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Investing in access: High country hospitals spend millions to increase residents’ access to care

Specialized labs, a new heliport and cancer treatment options are just a few of the access-to-health care improvements made both in the high country and on the Western Slope in the past two decades.

By investing in staff, facilities and transportation, Valley View Hospital in Glenwood Springs reduced its patients’ need to travel for specialized care, said Dr. Frank Laws, an electrophysiologist and interventional cardiologist at Valley View.

On the other end of the Roaring Fork Valley, Aspen Valley Hospital consolidated several health care services into one campus, providing a single destination for its patients’ care needs, Aspen Valley CEO Dave Ressler said.

Many of Colorado’s recent leaps and strides toward better, more accessible health care were facilitated in part by the state’s expansion of Medicaid under the Affordable Care Act in 2013, said Cara Welch, the Colorado Hospital Association director of communications.

Rural hospitals provide the foundation of health care throughout the state, but on the Western Slope, those hospitals can play an even larger role when requiring special services could mean an hourslong trip to Denver or Salt Lake City, Utah.

In the rare life-or-death situation, time spent on the road can play a deciding role in the outcome. On the flip side, people with special care needs, such as oncology, cardiology and chronic pain management, often choose where to live based on the services available within the area.

These factors combined with the rising cost of health care have contributed to a growing demand outside the metropolitan centers.

“Access to care is a major issue right now,” Laws explained. “A lot is economics, a lot of it is distance, but across the board the need is the same.”

Glenwood Springs

When Laws hired on with Valley View in 2006, many of the hospital’s patients were traveling to Denver or out-of-state for some of their cardiology needs, he said.

“I was recruited to enhance Valley View’s cardiovascular services and start a cardiac catheterization laboratory (cath lab),” Laws explained. “Learning how far people had to travel for certain services and procedures was a big eye-opener when I came here.”

A cath lab is a facility with diagnostic imaging equipment used to visualize the heart’s arteries and chambers as well as treat any abnormalities found.

As an interventional cardiologist, Laws provided the expertise needed to run the lab. Additionally, the facility drew more specialists to the hospital. Valley View’s cath lab was up and running by February 2007, just a few short months after Laws arrived.

The hospital also built a heliport in 2006, creating the ability to ensure patients with needs beyond the services provided could receive timely care.

“Prior to the heliport construction,” Laws said, “if you needed to be transported anywhere by air, we had to take you by ambulance to the airport in Rifle and catch a flight from there.”

During a yearlong sabbatical in 2014, Laws studied cardiac arrhythmia at the Tufts University School of Medicine.

Upon returning to the Glenwood community with his newly earned expertise, Valley View was able to start treating atrial fibrillations, a chaotic arrhythmia that arises in the heart’s top left atrial cavity, Laws said.

“Atrial fibrillation is very common in the mountains because of the prevalence of sleep apnea,” he explained.

The combination of services, specialists and equipment added since Laws’ arrival in Glenwood served to reduce travel times for patients, but also attracted new patients from around the globe.

“The fact that we have created a destination program also provides an economic impetus for the area,” Laws said. “Having these services nearby reduces stress on the patients and the family’s that often have to care for them throughout treatment.”

Aspen

Three phases into a four-phase master facility plan, Aspen Valley has endeavored to consolidate Pitkin County’s health care services into one convenient location, Ressler said.

“Our hospital’s vision is to foster our community as the healthiest in the nation,” he said. “We are looking at our social responsibility as a community-owned organization very differently than hospitals traditionally have in the past.”

As part of a special tax district, the hospital receives a portion of property taxes collected around Pitkin County to fund its operations.

One of Aspen Valley’s tenets is increased access to primary care, which was a focus during its recent expansions.

“Nowadays, data and evidence better illustrate the amount of total health care costs that can be contributed to chronic conditions,” Ressler said. “By taking a more holistic approach, a primary care practice can have greater impacts on the individuals willing to manage their lifestyles.”

Constructed in 1977, the hospital has undergone a number of expansions in recent years providing space for in-house ear, nose and throat services, expanded cardiology services, ophthalmology and primary practices.

The campus also leases space for general surgery, orthopedics, obstetrician/gynecologists, a pain clinic, rheumatology, pulmonology and endocrinology, Ressler said.

“By locating practices here on the campus, a patient can have adequate parking, and get all of their services done in one location,” he said. “Breast health is another example of where we have expanded. Our patients used to have to travel to Denver for breast biopsies and ultrasounds.”

While the pandemic reinforced the need for quality tele-health services, Aspen Valley was investing in its long-distance health care options prior to COVID-19.

Using an electronic platform, eClinicalWorks, the hospital enhanced its abilities to track medical records digitally.

“The improvements we made to our services in the last 10 years removes barriers to care,” Ressler said.

Statewide

Keeping Colorado’s rural hospitals open is one of the best ways to ensure residents maintain a high level of access to care, Welch said.

“We’ve seen a lot of rural hospital closures around the country, but that’s not happening here,” she said. “That is in large part because the state was quick to step up and expand Medicaid.”

A rural hospital has not closed in Colorado since the ’80s, according to the hospital association’s data.

Welch said community support and strong hospital leadership also played major roles in keeping Colorado’s hospitals open.

“Collaboration of our hospitals as a system is another factor,” Welch explained. “At times, they may compete for some business, but they collaborate in a number of ways that benefits all the hospitals throughout the state.”

Those efforts have paid off in a number of ways, particularly with reducing the need for patients to travel, Welch said.

“A lot of the higher acuity specialty care do still tend to come to the Denver Metro area,” she said. “But, all our hospitals have really focused on what services they need to provide their communities, so people don’t have to travel as far.”

Editor’s note: This is part 3 of a four-part series on longevity in the High Country. The series is being produced in partnership with The Aspen Times, Glenwood Springs Post Independent, Vail Daily, Summit Daily News and Steamboat Pilot. Read more at aspentimes.com/longevity

An unclear correlation: Colorado clinicians and researchers talk Alzheimer’s and other dementias risk, care in mountain communities

It isn’t noticeable at first, starting with changes to the brain that the brain can compensate for, meaning no real impact on day-to-day functions or cognition.

But as time passes the brain can no longer compensate for these changes and the damage it’s experiencing. Subtle problems with memory and thinking begin to pop up. Subtle turns to noticeable. Noticeable turns to inhibiting the ability to carry out everyday activities and eventually to requiring around-the-clock care.

