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      How to Care for Yourself as a Caregiver

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      Forget yoga or weekend escapes. There are more realistic tools to put in place, experts say.Once a quarter, Bich Le, 52, travels from her home outside of Minneapolis to St. Augustine, Fla., where she moves into her father’s guest room for three weeks.The health care executive is one of five siblings who take turns caring for their widowed 90-year-old father, who has lung cancer and requires constant assistance. While she’s in Florida this month, she will miss her daughter’s final high school prom; she missed it last year, too, due to her caregiving duties.The drugs Ms. Le’s father takes to manage pain can “negatively impact how he treats people,” she said. When he becomes volatile, Ms. Le said, she mostly tries to ignore it and “not add to the stress of the situation.” She tells herself to “just care for him and just let it go.” But sometimes, when she’s exhausted, his temper grates.“What runs through my brain is: ‘A simple thank you would really go a long way,’” she said. “‘You have me, or you have a nursing home.’”Caregiving can be fraught for the estimated 53 million Americans who assist family members and friends. And factors like financial strain and isolation can add to psychological distress. In a 2017 survey of 1,081 caregivers conducted by AARP, 51 percent of respondents reported feeling worried or stressed. But there was a surprising upside: The majority — 91 percent — also reported feeling pleased that they were able to help.How can caregivers hold on to that feeling amid the stress, fatigue and resentment that also come with the role? There are strategies for feeling “less burdened or stressed by the daily problems” they encounter, said William Haley, a professor of aging studies at the University of South Florida.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      How to Tell an Older Person It’s Time to Stop Driving

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      The “car key conversation” can be painful for families to navigate. Experts say there are ways to have it with empathy and care.Sherrie Waugh has been yelled at, insulted and wept upon in the course of her job administering driving tests. Typically these extreme reactions happen when she is forced to render an upsetting verdict: It’s time to hang up the car keys.Ms. Waugh, a certified driving rehabilitation specialist with The Brain Center, a private neuropsychology practice in Indiana, often works with older drivers, putting them through an assessment that measures things like visual skills, reaction time and processing speed.“I had one gentleman, who had early onset dementia, who was just sitting here crying,” Ms. Waugh said. “His wife was out in the car and she was crying. And we all came back, and we were all crying. Because it’s so hard.”Decisions about when an older person (or someone whose physical or mental circumstances make operating a vehicle dangerous) should stop driving are often agonizing. They can rock the driver’s sense of independence and identity, and add to the responsibilities that many family caregivers shoulder.“It’s a major, major loss for older people,” said Lauren Massimo, an assistant professor at Penn Nursing. “It’s been described to me as dehumanizing.”But it is important to raise concerns as soon as you have them, experts said, and there are ways to make the car key conversation less painful for older drivers and their loved ones.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Memory Loss Requires Careful Diagnosis, Scientists Say

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      A federal investigator said that President Biden had “poor memory” and “diminished faculties.” But such a diagnosis would require close medical assessment, experts said.A lengthy report by the Department of Justice on President Biden’s handling of classified documents contained some astonishing assessments of his well-being and mental health.Mr. Biden, 81, was an “elderly man with a poor memory” and “diminished faculties” who “did not remember when he was vice president,” the special counsel Robert K. Hur said.In conversations recorded in 2017, Mr. Biden was “often painfully slow” and “struggling to remember events and straining at times to read and relay his own notebook entries.” So impaired was Mr. Biden that a jury was unlikely to convict him, Mr. Hur said.Republicans were quick to pounce, some calling the president unfit for office and demanding his removal.But while the report disparaged Mr. Biden’s mental health, medical experts on Friday noted that its judgments were not based on science and that its methods bore no resemblance to those that doctors use to assess possible cognitive impairment.In its simplest form, the issue is one that doctors and family members have been dealing with for decades: How do you know when an episode of confusion or a memory lapse is part of a serious decline?We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      I Clerked for Justice O’Connor. She Was My Hero, but I Worry About Her Legacy.

