JOSE, Calif. ó When geriatrician Mehrdad Ayati first met Lee
Katz in 2011, he encountered yet another patient ó and her
spouse ó who were in despair over the conflicting and
contradictory information they received in her care.
Menlo Park woman was in a downward spiral of multiple chronic
conditions that would lead to her death in April 2013 at age
different specialists who rotated in and out of her case made
things worse, with mix-ups and questionable interventions that
took her in and out of the hospital and added to her
suffering, husband Martin Katz says.
didnít know what one another was doing," says Katz, who
is a retired a pharmaceutical researcher and executive.
"Then Dr. Ayati appeared on the scene. He started looking
at the entire patient, her personal and social history, all
her medical problems."
coordinated Lee Katzís care and the information coming at
them from different directions.
put it all together," Katz says.
Ayati did for Lee Katz, he is now doing for everyone in his
new book, "Paths to Healthy Aging." This
"guidebook," as Ayati calls it, is designed as a
concise overview of the basic ways people can improve their
physical and mental health and enjoy life as they age.
an assistant professor at the Stanford School of Medicine and
treats geriatric patients at the Stanford Medical Center and
the Veteranís Administration hospital in Palo Alto. He
specializes in providing comprehensive care with a focus on
wife and co-author, Arezou Azarani, who has a Ph.D. in
physiology, he synthesizes his experience and the latest
research on nutrition, exercise and geriatric medicine into a
book that emphasizes healthy lifestyle choices.
says those choices can be just as important as cutting edge
medicine in fending off many common complaints, from high
blood pressure to sleep disorders, from depression to frailty.
These choices include eating a balanced diet, exercising
regularly, being socially involved, and pursuing creative,
stimulating activities. Ayati also is a fan of keeping things
simple and affordable when it comes to eating better and
donít need to join expensive gyms or start a strenuous
program, he says.
health is achieved by persistent and enjoyable workouts,"
book similarly tries to keep things simple with how it uses
concise explanations and short chapters to acquaint people
with key concepts.
is so much information out there, but itís hard to know
which information is valid," Ayati says. "My goal is
to simplify the journey."
loves working with older patients, in part because he was born
and raised in Iran, where the culture reveres its elders.
are considered very sage, are highly respected and have a
central position in the family and their community,"
Ayati says. "Gray hair is considered an asset, and the
day you get your first gray hair, you donít dye it ó you
brag about it."
he works in a specialty facing a shortage of experienced
practitioners. About 80 percent of adults 65 and older require
care for chronic conditions. To meet their needs, the United
States would need about 17,000 more geriatricians, according
to the American Geriatrics Society.
students show an interest in geriatrics, Ayati gives them all
the encouragement he can. One thing he especially likes about
geriatrics is that doctors are encouraged to spend much more
than just 10 minutes with patients, who typically have a
complex set of medical issues.
Ayati, some of that time is spent just talking to patients and
learning their work and family history and how they live.
learn a lot from my geriatric patients," he says.
uses that same conversational approach in his book to correct
misconceptions, including his view that people should stay
away from nutritional and vitamin supplements unless a doctor
has found a serious deficiency that needs to be addressed.
Taking too much vitamin D, for example, can be toxic, he says.
Generally, people can get all the nutrients they need by
eating a balanced diet.
devotes a chapter to the problem of over medication, because
he has seen too many patients suffering the ill effects of
taking drugs they donít need.
misdiagnosis can lead to the "drug cascade
syndrome," where doctors pile on medications to treat the
side effects of other medications.
recalls one patient who ended up in a skilled nursing facility
after falling at home and breaking his hip. This downward
spiral started sometime earlier when the man went to see his
primary care doctor for depression.
doctor prescribed anti-depressants, but failed to get to the
root cause of the depression. The man had restless leg
syndrome, which caused him to lose sleep and go through his
days exhausted, unable to concentrate or remember things.
anti-depressants didnít alleviate his depression. They only
made his leg cramps worse, so he lost more sleep. He became
disoriented and fell, breaking his hip. By weaning him off the
anti-depressants and treating the restless leg syndrome, Ayati
was able to help the man fully recover from both his hip
injury and his depression.
chapter of Ayatiís book offers tips on how to find a
geriatrician, which he knows can be a daunting task. He points
out that most patients donít need to see a geriatrician too
often, sometimes just once a year.
his wife died, Martin Katz, 87, signed Ayati as his
geriatrician. The two have also become friends; Katz endorsed
Ayatiís book and its tips for healthy aging.
says he is in excellent health and admits he is
"genetically blessed." Despite his background in
pharmaceuticals, Katz shares Ayatiís belief that less is
better when it comes to drugs.
be one of Ayatiís model patients, eating right, exercising
regularly and staying active. Katz belongs to two senior
centers that provide wonderful "social interaction,
friends and activities."
importantly, he has "an avocation." He has taken up
sculpting, and this artistic endeavor keeps him physically
active, challenges him mentally and constantly introduces him
to new people.
learning to sculpt in the early 1990s, even before he retired.
He had never thought of himself as artistically inclined; he
was just curious. Many workshops and classes later, he has
launched a second career as a professional artist.
dreaded seeing those retired guys following their wives around
at the supermarket," he says.
October, he unveiled his newest bronze work, "Kaddish,"
at Congregation Beth Am in Los Altos Hills.
before meeting Ayati, he put into practice one of Ayatiís
favorite tips: He signs up for classes.
mantra is, if you donít join a class, youíre not going to
do it," Katz says. "I tend to be a Type A, highly
motivated, but with all that self-motivation, if Iím not
signed up for a class, and unless itís on my calendar for 9
a.m. Thursday, Iím not going to do it."
who also travels extensively, probably is busier than he is,
says Ayati, who also has a 1Ĺ-year-old son.
part, Katz wouldnít have it any other way and notes the
health benefits of everything he does to take care of himself.
number of pills that I have reduced or dropped," he says,
are prescriptions for mental and physical health from Stanford
geriatrician Mehrdad Ayati in his book "Paths to Healthy
trendy and drastic diets or exercise programs, especially
rigorous programs you wonít stick to.
arenít necessary unless a doctor identifies a deficiency,
and be wary of nutritional supplements. You can generally get
all your nutrients through a balanced diet of mostly whole,
organic foods; limit your intake of canned, frozen or instant
foods, as well as alcohol and caffeine.
hobby, or sign up for a class. Trying a new subject or
activity can challenge you mentally and physically.
just hang out with seniors; find ways to spend time with
people of all ages.
touch with your network of friends.
geriatrician. While there is a shortage of geriatricians, you
wonít necessarily have to see one often. This specialist
will offer care that is comprehensive and focuses on
Ayatiís "Paths to Healthy Aging" is available at