This is the broad view progression from pre-clinical to severe Alzheimer’s disease, a degenerative brain disease that becomes worse with time and age, and is the most common cause of dementia, as explained by the Alzheimer’s Association.

In Colorado, an estimated 76,000 people are living with Alzheimer’s dementia, and that number is expected to increase 21% to 92,000 by 2025, a 2020 Alzheimer’s Association report states. As of July 2019, 14.6% of Coloradans or roughly 840,000 people were 65 or older, U.S. Census data show.

But while generally speaking it’s been shown that living in higher altitude communities in places like Colorado can lead to a more active, healthier lifestyle and even prolonged life, how does living at altitude impact and correlate with degenerative brain diseases that cause dementia, like Alzheimer’s?

In short, the answer is complicated and not well researched by scientists and clinicians, as explained by Dr. Huntington Potter, director of the Alzheimer’s and Cognition Center at the University of Colorado Anschutz Medical Campus.

“As far as I know, there isn’t a lot of evidence one way or another about high altitudes versus low altitudes for Alzheimer’s disease risk,” Potter said. “We can’t say one way or another whether high altitude is a risk factor for Alzheimer’s.”

DEMENTIA AT ALTITUDE

Alzheimer’s disease is namely the result of the accumulation of the protein fragment beta-amyloid outside of neurons in the brain and of an abnormal form of the protein tau inside neurons, as described by the Alzheimer’s Association.

These accumulations over time can contribute to the damage and death of neurons by interfering with neuron-to-neuron communication at synapses, an Alzheimer’s Association report says, and can block the essential transport of nutrients and other essential molecules inside neurons — resulting in early symptoms of memory loss, apathy and depression; later symptoms of impaired communication, disorientation, confusion, poor judgment, behavioral changes; and ultimately difficulty speaking, swallowing and walking as neuron damage gets worse.

At the Alzheimer’s and Cognition Center, which is part of both the CU Anschutz Medical Campus and School of Medicine, clinicians and researchers are dedicated to discovering effective early diagnostics, preventions, treatments and ultimately cures for Alzheimer’s disease and related neurodegenerative disorders, according to its website.

For Potter, that means looking at biomarkers or diagnostic proteins in the blood that can help clinicians predict the disease earlier; conducting projects that look at the longitudinal sort of lifespan of people with Alzheimer’s disease; and other research that can quickly be translated to better care, treatment and hopefully a cure.

Right now, the center is studying a drug called Leukine, which preliminary data shows may actually improve Alzheimer’s disease in the short term, Potter explained. The center also is studying other drugs that attack the disease, which so far are looking very promising as well.

“Leukine may be the first one we found that looks promising but we have several coming up that look promising as well,” Potter said.

“It’s been a tremendous privilege to work with all of the clinicians and scientists and scientist clinicians at the Alzheimer’s and Cognition Center, and we’re absolutely determined to make Colorado one of the places that discovers the cure for Alzheimer’s disease.”

When it comes to looking at the potential correlation between living at high altitude and the risk for Alzheimer’s and other dementia-inducing diseases, Potter and Dr. Peter Pressman of the Alzheimer’s and Cognition Center said it would take great effort, time and funding to research.

Pressman, who is a behavioral neurologist and researcher with the center, said on top of securing and carefully selecting a large group of people living at altitude to participate in a study, researchers would also have to follow that group for around a decade to get meaningful results — which is not impossible, but not easy.

“It’s easy to fund a study for a few years. People give you money to do something for two to three years, but two to three years is not enough time for a process as slow as Alzheimer’s and dementia to really even pick up,” Pressman said. “I’m not saying that’s not possible, it’s doable, but it would take some effort.”

Dr. Brooke Allen, neurologist, founder of Roaring Fork Neurology in Basalt and medical director at Renew Roaring Fork, an assisted living and memory care center in Glenwood Springs, expressed similar thoughts.

Allen said as a part of any mild cognitive impairment or dementia evaluation, her team checks the oxygen level a patient has and considers the altitude at which that person spends most of their time.

Lower oxygen levels can certainly contribute to people experiencing confusion, dizziness and mild short-term memory issues. But outside of looking at oxygen levels and how they could be contributing to symptoms, Allen said she doesn’t consider altitude a higher risk situation.

“I’ve never really personally looked and it … but I think doing a retrospective sort of epidemiology review would probably make sense at first to even see if there’s a need to research it,” Allen said.

At Roaring Fork Neurology, where Allen and her team diagnose and treat headaches, migraines, concussions, Parkinson’s disease, dementia and other disorders of the nervous system, about 25% of the practice is treating patients with some sort of dementia or mild cognitive impairment, Allen said — a percentage that’s stayed fairly stable over the past 10 years she’s been working in the Basalt area.

This mild cognitive impairment means patients haven’t lost the ability to carry out the activities of daily living, but are having some trouble with things like using new equipment, not being able to work a remote control or having more trouble with finance calculations, Allen said.

To treat patients experiencing this mild cognitive impairment, Allen’s team first looks at risk factors like age, gender and DNA, which are not modifiable but are contributors; high blood pressure, diabetes, sleep apnea, high cholesterol, obesity, and exercise levels, which are modifiable; and B12 levels, signs of infection, a potential brain tumor or structural abnormality and oxygen levels, factors which can “reverse” the symptoms being experienced if they exist and are addressed.

But overall, Allen said she feels Roaring Fork Valley residents 65 and older tend to be much younger than their age in terms of their lifestyle, which is a positive in terms of dementia prevention.

About four years ago, Allen and her team conducted a long-term pre-clinical Alzheimer’s trial as part of the Alzheimer’s Prevention Initiative’s Generation Program, a study that looked at the effectiveness of preventative treatments for individuals between 65 and 75 who had no symptoms of dementia.

Allen said over 250 people came in to participate in the study and all generally led healthy, active lifestyles.

“I think in our valley, I’ve experienced meeting those kinds of people and not thinking of altitude as a risk factor but as a lifestyle opportunity in a rural area like ours,” Allen said of the people who participated in the recent study.

Looking at this potential correlation between living at high altitude and risk of Alzheimer’s dementia and others is not just a difficult feat for Colorado researchers — little research with concrete findings exists nationally and globally as well.