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      When I learned that Justice Sandra Day O’Connor had died, I felt not just the loss of a world historical figure but also the loss of someone who formed a part of my identity.As a young woman, I was in awe of Justice O’Connor. Her presence on the Supreme Court offered an answer to any doubts I had that I belonged in the law. As a young lawyer, I was lucky enough to work for a year as her law clerk.While clerking for her, I came to understand and appreciate not only her place in history but also her vision of the law. She refused opportunities to issue sweeping opinions that would substitute her ideals for the democratic process. This made it all the more tragic that toward the end of her career, she joined in a decision — Bush v. Gore — that represented a rejection of her cautious approach in favor of a starkly political one.For me, she stands as a shining example of how women — everyone, really — can approach life and work. I witnessed her warmth, humor and humanity while experiencing the gift of learning and seeing the law through her eyes. Those personal and legal impressions have left an enduring mark on me as a person and as a lawyer.At the time Justice O’Connor became a lawyer, women in that role were rare. As has now become familiar lore, after she graduated near the top of her class from Stanford Law School in 1952, she was unable to find work as a lawyer. As a justice, she made sure that opportunities denied to her were available to others. Shortly after I graduated from law school, I joined two other women and one man in her chambers, making a rare majority-woman chamber when just over a third of the clerks for Supreme Court justices were women.I always found it remarkable that I never heard Justice O’Connor talk with any bitterness of the barriers she faced pursuing her career. Instead, she worked hard and without drama to overcome them. Remarkably, that experience did not harden her.She had a wicked sense of humor. The door to our clerks’ office held a photocopied image of her hand with the words “For a pat on the back, lean here.” Her face transformed in an almost girlish way when she laughed, which she did often.When she met with the clerks on Saturday to discuss upcoming cases, she brought us a home-cooked lunch — often something inspired by her Western roots. (One memorable example was tortillas and a cheesy chicken filling, to make a kind of cross between a burrito and a chicken quesadilla. It was a bit of a mess to eat but delicious.) She insisted that we get out of the courthouse and walk with her to see the cherry blossoms, and she took us to one of her favorite museums; once we visited the National Arboretum and lingered at the bonsai exhibit. She believed firmly in the benefits of exercise, and she invited us to join daily aerobics sessions with a group of her friends early in the morning in the basketball court above the Supreme Court chamber, which she delighted in calling the “highest court in the land.”She was also a hopeless romantic, and she was well known for trying to find partners for her single clerks. She met her husband, John, in law school, and they married shortly after graduation. He had received an Alzheimer’s diagnosis when I clerked for her, though that knowledge was not yet public. He often came by her chambers as she worked to maintain a sense of normalcy. She retired in 2006 largely because of his progressing dementia. In a powerful lesson of what it is to love, she was happy for him when he struck up a romance with a fellow Alzheimer’s patient. It was devastating to learn that she was subsequently diagnosed with dementia herself.When I clerked for her in 1998 and ’99, she was at the height of her powers. She was the unquestioned swing justice, and some called her the most powerful woman in the world.But she approached the role with humility. Considered a minimalist, she worked to devise opinions that decided the case and usually little more. She was sometimes criticized for that approach. Justice Antonin Scalia made no secret of his frustration. When she refused to overturn Roe v. Wade, in the 1992 case Planned Parenthood v. Casey, he snarlingly referred to the opinion as a “jurisprudence of confusion.” She was criticized by many academics for failing to articulate a grand vision of the law.What they missed was that this was her grand vision of the law — or at least of the Supreme Court. She had spent the formative part of her career before she entered the court as a member of the Arizona State Legislature, where she rose to become the first female majority leader of a State Senate.She believed that the most important decisions about how to govern the country belonged to the political branches and to state legislatures, not to a court sitting in Washington. Seeing the law through her eyes during the year I worked for her, I realized that she was not looking for a sweeping theory that would change the face of the law. She wanted to decide the case before her and provide a bit of guidance to the lower courts as necessary but leave the rest to the