Popular views of old age in America, 1900-1950.

The aging of the American population has significantly changed medical practice over the last century. As is well known, life expectancy first began to increase dramatically in the late 19th century, but at the same time that the numbers of older people have been increasing, the social and cultural meanings of growing old have also changed. It is likely that different cohorts of older people have had different experiences with old age because of the time periods they lived through. This paper offers one way to look at some of the historical changes that have affected the public and the medical profession on the subject of old age by looking at old age through American popular literature in the first half of the 20th century in three overlapping time periods. In the first three decades of the century, the concept of old age was widely defined, and older people (rather than physicians) were the principal authorities in describing the qualities of old age. In the third and fourth decades of the century, the idea of old age was starting to acquire increasing negative connotations, but chronological age itself did not signal the beginning of old age. However, by the late 1930s and 1940s, old age became widely viewed as a specific social and medical problem to be addressed by professionals, and older people had become a recognizable population, with a variety of groups organized around their care. This paper illustrates changes in American understandings of old age within and without the medical profession and suggests ways in which popular conceptions of old age might continue to shift and affect how physicians take care of their older patients in the future.

Masculinity, work and the fountain of youth: Irving Fisher and the life extension Institute, 1914-31.

In 1914, Progressive Era reformer Irving Fisher and the wealthy contractor Harold Ley founded the Life Extension Institute (LEI), a business venture organized to address the problems of American health. For approximately two decades, from 1914 until the death of its medical director in 1931, the Life Extension Institute widely promoted its health maintenance program of annual physical examinations and health literature. The advertised goal of the LEI was to extend life without old age, as well as improve masculinity and good business practices through adherence to health principles. The first two decades of activities of the Life Extension Institute offer a window for examining early twentieth-century ideas about the relationships between health, old age, and masculinity. The LEI literature constructed a picture of healthy, vigorous, and efficient American working men that helped to cement ideals of masculinity to ideals of health.

Naloxone activation of mu-opioid receptors mutated at a histidine residue lining the opioid binding cavity.

The mu-opioid receptor is the principal site of action in the brain by which morphine, other opiate drugs of abuse, and endogenous opioid peptides effect analgesia and alter mood. A member of the seven-transmembrane domain (TM) G protein-coupled receptor (GPCR) superfamily, the mu-opioid receptor modulates ion channels and second messenger effectors in an opioid agonist-dependent fashion that is reversible by the classic opiate antagonist naloxone. Mutation of a histidine residue (His297) in TM 6 afforded agonist-like G protein-coupled signal transduction mediated by naloxone and other alkaloid antagonists and enhanced the intrinsic activity of documented alkaloid partial agonists, including buprenorphine. The intrinsic activities of all opioid peptide agonists and antagonists tested were not altered at the His297 mutant receptors. Consistent with a role for the TM 6 histidine in maintaining high affinity binding sites for opioid agonists and antagonists, opioid ligand-dependent protection of this residue from a histidine-specific alkylating agent indicated that the His297 side chain is positioned in or very near the binding cavity. The TM 6 His297 mutants identify a discrete region of the receptor critical for determining whether a specific drug pharmacophore triggers receptor activation. Because many GPCRs possess a similarly positioned TM histidine residue, our findings with the mu-opioid receptor may extend to these receptors and potentially serve as a model for rational design of therapeutic GPCR partial agonists and antagonists.