Skip to main content

Recent Covers on The Gerontologist


The most recent issues of The Gerontologist (June and August 2015) feature photos I took in 2012 on a trip to Kyrgyzstan in Central Asia. These strong  and beautiful people are descendants of Ghengis Khan and traders on the Silk Road.  I was amazed to learn the extent that elders are revered in traditional Kyrgyz society, but the collapse of the Soviet Union and globalization caused rapid economic and cultural change that have not been to the benefit of the older generation.

The Soviet regime brought Kyrgyzstan jobs and education but disrupted traditional life in many ways. Mandatory work for women ceased transmission of handicraft skills. Forced abandonment of nomadic lifestyles put skilled builders of yurt components out of business. The end of Soviet domination closed most factories, and privatization of land and businesses did not stem the economic downslide that resulted in massive unemployment. A large segment of the young male population left for Russia in search of jobs, leaving the elders to tend farms and raise grandchildren.

In past generations elders were the source for problem solving when it came to issues of morality, upbringing, domestic disputes, and arguments between neighbors. Traditional village life taught that a person's identity depended upon information transmitted by their society. Socialism dictated similar principles, and sharing was valued over individuality. Secular education and globalization have displaced elders from the role of transmitting cultural values. Instead the media has assumed the role of teaching society's rules, and identities are built more on differences rather than similarities - much like western society. The end result is a generation of elders who are no longer valued or integrated into daily life. 






It still is believed that blessings from an elder can influence a person's life. I experienced this in the Jety Orguz mountains when talking to a bearded shepherd in his 90's named Kodyr. He was wearing a tall white felt hat and a long, finely embroidered coat called a chepken, and looked like a character created by J.R.R. Tolkien. At a certain point in our discussion he paused and looked at me intently and said, "I am going to give you a blessing." After the blessing I felt a sense of humility, and all I could do was shake his hand, smile, and thank him.




Comments

Judith Henry said…
I so appreciated this post. While a large segment of our society seems to worship at the altar of youth, there are still those of us who appreciate the beauty and wisdom that comes with age. Marvelous photographs, Jeff. I'm sure it was the experience of a lifetime.
JeffreyLevineMD said…
Thanks for your kind words Judith!

Popular posts from this blog

Geroscience and it's Impact on the Human Healthspan: A podcast with John Newman

Ok, I'll admit it. When I hear the phrase "the biology of aging" I'm mentally preparing myself to only understand about 5% of what the presenter is going to talk about (that's on a good day).  While I have words like telomeres, sirtuins, or senolytics memorized for the boards, I've never been able to see how this applies to my clinical practice as it always feels so theoretical.  Well, today that changed for me thanks to our podcast interview with John Newman, a "geroscientist" and geriatrician here at UCSF and at the Buck Institute for Research on Aging.

In this podcast, John breaks down what geroscience is and how it impacts how we think about many age-related conditions and diseases. For example, rather than thinking about multimorbidity as the random collection of multiple different clinical problems, we can see it as an expression of the fundamental mechanisms of aging. This means, that rather than treating individuals diseases, targeting …

The Dangers of Fleet Enemas

The dangers of oral sodium phosphate preparations are fairly well known in the medical community. In 2006 the FDA issued it’s first warning that patients taking oral sodium phosphate preparations are at risk for potential for acute kidney injury. Two years later, over-the-counter preparations of these drugs were voluntarily withdrawn by the manufacturers.  Those agents still available by prescription were given black box warnings mainly due to acute phosphate nephropathy that can result in renal failure, especially in older adults. Despite all this talk of oral preparations, little was mentioned about a sodium phosphate preparation that is still available over-the-counter – the Fleet enema.

Why Oral Sodium Phosphate Preparations Are Dangerous 

Before we go into the risks of Fleet enemas, lets spend just a couple sentences on why oral sodium phosphate preparations carry significant risks. First, oral sodium phosphate preparations can cause significant fluid shifts within the colon …

Length of Stay in Nursing Homes at the End of Life

One out of every four of us will die while residing in a nursing home. For most of us, that stay in a nursing home will be brief, although this may depend upon social and demographic variables like our gender, net worth, and marital status. These are the conclusions of an important new study published in JAGS by Kelly and colleagues (many of whom are geripal contributors, including Alex Smith and Ken Covinsky).

The study authors used data from the Health and Retirement Study (HRS) to describe the lengths of stay of older adults who resided in nursing homes at the end of life. What they found was that out of the 8,433 study participants who died between 1992 and 2006, 27.3% of resided in a nursing home prior to their death. Most of these patients (70%) actually died in the nursing home without being transferred to another setting like a hospital.

 The length of stay data were striking:

the median length of stay in a nursing home before death was 5 months the average length of stay was l…