February 2010

This is the latest, and perhaps final blog on this topic. I've written them because many people have really strange ideas about aging. I still harbored some of them into my 70s. And today I get very unreal input from the young and middle-aged. So it seems to me these brief pieces might be useful to them.

My own education on aging shifted out of idle in 1961, when I was 35, and my mom moved to Fort Collins, Colorado, to live near us. That's when we discovered she was in early Alzheimers. I've described her subsequent decline and death in an earlier blog. I've also described the much later decline of my wife, Gail, who retained good cognitive function as long as she lived. And a couple of blogs on my own aging. The three cases were quite different. You might find each of them food for thought.

The last time I posted on this topic was, I believe, in 2008. At age 83, I'm overdue for an update. I'll start by summarizing, briefly, some of what I wrote in "About Aging."

I've been intellectually aware of my physical aging, of the routine, gradual, over-the-hill kind, for several decades. It was easy to ignore though, because for a long time I was very healthy and fit. Running was part of life for most of my years, but mostly a casual part. Then, in 1975, in my 49th year, I signed up for a 15 K cross-county race and trained seriously for it for months. I ended up out-running many racers in their 20s and 30s. A few weeks after the race, on the Friday before my 49th birthday, I ran a clocked mile on Northern Arizona University's indoor track in 6 minutes and 2 seconds — at 7,000 feet elevation — but I couldn't jump worth a darn.

I was still running at age 65, though I'd slowed a lot. In fact what I did then was no longer running; it was jogging. But I still pretty much ignored the aging process. It seemed to me that when I reached 80 or 90, I'd still be jogging, and doing everything else I did — nautilus workouts, mostly — just not as well. I was mistaken. Physical deterioration could not be ignored. What I called a workout at age…say 72, was far below what it had been at 65. But I still moved well, had military posture, and people told me I could pass for 60. Hmm. Perhaps. But I got tired more quickly; my workouts had come to feature 20-lb dumbells, and in lieu of running, I did 2-mile power walks with a major hill. And I'd even decided that those were pretty good workouts. Which they were — for my age.

Then, somewhere around age 75 or so, I discovered that when I went to help a friend move to a new residence, I was worn out after only an hour or two. Inevitable, I decided. Inevitable? What an attitudinal change that was! When I was about age 78, Michael Nelson, a Swedish-speaking convention pal who'd been away from conventions for a few years, told me "John, I almost didn't recognize you."

Å? Varför det ?" ("OH? Why is that?") (We tended to use English phraseolgy with Swedish words.) He mentioned my past military posture, then added "Now you don't stand as straight, and your head is cocked forward." That no doubt explained why some young people paused to hold doors for me. And I'd thought my posture was still military!

It should be noted that the onset and rate of decline varies with the individual. This holds as well among people who make a point of fitness. Wear on knee cartilages ended my running at about 65, except for occasional easy jogging. At about the same time, a long-time buddy, a year younger, was still participating in the annual Mount Katahdin run in Maine, running to the top of Maine's highest mountain, at 5,628 ft. Until his knees went sour on him, literally overnight. He ended up with two knee replacements. Not long afterward he was diagnosed with Parkinsons' syndrome.

His mind was keen to the end, or seemed so to me over the telephone and by mail.

Another long-time friend was another exceptional specimen. He was taking long cross-country walks in his mid-80s. Recent photographs show him erect and handsome, startlingly young looking. But he was on medication for early Alzheimers.

At age 79, my walks had shrunk to a mile and a half, on effectively level country roads, and by the time I neared home, I was wobbling, even staggering. My problem was early undiagnosed emphysema. Undiagnosed because I'd never been much of a smoker; hadn't started till age 28, had quit entirely at age 58, and been a fitness buff from age 11.

