- The Washington Times - Monday, December 15, 2003

The field of aging is booming — not only because of the growing older population, but also because of the nature of the organizations working in older Americans’ behalf.

As a result, confusion abounds about the purpose and identity of groups such as the nonprofit American Geriatrics Society and the Gerontological Society of America as well as what to call older people — seniors, elders or simply older adults.

Adding to the confusion is the fact that some professionals in the field are members of both the above organizations, which are dedicated in slightly different ways to improving the well-being of older people.

“I’m in both; it’s wonderful,” declares Dr. Linda Fried, 54, director of the division of geriatric medicine and gerontology at Johns Hopkins University School of Medicine and a member of the board of directors of the New York-based American Geriatrics Society (www.american geriatrics.org).

“I’m a geriatrician — a physician specially trained in the clinical care of older adults — and I am also a gerontologist, a scientist who studies aging and aging issues,” she explains. “I think we all do a better job because we do both. To maximize the relevance of research, you want it grounded in a concern for human beings.”

The field of geriatrics was founded about 30 years ago in response to awareness that aging brings on a unique set of health issues and health care needs. The National Institute on Aging (www.nia.nih.gov), one of about 25 research arms of the government-funded National Institutes of Health, opened its doors in 1974. The science of gerontology then was in its infancy. “Theories of aging abounded, but data was scant,” notes an NIA publication titled “Aging Under the Microscope: A Biological Quest.”

“Knowledge of aging clustered around specific diseases associated with advancing age; indeed, the notion that aging equated with decline and illness was widespread,” the publication states. Dementia and the relationship between caloric restriction and longevity are just two areas under intensive study by the institute.

At Johns Hopkins, as many as 80 scientists work on aging issues, many of them collaboratively across different fields such as public health and nursing, looking at matters as varied as the causes of frailty, its treatment and prevention; how to keep people independent; and diagnosis in general.

“We have designed a major health-promotion program hidden inside a social program,” Dr. Fried says, “whereby, for instance, the elderly do volunteer work in schools — to show many of the benefits of an aging society so it isn’t seen just as a deficit matter.”

“Pretty much anyone can be a gerontologist; everything falls under the term gerontology because all related areas of interest are involved,” states Todd Kluss, spokesman for the Washington-based Gerontological Society of America (www.geron.org), expanding on the definition.

Society members are behavioral and social scientists as well as medical educators, he says, 40 percent of whom are connected to universities. One-quarter of the members are nurses and physicians, and another quarter staff community centers and nursing homes. “Maybe 5 percent are research biologists,” Mr. Kluss adds.

As an example of special-interest areas under review by the group, Mr. Kluss cites two popular panels at the organization’s 56th annual meeting, which took place last month in San Diego: one on hormone therapy and the other on the future of human longevity.

“One side [of the longevity issue] was saying medicine can take care of every ill, and the other side believes the human body is only meant to live so long,” he reports. “Other hot topics are the aging work force and the anti-aging position, with most legitimate professionals trying to get out the message that there is no miracle drug to fight off old age.”

The definition of what constitutes old age itself is in flux.

“A lot of people would say it is anybody 20 years or older,” Dr. Fried says with a laugh. “[Americans] have the best-educated and healthiest population of older adults in the world,” she says, adding that there are more people older than 65 living right now than the total of all the 65-year-olds who lived before.

“In general, above 62 is elderly,” says Dale Welch, 61, head of the gerontology program at the University of Louisiana at Monroe, who refers to three subcategories printed in medical texts of the past 15 years that call 62 to 74 the “young-old,” 75 to 84 the “middle-old,” and 85 and up the “old-old.” “Some people suggest that 85-plus is the fastest-growing category because more and more people are living longer,” he says.

“Age is a lot more blurred than it used to be,” Mr. Welch adds.

Chronological age can be deceptive, says Dr. Charles A. Cefalu, 52, professor and chief of the section of geriatric medicine in the department of family medicine at Louisiana State University’s Health Science Center in New Orleans and newly appointed director of the new geriatric medicine program at the Medical Center of Louisiana in New Orleans.

“Chronologically, you might be 65, but be 55 or 60 physiologically because you have engaged in good eating habits and socialization and have a religious background that is protective,” he says. “Or the reverse: You may be 65 chronologically but look 80 because you have smoked, haven’t exercised enough and haven’t kept blood pressure and cholesterol under control. And maybe your emotional outlook is bad because you are depressed. It’s something you can determine by talking to a patient — their outlook has implications on the way they age.

“I stress independence — staying that way as long as possible, being socially active. Enjoying life. Psychosocial issues play a big role. And taking regular care of medical needs to help prevent a catastrophic illness later.”

As one sign of changing times, AARP, the 35-million-member organization for older Americans, dropped the word “retired” from its name in 1998, although the capital letter lingers on in its official letterhead.

“That’s because many of our members are not retired or retiring,” spokeswoman Carol Shirley says. “As we say in our magazine, 60 is the new 30.”

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