We chose to focus our July ENewsletter on two important issues: driving and falls prevention. Now that the warmer weather has arrived and the days seem longer, it is important to address the age old question of “to drive or not to drive”. The main focus here is on safety and living well.

To Drive Or Not To Drive?

Most drivers over the age of 65 drive only a few times a week (shopping, personal, medical and social appointments). Their trips are relatively short averaging from 11 to 17 km per day, driving less at night and typically at non-rush hour times. The predominant type of accidents involving older drivers … READ MORE

Falls Prevention

A serious concern for many health care professionals and older adults is the risk of falls. Research from the Public Health Agency of Canada suggests that seniors over the age of 65 are at a higher risk of falling. As busy Canadians we are often too task oriented and we forget the importance of slowing down and examining our surroundings.

 Seniors account or over 40 percent of people hospitalized for injuries.
 At least half will experience minor injuries and 5 to 25 percent will experience a serious injury (i.e. fracture).
 After a fall, 40 percent of people are ultimately admitted into a long term care facility as care needs become increased.
 If there was a decrease in the number of falls by 20 percent, there could be 7,500 fewer hospitalizations and save the health care system roughly $138 million annually.

Falls often occur in a variety of different settings and can be associated with completing day-to-day activities, reaching for objects slightly out of reach (including bending over to pick something up, tying a shoe lace) or standing up too fast and not using assistive devices like grab bars for increased stability. Scatter rugs, uneven pavement, clutter, ice and slippery floors are often major contributors to falls, but are often neglected hazards.

READ MORE to learn how you can help someone who is at risk.

If you are looking for help caring for an older family member, you might try giving your banker a call.

That might not seem like an obvious move. But private banks and trust companies say that they increasingly are helping older clients—or parents of younger clients—sort out medical bills, hire in-home care or even manage the sale of a home. Sometimes the bank charges an additional fee for such services; in other cases, they are included in the asset-management or trust fees families already pay.

Wells Fargo has expanded its private-bank Elder Services program—designed to provide comprehensive help to older clients and their caregivers—into 30 new regions across the country this year, bringing its total reach to 67 markets. Merrill Lynch’s family-office group—part of its private bank aimed at its wealthiest clients—started a “Stand Ready” initiative this year that helps clients organize all the details of their lives in case they suddenly become incapacitated. Bessemer Trust has expanded its focus on its “health advisory” services in recent years. has beefed up its training in the family dynamics involved in long-distance caregiving.

Atlanta-based Broadspire Care Management, which contracts with bank trust departments and wealth-management firms to provide geriatric-care management, says it has seen referrals rise 10% to 12% a year for the past three years.

Of course, banks and trust companies aren’t doing this solely out of the goodness of their hearts. Providing extra services targeted at the elderly and their family caregivers can bump up the asset-management fees that clients pay each year. The draw of the services may even persuade a few clients to move assets to an institution to meet its minimum deposit requirements—which can range from $1 million to $10 million or more—for accessing such help. Wells Fargo’s Elder Services program, for example, charges up to 2% a year in total fees on a $1 million minimum. (Customers whose assets dip below that level can stay in the program, however, and clients with trusts, many of whom already pay 1.25% a year, simply pay 2% total.)

Beyond any short-term gains, the services are a way for banks to deepen ties with a family’s younger generations, who otherwise are considered much less likely to stay loyal to a specific financial institution in the long run.

“This is not just a matter of revenue. This is a matter of developing an intimate, trusted relationship with the client,” says , director of the Massachusetts Institute of Technology’s AgeLab.

So what exactly will your banker do for Mom, beyond estate planning and setting up powers of attorney? Services include crisis management (triggered, say, by a broken hip or a car accident); health and home assessments; Medicare-coverage selection and claims management; and evaluating retirement communities and long-term-care facilities.

Recently, Earl Watson III, chief executive of North American Management Trust Co. in Boston, says he helped a client with advanced Alzheimer’s disease empty a condominium—and now is overseeing its sale. Clients must have at least $3 million under management.

