Aging with Grace, Secrets and Lifehacks - Book Report/Review Example

Aging with grace: Dr. David Snowden’s The Nun Study Aging gracefully maybe everyone’s dream, but it not easy to achieve it as many things can come inbetween. It requires discipline and some luck. An enterprising doctor looked into this issue among some nuns in a convent where his early findings are insightful but not without some debate. In the book titled Aging with Grace by Dr. David Snowden, dementia in Alzheimers disease takes center stage. The World Health Organization (2007) classifies at least five types of dementia in Alzheimers disease. Accordingly, dementia is a syndrome due to disease of the brain. The usual manifestation is a disturbance of functions including memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgment, and these maybe chronic or progressive. This paper gives a brief summary of the book, my impression of the book, the strength and weakness, a comparison of the book with three journals, the lessons I’ve learned, and a conclusion. Overall summary. Dr. David Snowden writes about a pilot study he had among the nuns in Mankato, Wisconsin associating educational level and age-related disabilities. This initial research gave him the idea of expanding his study to other convents and focusing on Alzheimers disease. In this study, the nuns (75 -104 years old) contracted to give access to their medical and personal histories and to donate their brain tissue after death to Snowden’s project. Among the Catholic nuns. Snowden studied every nun in that community that had the same health care provided, living situation and income status. Because he could do away with these factors, Dr. Snowden’s research can focus on which behaviors and attitudes most affect aging, especially mental fitness. The Nun Study’s scientific findings are well outlined in this book. These findings include: a) Better language abilities are linked to lower dementia risk; b) Diet and exercise are linked to healthy aging and longevity; and c) A positive attitude decreases the risk of age-related problems. Impression of the book. Tracking the lives of 678 elderly nuns who are members of the School Sisters of Notre Dame to assess the effects of aging is not an easy job. It is clear that Snowden had become emotionally involved with his subjects to draw out the many warm and sympathetic anecdotes that filled the book. Among the projects findings is a clear correlation between a low rate of Alzheimers and high linguistic ability. Snowden has also found a positive relationship between the consumption of certain antioxidants (e.g., lycopene, found in pink grapefruit, tomatoes and watermelon), an exercise program and an optimistic outlook and aging successfully. Snowdens human- centered and compassionate story gives many early insights. Strength. The writing is warm and personal. The insights given into religious life and aging are unique. The subjects of the study are equally intriguing with ages (74 – 106) that are not normally found elsewhere. More, these are not just any women but are those who have dedicated their lives to serving others. I appreciate the dedication of the researcher to carry out this time-intensive study. It is not easy to work the length of time he did. It is also not easy dealing with geriatrics to get their stories out to show us that there is so much we can all do to alter for the better how we age, and ultimately how long we live. The book offers a wealth of practical findings: why building linguistic ability in childhood may protect against Alzheimer’s; which ordinary foods promote longevity and healthy brain function; why preventing strokes and depression is key to avoiding Alzheimer’s; what role heredity plays; and why it’s never too late to start an exercise program; and how attitude, faith, and community can add years to our lives. Weakness. Any longitudinal research may suffer from time erosion of data. How did Snowden manage not to become too repetitive or not to condition respondents to particular questions over time? Granted that this is not a problem, the researcher has not clarified enough any bias he may bring into the study. It appears like everyone and everybody is saying the same thing. The lack of contrary information from the 678 nuns does not do the research any good. According to John Creswell (2003) discussing contrary information adds to the credibility of an account for a reader. This is because “real life is composed of different perspectives that do not always coalesce” (p. 196). What follows are three journals related to Snowden’s topic on aging. They are fist discussed separately and then integrated later for comparison. As compared with three journals. The following three journals also talk about successful aging and have mentioned more or less similar factors with some differences. 1) Jansen, Debra A. & Victoria von Sadovszky. Restorative Activities of Community-Dwelling Elders. Western Journal of Nursing Research, Vol. 26, No. 4, 381-399 (2004). DOI: 10.1177/0193945904263010. © 2004 SAGE Publications. This study was conducted to identify the restorative activities of community-dwelling elders. The major finding is that exposure to restorative activities, such as observing nature, is associated with improved concentration, more effective cognitive functioning, and feelings of greater mental energy, peacefulness, and refreshment. Twelve categories of restorative activities were found in the themes: creative outlets, altruism, nature, social connections, cognitive challenges, physical activity, reading, family connections, spirituality and reflection, cultural activities, travel, and other activities. 2) Onedera, Jill Duba and Fred Stickle. Healthy Aging in Later Life. The Family Journal. 