One study published in 2015 by Dr. Stephen Thielke in JAMA Psychiatry looked at deaths attributed to Alzheimer’s dementia reported in 58 counties in California to try to determine whether rates of dementia were associated with average altitude of residence. The study found that the counties at higher elevation generally had lower rates of dementia mortality.

“Oxidative abnormalities have been long proposed to be central to the pathogenesis of dementia,” the study research letter states. “One group of researchers previously found that hypoxia prevents neurodegeneration in rats in experimental Alzheimer disease and hypothesized that adaptation to induced hypoxia may prevent dementia. To our knowledge, our work is the first to find epidemiological evidence for such effects. Additional work is needed to determine whether this relationship holds in other populations.”

But beyond this study, there isn’t much conclusive evidence for or against a correlation, as emphasized by Dr. Brent Kious, a psychiatrist, assistant professor and researcher with both University of Utah Health and the school’s Department of Psychiatry.

Kious has studied the link between living at high altitude and major depressive disorder, anxiety and suicide, and said he and his research team have been interested in the impact of altitude on the incidence and median age of onset of Parkinson’s disease, but has not studied this impact or the effects of altitude on dementia risk.

However, Kious said decrements in cognitive performance due to chronic exposure to moderately high elevation might not necessarily translate into an increased risk of dementia, since the symptoms of dementia depend both on baseline cognitive performance and on pathological neurodegenerative processes.

“It is not clear whether altitude would affect those neurodegenerative processes or not, though there is some reason to think that they involve oxidative damage … so relative hypoxia might slow them,” Kious said via email. However, he went on to note that relative and prolonged hypoxia has also been associated with dementia risk, too. “In any case, a good epidemiological study of the association between altitude and dementia should control for things that might be associated with both.”

BETTER UNDERSTANDING AND ACCESS TO CARE

While there may not be good data for or against high altitude as an Alzheimer’s and dementia risk factor, there is evidence that people living in more rural communities do not have the same access to dementia care and treatment as those living in urban areas.

According to the 2020 Snapshot of Rural Health in Colorado, produced by the Colorado Rural Health Center, 721,500 people are living in rural Colorado and 19% of the rural population is age 65 or older. Rural is defined as a non-metropolitan county is no cities over 50,000 residents, the snapshot report says.

In Pitkin County, which is considered rural, 20.3% of the population is 65 or older, according to 2019 census data. And while Chad Federwitz, a gerontologist — specialist in the field of gerontology, or study of aging — and manager of Pitkin County Senior Services, says Alzheimer’s dementia and other dementias aren’t really prevalent locally and that he hasn’t seen any correlation or link between living at high altitude and dementia risk, he does know anecdotally that people may move downvalley, to Grand Junction or the Front Range if they have onset or early dementia because of lack of care resources in the upper Roaring Fork Valley area.

“Given the nature of our rural-ish community, we don’t have the same resources,” Federwitz said, referring to things like long-term assisted living and memory care options, professionals trained in Alzheimer’s disease, dementia and gerontology, and at-home caregiving service providers. “You can go to Grand Junction or the Front Range and have pages and pages of resources, as a opposed to (a handful or so) here.”

Before Federwitz started as the manager of Pitkin County Senior Services, he spent about seven years working in dementia care in the Boulder area, and is an Alzheimer’s Association community educator.

He said he feels education and access to informed and professional dementia and memory care is extremely important for Alzheimer’s and other dementia patients especially because there are still a lot of misconceptions surrounding what Alzheimer’s and dementia are, and unique challenges that come with caring for someone who has a degenerative brain disease.

Allen expressed similar thoughts, noting that a big part of dementia care and treatment is caregiver access and preventing caregiver burnout, especially with more severe states of dementia.

She said she feels a lot of times where people with dementia live in relation to their support system “matters in terms of their outcomes.” And while Allen feels there are an unusually large number of people that live in the Roaring Fork Valley that don’t have family in the valley, many people do tend to have good support networks through friends, which is important if that person is experiencing dementia.

“It really does take a village to help individuals cope with the changes happening in the brain and a lot of times that’s really picked up by a friend,” Allen said. “Oftentimes adult children of these individuals don’t live here, but we try to identify someone to support them, and there certainly are resources in the valley for homecare and private caregivers.”

But while there are some dementia care resources in the Roaring Fork Valley and other more rural Colorado communities, the Alzheimer’s and Cognition Center is working to do more to develop meaningful relationships with health care providers and dementia patients in the state’s mountain communities as part of its mission.

According to Pressman, who is heading this charge on behalf of the CU center, a lot of projects are in the planning stages and process of acquiring funding, but include virtually educating medical providers, nurse practitioners and primary care doctors on Alzheimer’s and general healthy brain aging, and mutual, participatory research with rural Colorado communities and communities of color.

Pressman explained that a lot of research related to Alzheimer’s overwhelmingly is based on middle class, well-educated, white participants. And so while researchers think they know a lot about the disease in general, they really only know about the disease related to this demographic group.

Through the center’s outreach and efforts to better connect with underrepresented communities, Pressman hopes to conduct better science and better serve the larger Colorado community.

“What motivates me is trying to do good work, trying to do good science and to makes sure our results actually represent real life,” Pressman said. “We want to make sure we’re helping everybody, not just a niche group, and that our services are available equitably to as many people as possible.”

Although there’s no clear correlation between living in higher altitude, mountain communities and dementia and Alzheimer’s risk, it is clear that as America’s aging population reaches 65 and older, these medical conditions will remain a relevant risk for seniors.

And with this continued risk and prevalence comes a need for more education, more research, more awareness and more connections surrounding the conditions, according to Federwitz.

“We all agree dementia is a horrible thing that can be overly daunting for everyone connected … but you as a person with a family member who has dementia or as a person with dementia, you’re not alone,” Federwitz said. “In my opinion and experience, there are hidden blessings. Joy can still happen. Happiness can still happen, laughter can still happen, genuine connection can still happen, even if all of those things happen in a moment.”

mvincent@aspentimes.com Editor’s note: This is part 2 of a four-part series on longevity in the High Country. The series is being produced in partnership with The Aspen Times, Vail Daily, Glenwood Springs Post Independent, Summit Daily News and Steamboat Pilot. Read more at aspentimes.com/longevity.

