Environmental Factor, December 2007, National Institute of Environmental Health Sciences
Symposium Highlights Age-Related Issues and Research
By Robin Arnette
In an effort to help the NIEHS community better understand the changing demographics of aging and emerging patterns of chronic disease among seniors, the NIEHS Diversity Council Disability Advocacy Committee (DAC) presented a mini symposium October 30 with experts in the fields of aging research and senior care. "The Science of Aging," held in Rodbell Auditorium, was co-sponsored by NIEHS and the National Institute on Aging (NIA) and chaired by DAC member Alicia Moore, a biologist in the Cellular and Molecular Pathology Branch at NIEHS.
The symposium's morning session was moderated by Darryl Zeldin, M.D., a senior investigator in the Laboratory of Respiratory Biology, and featured Family Care Advisor Angela Reynolds along with four specialists in aging and medicine from NIA. The afternoon session, moderated by Samuel Wilson, M.D., acting director of NIEHS, included presentations by two scientists from the NIEHS Epidemiology Branch and a roundtable discussion.
In her opening remarks, Moore set the tone for the symposium. "We will learn about health and aging in our society, as well as how the environment influences the development and progression of human disease," she stated. "Today's symposium attempts to carry out the NIEHS mission-to gain insight on how to reduce the burden of human illness and disability."
Following Reynolds' talk on the personal aspects of senior care (see text box), NIA Research Scientist Kushang Patel, Ph.D., opened the NIA portion of the scientific sessions with a talk on the demographics of aging. He said that the data generated by studies in population aging research are important since the country's population is not only becoming older, but also racially and ethnically diverse. "Because poverty rates and education level are strong predictors of health status in old age," Patel said, "minority groups are more likely to experience poor health compared to non-Hispanic whites."
The majority of the talk by Epidemiologist Eleanor Simonsick, Ph.D., focused on mobility limitation in older adults because "as rates of dementia increase, the rates of mobility limitation increase as well." Her research found that minimal exercise-walking a couple of blocks a day over a year's time-allowed older adults to maintain their walking ability.
Senior Investigator William Ershler, M.D., focused his research on determining the mechanisms involved in frailty, and the results suggested that inflammatory responses are at the root of the condition as he defined its criteria. "Levels of certain cytokines decrease with age, such as interleukin-2 (IL-2) and IL-12, while some increase with age, such as IL-6 and IL-10," Ershler explained. "Everything from function to mortality is associated with inflammatory proteins."
According to Senior Investigator E. Jeffrey Metter, M.D., the prostate is a pertinent topic for research in aging because prostate specific antigen (PSA) values-a screening test for prostate health-increase with age and as men develop diseases of the prostate. In 1992 Metter and colleagues at Johns Hopkins University began looking at PSA values in serum samples taken from men who participated in the Baltimore Longitudinal Study of Aging.
During the afternoon session, NIEHS Pre-doctoral Fellow Martha Montgomery reported on her research into the effects of age and environmental exposure on the development of age-related macular degeneration (AMD) among farm workers who applied pesticides and participated in the Agricultural Health Study (http://www.niehs.nih.gov/research/atniehs/labs/epi/studies/ahs/index.cfm). "Applicators over 60 years old who were exposed to pesticides, specifically organochlorine and organophosphate insecticides, had increased odds of getting AMD," Montgomery said. "These associations were not observed in people under 60."
Lou Gehrig's disease or Amyotrophic Lateral Sclerosis (ALS) is a rare neurodegenerative disorder. Studies (http://www.niehs.nih.gov/research/atniehs/labs/epi/studies/alss/index.cfm)led by NIEHS Staff Scientist Freya Kamel, Ph.D., determined that environmental exposures such as smoking, head injury and self-reported occupational lead exposure were associated with increased risk of ALS.
The roundtable discussion at the end of the symposium concluded that several areas of research, for example, studying environmental exposures in utero to age 70, could further scientific understanding of the mechanisms of aging.
"Negotiating the Senior Care Maze"
Angela Reynolds' Tips on Easing the Burdens of Finding Assisted Care
��"What I've learned from working with thousands of families is that the best thing you can do is be educated early," Reynolds said at the beginning of her presentation. "Because when you're in the middle of a crisis and you start to learn about these options, you make snap decisions... [and] you end up choosing things you might otherwise not have chosen."
To get ready for the enormous responsibilities and expenses of helping a family member who needs assisted care, Reynolds recommends getting a head start:
- Face the facts - according to Reynolds, 95 percent of people aged 45 to 60 whose parents are still alive will find themselves at some point searching for senior care. Depending on the level of assistance involved, residential senior care can cost between 30 November 2007300 and $5000 per month.
- Know the options - too many people don't understand what is available. Options range from home care, independent living communities and residential care to specially designed, dementia-specific communities and skilled nursing facilities.
- Plan ahead legally and financially - Draw up powers of attorney, living wills and medical health directives, and know where to locate personal and financial records Learn about the benefits available through insurance, Medicare, Medicaid and the Department of Veteran Affairs' pension programs . (http://www.vba.va.gov/bln/21/pension/vetpen.htm#3)
- Visit facilities and ask lots of questions of the staff and, especially, the residents. Conditions change constantly, and most facilities have waiting lists. Prior to the visits, prepare a list of questions to ask.
- Take advantage of free resources available from non-profit and for-profit organizations.
- Care for yourself and accept help - caregivers experience high levels of stress that actually can damage health. The best caregiver is a healthy caregiver, so don't try to do it all alone. Take advantage of support groups.