By Kay Quinn, St. Louis Post-Dispatch, January 21, 2008

Do you feel as if old age is something that’s far off in your life? Do you believe that whether you spend your last days or years in a nursing home is out of your control?

Dr. Consuelo Wilkins, director of a program called Collaborative Assessments to Revitalize the Elderly, or CARE, says each of us has control over many aspects of how we age. And she believes it’s never too early to take steps that will maximize our chances of making the last years of our lives vibrant, productive and independent ones.

"I think we have to start thinking about aging at a younger age," said Wilkins, who is an assistant professor of medicine in the division of Geriatrics and Gerontology at Washington University School of Medicine. "A lot of us don’t think about getting old until we’re already old, and so if we start thinking about successful aging when we’re younger, and we can implement some of these strategies to decrease frailty, I think we’ll be in much better shape."

Devan Strong, 78, of St. Louis, is happy to be living an active and independent life. He has someone to help him with housekeeping and making meals, but he lives on his own, despite being diagnosed with multiple sclerosis in 1985.

"I guess I took care of myself at an early age," said Strong, when I asked him why he was aging so successfully.

Strong uses a wheelchair to get around, but he also exercises every morning and teaches an exercise class three days a week. He’s vice president of his tenant association at Lutheran Senior Services at Halls Ferry Manor.

He can’t imagine living anywhere else.

"I am very happy with it, pleased with it," Strong said.

THREE RISK FACTORS

By assessing and following seniors like Strong through CARE, Wilkins and her colleagues hope to develop a medical model that can be used across the country to help people age independently and successfully.

CARE evaluates the health and well-being of individuals over 70 who are living in lower or low income senior housing. Their assessments concentrate on three risk areas that can increase their frailty: bone density or osteoporosis, depression and mobility.

Anyone found to have a treatable condition in any of these areas is given help to overcome it. For example, a senior who has trouble with mobility is given simple exercises aimed at improving his or her ability to live independently and lower health risks associated with frailty.

Wilkins said a previous program called PROOF — Prevention of Osteoporosis and Osteoporotic Fractures — showed how important screening for depression can be in this age group.

"When we did PROOF, we also found that a number of seniors in our community are depressed and it was actually very striking how many have depressive symptoms," said Wilkins.

Depression can affect everything from how compliant seniors are about taking daily medication to limiting activities of daily life that can prevent frailty.

ACTIVITY LEVELS ARE A KEY

Strong urges seniors who are still living independently to increase their activity levels through a regular exercise routine.

"Don’t expect to get results overnight," he said. "It’s going to take you from four to six weeks to start seeing improvement."

But he believes staying active mentally and physically is key to prevent frailty.

Wilkins agrees.

"We’re already at a point now where there’s not enough nursing homes to accommodate the aging population," Wilkins said. "Now, some people think the answer is to build more nursing homes, but as geriatricians we think the answer is to try to keep people out of the nursing homes."

CARE is funded by the Barnes-Jewish Hospital Foundation.