Staying active

Harvey Simpson skied roughly 30 days last season. It was a fraction of the 100-day winters the Vail resident enjoyed a few years ago, but it was, of course, an abbreviated season.

Also, Simpson is now 94 years old.

“I’m looking forward to next season,” he said. “Getting back up to 75 days again.”

For Simpson, skiing is the activity that keeps him young. And skiing is often times considered a young person’s sport, which no doubt helps Simpson feel young while he’s doing it. But the fact that he has some kind of activity keeping him going is the more important part, said Gini Patterson with Timberline Adult Day Services in Frisco.

“Whether you have a history of a physical impairment — we’ll call that a total joint replacement — or a mental issue like memory loss, it’s so important to stay active, mentally and physically,” she said.

Simpson has had two joint replacements, one on each hip. He said he wouldn’t be skiing without them.

“The pain was just too great,” he said.

Following his second hip replacement, Simpson took a hard look at his technique. Now that he was skiing pain-free, would it be possible to be a better skier at 90 than he was a 80? It was indeed possible, said his coach, Gunnar Moberg. With a renewed focus on technique, Simpson hit the slopes with a new passion.

His advice to aging skiers: “Improve your technique, and don’t fall.”

Ski racing at 85

Total joint replacement technology has made masters ski racing more competitive than ever in the older age categories.

Eagle resident Charlie Hauser, who was bored with traditional skiing, took up the competitive side of the sport in his 70s.

Now 85, he is preparing to enter a new age category as a downhill ski racer after competing in his last race in the 80-84 division in February. He said there’s more ski racers competing into their 80s than you might think.

“We’ve got all sorts of people with a couple of (replaced) knees or a couple of hips or all four of them,” Hauser said. “These people just keep going.

“One of the greatest things that has happened is total joint replacements. It has taken people who would have been absolute cripples and restored them to functionality. These people that have had total joints would not be competing otherwise — none of them.”

Hauser, himself a former surgeon, said the culture in the High Country of Colorado is different when it comes to being active.

“The orthopedists here are replacing joints because they want their patients to go back to skiing and go back to their other activities,” Hauser said. “In other parts of the country, which aren’t as familiar with this, they’ll say, ‘We’re replacing this, but you can’t ski anymore.’”

Recreation expectations

Dr. Ray Kim, an orthopedic surgeon who replaces hips and knees at The Steadman Clinic in Vail, said the expectations placed on orthopedists across Colorado’s High Country are more than you’ll find in other areas of the country or even the state.

Kim worked in Denver before moving to Vail.

“The patients that I took care of in Denver were different compared to our patients up here in the mountains,” Kim said. “Not that the folks in Denver are not active. I think, in general, people from Colorado enjoy recreation and are active, but I do think the activity expectations and demands of our community up here in the mountains is at a higher level. We just have a very high percentage of people who are aggressive skiers, aggressive hikers, aggressive cyclists. It’s just part of the thread of our community here. People just really worship recreation.”

Kim said that when patients visit him from outside of the community, often times it is because they are aware of that culture.

“We have folks that have flown in from other parts of the country and even from outside the country that understand the recreational culture here in Vail and seek out having a knee or hip replaced because of our understanding of that philosophy,” Kim said.

Kim said that was also what attracted him to The Steadman Clinic.

“Richard Steadman’s vision of keeping people active … his whole goal was to get them back on the ski mountain,” Kim said. “And we’ve kept that tradition going over the years in multiple different disciplines. His specialty was obviously knee preservation, but the clinic has expanded that to include everything from spines to hands to foot and ankle.”

‘Keeping people active’

The Steadman Clinic still uses the slogan “keeping people active,” which was based on Steadman’s philosophy.

“We know there’s huge advantages to keeping people active,” Kim said. “There’s a lot of benefits from a cardiac standpoint, from a bone-density standpoint, from a fitness and weight loss standpoint, and now there’s recent studies looking at behavioral health advantages to staying active.”

Patterson said for some aging people, a big knee or hip replacement surgery might not be possible. That’s why she embraces a philosophy based on Olympic silver medalist skier Jimmy Heuga’s “can do” effort to stay active following his diagnosis with multiple sclerosis.

“Do what you can do to stay active,” Patterson said. “That philosophy applies whether you’re in your 20s and diagnosed with MS, or you’re in your 90s and your mind is not working as sharply as it used to. What can you do?”

Patterson is currently caring for a 97-year-old woman.

“She is still physically active and still walks,” Patterson said.

Kim said he believes that the longevity people enjoy in the mountains is directly linked to the dedication people in the High Country of Colorado have to staying active.

“The higher activity level drives better health and longevity,” he said. “I just can’t find any other explanation.”

Editor’s note: This is Part 1 of a four-part series on longevity in the High Country. The series is being produced in partnership with The Aspen Times, Vail Daily, Glenwood Springs Post Independent, Summit Daily News and Steamboat Pilot. Read more at vaildaily.com/longevity.

Longevity Project: Aspen panelists highlight what longevity means to them at soldout event

The noun “longevity” has two definitions: The first is “a long duration of individual life” or “length of life”; the second is “long continuance.”

But for five Aspen locals, the definition of longevity is more nuanced than what a dictionary implies.

Alex Ferreira, X Games and 2018 Winter Olympics freeskier and medalist, said longevity for him means being able to ski until he’s 100.

Christy Mahon, one of the most accomplished ski mountaineers in the state, said the word means taking care of herself and morphing her lifestyle to what gives back to her heart, soul and body. And orthopedic surgeon Dr. Tomas Pevny said it means knowing his limitations and embracing the wisdom that comes with living a long, prosperous life.

For the five panelists who talked about their life experiences in Aspen and beyond Tuesday night for The Aspen Times’ Longevity Project event, chasing longevity had its nuances for each and some universal ties.

“It’s so exciting to be in a town that’s constantly active,” Mahon said of how living in Aspen impacts her lifestyle. “We motivate each other and seeing what’s being done by others is just contagious.”

On the fifth floor of the Mountain Chalet, a sold-out crowd of roughly 125 people listened as moderator Penn Newhard, founder of the Carbondale-based Backbone Media company, asked the panelists about what motivates and challenges each of them in their everyday lives.

Most of the panelists expressed their love of the mountains and the Aspen area’s active, adventurous culture as empowering and difficult. All highlighted camaraderie and community as their keys to success.

