What to Expect as You Age with Geriatrician Dr. Rosanne Leipzig, Author of ‘Honest Aging’
Show Snapshot:
Are you hellbent on living your later years with health, vitality, and joy? Want straight-talking, anti-anti-aging information on thriving as you age? If so, please meet Dr. Rosanne Leipzig, author of “Honest Aging: An Insider’s Guide to the Second Half of Life.” We dive into evidence-based recommendations for navigating the natural changes that impact bodies and minds as we age and learn what to expect in the next phase without any BS “aging backward” recommendations. Aging is living – we get into how to live your healthiest, best years as you add more birthday candles to every cake.
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Dr. Leipzig’s Book:
Honest Aging: An Insider's Guide to the Second Half of Life
Quotable:
“Our vision of what old people look like and are able to do is really skewed. Studies have shown that 70% of people who are 85 or older, say their health is good or excellent. Now, that's an amazing number.”
Transcript:
Katie Fogarty0:03
Welcome to A Certain Age, a show for women who are unafraid to age out loud. I'm your host, Katie Fogarty. Beauties, you know that over here in A Certain Age podcast land, we are age-positive and big believers that the second half of life is full of possibility, vibrancy, and joy. But we also recognize that aging brings challenges and change — our bodies and brains do not work like they did at 20 or 30, and if we are aging, our parents are way ahead of us. Personally, I'm hell-bent on setting myself up for healthy, active aging and learning how to better support my parents with their own evolving healthcare needs. What do you think? Are you in? If so, stick around, because today's guest is a powerhouse in the field of geriatrics with over 40 years of experience transforming how we approach aging. I am joined today by Dr. Roseanne Leipzig, who has an astonishingly long list of accolades and academic and aging advocacy leadership. Dr. Leipzig joins me today in her capacity as author. Her book is Honest Aging, and it is a practical, power-packed guide to navigating the second half of life with vitality and joy. Welcome, Roseanne.
Dr. Roseanne Leipzig1:16
Thank you very much, Katie. It's great to be here.
Katie Fogarty1:18
I am really excited. I know that you are a trailblazer in the field of aging and longevity. I'm so excited to get into all those things. But first, I want to ask you about the title of your book. Why Honest Aging? What does aging honestly mean to you?
Dr. Roseanne Leipzig3:13
Well, it is a four-letter word — but I think aging is seen as something to be fought off tooth and nail, right? That we should fear it, and do everything in our power to avoid it, and certainly not be out and proud, so to say, about getting older. So I think that's probably the biggest myth and the biggest cultural thing that we need to change.
Katie Fogarty3:33
Well, we are doing that. I literally wear an "Age Out Loud" sweater on my podcast cover art, because I really do believe that we should all be aging out loud and we shouldn't be hiding it. Absolutely — we can be role models for others, and there are lots of role models for us.
Dr. Roseanne Leipzig3:40
Yep, I agree.
Katie Fogarty3:47
And I know from reading your book that your grandmothers were role models for you. I've said on the show before that my own grandmother was one of my role models. My mother, my mother-in-law, who have approached aging with just so much joy and vitality — they are like Energizer Bunnies, very unstoppable, trying new things. My mother-in-law, who has had a number of different creative careers, is now writing children's books for the very first time. And it's so inspiring to see women who are not letting the fact that they're accumulating more chronological years get in their way of trying new things and new adventures. So I do want to ask you — one of the early chapters in your book, I'm forgetting the exact name of it, but it says something like "60 Is Not the New 80," or "80 Is Not the New 60." And you're very clear — and because we know that you're honest, you're standing in that truth — you say that old age is very different from middle age. Most of my listeners probably fall somewhere in the middle-age bracket, but I am willing to take a bet that most of them want to make it into the old-age stage. Your book is obviously a great guide. You've got a lot of practical chapters on dealing with aging-related concerns that affect things like mobility, weight, sex life, and nutrition. But you begin by saying the cornerstone of healthy aging is attitude and mindset. Can you explain why?
