THE TRUTH ABOUT SENILITY--AND HOW TO AVOID IT

In spite of the expos‚ title, Galton's latest treatise is one of his best achievements: a competent survey of the health problems of the aged. Principal among them is the practice of ""condescension"" medicine, with doctors all too ready to diagnose as senile any elderly person with symptoms of confusion, memory loss, agitation, or depression. True dementias--Alzheimer's disease and other organic brain syndromes--occur in a significant number of the elderly, but they are not inevitable concomitants of aging. They must be distinguished from pseudodementias, in which brain function is compromised by body disorders which are treatable. Pseudodementias can be brought on by heightened blood lipids, by hormone imbalances, by nutritional deficiences, or by any condition which deprives the nervous system of nutrients and oxygen (e.g., atherosclerosis; hypertension and its consequences). Proper diet, anticoagulants, antihypertensive drugs, vasodilators, or replacement therapy--using hormones, neurochemicals, or other substances vital to nervous system function--can effect remarkable recoveries. Galton points out that a surprising number of the elderly are undernourished. Also, because of slower metabolic and excretion rates, many elderly react more sensitively to alcohol, drugs, and attendant side effects. This is of considerable importance since 25 percent of all prescription drugs are consumed by elderly patients. Galton's plea that medications be labeled and treatment regimens fully explained makes plain common sense; and his lists of common drugs, their behavioral side effects, mutual interactions, etc., are helpful. The later chapters deal with promising research on the aging process and in particular with experiments in countering those changes now assumed to be the natural result of aging. The positive message that is conveyed throughout is nicely summarized in a newspaper quote reflecting viewpoints expressed at a seminar on aging: ""Don't overestimate the inevitability of deterioration from aging and don't underestimate the ability of the elderly body to respond to reasonable demands."" Responsible and specific.