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Growing Older, Living Better: Breakthroughs in Gerontology
Everyone grows old, but not everyone looks forward to it. Fears of physical or mental impairments may have you worried about the future. But you don’t need to be afraid of adding to your years.
“Gerontology is the study of physical, mental, and social changes in people as they age,” says Sophia Zhitomirsky, MD, a practitioner of geriatric medicine at Ryan Health | West 97th Street. “My role is to make sure patients and their families get the care they need as they enter their golden years. We need to help people stay active and independent as much as possible, but also set appropriate expectations for people as they age.”
Ryan Health’s geriatric patients are over 65, and many have complex health issues. Dr. Zhitomirsky sees her work with them as a combination of primary care and consultation.
“I help patients with complex medical histories and a long list of medications,” she says. “Our goal in doing a geriatric assessment is to focus on what’s important to the patient and not just accumulate a long list of diagnoses.”
Key to that work is helping families to navigate a challenging system and think about topics that may be uncomfortable to discuss. For instance, what is the best care setting for patients? How will their world change as the patient gets sicker and maybe approaches the end of life? But conversely, the focus could be on lifestyle adjustments patients can make to preserve their health and their memory.
“Feeling unwell or having a medical condition that is undertreated affects your energy level and mood,” Dr. Zhitomirsky says. “Being active and sociable helps with your motivation to manage physical ailments."
There is a strong connection between physical and mental issues as we age. Cardiac, vascular, and respiratory conditions can increase the risk of cognitive decline. Similarly, cognitive issues may negatively impact physical conditions and make them more difficult to manage. Loss of social contact can worsen both. That is especially evident when people become more dependent on their family, friends, and caregivers for daily function, taking their medications, and following up with multiple doctor’s appointments.
“It’s clear to me from experience that a strong community goes a long way to sustain patients in the best possible condition as they age,” Dr. Zhitomirsky says. “Some of the best treatments are non-medication treatments. That means social, mental, and occupational interventions, and finding the right environment. The community is an inherent part of the care that patients need.”
Memory loss can be difficult for a patient to process, but it is very common as people age.
“My main focus is to zero in on how they function in daily life,” Dr. Zhitomirsky says. We don’t want to take anything away from them but rather support and enhance their current level of function. We want to talk about what the future will look like and how treatment may change the progression of the disease. I will tailor the patient’s care to their goals. We need to set realistic expectations and choose which treatments and interventions make sense for them.”
The number of geriatricians like Dr. Zhitomirsky is falling, despite a rising aging population. “The number of board-certified geriatricians has fallen from about 10,000 in 2000 to barely 7,400 in 2022,” according to the New York Times.
“People want to grow old in their community,” Dr. Zhitomirsky says. “Ryan Health has an aspiration to provide care comprehensively and for as long as possible. We know people need us for healthcare but also for a long list of resources to help with getting older in a big city.”
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