Dr. Roseanne Leipzig5:23
Absolutely. My way of explaining it is really to tell you about studies that were done by a clinical psychologist up at Yale named Becca Levy. Basically, what she has shown is that if you feel negative about getting older, your old age will not be as good as if you felt positive about it. She's shown that people with positive attitudes toward aging live about seven and a half years longer, and they also live better — they're in better shape than people who have negative attitudes.
Dr. Roseanne Leipzig5:58
It's kind of like a self-fulfilling prophecy — "it's going to be all downhill," so it's going to be all downhill. She actually did a study where she took people who were 65 and older, sat them in front of computers, had them do something on the computers, but she flashed at them subliminally either negative or positive images of aging. After that, she had them do hearing and memory tests. Now, I'm a doctor — I have always thought that hearing tests and memory tests were objective. The way you do on a hearing test today is going to be the way you do on a hearing test in two weeks, unless something obvious has happened. And similarly with memory. What she found was that the people who had the negative perceptions of aging flashed at them did worse on their memory tests and on their hearing tests. The only explanation I can come up with for that is they didn't think they could do it as well. Maybe they didn't even try as hard.
Katie Fogarty7:03
That is absolutely fascinating. I totally believe it. I know that mindset has this reputation as being sort of very woo-woo, but I recognize for myself, at least as I've gotten older, that my mindset is so fundamental in terms of moving goals forward or driving change, or even being willing to start something new. I have to believe it's possible that I can do it in order to take action. And if you don't think you can do it, you're not going to be able to do it. I have this great yoga teacher who always says, "If you think you can't, you're right." It's one of the only things you can be 100% sure about. So for people listening to this conversation — I think most of my listeners are here because they are pro-age. They want to believe that things are possible, that you can take control of your life and your health and your choices and create a joyful, vibrant chapter in the second, third, fourth, and fifth acts of our lives. Do you have one or two tips to share that could help us rewire our mindset around aging?
Dr. Roseanne Leipzig7:50
Absolutely. The first is to recognize that most of us have 20 to 40 years to do something after we finish raising our kids — we're empty nesters, or we've retired. That's an incredible amount of time to do something, to have a second or third act. The second thing is: our vision of what older people look like and are able to do is really skewed. Studies have shown that 70% of people who are 85 or older say their health is good or excellent. Now, that's an amazing number.
Katie Fogarty8:28
I love that. I'm excited — and it's real.
Dr. Roseanne Leipzig8:33
We use that question in surveys in medicine, because if you say that, it's true. And if you said that your health was poor or fair, that's also true.
Katie Fogarty9:15
If you ask about the percentage of people who are frail and who are 85 and older — it's only about a quarter. These are 85-year-olds and older. Okay — yeah. I'm here for this. I want to be that 85-year-old, Roseanne. We're heading into a quick break, but when we come back, we're going to pick this up. What are the choices we need to be making to feel that way at 85?
Katie Fogarty9:39
We're back from the break. When we headed into it, you shared this very joyful stat — that people at age 85, a big percentage of them, feel healthy, fit, vibrant, and vital. And I love that, because I definitely plan on being that 85-year-old. So I have a quick, practical question. I said at the top of the show that you're a — I can't even say this word. Can you help me out?
Dr. Roseanne Leipzig10:06
The word is geriatrician.
Katie Fogarty10:10
Geriatrician. Okay, all right — geriatrician. Now that I've said it, please — no one needs to. Don't ask me to spell it, okay. But you are a geriatrician. So at what age does somebody need to see a doctor of your specialty? This is a two-part question: Does it depend upon somebody's overall health, or is there a specific numerical age where this makes sense?