democratic process.In December 2000, this made reading the opinion she joined in Bush v. Gore all the more heartbreaking. Her vote made a 5-to-4 majority for the decision to halt the recount in Florida rather than allow that process to play out, throwing the election to George W. Bush, who became the first president since 1888 to be elected without winning the popular vote. The decision, widely criticized for its shoddy reasoning, was the opposite of the careful, modest decisions she had spent her career crafting. It disenfranchised voters whose ballots had been rejected by ballot-counting machines in the interests of finality — in the process substituting the judgment of the court for the expressed will of the people.The court showed that it could — and would — behave in nakedly political ways. It had given into the temptation to engage in ends-driven reasoning that was utterly unpersuasive to those who did not already share its view of the right result. In doing so, the court might have opened the door to what has now become something of a habit.Justice O’Connor retired just over five years later, and she was replaced by Samuel Alito. It has been painful to watch as, in decision after decision, he has voted to undo much of the legacy she so carefully constructed. The blunt politics of Bush v. Gore now look less like an embarrassing outlier and more like a turning point toward a court that has cast aside Justice O’Connor’s cautious minimalism for a robustly unapologetic political view of the law. Unsurprisingly, public opinion of the court has fallen to a near historic low.Justice O’Connor remains a transformative figure in the law, a woman who charted a path that I and so many others have followed. If the court is to regain the public trust, it should look, once again, to her shining example, which embodied a powerful ideal: the court is not a body meant to enact the justices’ vision of what the law should be. Its role is, instead, to encourage our imperfect democracy to find its way forward on its own.Oona A. Hathaway is a professor of law and political science at Yale University and a nonresident scholar at the Carnegie Endowment for Peace.The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips. And here’s our email: letters@nytimes.com.Follow the New York Times Opinion section on Facebook, Instagram, TikTok, X and Threads. More

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      Compassionate Release for Those Aging Behind Bars

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      More from our inbox:Living Well, and Pursuing One’s Passion, With Parkinson’sThe ‘Absurd Contradictions’ of the Migrant SystemA Civilized Argument A Debate QuestionCecilia CarlstedtTo the Editor: Re “Inside a Dementia Unit in a Federal Prison” (Opinion guest essay, Aug. 13):Katie Engelhart vividly describes the absurdity and cruelty of incarcerating frail elders with debilitating dementia. It would be a mistake, though, to conclude simply that expanding compassionate release is the answer. Certainly, that’s warranted, but policymakers should be proactive, not just reactive.As a former parole commissioner, I know that dementia is just the tip of the iceberg of the problem of mass aging behind bars.Countless people (not just men) effectively face a slow death penalty behind bars because of extreme sentences or repeated denials of parole release despite these individuals’ complete transformations. Far from being helpless, many are violence interrupters, mentors, scholars and artists, including people previously convicted of causing serious harm. They have changed.Enacting elder parole bills, which do not guarantee release based on age but rather allow older adults to be individually considered for release by a parole board, can help resolve the crisis of aging behind bars, save substantial money, and return people to the community to repair the harm they long ago caused — before they are on death’s doorstep.Carol ShapiroNew YorkTo the Editor:Dementia units in prisons should primarily serve as a conduit to helping achieve compassionate release. As physicians volunteering with the Medical Justice Alliance, we review the medical care of numerous patients with dementia who are undiagnosed and untreated in the prison system. Patients wake up unsure why they are in prison, hoping that President Nixon might pardon them.We must consider the high cost of normalizing the imprisonment of elderly patients with dementia. Financially, developing “dementia-friendly” prison units incurs significant costs; that money could instead be used to improve community resources such as nursing facilities. Ethically, we must grapple with punishing people who do not pose a threat to others and are unable to understand why they are being punished.Compassionate release laws at the state and federal levels should make dementia an explicit criterion for early release. Facilities should also screen older patients for dementia on a regular basis and develop protocols for requesting compassionate release and expediting placement in memory care facilities. The U.S. prison population