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Dr. Caroline Cicero

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Addressing the Real Challenges of an Aging Population

Posted: 07/10/11 09:00 AM ET

The Census Bureau is doling out its 2010 data a little at a time, leaving cities, counties and demographers who count on the updated information to wait for their turn. Filling out the forms last year may have been an inconvenience to you, but the results are a highly-anticipated, golden treasure for me.

I need to know who lives where -- not in individual houses, but across communities. I cannot wait to analyze how the populations of our urban areas, suburbs and outlying exurbs have changed since the last comprehensive count in 2000. What am I so anxious to find? The latest data on baby boomers, whose numbers are 70-80 million strong!

You must have realized by now that baby boomers began turning 65 on January 1, 2011. If by chance you were watching the Rose Parade on last New Year's Day, you saw the Alzheimer's Association's flowery float entitled Boomer Express, sponsored by Pfizer. "It's Time to Face Alzheimer's," the backdrop read.

2011-07-06-Boomer_Express_Time_to_Face_Alzheimers3.jpg

The Alzheimer's Association is masterful at capitalizing on windows of opportunity -- and President Obama signed the National Alzheimer's Project Act (NAPA) into law just three days after the float puttered across millions of television sets. Per the law, the Department of Health and Human Services is putting together an Advisory Council to oversee NAPA's implementation. With one victory behind it, the association is now pressing Congress for a research funding commitment with the Alzheimer's Breakthrough Act. With rising health care costs and the new wave of aging baby boomers who will live longer than their parents, the disease is expected to cost Medicare and Medicaid $15 trillion dollars over the next 40 years.

More than 200,000 baby boomers are already living with early onset Alzheimer's. The disease is America's sixth leading cause of death. For people over 40, the fear of losing one's mind could be greater than the fear of death itself. The loss of cognitive functioning and independence -- followed by the potential need to move into a nursing home -- are tangible fears for aging baby boomers. Many caregiving baby boomers have already watched with heartbreak as their parents' memories faded. Tireless advocates such as Maria Shriver, have worked closely with the Alzheimer's Association to garner support from lawmakers and to grant empathy to others whose families have been impacted by the disease.

What will the 2010 Census data tell me about how Alzheimer's will impact local communities? At present, 12 percent of people over age 65 -- and half of all people over the age of 85 -- have the disease. By 2030 when baby boomers are aged 65-85, projections estimate that 8 million will have Alzheimer's. Many members of the baby boomer generation will live to be 85-105 years old, and unless there is a medical breakthrough, up to 16 million could have Alzheimer's by 2050.

Health and aging policies are formed and funded by the federal and state governments, but programs are implemented in local settings. Whether in early, high-functioning stages of the disease or later debilitating stages, the communities in which people live need to accommodate and care for people living with Alzheimer's.

Previous census data and post-WWII migration tell us that most baby boomers live in car-dependent suburbs developed after the war, as well as in sprawling, outlying exurbs, built up in the last 25 years. Boomer moms and dads who have spent their 40s and 50s shuttling kids, and who may also be caring for aging parents, know that without their cars their daily duties in these suburbs and exurbs are impossible. For their aging parents who develop memory problems, taking away their car keys is a very difficult but necessary loss of independence and often a burden for the elder and caregiver. The driving issue is only one problem of Alzheimer's that cities and states will need to face over the coming decades -- and one that will effect more than just Alzheimer's patients. Indeed, many older people who have vision impairments will have to give up their car keys as well.

Apart from transportation outside the home, the need for assistance inside the home is a challenge which has not been solved for the next generation of elders. The CLASS Act, part of health reform's Affordable Care Act, is an effective step in the right direction. It allows employees to make voluntary contributions to a fund which they can later access if and when they need in-home assistive care.

Anticipating the aging of the baby boomer generation, some local governments have begun discussing how to create more elder-friendly communities. This idea is easier to envision for communities where residents can walk to the store, doctors office, place of worship, or exercise class. For the majority of the suburban locations where baby boomers reside, we need to get busy figuring out how residents will age in their neighborhoods.

The "Boomer Express" is unstoppable. It is time to face up to wrinkles, own gray hair and get busy supporting solutions to the real challenges of aging.