“Connection is so vital to our longevity and when we don’t have it, we struggle,” panelist and mental health professional Christina King said. “There is a lot of individualism and competition in this valley. I think we get distracted by that sometimes and forget to wrap our arms around each other, too.”

Mountain Rescue Aspen member and avalanche educator Greg Shaffran expressed similar thoughts, noting that the backcountry rescue and mountain safety nonprofit couldn’t operate without its dedicated team.

“As individuals we’re OK,” Shaffran said, “but as a group we can combine and do some really amazing things.”

After roughly 45 minutes of discussion and an inspiring video featuring 99-year-old Klaus Obermeyer — the German native and longtime Aspen local known for his positive spirit and for helping revolutionize the ski industry — the panel concluded and National Geographic adventurer Mike Libecki took the stage. Overall, the speakers highlighted the importance of self-care and creating meaningful connections with others as key determinants of a long, prosperous life.

“We all want to be like Klaus. It’s a good way to live,” Shaffran said of chasing longevity. “I think finding diversity in your life sets you up for success down the road … but I also think longevity is about what you are able to leave and what kind of effect you can have on other people.”

mvincent@aspentimes.com

Mike Libecki shares passion for adventure at Longevity Project event

Similar to the five panelists who spoke during The Aspen Times’ Longevity Project event Tuesday night, NatGeo explorer Mike Libecki said chasing longevity for him is centered on fueling his “obsessive expedition climbing disorder,” maintaining his support network of family and friends, and keeping an optimistic outlook on life.

As the keynote speaker at the Tuesday night event, Libecki followed the local panel discussion with a presentation featuring video clips from some of his most memorable expeditions. The 2013 National Geographic Adventurer of the Year has been on over 60 expeditions and established multiple ascents on all seven continents.

Images of Libecki falling in love with polar bears in Greenland, making a muddy summit on French Polynesia’s Ua Pou island with some of his closest friends and traveling the world with his teenage daughter flashed across the screen at the Mountain Chalet as Libecki showed event attendees what longevity looks like and inspired them to live out their own dreams.

“I think that being present, being in the moment is a very important part of longevity,” Libecki said. “The time is now; why ration passion?”

mvincent@aspentimes.com

Having your ‘Klaus Obermeyer moment’ is an experience of a lifetime (VIDEO)

When you live in Aspen, eventually you get to have your Klaus moment. Mine came two years, seven months and five days after moving to this gem of a place.

Putting together our monthlong series on life and living in the mountains — Longevity Project: Elevate Your Life ­— it is a no-brainer, I said, that we have to ask Klaus Obermeyer his take.

I was fortunate in my 30-year sports journalism career (before moving to the news side and an editor role) to interview a number of all-stars, hall of famers and Olympians. I covered all the major all-star games as well as Super Bowls, World Series, Stanley Cups and NCAA tournaments of every kind.

But I have to admit the days before when I was working on my list of Klaus questions, I was a little anxious.

Wanting to be respectful of his time, and knowing he’s done just short of a gazillion interviews about “how do you stay so young,” I was really trying to keep my questions concise, on point and as fresh as possible.

As soon as we set up in his office and got the camera and questions rolling, Klaus answered each query with his trademark gusto and energy. His thoughtful responses on a range of topics kept us going for nearly an hour.

We wrapped up with Klaus showing me the focus needed in aikido, a Japanese martial arts he practices every day. Never would I have thought when I walked into his office that before I left the 99-year-old Klaus would be trying to pull down on my arm while I was putting my energy and focus into keeping it taunt.

Part of my interview with Klaus will be shown at Tuesday night’s Longevity Project event at the Mountain Chalet. After that, we’ll post the video online.

The rest of the interview, which includes Klaus’ life growing up in southern Germany near Austria before moving to the U.S. in the late 1940s and how he started Obermeyer with $10,000 he borrowed from a Basalt potato farmer, we’ll use for stories as Klaus celebrates his 100th birthday in December.

Now that we’ve meet in his office, I can only hope that we meet up on the mountain and I get to follow him down the hill. I know there’s no way I’ll be able to keep up with him, but it will be a privilege to try.

dkrause@aspentimes.com

Longevity Project: Local physicians feel health conscious culture sets Aspen area apart

On a recent evening in a Basalt backyard, three generations of family gathered for dinner.

The mother and daughter played volleyball for a few minutes while veggie burgers cooked on the grill, and the father and his parents sat on the porch discussing the news of the day as a black cat slinked around their feet.

Meet the Locke family. Over the past 20 years, the three generations have made their home in the Roaring Fork Valley, first when Kelly and Karen came to work as family physicians and to raise their four children; then when Marilyn and John retired and moved to the Basalt area full-time about 15 years later.

Reflecting on their two decades of experience as local physicians and parents, Kelly and Karen Locke see the Aspen area as an active, health conscious community, a characteristic they feel benefits all aspects of life in the valley for all ages.

“From a young age, people feel they need to be eating healthy, exercising regularly and it’s not just coming from their parents,” Karen said. “Health promotion extends into pretty much every aspect of life here.”

According to the most recent Regional Community Health Assessment — conducted to help guide public health initiatives in Pitkin, Eagle and Garfield counties from 2018-2022 — people with higher incomes or personal wealth, more years of education, and who live in healthy and safe environments also have longer life expectancies and better overall health outcomes, as previously reported.

For Kelly and Karen, the general heightened investment in individual health across the valley they’ve observed helps contribute to locals’ longevity, too.

“I think it’s more of a nationwide trend but I also think our valley is a bit unique because people are really dialed into what their health problems are,” Kelly said. “People in the valley seem to be go-getters who are used to digging in and figuring out how to solve things and so they often come in (to the clinic) with requests like ‘Well, can I do it this way or can I do it that way?’ ”

Karen and Kelly have job-shared as family physicians in both public and private practices since they moved to the Roaring Fork Valley from Wisconsin in 1999.

The couple currently works in the Aspen Valley Primary Care clinic in Basalt and sees a little bit of everything on a day-to-day basis.

“Family medicine allows us to apply all of the different aspects of medicine out there,” Kelly said. “It’s a variety.”

That variety means the Lockes can go from seeing children to grandparents and from helping with mental health challenges to conducting skin biopsies, and gives them the opportunity to treat “the whole patient.”