2008; 16; 73. DOI: 10.1177/1066480707309610 In this article, the authors addressed particular aspects of successful aging. Satisfaction, contentment, and health later in life might be due in part to an awareness or reflection of some of the benefits and opportunities that accompany age, such as wisdom and a holistic perspective on life, personally and globally. Other criteria for successful aging may include staying active, maintaining a level of social support, feeling as if one is contributing or reciprocating to others, and developing a foundation for healthy social relationships early in life. 3) Minkler, Meredith and Pamela Fadem. "Successful Aging:” A Disability Perspective. Journal of Disability Policy Studies. 2002; 12; 229. DOI: 10.1177/104420730201200402. Hammill Institute on Disabilities and http://www.sagepublications.com. Retrieved May 21, 2008. This article examines the "successful aging" paradigm in gerontology and the problems it poses when applied to the growing population of people who are aging with substantial physical disabilities. The authors reviewed an authority’s three characteristics of successful aging: low probability of disease and disease-related disability, high cognitive and physical functioning, and active engagement with life-and explore their relevance and limitations when applied to people with disabilities. The authors demonstrate how both the term, “ successful aging” and its specific dimensions can serve to further stigmatize and marginalize people who, by virtue of their disabilities, may not meet narrowly defined criteria for "aging well." The article concludes by arguing for models that accent a broader ecological approach, one that stresses environmental accommodations and policy changes, and acknowledges that gains as well as losses are a critical part of the aging process. Integrated comparison. It is understood that graceful aging to Dr. Snowden also defines or approximates what successful aging means to these researchers in these journals. It is more like escaping the fact of having to exhibit dementia in Alzheimers disease while being alive. This was made clear in the nuns’ study of Snowden when the brains were examined after they died. While the nuns were alive, working and teaching, they did not exhibit the symptoms of dementia – contrary to expectations of what were found in their brains. Except for this brain finding, the factors leading to successful aging mentioned in the first, second, and third journals mostly run parallel to Snowden’s study. Snowden had underscored mental fitness then in terms of linguistic ability, mentioned as educational level by some others. Specifically, his findings are that: a) Better language abilities are linked to lower dementia risk; b) Diet and exercise are linked to healthy aging and longevity; and c) A positive attitude decreases the risk of age-related problems. Findings b and c are true to studies mentioned in Journal 1 (Jansen & von Sadovszky, 2004) and Journal 2 (Onedera, Duba & Stickle, 2008). Journal 3 (Minkler & Fadem, 2002), however, takes another tack and critiques what researches says about notions of “successful” aging and pleads for a re-orientation of the concept. Since it is a policy study, it takes the cudgels for the disabled and claims that aging successfully is not limited to normal people but accommodates the others that are handicapped. Lessons I’ve learned. The following are what I have learned from the book and the journals. The common denominator among them are the factors or categories that influence successful aging, hence these shall be my focus. I will discuss first the book and then the journals, pointing out their deficiencies when compared, in terms of what lessons I’ve learned. The book. Since 1986, the School Sisters of Notre Dame in Mankato, MN, have opened their lives, personal histories, and medical records in an extraordinary way, thereby offering researchers a unique view of Alzheimers and aging. Snowden, a professor of neurology have studied this population of Catholic sisters, some of whom have remained active and lucid all their lives while others have become demented. Snowden writes with empathy and affection of these sisters, who also generously agreed to donate their brains for postmortem pathological studies. From this research, Snowden explains, it emerged that pathological changes did not always correlate with observable changes; that linguistic ability seems to protect against Alzheimers; that prevention of stroke and heart diseases can help avoid dementia; and that heredity, diet, and exercise also play a part. Many of the subjects of Snowden were teachers in various grades of school. Alzheimers clearly showed up in many of the nuns brains later on but while they taught Alzheimers showed no symptoms whatsoever until the end of their days. According to the World Health Organization (2007), there is a late onset of dementia in Alzheimers disease which comes after the age of 65, usually in the late 70s or thereafter. There is a slow progression, and with memory impairment as the principal feature. The nun subjects in Snowden’s study may fall under this classification, but since they have not exhibited the manifestations while they were alive, this is something for science to ponder. The journals. Jansen & von Sadovszky (2004) have well outlined that the following could restore one to health: creative outlets, altruism, nature, social connections, cognitive challenges, physical activity, reading, family connections, spirituality and reflection, cultural activities, travel, and other activities. Meanwhile, Onedera & Stickle (2008) mention wisdom and a holistic perspective on life as factors leading to successful aging. Specifically, they mentioned staying active, maintaining a level