Geriatric doctor offers tips for aging optimally; it's much-needed advice for Kentucky seniors, who rank 49th for seniors' health

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As life expectancy for both men and women keeps rising, it's important to adopt a handful of healthy habits that include things like exercising and staying social to ensure that you "age optimally."

That was the main message of Dr. Christian Furman, a geriatric physician from Louisville, on an episode of "Kentucky Health" with Dr. Wayne Tuckson on Kentucky Educational Television, Patrick Reed reports for KET.

Furman is interim chief of internal medicine, palliative medicine and medical education at the University of Louisville. She is also medical director of U of L’s Institute for Sustainable Health and Optimal Aging.

She told Tuckson that while “geriatric” applies officially to those age 65 and older, the field of geriatrics provides much of its expertise around what she called the "older old," those over 80. She added that most people can stay with their primary-care physician until they are 75, but should consider switching over to a geriatric physician at that age.

As for tips on living a long life, Furman said her advice is to adhere to the habits that are responsible for good health in general. She also noted that those who follow a healthy lifestyle during their youth and middle age are more likely to have a high quality of life during their senior years.

Here are her tips for "optimal aging" as reported by Reed:

• Exercise: She said, “You don’t have to do major exercise, just move," which she said could involve walking around the neighborhood.
• Follow a well-balanced diet: This means eating a diet that is low in red meat, avoiding foods that are high in cholesterol, and eating more fruits and vegetables.
• Eliminate tobacco use.
• Adhere to only moderate alcohol intake.
• Stay socially engaged: Furman says research shows that social isolation has negative health effects. “It’s like smoking 15 cigarettes a day, which is a lot of cigarettes,” she says.
• Yearly physicals and preventive screenings: Furman encouraged seniors to keep up with their yearly doctor's visits and preventive screenings, such as mammograms and colonoscopies.
• Regularly re-visit the need for each of your medications: “There is research that shows, the more medications you take, the more problems you will have,” she said. “About five or six is the tipping point. Once you get to six medicines, you will have more side effects and adverse drug reactions and problems.”

Overall, Furman encouraged older folks to continue doing everything that they have always done that brings them pleasure and fulfillment, if they are able to -- including sexual relations, Reed writes.

“You want people to be sexually active,” she said. “Sometimes sexual activity is different for different people, sometimes it’s cuddling, being intimate through skin contact. Sometimes the actual intercourse is hard for older people, but it doesn’t have to be.”

Furman said the goal is to keep older folks as functionally independent as they can for as long as they can, recognizing that they will not be able to function at the same pace or intensity as they did when they were younger, Reed reports.

“They should still do the things they love, but take a rest,” Furman said. “Sit, recuperate, and get up and do it again. They can still cook dinner, or decorate for the holidays. But for people who used to decorate three rooms, three Christmas trees – well, just do one room, and one Christmas tree. Everything in moderation. It’s really very individualized, but it’s totally not based on their age.”

All of this advice is especially important for Kentucky seniors, who are among some of the most unhealthy seniors in the nation. According to the most recent America's Health Rankings Report, Kentucky ranks 49th for senior's health and has been in the bottom 10 states for this measure since 2013, the first year AHR did the report.

By 2030, the U.S. Census Bureau projects that one in every five people in the United States will be 65 or older and by 2035 older people are projected to outnumber children for the first time in U.S. history.

Baby Boomers' number: 4.8% of older adults in U.S. used marijuana in 2013, up from 2.8% a decade ago

As the number of older adults using marijuana increases, researchers say more information is needed to determine the effects of the drug on seniors.

“Given the unprecedented aging of the U.S. population, we are facing a never before seen cohort of older adults who use recreational drugs,” Dr. Benjamin Han, a geriatrician and health-services researcher at New York University, said in the news release. “With the increased availability of legalized marijuana, there is an urgent need to understand the prevalence of its use and also its effects among older generations."

The researchers said older adults could be at high risk for adverse health outcomes when they concurrently use multiple substances, like marijuana and prescription drugs.

“Older people may use marijuana for a variety of reasons, including medical reasons. However, we need to make sure they are not using in a hazardous manner since older adults may be vulnerable to its possible adverse effects," Han said. "One particular concern for older users is the risk of falls while using marijuana; however, this has not yet been studied."