The Aspen Times, in conjunction with our sister papers the Steamboat Pilot & Today and Summit Daily, is publishing a four-part series on living and thriving in the mountains. The weekly “Longevity Project: Elevate Your Life” series in September will culminate Oct. 1 with a speaker and panel discussion in Aspen.

Elevate Your Life series:

Part 1: A conversation with Mike Libecki, National Geographic explorer

Part 2: How top athlete live, train at altitude

Part 3: Examining mental wellness at altitude

Part 4: General effects of life at 8,000-plus feet


When asked if they’ve noticed any health trends, positive or negative, related to living in high altitude communities such as Basalt and Aspen, the Lockes said they haven’t really seen any major detriments or advantages to living over 8,000 feet.

Kelly and Karen said they have seen more sleep apnea than other physicians at lower elevations, and some breathing conditions among both locals and tourists related to high altitude, but not a lot.

Kelly went on to say that he and Karen may not see as many patients with breathing complications related to high altitude because the patients “self-select” out, moving to lower elevation.

“We don’t have pollution or other things up here where people are chronically getting asthma flairs or other baseline lung issues,” Kelly said. “I mean we see lung problems but we don’t see a ton.”

However, two problems not necessarily related to living at high altitude Kelly and Karen have seen include chronic substance abuse and cost barriers to health care.

According to the most recent regional health assessment, substance abuse was determined one of the top health concerns across the region. The assessment also shows cost of health care and insurance as a reason some people in the valley do not seek the health care they may need.

“We have conversations with the patients about OK, does your insurance pay for this and say it may be cheaper to do it this way,” Karen said. “We’ll steer people to the least expensive route when possible.”

Overall, the Lockes said they feel the active lifestyle and health conscious culture has contributed to making the Roaring Fork Valley a predominately healthy place to live and to raise their four children.

“Knowing that once the kids left the door that some of the things you tried to instill in them would also be instilled by the teachers of the school or by other people in the community because we all have similar values made us feel reassured,” Kelly said.

For two of the Locke kids, these key values ingrained in them by their parents and valley locals include staying active and having an appreciation for the natural world.

“I think a lot of the individuals graduating from Aspen High School have a better appreciation for the outdoors and for spending as much time outside as they can, which I think has a significant positive impact on their health,” said Liam Locke, a junior studying neuroscience and biochemistry at Dartmouth College in New Hampshire.

Both Liam and his younger sister, Kira, noted specifically the Aspen School District’s outdoor education program as contributing to their desire to recreate outdoors and the Aspen area culture inspiring them to lead active lives.

“This environment is really healthy for me, I like that it’s a rural area where everyone knows each other and there’s so much to do,” Kira, an eighth-grader at Aspen Middle School said. “I can’t imagine being anywhere else.”

But this more active lifestyle hasn’t just impacted Kira, her siblings and her parents. It’s also impacted her grandparents.

About four years ago, Marilyn and John started living full time in Basalt. The retired couple said they’ve noticed the healthy, active culture of the Roaring Fork Valley and have quickly become a part of it.

“We’ve made a lot of progress with our health I think since we’ve been out here. We can hike longer and we can do hills, whereas before we only did the flat areas,” Marilyn said, referring to their previous home in Texas.

“Because of the emphasis on health out here I think I do get out and hike more than I would have back home,” John added. “I probably would be more sedentary if it weren’t for the culture.”

Outside of exercise, John and Marilyn also feel there are lots of social opportunities for them as a retired couple, and for their grandchildren as younger adults in the valley. Neither they nor Kelly and Karen said they really feel the youngest Lockes are missing out on much growing up in Basalt and Aspen, except for the experiences that come with traveling to other places, nationally or internationally.

But even then, John and Marilyn, who have made multiple trips around the world in recent years, said they can’t imagine calling anywhere else home.

“We travel quite a bit now that we’re retired and we always say at the end of our trip, let’s go home,” Marilyn said, laughing. “We can’t think of a better place, the Roaring Fork Valley is where we want to live.”

mvincent@aspentimes.com

Longevity Project: Mental health connected to culture, altitude of mountain communities

Soon after Jose Saez moved to the Aspen area four years ago, his well-being took a turn for the worse.

Convinced to relocate to the Roaring Fork Valley by a friend he went into business with, Saez said life was good for a little bit.

About a year-and-a-half into the partnership, the business crumbled.

“I wound up homeless with $300 bucks in my pocket, bought a $300 car and that’s how the saga started, I guess,” Saez said. “This is one of the most beautiful places in the world but if you’re not ready for what comes with that beauty, you find yourself in a world of hurt.”

In an upstairs office of the Pitkin County Health and Human Services building, Saez recalled what it was like to go from a stable to unstable mental, financial and housing situation so quickly while Jessica Beaulieu, mental health program administrator for the county, listened.

Now, just a few years later, Saez is working as the Pitkin Area Co-Responder Team peer specialist, helping decriminalize mental illness and getting people in the Aspen area connected with the mental health resources they need.

“It’s perfect. I’m giving back to where I once took from,” Saez said. “I’ve been through the mental health, I’ve been through the addiction, I’ve been through the anger and the pride, so my goal is to break down those barriers and show you that you don’t have to go through what you’re going through, that you’re not alone.”

According to the most recent Regional Community Health Assessment— conducted to help guide public health initiatives in Pitkin, Eagle and Garfield counties from 2018-2022 — people with higher incomes or personal wealth, more years of education, and who live in healthy and safe environments also have longer life expectancies and better overall health outcomes.

In Pitkin County, assessment statistics show locals are set up for longevity: The median family income is over $20,000 more than the state’s, the percentage of adults who have graduated college is higher than surrounding counties and Pitkin County is identified as having a generally safe, healthy environment.

But an aspect of health and longevity across the region not up to par is mental health. Eagle, Garfield and Pitkin county locals identified mental well-being as the top health concern in their communities and as lacking for myriad reasons, including barriers to accessing services and the stigma surrounding mental health.


The Aspen Times, in conjunction with our sister papers the Steamboat Pilot & Today and Summit Daily, is publishing a four-part series on living and thriving in the mountains. The weekly “Longevity Project: Elevate Your Life” series in September will culminate Oct. 1 with a speaker and panel discussion in Aspen.