Two years ago, Astrid Carlson, of Newport Beach, Calif., discovered that a neighbor of her then 93-year-old aunt had moved into her aunt’s condo—and tried to get her to make a large withdrawal from a trust for which Ms. Carlson served as co-trustee. Frustrated that she couldn’t get help from a local adult-protective-service agency, which was turned away several times from the aunt’s secured building, Ms. Carlson turned to Wells Fargo’s private bank, moving additional assets to qualify for the Elder Services program. Jann Watenpaugh, Ms. Carlson’s Elder Services adviser, persuaded local elder-abuse investigators to go back ready to deal with the building’s security. At her urging, they gained entry to the aunt’s condo with a police escort and took her to a hospital under protective custody.

A Wells Fargo representative accompanied the aunt to the hospital while Ms. Watenpaugh drove Ms. Carlson and a caseworker there. The trio spent a weekend getting Ms. Carlson’s house set up for her aunt, who was treated at the hospital for dehydration and malnutrition. They later moved her to an assisted-living facility.

Ms. Carlson’s aunt died last month, and now Ms. Watenpaugh is helping Ms. Carlson sort out the estate. She also helped Ms. Carlson figure out that another neighbor had persuaded her aunt to lend him $250,000 to finance a business condo, and Wells Fargo helped her foreclose on the loan.

“My uncle and aunt worked a lot of years for their money,” Ms. Carlson says, “and these people waltzed in and thought they could buy homes with it.”

When Your Loved One Has Had A Stroke

A stroke can be very traumatic. It often occurs suddenly, and the resulting damage can range from mild to severe. A person who has had a stroke will most often be admitted to a hospital for assessment and possible rehab; after which, the person will be discharged home.  

According to the Heart and Stroke Foundation, more than 14,000 Canadians will die from a stroke this year and after the age of 55, the risk of stroke doubles every 10 years. This will cost the health care system and the economy on average $2.7 billion a year in physician services, hospital costs, lost wages, and decreased productivity.    
 
To learn how you can prepare for your loved one’s return home READ MORE

To find out more about your stroke risk, complete the stroke assesment quiz to receive your free health report.

Helpful summer tips 

According to the Occupational and Environmental Health Unit in Quebec there are an additional 3.5 deaths per day attributable to excessive heat when the humidex level is between 40 and 45. Seniors are placed at a higher risk level due to changes in their physiological features, slowed heat release capabilities and some medications and chronic illnesses.

Please READ MORE for information on how to keep yourself and your loved ones from over heating this summer and for information on “how to beat the heat”.

‘Triple-decker-sandwich generation’ seeing higher rate of depression than earlier generation

OTTAWA—Between caring for elderly parents, raising children, and looking after their own busy lives, baby boomers have a higher rate of depression than the previous generation, says an expert.

Dr. Richard Earle, managing director at the Canadian Institute of Stress, describes this as a “triple-decker-sandwich generation” for the world’s boomers, a term generally referring to those born during the approximately two decades of strong employment and economic growth post-World War II.

“What we’re noticing at the Canadian Institute of Stress and throughout the research literature is a significant rise in mood disorders, including depression, in that baby boomer age group, which is 46 to 64,” said Dr. Earle.

In Canada, about 10 percent of baby boomers are still raising children while looking after—or just beginning to look after—elderly parents, he said.

“Then it’s not just a sandwich generation—it’s a triple-decker sandwich because they’re looking after husband or wife and job and the rest of it.”

Research shows that as many as 4 in 10 boomers are experiencing an unusually high level of stress which can lead to depression, Dr. Earle said.

About 32 percent say they’ve had to cancel travel plans, 34 percent have dropped personal hobbies and interests, and well over 70 percent say the balancing act is interfering with their ability to fulfill responsibilities at work.

There are emotional impacts as well—a feeling of not being able to find pleasure from things they used to enjoy, Dr. Earle explained, “and within that, not being able to concentrate, to focus on what they’re doing, making decisions, and certainly sleep disturbance.”

Baby boomer issues and the increase in the rate of depression are much the same worldwide.

In Canada, boomers are defined as those born between 1947 and 1966. They number more than 8 million and make up about a quarter of the population.

Statistics on American boomers, those born between 1946 and 1964, are almost identical, except that the United States has about 80 million baby boomers and they are reporting slightly higher impact on their jobs than Canadians due to stress from home, Dr. Earle said.

He noted that baby boomer issues and the increase in the rate of depression are much the same worldwide, including in such diverse places as Japan, the Middle East, Argentina, Saudi Arabia, India, Spain, and the United Kingdom.

Everywhere, “the core of the problem is very similar”—juggling the demands of caring for parents and children are causing stress.