is aging and change is urgently needed.Caitlin FarrellNicole MusheroWilliam WeberTo the Editor:As a person who has served three federal prison terms for antiwar protests for a total of almost three years, I found myself shaking my head that the Federal Bureau of Prisons maintains Federal Medical Center Devens to hold men with dementia.The essay noted that most of the men in the dementia unit have no memories of their crimes or why they are incarcerated, yet few are deemed eligible for compassionate release. The United States incarcerates nearly two million people in our thousands of jails and prisons. The U.S. prison system is primitive, lacks redemption and only metes out punishment. The term rehabilitation is simply not part of this cruel system.In my time in more than a half dozen federal prisons, I never met a man I would not have to my home as a dinner guest. Our jails and prisons are filled mostly with people convicted of nonviolent crimes. Many — perhaps the majority — of incarcerated people are poor, mentally ill or substance abusers. Most need medical treatment, not incarceration.I agree with F.M.C. Devens’s clinical director, Dr. Patricia Ruze, who thinks it would be “totally appropriate” to release the whole unit on compassionate grounds and relocate the men to community nursing homes.I’d go one step further: Let’s release all nonviolent people from prison with appropriate community support to help them prosper and avoid recidivism, as well as offer programs of human uplift to the remaining prisoners using the money we save by closing the prisons we will no longer need.Patrick O’NeillGarner, N.C.Living Well, and Pursuing One’s Passion, With Parkinson’sThe pianist Nicolas Hodges has continued to perform and record — with alterations and tough decisions — after receiving a Parkinson’s disease diagnosis.Roderick Aichinger for The New York TimesTo the Editor: Re “Pianist Adapts His Life to Parkinson’s” (Arts & Leisure, Aug. 13):Thank you for demonstrating how the pianist Nicolas Hodges is adapting to life with Parkinson’s disease. Mr. Hodges is testament to the fact that it is possible to continue to live well with Parkinson’s, and the article highlights two key ways to manage symptoms: consistently taking medications (dopamine) and reducing commitments or stress. Exercise and physical activity are also critical to managing symptoms.Recent research published by the Parkinson’s Foundation shows that the number of people in the U.S. diagnosed with Parkinson’s annually has increased by 50 percent, from approximately 60,000 to 90,000. This means that every six minutes, someone in the U.S. is diagnosed with the disease and may encounter similar challenges to those faced by Mr. Hodges.Further funding to support research and drug development are needed in order to find a cure, and the Parkinson’s Foundation and other organizations work tirelessly to advance this.In the meantime, we applaud Mr. Hodges for speaking about his experience with the disease and continuing to pursue his passion. Play on, Mr. Hodges.John L. LehrNew YorkThe writer is president and C.E.O. of the Parkinson’s Foundation.The ‘Absurd Contradictions’ of the Migrant SystemTo the Editor: We have millions of square feet of office space no longer being used and tens of thousands of homeless people and displaced immigrants needing shelter. Many employers cannot fill open jobs while the talents and proven determination of immigrants sit untapped in detention.We can strengthen our economy and confirm our commitment to human dignity and decency by correcting these absurd contradictions.It would be far more cost-effective to use the migrant detention system funds to create a system where people can be quickly helped and trained to be productive contributors to society instead of expensive drains on us all.Even if common decency is not a motivation, pure selfish economic need dictates that we end the waste and do the right thing.Michael E. MakoverGreat Neck, N.Y.A Civilized Argument Christopher Smith for The New York TimesTo the Editor: Re “Imagining the Face-Off in Trump’s Jan. 6 Case,” by David French (column, Aug. 12):I started feeling odd as I read Mr. French’s column. It was so quiet! Two measured, rational voices speaking through the ink, each backing up their arguments with researchable references and free of bitter, ad hominem jabs. A few bits of pique and tooth grinding to humanize both the defense and the prosecution, but all for the sake of clarifying a complex position.How civilized! How rare! It’s a shame that the essay was the voice of one man working his careful way through a thicket of legal complexity and not a real-life exchange of ideas in search of a mutually arrived at truth.Leslie BellDavenport, IowaA Debate QuestionTo the Editor: At the Republican debate I would like to see the moderator ask each of the participants if as president they would pardon Donald Trump if he is convicted of federal crimes.Walter RonaghanHarrison, N.Y. More

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      Biden Wants to Be President Into His 80s. How Might Age Affect His Health?

