TUESDAY, AUGUST 10, 2010
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Aging Well New programs reach out to seniors touched by loss loss continued from E1
withdrawn, isolating themselves further. Meanwhile, to make matters worse, many older adults lose their spouses, partners and friends, who were sources of companionship, stability and support. Isolation is a common gateway to this cycle of loss. A 2006 Uni- versity of Chicago study of people ages 50 to 68 found a mind-body link: Those measuring higher than others on loneliness scales had higher blood pressure, for example, a major risk factor for heart disease. The primary pre- dictor of loneliness in those older than 50 is not being married, ac- cording to a 2010 study by Laurie Theeke of the West Virginia Uni- versity School of Nursing. Isolation can be particularly
acute for seniors who lose their spouses or partners and live alone. Women far outnumber men in this group. Last year, 41 percent of American women old- er than 65 were widowed, com- pared with 13 percent of men, census data show. Losing a partner can affect older adults in several ways, es- pecially if they’re already ill or frail. A couple with health limita- tions can live independently by relying on each other; when one dies, the other may be ill-pre- pared for new responsibilities and stresses. Jackie Buttimer, for instance,
had never balanced a checkbook and rarely used a computer be- fore her husband of nearly 50 years died in April. “It’s a huge learning curve, and I had never lived alone,” says Buttimer, 71, who lives in Bethesda.
Among older Americans, the
death or illness of a spouse in- creases the mortality rate for the surviving spouse, a 2006 study published in the New England Journal of Medicine found. Over the nine years of the study, a wife’s death increased the hus- band’s risk of death by 21 per- cent; a husband’s death raised the wife’s risk by 17 percent. Even a spouse’s hospitalization raises the risk of death. Yet while bereaved spouses’ lives change forever, most find ways to “adapt over time and ar- rive at a level of functioning — physically, psychologically, emo- tionally,” says Michael Caserta, a University of Utah gerontologist and bereavement researcher.
center, unless it’s a new breed.” Mather’s — More Than a Cafe is just that: three diner-inspired restaurants that double as com- munity centers for aging Chica- goans, complete with computer and art classes, social events, and health and fitness programs. Mather LifeWays, the nonprofit organization that developed the concept, has helped other groups across the country create similar gathering spots. The Internet could serve a similar purpose. Boomers’ Web-savvy ways may give e-mail, instant messaging and Skype a critical role in in- creasing social interaction, espe- cially for the homebound. And boomers may prove more willing than their parents to seek help when life’s losses jeopardize their well-being. Frisch is frank about the toll that her late hus- band’s cancer took on her health. Unlike many older people, how- ever, she sought help after he died, seeing a therapist and re- turning to exercise. “I was determined mentally to
stay well,” she says. “I’m better off if I am productive, busy and so- cial.” That’s exactly what Katherine
DOMINIC BRACCO II FOR THE WASHINGTON POST “I thought that I had prepared myself for it. Maybe I did, but
I’m still feeling devastated. I’m still feeling practically immobile.” — Laurel Frisch of Rockville, who struggled for months after her husband of 52 years died
The boomer effect Isolation and widowhood can contribute to depression in cer- tain older adults. Among those who live independently, esti- mates of major depression range from less than 1 percent to about 5 percent, according to a 2003 study by the Duke University Medical Center. But the Duke study also shows that depression jumps to nearly 12 percent in el- derly hospital patients and to al- most 14 percent in those who need home health care.
And among those older than 85, the 2006 Health and Retire- ment Study, sponsored by the National Institute on Aging, found 19 percent reporting de- pressive symptoms. “Elderly populations in this country have
less social support than anyone,” explains Amy Fiske, a West Vir- ginia University psychologist. Late-life depression is treat- able, however. Psychotherapy and antidepressants have been shown to improve mood in peo- ple with depressive disorders. Outreach programs often use fre- quent phone calls and home vis- its to try to support such people. Still, the stigma of mental illness often makes older adults reluc- tant to seek help. That attitude can be fatal. The suicide rate among the elderly is high: In 2007, it reached 14.3 per 100,000 people, compared with 11.5 among all Americans. Cen- ters for Disease Control and Pre- vention statistics show that white men older than 85 had the
highest suicide risk. “Many feel that once they reach the nursing home, their lives are worthless because they’re not able to contribute to society,” says Yeates Conwell, co- director of the Center for the Study and Prevention of Suicide at the University of Rochester. Increasing public awareness,
expanding crisis hotlines and communicating with religious and community organizations could all help reduce the threat, says Briana Mezuk, an epi- demiologist at Virginia Com- monwealth University. Primary-
care physicians now ask probing questions about a patient’s emo- tional state during routine checkups. AARP has also taken notice by initiating a series of public education projects. Baby boomers entering their
60s with a legacy of activism and familiarity with technology may well alter the aging experience. “They are not going to go softly into the night,” says Victoria M. Rizzo of the Columbia University School of Social Work, who has spent decades working with old- er adults. “These baby boomers are not going to go to the senior
Hinton discovered. She cared for her second husband through years of illness until he died in 2005. She mourned, but “I finally caught my breath,” says Hinton, 71, a retired epidemiologist in New York. Drawing on her community, her Quaker faith, her work and an innate sense of independence, she has rebuilt a fulfilling life. With her daughter’s family in the same apartment complex and friends nearby, she maintains a busy social schedule. She holds leadership positions in her co-op and other organizations. On weekends, she hikes, and in the fall, she’s traveling to Siberia. “I’m alone, but I’m not lonely,”
Hinton says. “My life is very, very full.” She has known loss, but “I am okay, I can survive on my own.”
health-science@washpost.com
Connor Boals contributed to this report. Boals, Jones and Sell are fellows of News21. Mary Plummer, a News21 associate, also contributed reporting.
