely to be the culprits, but at the moment -- because of a particularly incessant nighttime barker in the neighborhood -- I'm not inclined to give the variety the benefit of the doubt.)
... And all any of this does is provide a reason for highlighting exercise as a way to reduce falls among older Americans.
Falls are the leading cause of injury death among older adults and, in 2005, were blamed for 15,800 deaths among people 65 and older. They were also responsible for about 1.8 million emergency room visits. (More fall-related stats.)
Such falls can often begin a downward health spiral -- leading to increased disability, a loss of independence and death -- hence the well-founded fear many people have of them.
So do what you have to do to prepare yourself to get moving -- have your vision checked, get handrails or walking accessories, and don't obsess too much about fear itself. (More information -- actually useful -- on fall prevention.) And, please, watch out for the pet dish.
It's a question that stumps evolutionary biologists and women of a certain age:
What's the deal with menopause?
OK, so maybe the evolutionary biologist puts the question a little differently: If the goal of any organism is to pass on his or her genes, why do females go on living beyond their reproductive years?
Researchers in Washington and British Columbia sought an answer in killer whales, the black-and-white beauties that cruise their inland and near-shore waterways. Among little-known killer-whale factoids: They are extremely long-lived. And not only do female killer whales go through menopause, they have the longest post-menopause lifespan of any mammal, including humans.
Male killer whales rarely live to be 50, although they can father calves up to their last spout. Females enter their reproductive years around age 10 and lose fertility rapidly after age 40, but live to be 55 and older. One of the female killer whales in the study was known to be more than 90 years old.
One possible explanation for menopause is the grandmother hypothesis: Females who are past their own reproductive stage can help their daughters or other kin raise their offspring, allowing the daughters to produce even more babies because grandma is around to babysit.
But in the study published in the journal Frontiers in Zoology, the scientists saw no effect of grandma whales on either the fecundity of their daughters or the survival of their grand-calves.
They did find some support for another explanation: the attentive-mother hypothesis. Like humans, killer-whale calves remain dependent on their mothers well beyond weaning. Living, on average, 10 years beyond menopause allows a mother to see her final offspring through to maturity (assuming that the "mature" young adult whale doesn't try to move back into the pod basement).
The researchers also found that the calves of the oldest mothers had a 10% greater chance of survival than the offspring of younger mothers -- a comforting thought for any older mammal undertaking motherhood and menopause back-to-back.
The decline in mental sharpness is among the most distressing aspects of aging. But a new study suggests that good blood sugar control, even in people without any evidence of diseases such as diabetes, may be an important strategy to maintain healthy brain function in later life.
The study, published today in the Annals of Neurology, focuses on changes in the hippocampus part of the brain. Even in people without Alzheimer's disease, the hippocampus is vulnerable to aging. As this part of the brain declines, so do functions like memory. Researchers from Columbia University Medical Center, however, have shown that rising levels of blood glucose, which occurs normally during aging, may be a contributing factor to a lackluster function in the hippocampus. Ways to reduce blood sugar levels, such as through exercise, could be a way for people to postpone some of that normal cognitive decline in old age.
"Whether through physical exercise, diet or drugs, our research suggests that improving glucose metabolism could help some of us avert the cognitive slide that occurs in many of us as we age," said the lead author of the study, Dr. Scott A. Small, in a news release.
To arrive at their findings, Small and his colleagues mapped out specific areas of the hippocampus impacted by diseases such as diabetes and stroke. They found that blood glucose selectively targets the dentate gyrus area of the brain. Decreasing activity in the dentate gyrus correlated with rising blood sugar levels. Other studies have also shown that exercise causes an improvement in the dentate gyrus function.
--Shari Roan
Photo: Cerebral blood flow is mapped in the brain of someone with diabetes. Warmer colors indicate greater activity. Credit: Columbia University Medical Center.
A so-called "anti-frailty" drug has shown promise in a small study, increasing muscle mass in the arms and legs of healthy older adults without causing side effects.
The medication is an oral drug called MK-677 that stimulates the normal release of growth hormone. Growth hormone is secreted throughout the day by the pituitary gland. The hormone, which peaks in puberty and gradually declines thereafter, plays a role in promoting muscle mass, decreasing fat mass and keeping bone and cartilage healthy. The reduction in growth hormone has long been thought to be a key reason why people become frail in old age.
The study, by researchers at the University of Virginia Health System, involved 65 men and women ranging in age from 60 to 81. Half of the participants received a single daily dose of MK-677 for a year and half received a placebo. After a year, the volunteers on the placebo were given the drug and those who got the drug in the first year were randomly assigned to continue receiving it or a placebo. The study found that the drug restored 20% of muscle-mass loss associated with normal aging. In seniors who took the drug, levels of growth hormone increased to those found in healthy young adults, and the pituitary gland released growth hormone in the normal pattern throughout the day.
