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Taking A New Approach To 'How We Age'

Feb 14, 2011 (Talk of the Nation)

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Many people fear growing old. The multibillion-dollar cosmetic surgery industry alone is a testament to how desperately some Americans cling to the appearance of youth.

But geriatric psychiatrist Marc Agronin has a different perspective — particularly when it comes to mental health. "I don't see aging as a disease," he tells NPR's Rebecca Roberts. "I see this as an inherent part of living ... so the idea of curing it, to me, doesn't make sense."

In his book, How We Age: A Doctor's Journey Into the Heart of Growing Old, Agronin argues that among seniors, mental disorders rarely receive the attention or treatment that they might in younger people.

Society has embraced the concept of hospice care, says Agronin, the idea that, until "the very second that someone's life ends ... we will provide them with as vital and meaningful life as possible."

But hospice care is typically reserved for a person's final days or weeks of life. And there are many older people, says Agronin, who "have years, if not a decade or more, ahead of them. We need to bring that same spirit and that same energy to helping them as well."

Unfortunately, says Agronin, "this is where I'm certain we sometimes fail." When it comes to disorders such as anxiety, depression or even Alzheimer's disease, "we make assumptions that this is simply old age, or this is a disease state that we can't do anything about."

Agronin, psychiatrist at the Miami Jewish Health Systems, treats patients with a wide variety of mental health symptoms — and in some cases, he says the medical community's willingness to regard serious problems as an inevitable part of the aging process can have very serious consequences.

In one case, says Agronin, he saw a patient who had "been completely written off as suffering from very rapidly progressive Alzheimer's disease." The man was losing the ability to speak or to walk. "It would have been quite easy to simply say, this is a man in his early 80s; there's not much we can do; let's prepare for the end."

But after giving the man a full medical workup, Agronin and his team found that the source of the patient's symptoms was actually an operable brain tumor. "He emerged, I would say not 100 percent, but 110 percent from this surgery," Agronin says. "It speaks to the fact that we can sometimes miss very simple things."

Agronin has also been cheered by a growing number of elderly people who are increasingly open to the idea of therapy.

"What's wonderful is to see ... the 80- or 90-year-olds who might in the past have never have considered seeking psychiatric care" come in for both group and individual psychotherapy. Those patients have "learned that there's change that's still possible, regardless of their age."

Agronin recently treated a nonagenarian patient who had been suffering from depression for several years. "He really felt that there was just nothing we could do for him. And indeed I would say, this is probably the way a lot of us look at old age, as if we hit a certain point where change is simply not possible."

But with therapy, says Agronin, his patient has had dramatic results. "Just the other day he came in and said, 'Dr. Agronin, my life has been turned around.' " The patient told Agronin that through individual therapy, he was able to change his outlook on his depression, his marriage and his familial relationships.

"At 96," says Agronin, "for someone to make such a change, should really give all of us incredible hope."

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How We Age: A Doctor's Journey Into The Heart Of Growing Old
By Marc Agronin
Hardcover, 320 pages
Da Capo Press
List price: $25
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