Elderly caring for the eldest                                        

                Growing older is inevitable; heart disease, stroke, type 2 diabetes and osteoporosis are not. These are the result of lifestyle choices, not the aging process. Hunter-gatherers that live today the way that their – and our – ancestors did tens of thousands of years ago are not burdened with such problems even when they reach the seventh or eighth decade of life. At the start of the 20^th century the classic heart attack had not yet been described in the medical literature because it was so uncommon. Almost all strokes back then were of the hemorrhagic variety, not the ischemic type that is characterized by gradual narrowing of blood vessels and years of disability. Type 2 diabetes was almost nonexistent in 1900. It now affects nearly one in ten Americans.

            The marvels of modern medicine are keeping our oldest citizens with all these maladies alive well into their 80s and 90s but who is caring for them? It is their children, the “young-old” in their 60s and 70s. We know of many such families. The children, often themselves eligible for Medicare, have illnesses of their own that are similarly lifestyle-related.

            A third wave will hit us before mid-century. For those who stay fit it’s true that “70 is the new 50” but there is drift backward among a large part of the population, the one third of Americans who are obese, some morbidly so. The age at which a first heart attack occurs is going down to the thirty-somethings. We no longer refer to type 2 diabetes as “adult-onset” because so many adolescents are affected. Will these chronically ill middle-agers be able to care for their parents and grandparents?

            We need to prevent these diseases, not treat them. Once established, the major killers cannot be cured or even reversed. Physicians can relieve symptoms, delay complications and postpone death but those should not be our goals. We should – and must – help the youngest generation to avoid them. The solutions are simple; they are not easy.

            Our forebears were not obese because they were active; they had almost no refined grains and refined sugar in their diet; the animals that they raised for food ate grass, not corn; soft drinks were an occasional, not daily, treat. Can we return to that lifestyle? Can we afford not to?

            If we don’t, who will care for the older and the oldest?