Dr. Roseanne Leipzig10:36
There's not a specific numerical age as such. There is such variability among older people — much more variability than among younger people. Some are incredibly fit, and some are really frail. I'm going to put a little bit of a caveat in here, and that is: there are not enough geriatricians in this country to take care of all people who are over 65 — or even 75. So we're kind of a rare breed, and we try to work with people who can really use our combination of skills. People who are 85 and older — definitely. Maybe even 80 or older, because if they don't need us now, they probably will in the near future.
Dr. Roseanne Leipzig11:20
But there are also people who are younger who haven't been as lucky, or who have some of what we call geriatric syndromes. These are things that you associate with aging — they don't happen to everyone, but they happen to a lot of people. And what are they? These are things like problems with your memory, weight loss, falls, balance problems...
Dr. Roseanne Leipzig11:50
...incontinence, frailty — which we've mentioned before. And is there a scientific definition for frailty? What is that? Is that when you have osteoporosis or osteopenia? That's a great question. Frailty has lots of definitions. What we do know is, whatever definition we use, people who are frail have worse outcomes medically — from medications, from surgeries, from diseases. So they are much...
Dr. Roseanne Leipzig12:27
...less likely to do as well. We really need to do everything to give them more reserve. And that's the problem — that's what frailty is. It's the idea that, when I was in medical school, I was taught that I had more brain than I could ever use in my life, and two kidneys, so I could give one away. But as you get older, you're using up a lot of that reserve. And if something happens, you need that reserve to get through it. So frailty is not having that reserve. So some people head into old age with this deficit of...
Katie Fogarty13:07
...I guess, what is the opposite of frailty? Strength? The ability to combat disease and fight off the inevitable?
Dr. Roseanne Leipzig13:13
I would call it fitness. Fitness.
Katie Fogarty13:20
I think that's true. And I think the thing to think about with...
Dr. Roseanne Leipzig13:26
...frailty and that question that you asked before the break — what are the things you need to think about? There's something called sarcopenia. It's a fancy word, but if you break it down: "sarco" means muscle, "penia" means too little. As you get older, your amount of muscle in your body decreases, the...
Dr. Roseanne Leipzig13:49
...strength that you have decreases, your bone density decreases, and even your ability to learn lists of words decreases. And this doesn't suddenly happen when you're 70. It actually starts in your 30s, and you have been compensating for it for many, many years — and then it gets to a point where you notice it more than you did before.
Dr. Roseanne Leipzig14:15
If you lose even more muscle than is usual, that impacts your ability to do things. You get tired faster. You're not able to do as much. You walk much more slowly. You stop doing things — kind of like during the pandemic, where people just sat on the couch. And it's a cycle — it goes around and around and around. So the thing you need to do is not let that happen. Throughout your life, you really need to keep yourself strong. You need to be walking. You don't have to be an exercise fanatic, but you do need to do things to keep yourself toned up. And the second thing you need to do...
Dr. Roseanne Leipzig15:00
...is to recognize that your body changes as you get older.
Dr. Roseanne Leipzig15:06
You lose muscle and you gain fat. If you want to gain that muscle back, you need more protein than we usually have in our diets. So you need to start thinking about eating more protein as you get older.
Katie Fogarty15:23
I've heard this from other experts, and I was happy to hear it. There are so many protein-rich foods that I enjoy. You're once again inspiring me — as so many guests have — to continue to prioritize heavy lifting and resistance training that help us keep our bones and musculoskeletal system healthy. I've had a bunch of phenomenal experts on the show. I had Amanda Thebe, who's a fitness pro, Megan Dallman recently, and I had Dr. Vonda Wright — she's been a guest twice. She's an orthopedic surgeon and she is a leading expert in the musculoskeletal impact of menopause on women's bodies, and she was just a phenomenal guest who really emphasized this as well. So I think that's so important. I'm delighted that you brought it up to remind us that we really need to be prioritizing these things.
Dr. Roseanne Leipzig16:25
Absolutely. And Katie, the other thing I have to say is: you don't have to live in a "no pain, no gain" world. Studies have shown that if you do the same exercises over and over again, and you're just challenging yourself — not making yourself grunt and sweat like crazy — you can still get the benefit.