Elevate Your Life series:

Part 1: A conversation with Mike Libecki, National Geographic explorer

Part 2: How top athlete live, train at altitude

Part 3: Examining mental wellness at altitude

Part 4: General effects of life at 8,000-plus feet


However, for local mental health officials like Beaulieu and Saez, there is an attainable solution to address these concerns: Increasing connectivity within communities and sparking conversation.

“Social support networks are key in suicide prevention and emotional, social and psychological health,” Beaulieu said. She went on to quote the recent regional health assessment, which states 19% of the population across Pitkin, Eagle and Garfield counties reported not having adequate social or emotional support.

“We attribute this predominately to the tourism culture, which really changes the way people work and live,” Beaulieu said. “It’s more difficult to build a (support) network within your immediate environment because people are hustling constantly to figure out a way to be in this beautiful place.”

Because Aspen, Snowmass and the surrounding communities are tourism hot spots, much of the local workforce is rooted in arts, entertainment, recreation and hospitality services. Roughly 40% of people working in Aspen-Snowmass are employed within these tourism-related industries, and many of these positions are seasonal, leaving gaps in employment for people looking to live in the valley year-round.

“We often see with our seasonal workers that they are riding high all season but then they lose their employee housing when they lose their job at the ski mountain or at a restaurant or wherever, and it’s like ‘Now what?’ ” Beaulieu said.

In Pitkin County, about 10% of the population had a depressive diagnosis between 2013 and 2015, according to the recent regional health assessment. In 2017, the region had a suicide rate of 18.6 per 100,000 people, which is lower than the state’s average rate of 20.3 but higher than the national average of 14.0.

But higher rates of depression, anxiety and suicide aren’t unique to Pitkin County or the state of Colorado. Research shows a strong correlation between living in higher altitude communities across the western United States and experiencing mental health challenges.

EXPLORING ALTITUDE’S ROLE IN MENTAL HEALTH

Brent Kious, a psychiatrist with University of Utah Health in Salt Lake City, is one of the researchers who have studied the link between living at high altitude and major depressive disorder, anxiety and suicide.

Kious said data suggests suicide and depression are associated with altitude, noting that suicide rates start to increase more dramatically around 2,000 to 2,500 feet of elevation.

“That doesn’t necessarily imply that the effect of altitude at that height starts to outweigh the impact of other socio-demographic or socioeconomic factors,” Kious emphasized.

MENTAL HEALTH TIPS

Top tips to help maintain good mental health:

1. Exercise daily

2. Eat healthy

3. Practice mindfulness

4. Avoid drugs, alcohol and tobacco use

5. Get a good night’s sleep

6. Identify an emotional support system

Other factors aside, Kious said the reason people living at higher altitudes have a higher risk of depression, anxiety or death by suicide is due to less oxygen reaching their brains. This lack of adequate oxygen, or hypoxia, can alter the brain’s ability to store or transport energy and to synthesize serotonin, the neurotransmitter that’s most often implicated in depression, Kious said.

For Kious and other researchers, this strong association between altitude and both depression and suicide rates highlights what’s known as the “paradise paradox.”

“I think although we’ve seen this consistent association with suicide rates and some evidence that moving to higher altitude increases the risk of depression, we also know that mountain communities tend to report higher satisfaction rates with life in general than elsewhere,” Kious said.

“The way I make sense of that is I think maybe living at altitude makes for a more extreme mood, whatever you’re prone to having,” Kious continued. “Maybe moving to altitude will tend to make your natural inclinations greater.”

At the local level, Beaulieu and Saez have seen that paradox play out when accessing mental health resources, too.

They feel that because Aspen area locals know they are living in “paradise,” when a mental health challenge arises they may feel they don’t have a right to complain.

“I’ve witnessed it in all ages of people in this valley where there’s this idea that I’m living the dream, how can I complain?” Bealieu said. “But I also think people don’t seek out services because of the stigma around mental health.”

TRYING TO BRIDGE THE GAP

Like Beaulieu, Christina King, local mental health clinician and founder of the Aspen Strong nonprofit, sees a lack of willingness to and education on how to talk about mental illness and mental health challenges as a major barrier to good mental hygiene, locally and nationally.

That’s why King said she started Aspen Strong, which aims not to be another mental health provider but a connector to all of the resources available in the Roaring Fork Valley.

“In the midst of working in this arena, I really began to notice the lack of community centered approach in addressing the issues behind mental health and suicide,” said King, who runs her own private counseling and consulting practice. “I felt there was a lot of individualization and thought, ‘Why are we not all trying to work together?’ That’s where Aspen Strong came in.”

Through Aspen Strong, King has aimed to build bridges between the various mental health resources, such as private practitioners, Mind Springs Health and the Aspen Hope Center.

King also has worked to educate locals on how to have conversations about mental health that associate the term more with maintaining hygiene versus fixing a deficiency.

“It’s like the flu, you’re gonna feel sad sometimes, you’re gonna experience grief, you’re gonna experience anxiety and if you’re not checking up on your mental hygiene, then what happens?” King said. “It’s like what are we doing to floss our brain and be equipped with the tools to work through some of the issues that come our way.”

King, Beaulideau and other mental health professionals throughout Pitkin County are working to change the way locals think of and talk about mental health by sparking these conversations and through programs such as PACT, which aims to connect people with the resources they need to address their mental hygiene before a challenge becomes a crisis.

Although the Aspen area has a long way to go, King, Beaulideau and Saez feel the culture around mental health is changing for the better, but feel it will take the efforts of the entire community to create a more open, proactive approach to maintaining mental well-being.

“We don’t care if you live in a $10 million mansion, we don’t care if you’re sleeping under that tree out there, we’re going to meet you where you’re at. To me, that’s really bridging a big gap,” Saez said. “But it’s going to take everybody coming together saying it’s OK to be sick, it’s OK to not feel like a million bucks today, to make a real difference. It has to be a whole community thing.”

mvincent@aspentimes.com

Longevity Project: Aspen-area elite athletes breakdown training, competing at altitude

Noah Hoffman never quite found eternal glory as a member of the U.S. cross-country ski team. He had a solid career, competing on the World Cup for the better part of eight years before retiring in 2018 after two Olympic appearances, but success was few and far between.