The effects of the drug lasted for those who received it for the full two years but went away when the medication was stopped. The study appears in this week's issue of Annals of Internal Medicine.
Researchers caution that the medication is experimental and more studies are needed. This study was too small to evaluate the long-term effects of increasing growth-hormone secretion. An editorial accompanying the study cautioned that manipulation of growth hormone should be limited to controlled clinical trials. The treatment "is not ready for prime time," said the author of the editorial, Dr. Marc R. Blackman of the Veterans Affairs Medical Center in Washington, D.C.
But one of the study's authors, Dr. Michael O. Thorner, noted:
"Our study opens the door to the possibility of developing treatments that avert the frailty of aging. The search for anti-frailty medications has become increasingly important because the average American is expected to live into his or her 80s, and most seniors want to stay strong enough to remain independent as they age."
So what does it take to live well in old age? You’d better sit down for this one, it’s going to be a shocker.
According to a study in this month’s Journals of Gerontology, those who are more likely to "thrive" (their word) in old age have these things going on: a positive outlook, lower levels of stress, not smoking, drinking moderately, a moderate to higher income, and no chronic health conditions. Yep, that’s all it takes!
Researchers surveyed nearly 2,500 Canadians ages 65 to 85 who took part in a 10-year Canadian National Population Health Survey about their quality of life. They were then put into four categories: thrivers, or people who sustained exceptional health with no or only mild disability; nonthrivers, those who had a moderate or severe disability; those who were institutionalized; and those who died during the course of the study.
Although about 50% of participants were categorized as thrivers at the beginning of the study, after 10 years, a scant 8% were classified as thrivers, 47% were nonthrivers, 9% were institutionalized, and 36% died. Those who made the thriver category at the end had a higher income, lower psychological distress, never smoked, drank moderately and had more self-esteem. They were also younger at the beginning of the study.
While this may elicit a collective "duh" from everyone, let’s think for a minute what we can take away from the information. Study co-author David Feeny, senior investigator at the Kaiser Permanente Center for Health Research, offers this: "Many of these factors can be modified when you are young or middle-aged," he said in a release. Also, many of the commonalities in the thrivers were not physiological, such as having more self-esteem and lower stress.
If only other aspects of life were as easy to figure out.
Tami Dennis, who takes the word "skeptic" to previously uncharted territory, is the Times' Health and Science editor. She's adamant that pitches promoting awareness days, weeks or months are, by their nature, non-stories. And, because she's an adult, she refuses to use words like "veggies," "tummy" and "yummy."
Rosie Mestel, deputy Health and Science editor, studied genetics before abandoning flies, fungi and DNA for health/medical writing. Her hero is the biologist Ernst Haeckel, whose jellyfish paintings inspired snazzy chandeliers. Her favorite toast-spread is Marmite, a British delicacy made of yeast extract. Her least-favorite word is "millenniums."
Melissa Healy is a staff writer for the Health section reporting from Washington D.C. Healy's a veteran of The Times' National staff, having covered the Pentagon, Congress, poverty and social welfare, the environment, and the White House before shifting to Health in 2003. She writes frequently about mental health and human behavior, about federal health policy, prescription medication and ethics in medicine. More wonk than wellness freak, Healy chooses to believe in the health benefits of coffee and wine, and considers water a better work-out medium than beverage.
Karen Kaplan covers genetics, stem cells and cloning. She and colleague Thomas H. Maugh II comprise about 25% of the unofficial MIT-Alumni-in-Journalism Club, and she is proud to have taken more math (5) than English (0) courses in college. Her contributions to Booster Shots will, she hopes, appear more frequently than postings to her mommy blog.
Thomas H. Maugh II has been a science and medical writer at the Times for 23 years. Before that, he was on the staff of the journal Science for 13 years.
He has bachelor's degrees in English and chemistry from MIT and a doctorate in chemistry from UC Santa Barbara.
After a brief stint as a sports writer, Shari Roan turned to health journalism and has covered the topic for The Times for 18 years. She is the author of three books and the mother of two daughters, both teenagers who refer to her as a "health freak." She likes to jog, watch baseball and is very happy that dark chocolate contains some health benefit.
Jeannine Stein writes about fitness, sports medicine and obesity for the Health section. She’s a gym rat from way back and never met an elliptical trainer she didn’t like. Well, maybe one or two. She tempers exercise with a steady diet of reality television because she believes it’s all about balance.
OK, so maybe the evolutionary biologist puts the question a little differently: If the goal of any organism is to pass on his or her genes, why do females go on living beyond their reproductive years? 
The decline in mental sharpness is among the most distressing aspects of aging. But a new study suggests that good blood sugar control, even in people without any evidence of diseases such as diabetes, may be an important strategy to maintain healthy brain function in later life.
A so-called "anti-frailty" drug has shown promise in a small 
According to a study in this month’s 