In particular, Japan has an extremely low birthrate and a significantly older average age than almost any other country, Dr. Earle said. “You have fewer younger people to take care of more older people.” Japan has also been dealing with the boomer depression issue longer than other countries.

As the first wave of boomers turns 65, their needs have been prompting services and research interest in every area from health and lifestyle to leisure and travel, from art and technology to financial services and economic planning.

A recent study by the U.S.-based Hartford Financial Services Group, a major provider of employee-assistance programs, found that more than 80 percent of boomers report feeling moderate to high levels of stress from providing care or support to children, spouses, and/or parents.

Moreover, 46.6 percent said they felt worried about how caregiving is impacting their job, with 68 percent saying they missed work or left work early due to caregiving duties in the last six months.

University of Waterloo and Royal Bank of Canada launched a retirement research centre last month, noted as the first collaborative approach of its kind between academic researchers and the financial services industry aimed at providing solutions and advice to boomers for retiring planning and living.

At last week’s 2010 Congress of the Humanities and Social Sciences held at Montreal’s Concordia University, University of Montreal professor Jacques Légaré presented a paper showing that aging boomers will have to either pay for their own care or find support from sources outside their immediate family circle.

Prof. Légaré said that about 70 percent of elderly care currently comes from spouses or children. However, today’s boomers have fewer children to care for them. In addition, the rise in divorce, common-law unions, and blended families means that many boomers may not have a partner to rely on within a stable relationship as they age.

“The world will work out well to the extent that we look after ourselves and our families in a more informed way.” — Dr. Richard Earle

Meanwhile, average life expectancies are rising, putting further demands on society and boomers to create new support systems for tomorrow’s seniors.

The Canadian Institute of Stress is a charitable organization founded 30 years ago by Hungarian-Canadian Dr. Hans Selye, known as “the father of the stress field,” who published the world’s first scientific paper to identify and define stress in 1936.

The institute tracks trends in research literature and provides education to the public, healthcare professionals, and workplaces in Canada and other countries on earlier detection of stress problems and methods for controlling stress.

“There are so many things that catch our attention, quite challenging, disturbing things happening in this world,” said Dr. Earle. “[But] the world will work out well to the extent that we look after ourselves and our families in a more informed way.”

He recommends that baby boomers “get refocused back on one’s own family situation and basically on ourselves—not in a selfish way, but in a self-maintaining way.”

When Chief Joel Abram learned of a proposed program to help First Nations people and families living with dementia, he saw the initiative as a way to fill a gap in sorely-needed support in his community.

But since the launch of the First Nations First Link program, the issue has struck closer to home than he likely anticipated.

The chief of the Oneida Nation of the Thames, located outside London, Ont., said it started when his aunt realized something wasn’t quite right and her memory wasn’t the same as it had been.

After she spoke with First Nations First Link coordinator Robin Shawanoo and had testing done, it was determined Abram’s aunt had early onset of Alzheimer’s disease. Through early detection, Abram said she has been able to get the proper help sooner.

“At first, it was kind of hard for her to come to grips with the fact that she does have this,” he said. “Now, we’re going to be setting up a family meeting so the whole family knows what to expect from here on out.”

Individual and family support, crisis intervention and long-term care preparations are among the hallmarks of the program, which was developed collaboratively with the Alzheimer Society London and Middlesex and Oneida Nation of the Thames. The program will be featured Tuesday at the Aboriginal Health Forum co-chaired by Abram in Toronto.

First Link takes a holistic approach to the illness by integrating elements of culture, tradition and spirituality in administering care. Part of that includes use of an adapted screening tool created specifically for the First Nations community.

Shawanoo has modified the Montreal Cognitive Assessment, or MoCA, a screening test designed to help health professionals detect mild cognitive impairment, making it more “culturally appropriate.”

For example, rather than have individuals identify a lion, rhinoceros and camel, the animals have been changed to a bear, wolf or turtle — each representative of Oneida clans, Shawanoo noted.

Another change is the inclusion of a 3-D circle resembling a medicine wheel — a predominant symbol across every tribe — taking the place of the 3-D cube featured in the original MoCA, Shawanoo said.

In counselling work, he has adopted use of inner child therapy which incorporates spirituality. Assessments and counselling are done in a person’s home, with early and direct intervention that is tailored for their needs, he said. Counselling support is also extended to family members.