 
The Census Bureau is doling out its 2010 data a little at a time, leaving cities, counties and demographers who count on the updated information to wait for their turn. Filling out the forms last yea...
The Census Bureau is doling out its 2010 data a little at a time, leaving cities, counties and demographers who count on the updated information to wait for their turn. Filling out the forms last yea...
 
 
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08:15 PM on 08/21/2011
Great article! I had never considered how suburb-dwelling will pose an increased complication as we move into this new season as a culture. My grandma was both blind and had Alzheimer's so I'm very aware of the complexities of being a family caring for a loved one with these issues. We took her keys away, and somehow she found a spare pair and didn't tell anyone. We only knew she'd driven when the hedge was destroyed or she had some miscellaneous items she'd bought at the store to share. "Where did you get this?" we'd ask, and she'd answer, "Oh, when I drove to the store." Busted. :) It was that day my dad and his siblings realized it was time to sell her car. So tough.

All light-hearted storytelling aside, glad that wonderful people like yourself are leading the charge to bring awareness to the issues that will be at the forefront of this developing need.
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Dr. Caroline Cicero
01:39 PM on 08/04/2011
President Obama is on board! Happy Birthday Mr. President

http://www.youtube.com/watch?v=jPM2uhYcpbQ&feature=youtu.be
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FeralForever
I'm watching you...so play nice
04:43 AM on 07/18/2011
Great article, Dr. Cicero, and thank you. I feel that not enough has been done by our country in anticipation of the baby boomers. The warehousing of our elderly is a disgrace. The expense is phenomenal and the care abominable. You mentioned a very important symbol for our beloved elders, which is driving. It means their freedom, both figuratively and literally. I urge anyone reading this to be tender and instead of just snatching away the car keys, it is easier to call their doctor and explain that you think your relative would be a hazard on the road. You can then arrange for them to get a check-up or whatever reason you might have (prescription refills, etc.) for a visit. Let the doctor inform them that driving may not be a good idea on a temporary basis until their balance improves, new glasses are gotten, or whatever reason you may have worked out with the doctor beforehand. You may just need to repeat the process so they are not in danger from driving and you have maintained ownership of the keys in the most humane way possible. Being elderly does NOT mean they don't have feelings. They are subject to depression which may exacerbate dementia. A little forethought and kindness goes a long way.
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Dr. Caroline Cicero
01:42 PM on 08/04/2011
Thank you for reminding us to be sensitive.
The loss of the ability to drive is a huge issue for people at risk of losing their independence.
12:27 PM on 07/10/2011
Regarding "vision impairment" (macular degeneration in particular)...


Vitamin D intakes can “Significantly Influence Course of Macular Degeneration".

See the story from Science Daily regarding macular degeneration study just released:

http://www.sciencedaily.com/releases/2011/07/110705183859.htm


Raise, and maintain, circulating (blood levels) of vitamin D to the natural, healthy range of 50-80 ng/ml, 25 OH.

No other single medical intervention will reduce early onset, chronic disease than maintaining EVOLUTIONARY correct levels of vitamin D.

And no, absolutely not, is just 30 ng/ml of vitamin D adequate. This is below the all important repletion range- thought to be at least 40, and probably higher.

"Repletion" is the level of circulating (blood level) vitamin D where EVERY cell in the human body is able to consume and apply it for its own health and well being. This is absolutely CRITICAL in the maintenance of human cellular function.
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Dr. Caroline Cicero
02:35 PM on 07/11/2011
Thanks for sharing on Vitamin D. Amazing research is being done in the field of aging, including vision and Alzheimer's Disease. We need to support it to get breakthroughs.
11:44 AM on 07/10/2011
New research finding regarding AD:

Vitamin D helps the transport of amyloid beta protiens from cerebral spinal fluid (CSF) across teh blood brain barrier (BBB).

"Prof Tetsuya Terasaki said, "Vitamin D appears increase transport of amyloid β across the blood brain barrier (BBB) by regulating protein expression, via the vitamin D receptor, and also by regulating cell signaling via the MEK pathway. These results lead the way towards new therapeutic targets in the search for prevention of Alzheimer's disease."

Science Daily refernce link:

http://www.sciencedaily.com/releases/2011/07/110709113610.htm