of social support, feeling as if one is contributing or reciprocating to others, and developing a foundation for healthy social relationships early in life. This is more closely like Snowden’s study. It is other-oriented rather than the more self-oriented subjects of study mentioned in Jansen & von Sadovszky (2004). However, in both studies, the respondents are normal, without handicap, with an environment that is not burdensome unlike in the study mentioned in the third journal (Minkle & Fadem, 2002). I am giving it more space as the study proposes changes in policy and represents the less represented in society. Minkler & Fadem (2002) studied successful aging from the perspective of the disabled. They agree that a more positive view of aging can play a critical role in helping individuals achieve and maintain higher levels of function as they grow older. They argue, however, that from a disability perspective, neither the semantics (a lot of talk) nor the theoretical conceptualization of successful aging constitutes the best approach to achieving this goal. The disablement process, according to them, is a dynamic social phenomenon that has as much to do with cultural norms and socioeconomic status as it does with individual physiological conditions. In other words, they are saying there could also be successful aging with disability. Accordingly, the individual should be considered in terms of the immediate settings in which he or she lives, the larger environment in which these settings are placed, and the interactions among all of these levels. As argued by Minkler & Fadem (2002), the concept of successful aging has been helpful in focusing renewed attention on health promotion, and disease and injury prevention, as means of adding life to years and not merely years to life. Studies of successful aging similarly have made a real contribution to clarifying the many health-promotion and disease-prevention strategies that can help ensure a healthier old age. Yet, the new emphasis on successful aging is problematic, as well. The concept has been criticized for paying insufficient attention to aging over the life course; race, class, and gender inequities; and the realities and importance of losses as well as gains in later life. Many of these criticisms, according to Minkler & Fadem (2002), are highly relevant to the issues and concerns of people with disabilities. They reviewed past successful-aging paradigms and its three components: low probability of disease and disease-related disability; high cognitive and physical functioning; and active engagement with life (much like Snowden’s study). Then they examined each of these characteristics specifically as they relate to the lives of older adults with substantial physical disabilities. Minkler & Fadem suggest that although the concept of successful aging has moved the field forward in some important new ways, both the term itself and some of its specific dimensions and meanings may serve to further stigmatize and marginalize people who are aging with severe disabilities, and who may not meet the criteria for aging successfully. They conclude by making a case for the use of alternative or other conceptualizations that emphasize the environmental conditions needed to optimize the aging experience for both individuals with disabilities and those without. Integrated learning. I have learned that researches may be done in different approaches with different subjects, and in different contexts, therefore the findings are also contextual. Minkler & Fadem’s (2002) study, for example, is mostly a literature review. Snowden’s was longitudinal and qualitative. He had opted to be less objective as he studied the nuns and let them construct reality to find out what it was that made them live long without dementia. The results of studies depend in large part, therefore, on the particulars of the study, the kind of subjects, the environmental particulars. It also depends on the purpose of the study and its limitations. Still, there are commonalities that could be found in these researches in terms of findings. For example, there is the commonality of associated healthy outlook and aging in these research findings. I have also learned that one can age successfully even though found with handicap. It is not in material things or pleasing physical looks that successful aging can be found. It is more of one’s mental and spiritual outlook and being useful for others that one can say he or she has aged successfully. I have learned this through the third journal by Minkler & Fadem (2002). Without reading this journal, I would have thought that successful aging is only based on normal conditions and excluding the handicapped as impressed by Snowden’s book and the two other journals. I would have thought that once a person is handicapped, he has not aged successfully. Snowden has not given enough advice on how to make changes in the readers life. This is one of the things the book did not impart. However, this aspect was dealt with clearly by the first two journals, particularly by Jansen & von Sadovszky (2004) who studied restorative activities. Reading Snowden’s book, therefore, is limited. One needs to know the perspectives of other researchers from other contexts. The last journal by Minkler & Fadem (2002) was quite distinct in that it was campaigning for a new public outlook on the concept of successful aging to include the disabled. If I just read Snowden’s book, I would not have this added insight of appreciating the fact that the disabled could also gracefully age. Conclusion In Aging with Grace, Dr. Snowden offers practical suggestions for avoiding dementia. Dietary suggestions range from the proven value of folic acid (found in cooked tomatoes) to the possible