Last summer, the release of findings from the Women’s Health Initiative sent up shock waves that haven’t died down yet. For decades, hormone replacement therapy (HRT) had been hailed as a magical remedy that cured menopausal symptoms but also protected against osteoporosis, heart disease, and Alzheimer's disease. Instead, as our story (Estrogen Update) explains, it turns out that HRT can actually increase the risk of cancer, heart disease and Alzheimer’s. Most doctors now recommend that women use HRT only for short-term relief of menopausal symptoms, and stop HRT when symptoms abate.
Much of the widespread HRT use among American women resulted from a tendency to treat menopause as a “disease” that needed to be “cured,” rather than as a natural part of healthy aging. In fact, much of our culture treats aging itself as a disease—hence the proliferation of anti-aging creams and other treatments to help mind and body "stay young." But, of course, aging itself is not a disease and many people maintain good health and strong mental function even into advanced years.
But these "healthy agers" have been largely overlooked while medical research has focused on diseases like Alzheimer's and other forms of dementia. Of course, such research is of vital importance to curing and preventing disease. But perhaps it's time to stop focusing exclusively on the diseases that can sometimes accompany old age, and to start paying some attention to the healthy agers—and how they do it.
The MacArthur study, as our story (Use It or Lose It) explains, is a step in that direction. It followed a large group of seniors for several decades, and attempted to determine what the healthy agers were doing differently. Several trends emerged—the healthy agers were more likely to be physically and mentally active, and so on. Of course, we have to interpret these findings with caution: just because physical and mental activity are correlated with healthy aging, doesn't necessarily mean that they are causing the healthy aging. But at least the MacArthur study gives us a place to start in our understanding of what makes some people age well—and it should give us all a better appreciation of how aging, like menopause, is not a disease to be cured, but a normal part of healthy life.
Catherine E. Myers, Ph.D.
Memory Disorders Project at Rutgers University-Newark
Copyright © 2004 Memory Loss and the Brain