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      Experts weigh in on octogenarian health.President Biden has announced his plans to run for re-election in 2024. If he wins, he will be 82 when he takes office and 86 when his term ends — which would establish him, for a second time, as the oldest person to assume the U.S. presidency. (Donald Trump is not far behind; he will be 78 during the 2024 election and would enter octogenarian territory during another presidential term.)President Biden is “a healthy, vigorous 80-year-old male,” according to a February report from the White House physician, Dr. Kevin C. O’Connor. Although he was recently treated for basal cell carcinoma, a common and slow-growing skin cancer, Mr. Biden has no major medical problems, doesn’t smoke or drink and exercises at least five days a week.“The spectrum of health at older ages varies so widely,” said Dr. Holly Holmes, a professor and the chair in gerontology at the University of Texas Health Science Center at Houston. “As we get older, we are more and more unlike our peers, and it becomes harder to generalize what a ‘typical’ 80-year-old would be like.”Dr. R. Sean Morrison, a professor and the chair in geriatrics at the Icahn School of Medicine at Mount Sinai in New York, added that the changes that occur during aging happen to different people at different times. Some 85-year-olds have healthier bodies than some 65-year-olds, and much of the variation comes down to genes and a person’s lifestyle before the age of 60.Yet, as people enter their 80s, and even their mid-to-late 70s, some standard age-related shifts tend to occur, like muscle loss and a drop in bone strength, that make people more prone to disease and injury.Here’s a head-to-toe snapshot of the body and mind of an octogenarian and the potential problems doctors look out for.BrainMost healthy people in their 80s don’t have trouble performing complex cognitive tasks such as problem-solving and planning, Dr. Morrison said, but they may find it harder to multitask and learn new things. Some may struggle to remember words. Reaction time can also slow, but usually only slightly — on the order of fractions of a millisecond, Dr. Morrison said.Scientists don’t know exactly why these changes happen, but the brain does get slightly smaller with age because of brain cell loss, so that could be playing a role, said Dr. Scott Kaiser, director of geriatric cognitive health at Pacific Neuroscience Institute in Santa Monica, Calif. Interestingly, certain cognitive skills — such as vocabulary and abstract reasoning — may stay constant or even improve with age, also for unknown reasons, he said.Dementia does become more common with age, but it still only affects a minority of adults in their 80s. According to the National Health and Aging Trends Study, 10.9 percent of adults ages 80 to 84, and 18.7 percent of adults ages 85 to 89, dealt with dementia in 2019. “These conditions are not a normal or inevitable part of aging,” Dr. Kaiser said.Eyes and earsVision tends to worsen over time. Octogenarians often need reading glasses and become more sensitive to glare, Dr. Morrison said. Nearly 70 percent of adults over 80 have cataracts, a clouding of the lens of the eye, but the condition can be treated effectively with surgery, he said.Age-related hearing loss is another common problem. First, people lose the ability to hear high-frequency sounds such as bird chirps and alarm clocks; this can start early, even in a person’s 30s or 40s. Low-frequency changes, affecting the ability to hear men’s voices and bass sounds in music, come later. Hearing loss can be treated with hearing aids — now available over the counter — or other devices, and it’s crucial to do so: “We have increasing data now that suggests that people who go longer with untreated hearing loss and don’t get hearing correction are more likely to develop dementia or diseases like Alzheimer’s disease,” Dr. Morrison said.Heart and lungsAs a person ages, heart rate slows slightly, and the heart can’t beat as fast during physical activity, which can make aerobic exercise more challenging. That said, an aging healthy heart typically “functions quite well,” said Dr. Lona Mody, a geriatrician at Michigan Medicine.Doctors monitor for heart disease in their octogenarian patients. “Blood vessels become stiffer with age, and this leads to higher blood pressure,” Dr. Mody said, which can increase the risk of hypertension and heart disease. According to the American Heart Association, 83 percent of men and 87 percent of women age 80 and older have heart disease, sometimes requiring the use of medications or surgery. Mr. Biden has asymptomatic atrial fibrillation — an