World Congress Reflects Need To Work Across Borders

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Approximately 3,500 delegates from nearly 85 nations gathered in Vancouver, British Columbia, July 1­5, at the 17th World Congress of Gerontology. The quadrennial conclave, sponsored by the International Association of Gerontology (IAG), based in Bedford Park, Australia, included more than 3,200 papers and presentations relating to the conference theme, "Global Aging: Working Together in a Changing World." IAG president Gloria M. Gutman, who directs the Gerontology Research Centre at Simon Fraser University in Vancouver, stated that the theme "reflects the idea that we need to work together across disciplines, across borders and across organizations if we are going to meet the challenges of the forthcoming decades."

Major sessions at the conference addressed such topics as recent findings by Mary Tinetti at the Yale University School of Medicine, New Haven, Conn., about predicting and preventing falls among elders, as well as research on elder abuse from countries ranging from Germany to Japan (see pages 14 and 15 of this issue).

Caged Men

Symposia on housing and aging in place spanned diverse issues. Kuniko Makigami, now of the University of Southern California, Los Angeles, presented a study raising questions about whether Japan's new national long-term-care insurance program allocates enough money for elders to modify steep staircases and other design problems that are common to Japanese homes and that could lead to injuries.

A study from Hong Kong by Oi-ling Siu of Lingnan University and Gemma K. C. Wong of the University of Hong Kong corroborated previous studies in the United States and other Western nations showing that poor living environments result in low self-esteem, which can lead to diminished health. Siu and Wong interviewed some of Hong Kong's "caged men," impoverished elders who are given a bed in one of many large, ward-like rooms. Each protects his bed space by surrounding it in caging wire.

Comparing the caged men to elders residing in either an apartment or a private room, the investigators determined that "cleanliness, hygiene, ventilation and temperature of caged housing are unfavorable, [which adversely] affects physical health, then self-image and self-esteem." The research team called for improved living environments for these men and a public education campaign based on the "ideal of filial piety" toward elders--both to build public support for helping the men and to improve their self-respect.

Ageism

In a featured symposium titled "Aging Without Ageism," Francois Forette of the National Foundation of Gerontology and International Longevity Center in Paris expressed concern that increasing openness in Europe toward euthanasia and the right to die may stem in part from people's mistaken association of aging with deterioration. She commented, "The current opinion in France is that elderly people are expensive for the social security system, yet the cost per illness in older people has fallen." Forette, a medical doctor, stressed that although programs for geriatric care have been shown to reduce morbidity and placement in institutional care, they remain underfinanced and understaffed.

Brian Gleberzon of the Canadian Memorial Chiropractic College in Toronto said that older people "are often labeled resistant to treatment or clinically uninteresting" in areas of healthcare ranging from oncology to chiropractic medicine. In training students to work with elders, Gleberzon said he requires them to "hold up a mirror" to themselves as they examine common clichés associated with older people, such as the notion that they are invariably frail and slow. He called it a "geriatric paradox" that elders are given more prescriptions as they age but are more susceptible to drug side effects. He said students should be taught that many elders respond well to nonpharmacological treatments, such as nutrition or spinal manipulation, for such conditions as type II diabetes, hypertension and back pain.

Glebrezon said educators should focus on a contextual paradigm of health that emphasizes such variables as environment, psychosocial factors and genetics as a more humanistic way of regarding older people.

Erdman Palmor of Duke University, Raleigh, N.C., presented a survey on ageism that he said could be used to generate public awareness of the problem and to develop "an epidemiology of ageism" that could track the prevalence of different types of age bias. In one small survey he conducted with 84 elders ages 60 to 93, he found that 51% had recently heard a joke demeaning to older people; 30% reported having been shown disrespect because of their age; and 43% said that a physician or nurse had declined to treat an ailment because they assumed it was caused by old age. Those wishing a copy of the survey can contact Palmor by e-mail at ebp@geri-duke.edu.

Paul Kleyman and
Stephanie Renfrow Hamilton

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