Myth #4: Aging Inherently Sucks
Doctors love to diagnose, fix, and tie things in a bow. Sometimes what patients need most is a sense of agency — and simply to be heard.
Welcome to week 4 of medical myth-busting! (I’ve already tried to dispel myths around psychotherapy, medications for anxiety and depression, the new COVID booster, and hormone replacement therapy.)
Let’s keep going!
A few weeks ago I asked you, dear reader, what topics you wanted to hear more about. The following reply from a man in Virginia made me smile — and then think: Why does aging get such a bad rap?
Dear Dr. McBride,
I will be 83 years old in December. This is my diatribe in response to the request in your letter this week: “Got a favorite medical woe you want me to discuss?”
Do my hips hurt when I walk? Yes
Do I have to pee at night? Yes
Are my stools inconsistent? Yes
Do I forget people’s names? Yes
Do I groan when I get up? Yes
Am I dizzy when I stand? Yes
Is my skin shriveling? Yes
Are my arms numb when I wake up? Yes
Do I have difficulty getting out of my car? Yes
Do I fart a lot? Yes
Do I forget what I was meaning to do 5 seconds ago? Yes
Do I feel okay? YES
There are so many parts of this that I love, particularly the heavy dose of acceptance and the explicit desire for medical professionals not to medicalize normal human experiences.
To be clear, acceptance doesn’t mean giving up. It means acknowledging the fixed realities about our health in order to redirect our energy to the things we can control. Acceptance lays the groundwork for improved agency.
Aging is no picnic. It can be dreadful and depressing in myriad ways. And there’s a lot about aging we cannot control. But when patients ask me how they can “age gracefully,” or how to prevent age-related illness and despair, I remind them that they have a lot more agency than they think.
Here are my three top pieces of advice:
Focus on your muscles.
We all know that exercise is important for every aspect of our health. But what my patients often don’t realize is how important strength training is. We lose muscle mass with age. Muscle mass is essential for metabolism, energy, balance, and coordination — not to mention things like getting up from a chair and lifting grandkids. When our muscles are strong and engaged, we spare our joints from doing extra work. Some simple ways to get strength training are though:
Yoga. (If unable to “downward” your dog, try chair yoga!)
Resistance bands.
Lifting light weights.
Working with a trainer, either online or in person.
Formal physical therapy. I think every patient should have a good body mechanic in speed-dial — for tune-ups when needed and for maintenance of good skeletal health. Ask your insurance if they’d cover it!
Optimize cognitive health.
One of the top concerns from patients of all ages is memory loss. Of course memory loss can also be a sign underlying medical conditions like dementia, sleep apnea, and PTSD. Distinguishing normal, age-related memory loss from true health problems requires a medical evaluation, but here are some basic tools I recommend to my patient to help optimize cognitive function:
Regular exercise. Again and again, exercise — even walking — has been proven to improve cognitive function and prevent decline.
Eat lots of antioxidant foods. Omega 3 fatty acids are key! Think: blueberries, walnuts, salmon, and avocado.
Prioritize sleep. Sleep is the glue for our health and is critical for our cognitive health. If you are having trouble getting the sleep you know you need, talk to your doctor about it!
Use it or lose it. Keeping your brain active is essential. From crossword puzzles to polishing up your high school French, flexing your mental muscles is the best way to keep your brain healthy.
Face mental health issues head on. Depression and anxiety disorders are commonly missed in older patients. Patients, family members, and even doctors often assume that an elder’s fears about health conditions or their low moods are a “natural” or “expected” feature of aging. Because depression and anxiety can mimic dementia and cause myriad other health problems, it’s critical to address mental health issues like we do any other organ system.
Prioritize social connection.
Loneliness is the feeling of being alone, regardless of the amount of social contact. Social isolation is a lack of social connections. There’s no shortage of data showing that loneliness and social isolation are linked to serious medical conditions, from heart disease to dementia. Similarly, the data are clear that feelings of connectedness and belonging are good for our health — and that being with other people is a basic biological need.
The social isolation during COVID disproportionately affected my older patients. Between the fear of getting seriously ill from COVID and the shutting-down of activities that normally provide human interaction, many of my older patients report “feeling their age” more than they did pre-COVID.
The solution? Reach out to friends and family. Show up in person when able. Resume pre-pandemic activities — from your yoga class to your bridge group. COVID is here to stay. Know that once you’ve been vaccinated and boosted, you’ve done your best to protect against serious COVID outcomes. And connecting with other people isn’t a luxury; it’s critical for our health.
The upshot.
Our impulse in medicine is to fix, to problem-solve, to make a diagnosis. Doctors love to tidily wrap things up in a bow. We have a label and a pill for just about everything. By the time the average American is 80 years old, they have a doctor for every body part, but no one is in charge.
What patients often need most is simply to be heard — and to be reassured that their complaints aren’t worthy of alarm.
Of course, reassurance isn’t always appropriate. For example, I don’t tell an older patient who is newly short of breath simply to “practice gratitude” for being alive. I don’t assume that every joint pain in a septuagenarian is “just part of life.”
My point is this: You, the patient, should be in the driver’s seat of how to approach your medical issues. Whether it’s with a “full-court-press” or a “less-is-more” style, your doctor should start by meeting you where you are. And remember, through physical exercise, cognitive optimizers and social connections, you have more agency over aging than you may realize!
—
My friend Gloria Riviera isn’t old, but having grappled with childhood trauma, bulimia, brain cancer, she’s an old soul. (That’s a compliment!)
As a reporter for ABC, Gloria has spent two decades reporting on hard hitting topics like underaged sex trafficking. She’s also the host of the No One is Coming to Save Us podcast, where she examines the broken American child care system and life in a post-Roe world.
In this episode of Beyond the Prescription, Gloria openly discusses how past trauma “prepared” her to cope with cancer, the lessons learned during her treatment, and why she doesn’t fear death.
I will see you next week. Until then, be well.