irregular heartbeat — and takes apixaban (Eliquis), an anticoagulant drug that is often prescribed to help prevent blood clots and strokes. He also takes rosuvastatin (Crestor) to lower his cholesterol.Lung capacity often slightly drops with age because of changes in the strength and elasticity of the lung tissue and diaphragm, which can make breathing a bit harder, Dr. Mody said. One disease doctors look out for is chronic obstructive pulmonary disease, an inflammatory lung disease seen in just under 11 percent of people 65 and over.Digestive systemPeople in their 80s tend to eat less than they used to, in part because “food doesn’t taste quite the same,” Dr. Morrison said. Over time, people lose taste buds and their sense of smell, he said, both of which affect how much they enjoy eating. This helps to explain why older adults have an increased risk of nutritional deficiencies.But seniors also need fewer calories than younger people because of losses in lean muscle mass and slowing metabolism. According to the government’s Dietary Guidelines for Americans, women age 60 and older should consume a minimum of 1,600 calories a day, and men age 60 and older a minimum of 2,000 calories a day (as opposed to a minimum of 1,800 for women and 2,400 for men ages 19 to 30).Older people are at greater risk for heartburn and gastrointestinal reflux. Mr. Biden’s occasional coughing and throat-clearing are tied to gastroesophageal reflux, and he takes famotidine (Pepcid) as needed to treat his symptoms.Octogenarians digest food more slowly, too. Research suggests that 34 percent of women and 26 percent of men age 84 or older experience constipation.Bones and jointsBones become more brittle with age. The body starts to reabsorb the minerals that strengthen them, such as calcium and phosphate, in part because the intestines can’t absorb what is needed from food as effectively as they used to. For women, this degeneration is accelerated by the drop in estrogen after menopause, which reduces bone density.Decreased bone density puts older people at an increased risk for bone fractures and osteoporosis. In 2020, when Mr. Biden was the president-elect, he had a hairline fracture in his foot, requiring him to wear a walking boot as he healed. The bone injuries that doctors worry about most are hip fractures, which hospitalize more than 300,000 Americans over the age of 65 every year. “Hip fractures are one of the most common reasons for hospitalization among people 85 and over,” said Dr. Susan Wehry, a geriatrician at the University of New England. Recovery is often difficult because of complications such as infections, sometimes picked up at the hospital, and internal bleeding, or because conditions such as heart disease slow healing.Joints can also become more painful because the bones and cartilage that make up the joints start to wear down. According to the Centers for Disease Control and Prevention, nearly half of all Americans over 65 have been diagnosed with osteoarthritis, which causes joint pain and stiffness. President Biden has been diagnosed with osteoarthritis of the spine, which has stiffened his gait.SkinThe risk of skin cancer increases as people get older. The average age at which Americans are diagnosed with melanoma, a potentially deadly skin cancer, is 65. Men are at higher risk for melanoma than women. Dr. Holmes recommends that people in their 80s see a doctor or dermatologist once a year for a skin check.Non-melanoma forms of skin cancer, such as basal cell carcinoma and squamous cell carcinoma, affect more than three million Americans a year. These cancers grow slower than melanomas and are highly treatable when detected and removed early. In February, President Biden, who has said he spent a lot of time in the sun during his youth, had a basal cell carcinoma removed from his chest. He also had several other non-melanoma skin cancers removed before his presidency.Strength and balanceMost healthy people in their mid-80s can and should engage in physical activity, and many remain strong and agile, Dr. Holmes said. She encourages patients to participate in aerobic exercise and weight training a couple of days a week and to stretch at least once a week, but sometimes recommends modifications for patients with pain, orthopedic problems or cardiac issues.Adults “start to lose muscle mass and start to gain fat” as they get older, Dr. Morrison said. Between 42 and 62 percent of people in their mid-80s have sarcopenia, a disease characterized by loss of muscle mass and strength. Common symptoms include difficulty walking, ascending stairs and holding shopping bags.In addition, the spaces between the spinal vertebrae dry and compress, causing people to lean forward, which can affect their balance, Dr. Morrison said. People in their 80s tend to walk slowly and have a short gait, which also worsens balance, he added.In some older adults, the insulating layer that surrounds nerves and helps them communicate with one another, called myelin, starts to break down. This can slow reflexes and make people clumsy, Dr. Kaiser said.