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Expert on aging offers his advice

By SHEILA REED, Times Staff Writer
© St. Petersburg Times
published January 28, 2003

One of the nice things about living in the Tampa Bay area is the number of useful medical, academic and social services resources that are available.

One of those is the Institute on Aging at the University of South Florida in Tampa. The director of the institute is professor James A. Mortimer; he has been the permanent director since 1996. Mortimer has an extensive background in gerontology, epidemiology and biostatistics. You've got to love a place called the Institute on Aging. The word "institute" might be too clinical-sounding for some, but I think of it as a haven for cultivating and nurturing all things wise.

The institute is involved in a variety of research, with education a key component in its work.

"There is a tremendous future in senior education," Mortimer said. "Seniors have gone from having just eighth-grade educations to having college degrees. Today's seniors are, on a whole, quite educated. They want something to challenge their minds.

"The question becomes how to design retirement options that allow them to do things they want to do and have some fun." On the issue of children caring for parents, Mortimer said, "We see children in their 60s and 70s taking care of their parents, who are in their 80s and 90s. Many baby boomers are 'postponed caregivers' because their parents are living longer.

"So it means at your retirement age, you might be taking care of a parent. There is an audience for mid age caregivers, those who are not only aging but who are taking care of older parents."

I talked with Mortimer about a number of senior-related issues and trends. My goal is to get to know him and to let you get to know him.

Question: Your resume shows that you've done extensive research on Alzheimer's disease and that you're considered a leading authority on the topic. Can you explain how the medical/research community is faring in diagnosing and curing this illness?

Answer: There is exciting news on both fronts. For some time, the accuracy of a diagnosis of Alzheimer's disease has been quite high once someone has been presented to a physician with dementia symptoms. About 90 percent of the cases diagnosed as Alzheimer's disease are confirmed in people who have a brain autopsy. Although this news is good, it should be kept in mind that in more than 80 percent of cases presenting as dementia, the underlying disease turns out to be Alzheimer's. Also, about a third of cases with severe Alzheimer's disease in the brain are not diagnosed during life.

With regard to a cure, we are not there yet. However, remark able progress has been made by screening drugs in mice genetically programmed to get Alzheimer's disease. In addition to the initial work in developing a vaccine, we now have found several drugs that appear to greatly slow the disease process in mice. Because Alzheimer's disease progresses for decades without symptoms before it presents clinically, it will be very important to identify people with this disease as soon as possible.

MRI scans reveal shrinkage of specific regions of the brain known to be involved in the disease process long before dementia occurs. This, along with other markers of the disease, may permit us to identify people with Alzheimer's at a stage when relatively little damage has occurred to the brain and prevention is still possible.

Q: What advice can you offer families who are starting to deal with a loved one with the illness?

A: We have drugs available that have substantial benefit for people in early stages of the disease. It is very important that families establish contact with a memory disorder clinic like that at the University of South Florida as soon as possible and take advantage of the many resources available.

Q: For those unfamiliar with the Institute on Aging, would you explain how the institute functions as a partner with the community. Is it involved in any outreaches?

A: The Institute on Aging was started in 1994 by the state Legislature. It was set at the University of South Florida because of the large number of faculty involved in aging-related research. The institute has its own research studies and it helps promote research. Educational programs include a doctoral program in aging studies and many programs for seniors. The institute addresses the entire spectrum of aging from biology through public policy and everything in between.

Q: The high cost of prescription medicine is an area of concern for just about everyone, but why can't drug companies hold down costs for the elderly and those with low incomes? Aren't they the ones who really need a break?

A: There is some progress in this area. A consortium of drug companies has organized a new program called "Together Rx" that offers substantial reductions on the prices of 150 common drugs. Interested readers can obtain more information at the Web site www.togetherrx.com. Q: Florida continues to be a popular state for retirees, but what do you think our state should do to remain a desirable location for them?

A: As you know, Florida is in for some stiff competition for retirees from several states, including the Carolinas, Arkansas, Arizona and Texas. Other states getting into the picture include Maine, Tennessee, Colorado and Oregon. While traditionally retirement communities have been located in states with mild climates that permit year-round golfing and other outdoor recreation, the more well-educated baby boomers who will begin retiring in the next 10 years will likely want opportunities for intellectual growth and stimulation in addition.

Such opportunities are not limited by weather to a great extent, permitting retirement communities to be located in Northern states with access to universities, cities and other stimulating environments. The first wave of such communities is already being developed and marketed. To remain competitive, Florida must consider development of more high-end communities that include educational programs and cultural opportunities, perhaps in association with its state universities.

We also can expect the market for retirement communities to become much more diversified, offering retirees greater choice. Because of the availability of reasonably priced land (particularly in the middle of the state) and a warm climate, Florida should remain the choice of cost-conscious retirees.

Q: Many people are living with long-term illnesses and diseases they may not recover from. What advice for coping can you offer to those people and their family members?

A: It is important to remember that long-term illnesses and diseases do not have to result in substantial loss of functional capacity. In a study we are conducting in Charlotte County, we discovered that seniors living in the county are much more functional, despite having the same frequency of illnesses as the rest of the United States. The underlying reason for their greater function appears to be exercise and good medical care.

Diseases such as diabetes, Parkinson's and even Alzheimer's are treatable. Long-term illnesses, including heart disease, can be treated to the extent that they should not interfere with quality of life.

Q: There are so many factors that affect one's ability to grow old gracefully and dignity. What are some golden rules for aging well?

A: Successful aging depends on maintaining one's functional health to the greatest extent possible as well as one's connection to the outside world.

It is important to exercise, eat right, continue to receive optimum medical care and to set reasonable goals each day.

- Sheila Reed, Seniority editor, can be reached at (727) 893-8452 or toll-free 1-800-333-7505, ext. 8452. Write to her in care of the St. Petersburg Times, P.O. Box 1121, St. Petersburg, FL 33731; or send e-mail to sreed@sptimes.com.

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