November 17, 2008

Anti-Anti-Aging: Alternative Perspectives on Getting Older

In my last post, I explored the world of "brain training" and offered my opinion on some of the lofty claims of the burgeoning brain fitness industry. Although there are several such programs available on the market offering a variety of games and activities, each strives to accomplish a common end result: delay, if not reverse, the cognitive declines associated with aging. Much of their success comes from the fact that this promise is appealing to many people who view aging with trepidation and perhaps even disgust. Especially in the United States, to a society that prizes youth and beauty above all else, the stereotypical characteristics we associate with getting older are decidedly unpleasant. Although the millions of dollars generated by industries capitalizing on this public fear (anti-aging cosmetic products, plastic surgery, etc.) speaks volumes about the majority's view of aging, alternate views have emerged in recent years and are also enjoying increasing support within the aging communities.

Whether concerned with the physical or intellectual tolls of "normal" aging, much of the research emanating from laboratories today ultimately ends up being put to use to make a product available to the public for sale. The anti-aging industry is, after all, a business. New studies, however, have implications that go beyond the superficial aspects of aging and the preventative measures (such as diet and exercise and the prophylactic use of vitamins and supplements). In his post, "How a story reversed the aging process," Improved Lives blogger Stu describes the recent research showing that merely imagining yourself younger can often bring the health benefits of actually being younger. The post goes on to suggest the beneficial consequences of this "mind over matter" approach, illustrating one perspective that deviates away from the money-based solutions that dominate the current market. Money too is at the heart of the approach taken by guest essayist Dr. Daniel Callahan in a recent post featured on the New York Times New Old Age blog. "How old is too old for lifesaving surgery?" is distinct from other views on the aging process in that he asserts that risky and costly procedures are too often performed on elderly patients that in the past would have been turned down simply due to their age. It is Callahan's belief that our already cash-strapped Medicare system would benefit hugely from an "age-based rationing" of care, denying expensive surgeries to patients who most likely will only go on to develop another fatal complication of old age. Almost 20 years after he first published his proposal in his book (pictured below), Callahan updates and defends his controversial position, citing a Medicare system that has only gotten worse in the years since. Although the content of the posts themselves are distinct, both refuse to view aging as a disease to be avoided at all costs. In addition to posting them on their respective blog sites, I have included my comments to each below.

"How a story reversed the aging process"
I would like to first thank you for your interesting and thought-provoking review of the recent experiments that have demonstrated aging to be as much of a state-of-mind as it is a physical process. Although it may simply be the implication that we have a considerable amount of control over the nature of getting older that is so appealing, these studies have the potential to dramatically change the approaches to aging we take. On one hand, it seems as though so much of the admittedly admirable work that comes out of the science and research communities focuses on the abnormal aspects of aging, while on the other, the booming cosmetic and plastic surgery industries bombard us with the notion that vigor and vitality are things we have to buy in a bottle. For so many left somewhere in between the two extremes, it is refreshing to learn that psychological as well as physiological benefits can be had using the power of thought. While the three "suggestions" you set forth might seem like common sense in achieving these ends, I believe they speak to a larger acceptance of aging as a journey within itself, rather than an obstacle to be overcome or an ending to be dreaded.

"How old is too old for lifesaving surgery?"
While I may not agree entirely with your proposal to ration care to the elderly, I thank you for sharing a fascinating and provocative perspective I was previously unfamiliar with. As someone who is passionate about both the scientific and societal aspects of aging, I had yet to recognize the conflict created by advances of the former and inflicted upon the latter as an explanation for our floundering Medicare system. Although I am undeniably supportive of research efforts to diminish or altogether do away with the unpleasant physical declines of aging through use of surgery and other medical procedures, I am also of the opinion that aging overall ought not to be viewed as a disease to be eradicated completely. Instead of being grateful for the added years science and improved technology has brought us, we are all too quick to assume that human longevity can, and should, be infinitely drawn out. The argument that costly procedures are, for lack of a better word, wasted on individuals who have little chance of survival, and will likely face additional diseases even if they do, is a persuasive one, especially amid the staggering Medicare figures you cite. Although I would prefer an alternative path to fixing our health care system that does not include cutting off benefits to patients based solely on age, the fact remains that something has to change. That you first proposed this policy change almost 20 years ago only emphasizes the magnitude of the country's dilemma.

2 comments:

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