STATUS OF MARIJUANA LEGALIZATION
The map does not include states that allow cannabis oil
for certain medical conditions. Kentucky passed such a
law in 2014. (Governing magazine map)

The research, published in the journal Addiction, reviewed self-reported data from more than 47,000 adults aged 50 and older from the National Survey on Drug Use and Health from 2006 to 2013.

It found that marijuana use rose 71 percent among adults 50 and older in 2006-13, increasing from 2.8 percent a decade ago to 4.8 percent in 2013, reports the Associated Press. It also found the rate of use dropped "significantly" for adults 65 and older, though it rose 2.5 times over eight years.

Most older adults in the study didn't consider marijuana risky, with only 5 percent said they felt using marijuana once or twice a week was not a great risk to their health.

"I thought the perception of low risk was fascinating because, typically, we think of older generations as drug-adverse, and perceiving most drugs to be risky," Joseph J. Palamar, one of the researchers said in the release. "But apparently very few Baby Boomers consider marijuana use risky. But after all, this was the generation who was there, in the late 1960s, when the counterculture revolution exploded marijuana into mainstream popularity."

Pineville Community Hospital restructures debt and creates a geriatric psychiatric unit; 326 jobs saved and 12 new ones created

A combination of local, state and federal efforts have saved more than 300 Pineville Community Hospital jobs and created 12 new ones, according to a Kentucky Highlands Investment Corp. news release.

KHIC worked with First State Financial and the hospital to restructure the hospital's existing debt into a $3.1 million Business and Industry Guaranteed Loan from the U.S. Department of Agriculture, which allowed the bank to provide private working capital through a $3 million line of credit from First State, according to the release.

“The $3.1 million USDA loan guarantee is important to the Pineville community in many ways: It provides residents access to quality health care, supports the employment of 326 employees and allowed for the creation of 12 additional jobs,” Tom Fern, Kentucky director for USDA Rural Development, said in the release. “In a time when the region has seen a significant loss of employment, these existing and new jobs being created by Pineville Community Hospital are critical.”

In addition to restructuring its existing debt, the hospital used some of the funds to convert an unused labor-and-deliver wing into a 12-bed geriatric psychiatric unit and used other funds for repairs.

“Research showed this type of service was not being offered within 30-mile radius, which affects more than 38,000 residents," hospital CEO Stace Holland said in the release.

U.S. Rep. Hal Rogers said in the release. “I commend the board of directors for not only diligently working to protect the jobs at this facility, but for having the vision to expand health care in an area under-served for mental-health concerns.”

U of L gets grant for care for seniors, Alzheimer's and Hispanics in Barren, Hart, Metcalfe, Bullitt, Shelby and Henry counties

The U.S. Department of Health and Human Services has awarded the Institute for Sustainable Health & Optimal Aging at the University of Louisville $2.55 million to create the Kentucky Rural & Underserved Geriatric Interprofessional Program.

The three-year initiative will include partnering organizations from six rural counties: Hart, Metcalfe and Barren in Southern Kentucky; and Bullitt, Henry and Shelby, counties in the Louisville metropolitan area with large rural populations.

The project will addresses the shortage of workers in geriatric and primary care, the need to train health-care providers for culturally appropriate services to Kentucky’s growing Hispanic population, the need to decrease the chronic disease burden in rural Kentucky, the lack of supportive environments to promote health among seniors, and the need for supportive education and resources in Alzheimer’s disease and related dementias.

The institute, created in 2014, will develop an interprofessional education center for geriatric education for students and professionals in medicine, nursing, social work, dentistry, pharmacy, community health and law; help primary care sites deliver integrated patient-centered geriatric primary care; and provide training and community engagement resources for Alzheimer's and other dementias in the six counties.

“This project is unique in its integration of community health teams and mental health specialists within geriatric primary care delivery systems,” Institute Executive Director Anna Faul said in a press release. “We are going to use a systemic approach of collaborative care and develop an inter-agency consortium that strengthen the links among related services for older adults.”

Partner sites in the first year will be Glasgow Family Medicine Clinic serving Barren, Hart and Metcalfe counties; Shelby Family Medicine and Mercy Medical in Shelby County; Kentucky River Medical Partners in Henry County and UofL Geriatrics Home Care Practice in Bullitt County.