Katie Fogarty16:38
That's so reassuring to hear, because I like an easy button when I can find one.
Katie Fogarty16:48
I'm actually reading the book Atomic Habits right now, which I feel like everyone on the planet read five years ago. But I'm a late bloomer, so I'm finally reading it. He talks about habit-building, and one of the key principles is to make it easy, because what's easy and right in front of us gets done. So that's why I'm so delighted we're having this conversation — you're reminding me and our listeners that we really need to prioritize this. So Roseanne, I want to ask you — your book offers wonderful chapters that are super clear about what we need to be doing for ourselves to manage our health and set ourselves up for healthy, vital aging, which is possible for us — we heard about those 85-year-olds. But many of us are also helping our parents right now start to manage their own caregiving. The tables start to turn as the needs of our parents might require us to be more involved in a way that we've never been before. I had a phenomenal show a couple of weeks ago with Kitty Eisler, who is the host of the podcast 24/7, a podcast about caregiving, and she walked us through a lot of practical, tactical tips about managing paperwork and how to have the hard conversations that allow us to become part of our parents' caregiving. But I want to ask you — you've been practicing medicine for 40 years. You have people walk into your office who want to be healthier and age vibrantly, but you've probably also had patients walk in who are accompanied by their adult children. Is that true? So when the shoe is on the other foot and we are the ones going in with our parents — if you could wave a magic wand, what would you want the adult children of your patients to be doing, supporting, asking, in order to really help with their parents' healthcare?
Dr. Roseanne Leipzig19:08
The first thing I would say is both parties — the children and the parents — have to really try to understand what the other one is going through. Put yourself in their shoes. And I'll talk primarily to your audience, which are adult children. It's a change in the relationship. For many older people, they feel diminished. They feel like their children are starting to run their lives for them, and they didn't give them that permission.
Dr. Roseanne Leipzig19:27
So I think it's really important, whenever you start to have a conversation like this, to raise it gently and ask your parent what they think before you start coming up with, "We need to do this. We need to do that." And in the book, I've actually put advice for loved ones in all of the geriatric syndrome...
Dr. Roseanne Leipzig19:52
...chapters, because I think how you approach these things — if somebody is falling, if their memory is failing...
Dr. Roseanne Leipzig20:02
...you've got to be careful. It's...
Dr. Roseanne Leipzig20:06
...it's ground that can be contentious, and you don't want that.
Katie Fogarty20:10
No, absolutely. Hearing you speak actually jogged a thought. It sounds a little bit like having hard conversations with your teenagers. We go through a time when our kids are really young and you say, "Do this, not that," and you expect them to listen. Then your kids grow up, and that heavy-handed approach just doesn't work — it's going to push your teenager away. We learn as parents to have conversations with our teens and young adults that are respectful of their needs. And yet, it's interesting to think that we have to learn that lesson again as caregiving adult children. That heavy-handed approach is always going to feel unpleasant and unwelcome. So thank you for flagging that. I love that the book offers concrete tips for each of the specific situations you might face as you begin to age. One of the things the book identifies is that caring for aging parents sometimes goes beyond simply monitoring their medications or accompanying them to doctor's appointments. Sometimes people need to step in and take the car keys away — and that's a healthcare decision.
Katie Fogarty21:27
So for listeners right now who are thinking, "I'd love a tip or a tool or a conversation jump-starter" —
Katie Fogarty21:37
— what might you recommend they say when they're trying to talk to their parents about the hard conversation of having to step in and help manage daily life activities?
Dr. Roseanne Leipzig21:47
I think the first thing to do is to ask your parent how they think things are going, so that you have an idea of what their understanding of the situation is. And then sometimes what you need to do is reality-test for them — let them know what you're concerned about, and have them work with you through why you're concerned and why they're not.
