Adverse Geriatric Experiences: AGE
In 1998, The American Journal of Preventative Medicine published a landmark study known now as the ACEs study. https://www.ajpmonline.org/article/S0749-3797(98)00017-8/abstract . This was a joint venture between the CDC and Kaiser Permanente, citing the relationship of childhood abuse (physical, emotional, sexual) to leading causes of death in adults, “alcoholism, drug abuse, depression, and suicide attempt; a 2- to 4-fold increase in smoking, poor self-rated health, ≥50 sexual intercourse partners, and sexually transmitted disease; and a 1.4- to 1.6-fold increase in physical inactivity and severe obesity. The number of categories of adverse childhood exposures showed a graded relationship to the presence of adult diseases including ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease.”
I am neither a pediatrician, nor a geriatrician. I am barely 50 years young as I write this. However nearly 30 years practicing in geriatric physical therapy and discussions with esteemed colleagues has brought me thousands of opportunities to see what I have finally come to realize, and now name, as AGE, “Adverse Geriatric Experiences”.
Our older adults are susceptible to all forms of abuse, as cited with children in the ACE study, yet additionally to fear of falling, discrimination in the workforce, scams of all kinds, and perhaps most prevalent if not significant – social isolation. It is beyond my scope in this blog to expand all of the possible directions of this concept, or the call to action that should arise from this “awakening”, as I am but one. A very impassioned one that is moved to make change, however.
I will cite recent discussions with Tiffany Shubert, Lavinia Goto, and Matthew Smith that have pushed me to the point that yesterday morning, at about 3:30am, I coined this term Adverse Geriatric Experiences (AGEs). Thank you, friends.
After years of practice, I have realized that ‘ we start with diapers and end with diapers ‘. The rules that apply to the early stages of our life is the same at the latter stages of our life. We start acquiring milesstones and eventually loose milestones, start being dependent and end up being dependent, our physiology, emotional and cognitive functions are similar in both ends of life. This leads to similar vulnerabilities in geriatric stage like the pediatric beginning of our life. While our legal system is not entirely perfect, yet it has provisions for us to protect both ends of life. I believe while entire lifespan is at risk for trauma and adversity, both ends of life is particularly vulnerable and impact of trauma is cumulative and transmitted generationally.
100% agreed and appreciated!