benefits of Vitamins E and C supplements and the anti-inflammatory drug Celebrex. Throughout the book, he emphasizes the importance of daily exercise, constant and continual intellectual stimulus and, above all, maintaining a positive outlook on life. The scientific researchers went to a great deal of trouble and expense to confirm that aging well results from: a lively mind, a love of learning, meaningful work, a genuine interest in other people, a loving family/community, a healthy diet, an optimistic and grateful attitude, and a strong spiritual life. To sum up, one finding of Snowden is that diet and exercise are linked to healthy aging and longevity. There is no debate on this in literature. The other finding is that of positive attitude decreasing the risk of age-related problems. Again, no literature would counter this finding as it appears to be a general fact. There is one finding, though, that seems debatable. In an editorial penned by Lawrence Whalley (2002) on brain ageing and dementia, he posed the question whether these two are different. This statement is made in view of the fact that Snowden’s first finding is that better language abilities are linked to lower dementia risk. Whalley, however, implies that there is no boundary between these two, or the boundary is at least unclear, and that as a person ages, dementia does not necessarily set in, regardless of better language abilities. Clarifying himself by associating brain aging and cognitive decline, Whalley (2002) said - The association between brain ageing and age-related cognitive decline is uncertain. Largely because ageing studies are only just beginning, brain ageing is yet to be linked informatively to what is known about the neurobiological basis of cognitive decline. Higher brain functions comprise abilities like language, learning, memory, planning, abstract reasoning and self-awareness; most of these are impaired as age-related cognitive decline progresses to dementia. What Whalley implied is that Snowden’s finding may be true. The fact that he asks the question whether brain ageing and dementia are different means there are those who think otherwise. In fact, Whalley (2002) who is a psychiatrist (Snowden is a neurologist and epidemiologist) said understanding individual differences in age-related cognitive decline is beset with difficulty. He concluded that neuropathological evidence of the hypothetical discontinuity between ‘normal’ ageing and dementia is lacking, but that the best available evidence suggests that there is no boundary at all. From Whalley’s question in the editorial, it can be said that Snowden’s study is not totally accepted by all. This is the nature of scientific research. It has to be validated by more research of its kind. However, Debra Jansen (2005) named in the first journal had extended her writings the following year and talked of restorative activities. What can be restored but what can be barred? A content analysis of interview data in her study from 30 community-dwelling elders (28 women, 2 men) revealed 11 barrier categories to restoration. These included health limitations, lack of time, ageist attitudes, transportation difficulties, lack of companion, financial constraints, weather, limited opportunities, family separation, safety, and lack of space. These are enough to disable one from aging gracefully. In order words, the disablement is structural. Jansen (2005) called them perceived barriers to engaging in mentally restorative act. Does this mean then that what age has eroded, they can still be restored? Does this mean then that there is hope in Snowden’s first research finding about dementia? Jansen (2005) was saying that there are problems but these are merely environmental or simply outside of the problem. It is therefore concluded that as earlier mentioned, aging gracefully maybe everyone’s dream, but it not easy to achieve it as many things can come in between. It requires some discipline and some luck. Coping schemes like having a positive attitude towards one’s lot is expected of anyone with any form of disability like aging. However, being other-oriented, which seems to have been what carried the nuns through dementia in Snowden’s study seems to take it all. These nuns thought of serving others rather than fight with time and what time may bring over their own bodies. References Creswell, J. (2003). Research Design. Qualitative, quantitative, and mixed methods approaches. 2nd edition. Thousand Oaks: SAGE Publications. Jansen, D. A. & von Sadovszky, V. Restorative activities of community-dwelling elders. Western Journal of Nursing Research, Vol. 26, No. 4, 381-399 (2004). DOI: 10.1177/0193945904263010. © 2004 SAGE Publications. Jansen, D. A (2005). Activities, adaptation & aging. The Journal of Activities Management. Volume: 29 Issue: 2. ISSN: 0192-4788. June 28, 2005. DOI: 10.1300/J016v29n02_03. Page Range: 35 – 53. Minkler, M. & Fadem, P. "Successful aging:" A disability perspective. Journal of Disability Policy Studies. 2002; 12; 229. DOI: 10.1177/104420730201200402. Retrieved May 21, 2008, from Hammill Institute on Disabilities and http://www.sagepublications.com. Robson, S. M., Hansson, R.O., Abalos, A. & Booth, A. Successful aging: Criteria for aging well in the Workplace. Journal of Career Development. 2006; 33; 156. DOI: 10.1177/0894845306292533. Snowden, D. Aging with grace: Leading longer, healthier and more meaningful lives. New York: Bantam Books, 2001. 237 pp. Whalley, L. J. (2002). Brain ageing and dementia: what makes the difference? The British Journal of Psychiatry (2002) 181: 369-371. World Health Organization. Mental and behavioral disorders. ICD. 2007. Retrieved May 32, 2008, from http://www.who.int/classifications/apps/icd/icd10online/?gf00.htm+f00 Read More