Katie Fogarty22:19
That's a great piece of advice, because that way you really pull out of your parents what they think is happening. No one's a mind reader. You might assume that your parent knows they're having trouble with certain things, but until you hear them say they don't think they are, that helps you understand the gap you need to close between your concerns and their understanding of what they think they've got covered. I love that. So for parents who are just sort of digging their heels in and are not interested in managing their health, or don't want their child to be supportive — as a doctor, what is the ability of the healthcare system to help...
Katie Fogarty23:11
...with those intractable situations? Or does that not occur?
Dr. Roseanne Leipzig23:16
Oh, there are intractable situations, and our society is not set up for them. Driving is something your doctor can help with. Most states — not all —
Dr. Roseanne Leipzig23:30
— the doctor can write a note saying this person needs to be tested. But before we get to that point — because that obviously can cause friction between the doctor and the patient — there are a number of things you can do along the way. So it's really...
Dr. Roseanne Leipzig23:49
...trying to get the parent to understand...
Dr. Roseanne Leipzig23:54
...that there is a problem, or that you're concerned there's a problem. And as a doctor, I'm speaking right now — okay, I'm sorry — yes, I get it.
Dr. Roseanne Leipzig24:06
Driving is incredibly complex.
Dr. Roseanne Leipzig24:10
You need vision, you need speed, you need reaction time. Even being able to turn your neck as you get older is harder. That's why they've put cameras in all these new cars.
Dr. Roseanne Leipzig24:27
There are things I can say to someone, like, "Have you noticed anything like this? Any fender-benders? Any concerns in those ways? Are your kids afraid to have their own kids ride with you?" Which is what happened. And there do exist places that do drivers' assessments — not legal drivers' tests, but assessments to understand where the problems are and whether they're remediable.
Dr. Roseanne Leipzig25:00
There are also rehabilitation programs for driving, to teach people how to drive more safely. Those associated with the VA have that as well.
Katie Fogarty25:08
That is so fascinating. But we're talking right now about when kids step in. And I'm making the assumption that people have children to step in and help. If you do have a loving, supportive family that surrounds you, that is extremely fortunate. But I have many friends in my life who are not married or do not have children, and so as they age, they will be doing solo aging. What are your recommendations for listeners who are thinking, "Oh my God, I don't have five kids who are going to help me." What steps can they be taking today to prepare for that future?
Dr. Roseanne Leipzig25:48
One of the things that we don't have enough of — and we need more of — is community. We need people who we do things for, and who do things for us. There are community centers. Some people get it through their houses of worship. There are different places, but you really need friends who are not your age as well. You need to make friends, as an older person, with younger people — and as a younger person, with older people. Some communities are getting very smart about this and connecting people with each other, or having...
Dr. Roseanne Leipzig26:21
...the ability to have someone call in and say, "I have a doctor's appointment and I have no way of getting there," or "I need a colonoscopy — they won't do it unless somebody's there to take me home, and I don't have anybody." Those sorts of things we as a society should be able to handle. And there are a lot of nonprofits that are trying to do that as well.
Katie Fogarty26:38
What would some of those be? Do you have any off the top of your head...
Katie Fogarty26:53
...of the nonprofits?
Dr. Roseanne Leipzig26:55
Yes. I'm in New York City — the Manhattan JCC has a huge program like that.
Dr. Roseanne Leipzig27:05
There are...