“Someone may come in and it’s ‘I’m stressed out trying to deal with my mom who is wandering and always forgets who everyone is,’” he said. “It could be somebody who knows about the stages of dementia and knows towards the end it’s not very pretty and they want to be pre-prepared for the person’s death and starts grieving before it happens. It’s pretty diverse — it’s whatever that person is dealing with.”

Bereavement support can be offered privately or in a group, and the latter can include traditional drummers and an elder in the process. Shawanoo said another aspect that makes the bereavement group unique is its duration, as the process is three months long.

“At the end of three months, if you feel you need it, you just come back, so it just keeps circulating, it just keeps going around which, again, is another First Nations principle that everything is circular,” he said.

“Here, we have a therapy program that is not time-limited, it’s not session-limited. It’s come as you are, come as you need it and it just keeps going.”

First Link public education coordinator Susan Oster has visited elementary school classes and has also done work with seniors to discuss dementia and lifestyles factors.

“It’s a way of saying ‘OK, we want to bring the information to you and make it more accessible’ and to make sure that there’s not that gap, so people are not feeling we’re disconnected from the rest of the community,” Oster said.

Oneida has a total membership of more than 5,100 people, making it the fifth largest First Nation in Ontario in terms of population. More than 2,200 live on the reserve, with many others living in surrounding cities of London and St. Thomas, Abram said.

Betsy Little, executive director of the Alzheimer Society London and Middlesex, said since the January launch they’re already making an impact. Shawanoo had 16 referrals to see clients and make assessments when he first arrived, she said.

At the outset, Little said people were coming forward saying they wanted to be seen or assessed. However, she acknowledged there have been “bumps along the road” due in part to the stigma that is attached to the disease within the community.

“What we’re encountering is that people are not wanting to come forward very quickly,” she said.

“They need to really know that there’s a rapport established, and what we’re really focusing on is more education sessions, more information sessions and just being out there in the community on a regular basis,” she said.

For his part, Abram said he plans to help spread the message about the program on community radio and hopes to hold community information sessions in the future.

I invite you to complete the Mood Disorders Organization of Ontario quiz and “have a check up from the neck up”.  Good mental health is important for all of us and caregivers and care recipients are no exception. Take their quiz at CHECK UP FROM THE NECK UP. If you took the short quiz last year, compare your results to your previous score and help determine how you are managing with your current situation. If this is your first time taking the quiz, the results will be good food for thought

Interesting New Developments in MS research 

According to the MS Society of Canada, we have the highest prevalence rate of MS in the world, with 3 people being diagnosed with MS everyday. Atlantic Canada and the Prairies have the highest prevalence rates of MS at 340 per 100,000 people and 450 per 100,000 people respectively. The number of people affected by MS is staggering, if you factor in family members, friends and service providers who are also affected by the complications of this disease.

A study was recently published by Dr. Zamboni and his team of researchers in the Journal of Vascular Surgery, that suggests there is a connection between chronic cerebrospinal venous insufficiency (CCSVI) and Multiple Sclerosis (MS). This theory describes MS as a vascular condition caused by a blocked or malformed vein that is responsible for draining blood from the brain. The researchers propose that MS can be treated with surgery to reopen these veins.

The media has been following  this research study and how it might influence the lives for those living with MS.  Caution has been expressed for those who are seeking out this treatment because of the limitations in the research that has been completed thus far.

It will be interesting to follow how Dr. Zamboni’s research impacts people living with MS, if doctors are allowed to continue implementing the procedure and how it will impact future MS funding.

Disability Tax Credit (DTC), Caregiver Tax Credit (CTC): Do I Qualify?

As a social worker I have worked with differently-abled individuals of all ages. Growing older with a disability raises questions for parents and adult children alike. For many parents raising a child with special needs, they worry who will look after their adult child when they are no longer capable. As well, many of us are looking after parents or other family members who require caregiving assistance. For both groups, there are questions as to which specialized services are available and concerns about accessing them as well as related costs. I have asked Ken Pope, lawyer and tax expert to provide answers to some commonly asked questions regarding the Disability Tax and the Caregiver Tax credit.  READ MORE

TWO years ago my father, then 83, became very ill. Until then, he had been living alone in a pleasant one-bedroom apartment on the Hudson River, an hour’s drive from my home in Brooklyn.

