Pictures of aging patients

Dr. Jeffrey M. Levine from St. Vincent's Hospital in New York City has an exhibition of his photos called "Aging through a Physician's Lens," opening May 12 at The National Arts Club, also in New York. Click here to see some of the photos. I think I love the "Social Networks" one the best (note the number of older women to men, the usual pattern I have seen in my travels through assisted living centers and nursing homes). The "Frailty" photo is so gentle and sweet, almost humbling … you wonder what he is thinking about. This exhibit is apparently planning to travel to medical schools as well.

In a loosely related item, "they" now recommend bone mineral density screening for all MEN over the age of 70. This got me to thinking about how many of the men that are put on primary hormonal treatment for their prostate cancer are getting baseline and repeat BMDs. We do know that castration and combined androgen blockade lower bone mineral density. These findings are also demonstrated here. We also know that castration and combined androgen blockade lead to more fractures and higher health care costs. Maybe, though, this is not much of an issue since most patients with metastatic prostate cancer to bones are receiving zolendronate. A study further found that once yearly dosing of zolendronate is sufficient to maintain bone mass in hypogonadal men (similar to what has been seen with women). This is a good option for men who maybe don't have spinal mets, but are on a GNRH analog and have thin bones from the outset. Alendronate may also be useful in this setting. A lot to chew on.