“One important consequence of these age-related changes to the brain and overall nervous system — along with changes to other systems and a broad range of other factors — is an increased risk of falls,” Dr. Kaiser said, which in turn can become more dangerous because bones are weaker and break more easily.Stress, stamina and sleepPeople in their mid-80s tend to have lower energy than younger people, so they fatigue more easily, Dr. Morrison said.Dr. Mody added that stress and changes to routine can be “harder to bounce back from” because older people’s tissues and organs take a longer time to recover after stresses or injuries. People may also take longer to recover from colds, Covid-19 and other infections, as the immune system becomes less responsive with age.Many older adults don’t sleep well, in part because they spend less time in deep slow-wave sleep, which makes them more prone to middle-of-the-night wake-ups. “Eighty-year-olds tend to sleep about an hour less than younger adults,” Dr. Morrison said.Still, it’s important to remember that everybody ages differently, and that age does not define a person’s health. Many people in their 80s are healthier than people 20 years younger, Dr. Mody said, and the choices they make late in life matter, too: Research suggests that adopting healthy behaviors even in the ninth decade can extend one’s life.Many octogenarians, Dr. Holmes said, are “quite resilient.” More

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      Nikki Haley’s Run for the Presidency

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      More from our inbox:Tucker Carlson’s Spin on the Jan. 6 TapesA Descent Into DementiaAgeism and CovidRisk Management Haiyun Jiang/The New York TimesTo the Editor:Re “Run by Haley Is a Tightrope in the G.O.P.” (front page, Feb. 19):Nikki Haley has no choice but to to use her gender to promote her candidacy. It is the only thing that distinguishes her from the pack of hypocritical, unprincipled Republican politicians likely to run for president.She long ago joined the ranks of Lindsey Graham, Ted Cruz, Marco Rubio, etc., who discarded their justifiable contempt for Donald Trump in favor of attaining or retaining elective office. In her singular pursuit of the presidency she’s discarded any integrity she might have once had.Ms. Haley is unqualified to be president not because she is a woman, but because she became “one of the boys” — the boys who sold their souls for power and position.Jay AdolfNew YorkTo the Editor:Re “Could Haley Be Our Next President?” (Opinion, Feb. 19):It’s independents who often swing elections, and not one of the Times Opinion writers discussing Nikki Haley’s chances considered her appeal to these voters. By thinking only of how she does or doesn’t fit within the current Republican Party, they miss her considerable appeal as a non-Trumpian traditional Republican, which will attract swing independents.Thomas B. RobertsSycamore, Ill.To the Editor:As an immigrant from India, a woman and an independent voter who sometimes voted Republican pre-Trump, I was excited when Nikki Haley became governor of South Carolina. But I do not support Ms. Haley’s presidential candidacy.David Brooks nailed it, saying “there was an awful lot of complicity and silence when she served under Trump.” She subverted her independence and her fighting spirit by becoming part of Donald Trump’s establishment.No self-respecting Democrat would ever cross party lines to vote for Ms. Haley even if she miraculously manages to secure the nomination. She would not beat Joe Biden!Mona JhaMontclair, N.J.To the Editor:Nikki Haley kicked off her campaign by suggesting that politicians over 75 should be required to take mental competency tests, implying that Donald Trump and President Biden were too old to be president.She would do well to remember Ronald Reagan’s quip during the 1984 presidential debates with Walter Mondale: “I will not make age an issue of this campaign. I am not going to exploit for political purposes my opponent’s youth and inexperience.”Robert BatyOakland, Calif.To the Editor:Re “The Fox Newsification of Nikki Haley,” by Thomas L. Friedman (column, Feb. 22):Mr. Friedman isn’t taking into account what Nikki Haley must do to win the Republican nomination.Questions about the pandemicCard 1 of 4When will the pandemic end? More