Katie Fogarty27:08
Now I'm blanking, of course. That's okay, Roseanne — that's what Google is for. Just pointing out the fact that JCCs, which are all across the country, can step into the breach in some ways, and there are other nonprofits too. By the way, I'm going to look this up myself after the show and put some resources in the show notes to share with people, because I think that's so valuable. You triggered a memory when you said that you need to have younger friends. I think of countless Christmas Eve lunches that we had in my house where my mother invited a friend of hers who was several years older and was alone. She would come and spend the meal with us. My mother was wonderful — my youngest brother is 11 years younger than I am, and he had a babysitter because my mom was at work. And as that friend aged and my mom was no longer working, my mom almost took care of her. She would help get her prescriptions and her medicines, and she would invite her over, and she would take her to some doctor's appointments. The roles reversed after she was no longer babysitting my little brother, who was now an adult — but my mom was caring for her because of that relationship and that connective tissue. So this notion — and I've got an amazing mom, she's just an incredible human — but this notion of connective tissue across generations and across different interests, like church, synagogue, activities, joining a running club — there are just so many different ways to find relationships. And I love when doctors make recommendations like this that are so common sense. We should all be recognizing that these kinds of relationships are not only generous — they're also good for your health. Isolation is very bad for your health. We learned during the pandemic that isolation is as bad as smoking as far as life expectancy.
Dr. Roseanne Leipzig28:55
Yeah, totally. We need socialization — 100%.
Katie Fogarty29:07
This podcast launched during the pandemic because I missed hanging out in a room full of amazing women. And I was like, "All right, well, I can grab a mic and I can talk to amazing women." So I completely agree with you, Dr. Leipzig. We're running into the end of our time here, but I do want to ask you some last questions before we say goodbye. This is what I call our Speed Round — just one to two word answers to complete a thought. Are you ready? Okay. I could talk about this aging topic again and again...
Dr. Roseanne Leipzig29:42
Use it or lose it.
Katie Fogarty29:45
Ooh, okay — nice. That's intriguing. No one wants to fall and break a hip. What's an action we can take today to make sure this is not in our future?
Dr. Roseanne Leipzig29:54
Strengthen your legs.
Katie Fogarty29:57
Nice. Brain health is such a key factor in vital aging. What's an action that supports healthy brain aging?
Dr. Roseanne Leipzig30:04
Healthy heart, healthy brain.
Katie Fogarty30:08
Oh, okay — didn't see that coming. You've written an incredibly comprehensive and well-regarded book on health as we age. What is another book, podcast, or resource that you think our listeners should have on their radar?
Dr. Roseanne Leipzig30:20
Elderhood, by Louise Aronson.
Katie Fogarty30:24
Nice. The American healthcare system can feel overwhelming — I myself get confused, and I'm 54. What resource can you point us to that can help us figure out how to guide our parents through what can feel like a Byzantine maze?
Dr. Roseanne Leipzig30:40
Learn about advocacy organizations — and advocate.
Katie Fogarty30:44
Nice — good advice. Okay. Even doctors need to work on their well-being. What lifestyle choice or hack helps fuel your inner peace?
Dr. Roseanne Leipzig30:48
Meditation.
Katie Fogarty30:50
You know what? Everyone says that, and I still don't do it. Okay, you're inspiring me. All right. Finally, your one-word answer to complete this sentence: As I age, I feel...
Dr. Roseanne Leipzig31:01
Lucky.
Katie Fogarty31:03
Nice. I feel lucky too, and I feel lucky you said yes and came on the show to talk about Honest Aging and share so many wonderful resources and smart ideas with our listeners. I really appreciate it. So before we say goodbye, how can our listeners keep following you and your work, and learn about where they can get your book?
Dr. Roseanne Leipzig31:22
I have a website. It's RoseanMD.com —
Dr. Roseanne Leipzig31:24
— it's R-O-S-A-N-N-E — everybody gets that wrong.
Katie Fogarty31:30
I love it. I'm putting that in the show notes. Thank you so much. This wraps A Certain Age, a show for women who are aging without apology. And before I say goodbye, a quick favor: last time I checked, we were just three reviews away from reaching 200 Apple Podcast reviews. If you've learned something on today's show, if you feel smarter, more informed, or better supported, please take five minutes to write a short review on Apple Podcasts. Every review helps the show grow. Special thanks to Michael Mancini, who composed and produced our theme music. See you next time, and until then — age boldly, beauties.
Dr. Roseanne Leipzig32:20
Thank you.