After a couple of months in the hospital it became clear that my dad, Harvey Alderman, could not return to solo living. He was fragile and forgetful, and there was no way he could keep track of the 14 or so pills he had to take each day.

But where would he go — and how would we pay for it? Could he stay in his apartment if he had regular visits from an aide? Or should he go to an assisted-living facility where there would be more services available for him?

So began my family’s crash course in caring for an aging parent in declining health. 

If you’re in this predicament, you know already there is no simple answer. Older people each have unique medical and emotional needs. And finances often dictate how far you can go in creating the ideal situation for them.

That is what Linda Chase, a lawyer in Reston, Va., realized after running the numbers on what it would cost for home care for her mother, who has dementia and needs round-the-clock attention.

“We couldn’t afford private home-health care, so the only option for us was assisted living in a facility with dementia care,” Ms. Chase said.

Below, I offer guidelines and considerations that can help you make an informed — if not always easy — decision about what type of housing will support your parent’s needs, without bankrupting the family in the process.

And note: While the following discussion refers to a single parent who lives alone, many of the considerations would also apply to an elderly couple who are each in declining health.

IS HOME STILL SAFE? If your parent is living at home, he or she probably wants to stay there. If that’s the case, hire an expert, like a geriatric care manager, who can assess whether your parent will be able to manage at home and what kind of support will be needed.

A geriatric care manager, who charges $50 to $200 an hour, will look at how your parent functions in the space — able to cook? able to manage medications?— and may suggest modifications. These may include adding grab bars and removing throw rugs, to make the home safer. If your parent will be in a wheelchair, the care manager can figure out whether doorways need to be widened or a stair lift should be added.

In a column last fall, I offered fuller advice on how to find a geriatric care manager, but here are a few basics:

Ask friends for references or contact the National Association of Professional Geriatric Care Managers (www.caremanager.org). If money is tight, call the local federally funded office on aging or plug your ZIP code in at www.eldercare.gov to find the nearest one.

“The office should be able to send a case manager to your parent’s home to do a home assessment at no charge,” says Chris Stone, a registered nurse and clinical liaison for LifeQuest Nursing Center, in Quakertown, Pa.

Next, determine what kind of day-to-day care your parent requires. A care manager or your parent’s doctor should be able to help you figure this out. Some older people can manage surprisingly well with minimal help. But parents with dementia or a chronic medical condition may require a full-time aide, and the cost of that can add up quickly.

According to a survey by Genworth Financial, an insurance company that sells long-term care policies, the median hourly rate for a licensed caregiver ranges from $18 to $46 an hour, depending on the qualifications of the aide. The cost runs on the higher side if the aide works for a Medicare-certified agency.

To learn about rates in your area, call a local home health care agency, said Vanessa Bishop, president of Elder Care Consultants (www.eldercc.com), in Reston, Va. If you do opt for in-home care, be sure to use an agency that is licensed, bonded and insured, Ms. Bishop says, and one that conducts thorough background checks on its employees.

THE ASSISTED-LIVING OPTION Even if parents insist on remaining in the home, doing so may not be in their best interests. A parent in failing health or somehow impaired is not the only one in jeopardy; other family members may be under a lot of stress, too. It can also be lonely and isolating for a parent to stay at home.

Assisted-living residences, which have proliferated in recent years, have small apartments that residents can furnish with their own belongings, along with a common dining room where meals are served, a nurse’s office where prescription drugs are dispensed and activity rooms for socializing. The great advantage of such places is that you can ramp up the level of care as your parent needs it, adding services like help with dressing and bathing. Many have special wings or floors for people with Alzheimer’s. My sisters and I ultimately decided to move our dad to an assisted-living facility in Ardsley, N.Y., just across the river from his previous home. He wasn’t keen on the idea at first, but the move turned out well for him and for us. He has his own studio apartment, but he doesn’t have to cook, clean, do his laundry or think about which pill to take when.

And he has a built-in social network of other residents and the bustling staff. (In fact, he often prefers the young staff to the residents.) We all have less to worry about.

WHAT CAN YOU AFFORD? Ultimately, it may all come down to money. Find out how much your parent has and whether he or she bought long-term care insurance. If the assets are plentiful, you may need to see a financial planner for advice on how to stretch the funds over time.

We were able to pay for my dad’s rather steep assisted-living bill through a combination of his annual income and the proceeds from the sale of his apartment.

