Moving Ahead With Positive Health Lessons and Innovative Predictions

Mehrdad Ayati, MD

January 25, 2022

It's time for being positive to be a good thing again. As we brace ourselves to require more patients to isolate, I see at least three positive lessons from this pandemic experience: We are prioritizing personal and digital connections, disease prevention, and aging research.

Three Positive Lessons

First, people are becoming more united and caring. Rather than focusing on exclusion, we're finding ways to include people in gatherings and conversations. Because in-person events have been limited, older adults have improved their technology skills and gained experience using online platforms. This means they can communicate with doctors, family, friends, clergy, and teachers safely and enjoy the health benefit of staying connected.

Telemedicine and cloud-based solutions have been critically important to symptom checking, disease and condition treatment, medication management, and mental health. During the pandemic, as people checked in on one another, familial and intergenerational connections have grown stronger. We learned that everybody should be responsible for their own health. More people became active participants in their healthcare, sharing information via digital tools.

Mehrdad Ayati, MD
Photo courtesy of Darmiyan

Deep digital disparities still exist when it comes to connecting online, and that is where local organizations like Avenidas and affiliated national organizations like Older Adults Technology Services (OATS) from AARP can help. As we in our practices identify communities or individuals that still need devices, broadband access, better digital literacy, or tech assistance, they can turn to , which is run by OATS (or 1-888-713-3495) for support. Avenidas, the Palo Alto-based center where I frequently speak, is among many senior centers nationwide that seek to help older adults experiencing anxiety or depression find online community programming and healing connections.

Second, preventive and precautionary measures such as masking have become normalized. The masks that were available in various settings now are in frequent use by all. Managing aging in a way that promotes and extends health is increasingly possible. Baby boomers in particular recognized  that modern medicine couldn't cure as much as they'd hoped.

Now that behavioral norms have shifted, we have begun to divide medicine into the pre-COVID and post-COVID vaccine era. Smokers realized that during COVID they had a harder time surviving. Today many focus on developing healthy habits.

Doctors need to make sure to screen for significant problems — like memory loss — early and explain that an MCI diagnosis might not dictate a death by Alzheimer's. We should applaud  the new risk-reduction goal that HHS Secretary Xavier Becerra recently added to the National Alzheimer's Plan.

As Omicron spreads more easily, we need to be vigilant about protecting our most vulnerable elders. They are at risk due to cognitive and sensory deficits and physical frailty. When they cannot remember why masking is important or whether they were tested, they will be less safe. In addition, their multiple comorbidities and weakened immune systems give them a greater chance of developing pneumonia.

Fortunately, older adults are gaining more respect for self-care and time management that enables them to sleep and exercise. We learned from COVID that healthier people have a greater chance of fighting the disease and surviving. Innovators pivoted to make monitoring easier, and we found that people are willing to report on vitals as long as that lets them remain independent, often staying home and out of the hospital.

Positive Strides Toward Prevention and Personalized Care

One area where there have been positive strides is in validation of technology focused on understanding cognitive health, especially the confusing area between normal forgetfulness and Alzheimer's dementia. Identifying whether someone has MCI that will convert to dementia is significantly more useful than merely waiting to manage dementia.

With early detection tools such as Darmiyan's MR image analysis platform, BrainSee, we will have the opportunity to assess the risk factors, whether they are metabolic, cardiovascular, or something else. Once FDA approved, Darmiyan's technology can aid clinicians in understanding what's happening at the earlier stages of neurodegenerative disease.

If I can see something happening, there's a possibility of preventing complications and slowing the progression. Right now we don't have the data. Imagine if we did. Might we find a cause of neurologic problems and prevent dementia? Might we have proactively healthier future generations?

Remember years ago how things were with cardiac care? Between 2000 and 2019, deaths from heart disease have decreased 7.3% while deaths due to Alzheimer's have increased 145%, according to the Alzheimer's Association.

As we do with the heart, when we know that something's unhealthy in the brain, we can find something to treat it and prevent it from getting worse for the patient.

What we are lacking are the screening tools and the opportunity to educate people about being healthier. Science, medical, and technology leaders need to work together to change the standards for brain health.

Third, therefore, is that additional research on aging is critical. Our biggest mistake of past decades was cutting research funding that led to improved geriatrics and neurodegenerative disease management. We're good with a screening test for colon cancer and checking biomarkers for heart disease. We should have a similar system for neurodegenerative disease so diagnosis doesn't happen too late. It is so important that we also shift the research toward finding the risk factors  for dementia. Medicare patients living with dementia have the highest mortality rate — 1 in 3 — for COVID.

In 2022 we can't let COVID force us backward in personalizing care. We need to leverage new tools that forge new connections and insights, propelling us positively past this new challenge.

Mehrdad Ayati, MD, a geriatrician, is a member of Darmiyan's advisory board, author of Paths to Healthy Aging, medical advisor to skilled nursing facilities dealing with COVID patients, guest speaker on NPR/KQED, and Stanford School of Medicine adjunct clinical assistant professor of primary care and population health. Ayati is a voice for the elderly through work with the Alzheimer's Association and other advocates for aging services in Northern California.

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