For the past four years, my workouts have stressed flexibility exercises for mobility, and balancing exercises to avoid falling, along with mild resistance exercises to maintain strong bones and enough muscle strength to get up if I do fall. Until last spring (2009) I still did a modest amount of walking for pleasure, and to salvage what remained of my cardiovascular fitness. In August 2005 we'd moved to Ohio, and in the following three years I fell just twice — once walking into the supermarket when the floor was wet from tracked-in water during a hard rain, and once a few months later on icy pavement. And anyone can fall in those circumstances. Then, on Sept 25, 2008, I fell when I turned my head to look back over my shoulder for traffic.

Nonetheless, even during my last couple of years in Spokane, I was aware that if I was tired, I didn't walk in a straight line, and in any case did not adjust quickly to a change in direction. On one occasion in 2006, while walking along a country road, a patrol car pulled up and the driver beckoned me over. "Where are you going?" he asked politely. I do not doubt he was sniffing for whiskey breath. "Just out for my evening walk." I gestured. "I live in Dan Gingerich's condo development."

"Ah. Well, take care."

I seemed all right, didn't smell like the bottom of a silo or anything, and in Plain City OH, population 3,000, most people know building contractor Dan Gingerich, who is or was also an assistant pastor in a local Mennonite church.

That was then. Now a half-mile walk is my limit, and I don't take walks in winter.

Also I type more slowly and uncertainly, with more mistakes. Another evidence of kinesthetic decline. But oddly enough, I can still snatch flies, especially in late summer when they get sluggish. Fly senility? (And it just took three tries to type the word "senility." A nuisance!)

Mental Condition

So. How about mentally? Ah, there's a sensitive question. I'll begin with two definitions of "cognitive function."

cognitive function

an intellectual process by which one becomes aware of, perceives, or comprehends ideas. It involves all aspects of perception, thinking, reasoning, and remembering.
Mosby's Medical Dictionary, 8th edition. © 2009, Elsevier.

cognitive function

Neurology. Any mental process that involves symbolic operations–eg, perception, memory, creation of imagery, and thinking; CF [cognitive function] encompasses awareness and capacity for judgment.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.

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That pretty much covers what I think of as our mental life. I'll divide it into four parts: memory, focus, reasoning, and emotions.

Memory— I am rich in senior moments, a nuisance for a writer. "What the heck is that word?" Or that name? I've had that problem since childhood, but it strikes much more frequently now. Still, I've developed strategies for finding them, strategies that are slower than just knowing, but quite useful. Comes under the heading of coping. Oddly enough, I can recite my old army serial number, my rifle number, our platoon's radio call number, the radio call number of our LCI, my Social Security number, my wife's...

Focus— More serious, my focus tends to be poorer, quite a lot poorer regarding things I'm not interested in, but it goes well beyond that. I sometimes forget what I'm doing, but it comes back to me pretty readily. Unless I'm tired; then I may dope off, so to speak. (Naps can sneak up on you.) And if I'm doing something I really enjoy, like writing an essay or a chapter, I retain focus quite well. My problem then becomes remembering to make that phone call, or prepare supper.

Reasoning— Within limits, declining memory and declining focus are not so threatening. Most of us, I suspect, consider loss of reasoning ability, the intellect, to be the real threat. In the absence of something drastic, like Alzheimer's, some people seem to retain decent cognitive function to past age 100. Garfield was president of the U.S, and Victoria was queen of the British Empire, when Otto Johansson Till was born in a Swedish-speaking part of Finland, which at that time was part of the Russian Empire. He would die 109 years later in a nursing home in Spokane WA. He enjoyed arguing politics till very near the end, and died of congestive heart failure, as I recall. That makes being a centenarian seem not so bad.

And one of the best books I've ever read is Jacques Barzun's From Dawn to Decadence: 1500 to the Present: 500 years of Western Cultural Life, published in 2000, when he was 92 years old. I am not a fan of "great lit'ry figures," but I'm a fan of Barzun, and not because of his age. From Dawn to Decadence is  a marvelous read. In 2007, his centennial year, Barzun commented that "Old age is like learning a new profession. And not one of your own choosing."