E5
Wisdom seems to flow from experience wisdom continued from E1
the Proceedings of the National Academy of Science found a U- shaped relationship between happiness and age: Adults were happiest in youth and again in their 70s and early 80s, and least happy in middle age. A 2007 Uni- versity of Chicago study similarly concluded that rates of happi- ness — “the degree to which a person evaluates the overall quality of his present life posi- tively” — crept upward from age 65 to 85 and beyond, in both sex- es.
Wisdom appears to follow a similar trajectory and not only because raising a family, navigat- ing a career and experiencing love, loss, success and failure all educate older adults. Researchers caution that life
experience is “a necessary but not sufficient precondition for wisdom,” says Judith Gluck, a psychologist working with the University of Chicago’s Defining Wisdom project. “People who are observant, empathetic and re- flective may learn a lot from ex- periences that others around them encounter,” she says, “even if they are not directly involved themselves.” What constitutes wisdom? Ip-
sit Vahia, a geriatric psychiatrist at the University of California at San Diego, says it “involves mak- ing decisions that would be to the greater benefit of a larger number of people” and maintain- ing “an element of pragmatism, not pure idealism. And it would involve some sense of reflection and self-understanding.” These qualities appear age-re-
lated. A recent University of Michigan study on aging and so- cial reasoning tested people in three age groups, the oldest be- ing 60 and older. Presented with a fictional geopolitical conflict, participants specified what they thought would happen and why. Igor Grossman, a social psychol- ogist and lead researcher on the study, and his team sorted the answers into six categories of “wisdom-related thinking,” in- cluding searching for compro- mise, admitting uncertainty and finding flexibility. The oldest
some volunteers in each age group to shake off the negative imagery and play a memory game. People in the older age group performed better on the memory test.
John W. McDonald, 88, and Carolyn Miller Parr, 73, have learned the value of controlling their emotions to settle disputes.
group earned the highest wis- dom score in each category. “Wisdom is the ability to navi-
gate the important challenges of social life,” Grossman says. Whether this development comes from neurobiological or emotional sources is a matter of some debate. If the older brain becomes hard-wired for wise de- cision-making, science has yet to document that change. An MRI scan cannot isolate a part of the brain associated with wisdom, says Elkhonon Goldberg, a neu- ropsychologist and author of “The Wisdom Paradox.” Still, he says, the aging brain has a great- er sense of “pattern recognition,” the ability to capture a range of similar but nonidentical infor- mation, then extract and piece together common features. That, Goldberg says, “gives some old people a cognitive leg up.” Others investigating the ben-
efits of old age are more likely to point to social or emotional fac- tors, such as the ability to better regulate emotions, as the un- derpinning for wiser behavior. “I never lose control,” says
John W. McDonald, who at 88 continues to work in interna- tional conflict resolution as chair of the Institute for Multi-Track Diplomacy in Rosslyn. “If you want to do a good job, you have to learn how to control your emotions.”
Older adults have an advan-
tage there. In a 2007 study , Blan- chard-Fields and Susanne Scheibe screened a disturbing video for two groups of adults, ages 20 to 30 and 60 to 75. They recorded the participants’ emo- tional responses to the scene (of a disgusting meal), then asked
Carstensen credits this re- sponse to something called “so- cioemotional selectivity theory,” a focus on positive emotional goals in late life. The elderly bet- ter tailor their social interactions to increase their well-being; re- searchers theorize that, as a re- sult, they make thoughtful, “wise” decisions. “Old people are good at shap-
ing everyday life to suit their needs,” explains Scheibe. By care- fully pruning their social net- works or looking at life in rela- tive terms, older adults maintain cognitive control. And although multiple chronic illnesses that cause functional disability or cognitive decline can affect well- being, most older adults are able to tune out negative information into their late 70s and 80s. “As people age, they don’t have
large futures,” adds Susan Turk Charles, a psychologist at the University of California at Irvine. “Time left in life makes you know what bothers you and what you need to avoid.”
Despite their intriguing find- ings, however, researchers still have an imperfect understand- ing of wisdom. “One man’s wis- dom might not be another man’s wisdom,” Vahia says. The next phase of research, he and Grossman say, examines whether wisdom can be fostered or heightened. If older adults are predisposed to wisdom, perhaps a graying population means a wiser one. Parr, meanwhile, is satisfied with her definition of wisdom. “At first you think wisdom is knowing the answers,” the medi- ator says. “And then, as you get a little older and make a few mis- takes in your life, you find out that wisdom is asking questions — and listening to the answers that you hear from other people.”
health-science@washpost.com
Tapper is a fellow of News21. News21 associate Mary Plummer contributed to this report.
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