Born in Evergreen, Hoffman grew up in Aspen and certainly credits the altitude — Aspen sits at roughly 8,000 feet — for him being able to develop “one of the biggest engines in the world” in terms of aerobic capacity. At elevation, Hoffman was certainly one of the best. Unfortunately, most World Cup cross-country ski races are held closer to sea level, leaving him at somewhat of a disadvantage.

“My weaknesses were more noticeable when I went down to sea level,” Hoffman said. “I would have been better and consistently maybe top 10 if every race was held above 6,000 feet rather than below 6,000 feet. But that wasn’t the nature of the sport and that wasn’t what I was training for.”

The reasoning for his disadvantage came down to technique and the ability to develop those fast-twitch muscles needed for elite racing. Sure, racing at sea level wasn’t challenging for him in terms of cardio, but training at elevation as much as he did made it more difficult for him to develop those fine-tuned skills.

This is a big reason why Hailey Swirbul, a second-year member of the U.S. cross-country ski team who also grew up in the Roaring Fork Valley, wanted to leave her mountain paradise for training opportunities closer to the ocean.

“One of my main criteria for where I wanted to go to school was to have it be at sea level,” said Swirbul, who trains and goes to college in Anchorage, Alaska. “Moving to sea level was a really important step in my career because I developed a lot more power and more strength and you are able to train at a higher pace, so you are able to do more race simulation and race-like movements at sea level when you have more oxygen available and the ability to not cross the redline quite as quickly.”

BECOMING SUPERHUMAN

Training and competing at altitude has long been popular among elite athletes. As the body adapts to the lower oxygen levels, it can make competing at lower elevations all that easier. However, it’s not necessarily a guarantee of success and can come with its own downside.

It can take months to truly acclimatize to higher elevations, say above 10,000 feet, where many foot races and ski mountaineering events are held here in Colorado. And as long as it can take to develop those lungs, only a few weeks back at sea level can undo all that work.

“The more you live here, the longer you live here, the more it lingers and the faster you get it back,” Aspen’s Ted Mahon said. “There are no shortcuts. Your body either is acclimated or isn’t. People show up to races at altitude and if they don’t have the time or the ability to get acclimated, they are going to notice it pretty quickly.”


The Aspen Times, in conjunction with our sister papers the Steamboat Pilot & Today and Summit Daily, is publishing a four-part series on living and thriving in the mountains. The weekly “Longevity Project: Elevate Your Life” series in September will culminate Oct. 1 with a speaker and panel discussion in Aspen.

Elevate Your Life series:

Part 1: A conversation with Mike Libecki, National Geographic explorer

Part 2: How top athlete live, train at altitude

Part 3: Examining mental wellness at altitude

Part 4: General effects of life at 8,000-plus feet


Mahon, along with his wife, Christy Mahon, is a noted endurance athlete who has finished the famed Hardrock 100 endurance race a mind-blowing 10 times. Part of the reason for his success is having spent years training above the tree line and living in Aspen makes that easy with its quick access to high-elevation terrain.

Training at altitude has less to do with oxygen and more to do with red blood cells. It’s the hemoglobin in those cells that transports oxygen through the body, and the amount of hemoglobin in the blood increases the higher you go. So, when an athlete trains at elevation long enough to develop a higher hemoglobin count, going back to a more oxygen-rich environment can make one feel almost superhuman.

However, as was the case for Hoffman, this sort of training helps more in terms of endurance and can limit the development of those smaller skills that are honed in during hours and hours of high-intensity training, which comes easier at sea level.

“It definitely impairs your ability to recover and you can’t train quite as hard. You can’t get quite as much volume,” said Carbondale’s Sean Van Horn, another noted endurance athlete. “I do think the body adapts. Over years it seems you get use to that stress due to lack of oxygen.”

A different kind of cardio

Being an endurance athlete comes in many forms. A halfpipe skier, for example, doesn’t sound like someone who needs a great cardio capacity, but it certainly can have its benefits.

“The endurance needs to be there because it’s all of your energy, everything, in a matter of 35 seconds,” Aspen Olympian Alex Ferreira said of a run through the halfpipe. “I get a lot of my stamina endurance actually from the trampoline. It’s so much energy bouncing up and down. What might seem like a little amount of time, a half an hour is actually equivalent to me running 12 miles I feel like.”

Ferreira won an Olympic silver medal in 2018 and is the reigning X Games Aspen gold medalist in the ski pipe. Having grown up in Aspen, competing and training at altitude is all his body knows. He trains nearly every day and takes his status as a professional athlete seriously.

“I just grew up here so I don’t know anything different,” Ferreira said of training at altitude. “I used to not work out nearly as much or really think it was effective. Once I started doing it I realized it was not only effective for training and skiing purposes, but it was also helping me mentally. I was much happier psychologically. I was just doing a lot better.”

TO TRAIN AT ELEVATION OR NOT

So does living and training at altitude make you into an elite athlete? It certainly can, but simply being at altitude is only a small piece of the puzzle.

“If I’m being honest, there is a lot of science behind our sports because humans like to feel like they can control things,” Swirbul said. “But I think there is no one right way. If you believe in what you are doing that’s the only right way there is. You can live at 10,000 feet your whole life and you can probably be just as good as if you lived at sea level.”

Swirbul pointed out that many of her U.S. teammates, including 2018 Olympic gold medalist Jessica Diggins, are opting to not train at elevation this fall. With the World Cup season fast approaching, some athletes are opting for a camp in Lake Placid, New York, while others, like Swirbul, will go to Park City, Utah.

It’s all a matter of preference.

“She didn’t want to go to altitude at this time of year because it’s more exhausting and it’s harder to recover and it’s getting close to the season,” Swirbul said of Diggins. “You see a lot of altitude skiers doing worse because they are not used to the pace and being able to push yourself a little bit harder and still be able to recover.”

Hoffman and Swirbul mentioned that some of the best cross-country skiing sprint specialists come from lower elevations — three-time Aspen Olympian Simi Hamilton is among the exceptions — while athletes coming from higher elevations tend to be better distance racers.

“I believe I had one of the biggest engines in the world, the biggest cardio aerobic capacities in the world and I think that came from growing up at 8,000 feet in the mountains,” Hoffman said. “On the flip side of that there are the Norwegians, who tend to be the best skiers in the world, who think training at altitude all year round is insane and they would never even dream of doing that.”

acolbert@aspentimes.com