And now, back to a far less renowned and much younger literary figure! A year or so ago, I needed to calculate a value, and started to set it up algebraically …and couldn't do it! Memory? Couldn't recall the rules, the procedure? Maybe. But it seemed to me it should have come together intuitively, growing out of the nature of the problem, and I assumed the problem would induce the procedure to present itself. But I just couldn't juggle the variables. I suspect it was a level of complexity too far for me anymore.

Furthermore, I've noticed that well learned and much used procedures that used to activate automatically at need, now may not. These incidents can sneak up on you. I'll be working away at the computer, and suddenly…nothing! What do I do next? Some procedure that's been automatic for years has suddenly dived down a marmot hole, out of sight. Then, after a second or five there's an "oh yeah" moment, and I proceed. What happened there? There's quite a bit of that, actually. And by hindsight I can see that it's been sneaking up on me for years now; I've just been ignoring it. Also…

I can still do simple arithmetic in my head, on the infrequent occasions I have cause to, like tax time. My kids, when they were small, liked me to tell them how many days old they were. Especially Judy, who despite her 138 IQ, found arithmetic difficult. And speaking of IQ — I wonder what mine would be now. I suspect I recognize similarities and differences as well as ever, and I reason by analogy perhaps better than ever, which is useful to a novelist and essayist. But in my experience, IQ tests are timed. I doubt I could finish one in the time allotted.

My emphysema has recently worsened to the point that my doctor wants me on supplemental oxygen full-time. (I cheat and disconnect before taking a shower though.) R2-D2's ugly cousin dwells in my living room, concentrating atmospheric oxygen and pumping it through a 50-foot tube to my nose. (I've named him R2-O2 for obvious reasons, and have become rather fond of him.) Without supplemental O2, peripheral circulation tends to shut down. My fingers get numb and wooden — clumsy and uncooperative; I can't even put my key in the key hole — and the mind gets vague. Makes driving risky. I asked my doctor if I was developing Alzheimer's. He didn't think so, but gave me a test, and took blood. The test showed no sign of Alzheimers, and blood analysis showed no sign of other candidate problems, including pharmaceutical side effects.

At any rate I sold my car.

Last week I planned to fly to a science fiction convention at the Tri-Cities in Washington state. This would require a day on airplanes and in terminals going, and another day coming back, with three days at the con. Play Time!!! But first I'd need to get there. I no longer function reliably in the real world — complexities galore, with a mind that doesn't shift focus well at all! Nor does it help that I'm getting deafer and deafer. And slower and slower.

So daughter-in-law Jill has shouldered my more complex real-world challenges, like following instructions.

So I got a prescription for travel oxygen gear, the use of which, it turns out, is more complicated than I'd imagined. Jill drove me to a local company to pick up the gear and check out on its use. And to make a long story short, I did not do well; it was deemed too risky. I'd have to have someone tending to me. And there wasn't time to arrange for that.  

Emotions— Herein lies my saving grace— emotional balance. (Knock wood.) My observation is that some old people do not decay emotionally. An old boyhood pal of mine has had Alzheimers for some years now, and still lives at home, cared for by his wife, a long-time nurse, who is 4 or 5 years younger than he. She finds Bob as sweet-tempered as ever. He even tells funny stories; the same ones over and over, she says laughing. Also he loves ice cream, and if he asks for ice cream, she gives him ice cream. So what, if a lot of ice cream isn't good for him. It's a great way to go.

Seemingly he came to terms with the disease early on. I suspect it's made a large difference that he's in a familiar place and well cared for, by someone not greatly stressed, who loves him and has a good sense of relative importances. How long that can continue, I can't guess; we're some 2,000 miles apart. If he were to become ill-tempered…but I really don't foresee that happening. He was a sweet-tempered kid, too, with good-tempered parents.

Closing

And with that I'll call this a report. And may not come back to the topic of aging, though I'll likely comment on it in passing, in future pieces.