It might also be wise to speak with an elder-law lawyer, who can explain when your parent might qualify for government programs like Medicaid. Medicaid does not cover the costs of assisted living, but it does cover care provided in nursing homes.

“Everyone thinks Medicaid is only for the poor, and that you have to impoverish yourself to be eligible,” says Robert S. Bullock, a lawyer in Washington and a senior partner of the Elder and Disability Law Center, “But it’s not.”

COMPARE COSTS Add up the costs that would be involved in keeping your parent at home, including home upgrades, caregivers, rent, mortgage payments and taxes. Factor in what long-term care insurance will cover, if there is any.

If your parent is a military veteran, find out if he or she is eligible for the Aid and Attendance Pension benefit, which provides a monthly stipend of up to $1,632 (or $1,949 for couples), to veterans who need help with basic daily tasks, like eating and dressing.

Once you have an idea of what it would cost to keep your parent at home, the decision might be made for you. The Genworth survey found that the median cost for an assisted-living facility was $34,000 a year, which translates into about 30 hours a week of home care at $20 an hour. But in major urban areas the cost for assisted living can be twice or even three times that amount.

Even so, assisted living sometimes works out to be a better deal, as Ms. Chase, the lawyer in Virginia, learned. When she did her research, Ms. Chase found it would cost around $150,000 a year to hire full-time home caregivers for her mother, Jeanette Chase.

“It was a horrendous amount of money,” Ms. Chase said.

A nearby assisted-living facility, on the other hand, charged $80,000 a year for a room on a secure floor intended for memory-impaired patients. And her mother’s long-term care insurance, which did not cover in-home care, covered 40 percent of the bill for assisted living.

Even assisted living “was expensive — but worth it,” Ms. Chase said. “I was able to continue working and she was safe and nearby.”

Men can expect to be sexually active until they hit 70, while women remain sexually active until about 66, the study led by researchers at the University of Chicago found.
Women may live longer, but it appears men are more likely to go out with a smile.
A study published Tuesday in the British Medical Journal found that the sex lives of men tend to significantly outlast those of women, even though women live about five years longer.
Men can expect to be sexually active until they hit 70, while women remain sexually active until about 66, the study led by researchers at the University of Chicago found.
Meanwhile, researchers found that only half of women aged 75-85 who remained sexually active rated their sex lives as “good,” and only 11 per cent of all women that age reported regularly thinking about or being interested in sex.
“Men have more interest in sex and seem to be happier with the quality of their sexual activity, and the gender gap only widened with age,” said lead researcher Stacy Tessler Lindau, an associate professor of obstetrics and gynecology.
Men tend to have younger partners, said the study.
The research focused on two large American surveys, the National Survey of Midlife Development, involving about 3,000 adults aged 25 to 74 and completed in 1996, and the 2006 National Social Life Health and Aging Project, involving another 3,000 adults aged 57 to 85.
Participants provided information about their relationship status and rated the quality of their sex lives and how often they had sex.
While the study confirmed what has been widely reported in recent years — elderly people are having sex — the gender differences are striking.
“We live in an ageist society, and sex-lives are often about attitudes,” Lindau said. “Older women are seen as asexual.”
Lindau said some of the contrast can be attributed to the introduction of medications that help men with sexual health.
When the erectile dysfunction drug Viagra was introduced in 1998, it quickly became a pop culture phenomenon, and one of the top sellers in the pharmaceutical industry.
Lindau said the popularity of the Viagra advertisements, most famously with former U.S. presidential candidate Bob Dole acting as a spokesman, helped prompt a sort of age-related sexual renaissance.
The recent death of an elderly retiree prompted some brothels in Switzerland to train their prostitutes to use defibrillators to help prevent their clients from dying in the throes of passion.
Audrey Miller, a social worker with Toronto-based Elder Caring, a consulting group that helps families and organizations deal with aging issues, said sexuality doesn’t really change when people get older.
“I see it as no different,” she said. “There might be different issues, medical issues, but they can be addressed.”
For women, she said the biggest problem is that they outlive their spouses.
“Where do they find a new companion after decades with the same person?” she asked.
While the study shines light on some of the issues with aging and sex, it remains a topic that some people are uncomfortable discussing, said Lindau.
“Until attitudes change, things will probably stay the same,” she said.

An elderly couple I knew lived together in a nursing home well into their 90s.

