Geriatric astronauts
1
VOLUME 80 NUMBER 5 MAY 1986 The American Journal of Medicine@ EDITORIAL Geriatric Astronauts MARK ROSENTHAL, M.D. N owadays, minorities are considered suitable astro- nauts: women, blacks, even physicians. One seg- ment of the population, though, seems to have been ignored by the space program: the elderly. Astronauts are usually selected for those talents considered critical to a mission’s success. Sometimes crew members are cho- sen to indicate the esteem with which certain groups are viewed, such as legislators. Another rationale has yet to be considered, that outer space will benefit the astronaut as much as we benefit from the astronaut’s services. This could potentially be the case for certain geriatric patients. Launching old persons into orbit poses new problems, but presupposing a successful shuttle trip, outer space might prove a superior environment for the disabled elderly. As recently discussed by Bortz [l], disuse and aging show remarkable parallels. Astronauts and cosmonauts who work over a long period under weightless conditions deteriorate physiologically. Both bone and muscle atro- phy; cardiac deconditioning occurs [2]. Such physiologic decline limits the safe tour of duty and jeopardizes future life back on terra firma. Much expense has been aimed at preventing this. Geriatric patients are already afflicted with these deteriorations, which cause them considerable dis- ability while they are earthbound. Will disuse atrophy progress less in these persons than in young, well-trained astronauts? Isolation from society is also a problem for space travelers. Older persons have proved their adaptability to such a life. Nevertheless, many incurable elderly are perceived as an economic burden to society. Might they return to work in an environment in which others could not safely perform? Outer space offers a choice to these elderly that earth does not. On one hand, they run the risk of worsened disease and thus decreasing likelihood of return to what- ever was their lot on earth. Outweighing these risks because of, not despite, the low gravity is the chance at vastly improved functional capacity. Mobility is crucial to the well-being of older persons. Of all the abilities consid- ered instrumental for independent daily living, locomotion is the most important. For a severely osteoporotic woman, weightbearing is a painful and dangerous chore. Imagine moving her from a bed or wheelchair, to newborn mobility in a zero-gravity environment. Like a person visiting some celestial Lourdes, she could cast her crutches into the void. Stroke victims, bedridden on earth, might have enough strength to overcome the minimal inertia aboard a space station. Without gravity, otherwise insurmountable obstacles be- come obsolete: pathologic fractures, decubiti, orthostatic hypotension, gait disorders, recurrent falls. New problems may arise. Older astronauts might be more prone to constipation or space-induced nausea. The idea of allowing invalids in space is not new. Heinlein [3] wrote an entire novel about Waldo, a despica- bly weak character who was marvelously adapted to life in space. Despite this, Waldo had a secret yearning to return to earth. Would such be the case for the geriatric astronauts or is this just a terrestrial bias of Waldo’s creator? The nursing home characters in a recent movie, Cocoon, were cured by the magical force of an alien intelligence. Could this magical force be outer space itself? REFERENCES 1. Bortz W: Disuse and aging. JAMA 1982; 248: 1203-1208. 2. Leach CS, Altchuler SI, Cintron-Trevino NM: The endocrine and metabolic responses to space flight. Med Sci Sports Exert 1983; 15: 432-440. 3. Heinlein R: Waldo & Magic, Inc. New York: Doubleday, 1950. From the University of New Mexico, School of Medicine, Albuquerque, New Mexico. Requests for reprints should be addressed to Dr. Mark Rosenthal, University of New Mexico, School of Medicine, Albuquerque, New Mexico 87131. May 1986 The American Journal of Medicine Volume 80 763
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Transcript of Geriatric astronauts
VOLUME 80 NUMBER 5 MAY 1986
The American Journal of Medicine@
EDITORIAL
Geriatric Astronauts MARK ROSENTHAL, M.D.
N owadays, minorities are considered suitable astro- nauts: women, blacks, even physicians. One seg-
ment of the population, though, seems to have been ignored by the space program: the elderly. Astronauts are usually selected for those talents considered critical to a mission’s success. Sometimes crew members are cho- sen to indicate the esteem with which certain groups are viewed, such as legislators. Another rationale has yet to be considered, that outer space will benefit the astronaut as much as we benefit from the astronaut’s services. This could potentially be the case for certain geriatric patients. Launching old persons into orbit poses new problems, but presupposing a successful shuttle trip, outer space might prove a superior environment for the disabled elderly.
As recently discussed by Bortz [l], disuse and aging show remarkable parallels. Astronauts and cosmonauts who work over a long period under weightless conditions deteriorate physiologically. Both bone and muscle atro- phy; cardiac deconditioning occurs [2]. Such physiologic decline limits the safe tour of duty and jeopardizes future life back on terra firma. Much expense has been aimed at preventing this. Geriatric patients are already afflicted with these deteriorations, which cause them considerable dis- ability while they are earthbound. Will disuse atrophy progress less in these persons than in young, well-trained astronauts?
Isolation from society is also a problem for space travelers. Older persons have proved their adaptability to such a life. Nevertheless, many incurable elderly are perceived as an economic burden to society. Might they return to work in an environment in which others could not safely perform?
Outer space offers a choice to these elderly that earth does not. On one hand, they run the risk of worsened disease and thus decreasing likelihood of return to what-
ever was their lot on earth. Outweighing these risks because of, not despite, the low gravity is the chance at vastly improved functional capacity. Mobility is crucial to the well-being of older persons. Of all the abilities consid- ered instrumental for independent daily living, locomotion is the most important.
For a severely osteoporotic woman, weightbearing is a painful and dangerous chore. Imagine moving her from a bed or wheelchair, to newborn mobility in a zero-gravity environment. Like a person visiting some celestial Lourdes, she could cast her crutches into the void. Stroke victims, bedridden on earth, might have enough strength to overcome the minimal inertia aboard a space station. Without gravity, otherwise insurmountable obstacles be- come obsolete: pathologic fractures, decubiti, orthostatic hypotension, gait disorders, recurrent falls. New problems may arise. Older astronauts might be more prone to constipation or space-induced nausea.
The idea of allowing invalids in space is not new. Heinlein [3] wrote an entire novel about Waldo, a despica- bly weak character who was marvelously adapted to life in space. Despite this, Waldo had a secret yearning to return to earth. Would such be the case for the geriatric astronauts or is this just a terrestrial bias of Waldo’s creator? The nursing home characters in a recent movie, Cocoon, were cured by the magical force of an alien intelligence. Could this magical force be outer space itself?
REFERENCES
1. Bortz W: Disuse and aging. JAMA 1982; 248: 1203-1208. 2. Leach CS, Altchuler SI, Cintron-Trevino NM: The endocrine
and metabolic responses to space flight. Med Sci Sports Exert 1983; 15: 432-440.
3. Heinlein R: Waldo & Magic, Inc. New York: Doubleday, 1950.
From the University of New Mexico, School of Medicine, Albuquerque, New Mexico. Requests for reprints should be addressed to Dr. Mark Rosenthal, University of New Mexico, School of Medicine, Albuquerque, New Mexico 87131.
May 1986 The American Journal of Medicine Volume 80 763