He had advanced dementia, inhabiting a world separate from reality, but physically he was strong and healthy.

She was physically frail and unsteady, with constant pain and suffering from chronic diseases. But her mind was not impaired at all, and she could engage with the world and express herself clearly.

We marvelled at how each compensated for the other’s disabilities.

And yet, anyone over 40 who knew the couple couldn’t help thinking, “Which loss would be worse for me? Loss of a functioning, healthy mind? Or loss of a functioning, healthy body?”

“I think that people fear both,” says Dr. William Reichman, president and CEO of Baycrest, a world-renowned centre for studying and treating diseases of aging.

And we’re right to fear both. Because, except for a lucky few, most people who reach a great age will be in a “state of fairly severe physical and mental frailty,” Reichman says.

“We will ultimately get more frail physically and mentally if we live long enough.”

The good news?

“Morbidity compression.”

Dire as it sounds, it’s a happy thought. It means we’ll be spending a shrinking percentage of our overall lifespan in that state of physical and mental frailty.

“There is,” Reichman says, “the ability to hold at bay some of the things we thought inevitable as we get old.”

Until now, that’s been mostly true for the physical fallout of aging, particularly musculoskeletal and cardiovascular health: joint replacements, steroids, blood thinners, statins, stents and more.

But Reichman promises, “What we did for heart health in the 20th century, we can do for brain health in the 21st century.”

At Baycrest’s Rotman Research Centre and in other centres around the world, scientists are using imaging technology that’s been developing over the last decade to focus on prevention: understanding the risk factors of brain failure and how to support brain health.

As with reducing mortality from heart attacks and heart failure, it’s early intervention that makes a difference. “By the time you show symptoms, you’re already in a pretty advanced stage of brain failure,” says Reichman.

A major motivation for the focus on prevention is the threat of a “coming epidemic of dementia.”

Already, 30 to 40 per cent of people over the age of 80 are suffering from dementia. And, with more and more people living over the age of 85, the prevalence of dementia, with Alzheimer’s being most common, is going to double.

It’s no wonder that what scares us leading edge boomers most, even more than losing our mobility, is losing our minds.

I have an aunt in her 90s, the last family member of the generation ahead of mine, who lives in a nursing home and stands at the dementia unit’s locked door at the end of every day, a frightened child trying to get out to find her mother in Moldova, the place she left when she was seven.

Next up is my generation.

And so I was overjoyed to learn about some of the research at Baycrest that just might help keep my mind sound as the decades continue to accumulate.

Working at the deepest, broadest and perhaps most profound level, in the emerging field of population neuroscience, is a couple new to town.

Dr. Tomas Paus, working with his wife, Dr. Zdenka Pausova who is based at SickKids, will screen generations of Toronto families in different ethnic communities to learn how environment, culture and genes interact to shape the human brain and body.

“Obesity, cardiovascular disease, metabolic disorders – most are complex traits,” he explains, “and not just (caused by) a single gene or even multiple genes in isolation from the environment.

“And it’s pretty much the same for disorders of the brain, psychiatric disorders, depression. It’s multiple genes interacting with environment.”

For example, he says, the probability of depression can be affected by your genetic component for serotonin interacting with the number of stressors and stressful events that occur in your environment and in your life.

Researcher Nicole Anderson is leading a brain imaging study with both healthy aging adults and adults with mild cognitive impairment to see if cognitive rehab training can help people improve their cognitive powers.

And scientist Carol Greenwood is researching how diet impacts brain function, and the relationship of Type 2 diabetes to cognitive function.

As someone who spent hours every day practising the piano all through my school years, I was especially glad to talk to psychologist Claude Alain whose research involves how musical training impacts brain circuits.

Hearing decreases as we get older, he explains, and one of the more common complaints is trying to have a conversation in a noisy setting – in other words, sorting out and separating sounds.

Researchers aren’t sure whether this is related to the mechanics of the ear itself, or whether it’s a function of the brain’s loss of ability to concentrate.

“So we came up with this idea to look at whether musical expertise and training has an impact on how you process or solve complex auditory problems,” he said.

Preliminary findings, he says, suggest that “the rate of decline is shallower in musicians” and that “musical expertise or training does alleviate some of the change in auditory perception.”

More and more, scientists are telling us what poets already put forth: That in the end is the beginning and that how and where we finish up is determined by the path we followed on the way.