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Medical Conditions for The Aging

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Common medical issues for the aging ranges from dementia, arthritis, heart disease, vision loss, hearing loss, Sundowner’s Syndrome, to Urinary Tract Infection (UTI).  While these do not reflect all of the potential medical issues you may face, they reflect a set of conditions that many experience at some point in their lives.  Understanding each medical issue helps you know what to look for and reduces the anxiety associated with the unknown.

Dementia

Proper diagnosis of dementia is critical for providing optimal treatment.  We are all forgetful from time to time.  But an increase in a struggle to remember why you entered a room, expressing your thoughts, repeating yourself, and an unexplained change in your mood can be early signs of dementia.  If you lack the interest you once had for being involved or find yourself easily confused, talk to your doctor.   Early diagnosis and treatment is beneficial to delay onset of more severe symptoms.  All causes of dementia result from death and damage of nerve cells in the brain; genetics and possibly the formation of different types of inclusions in the brain cells are likely the major causes, although some researchers suggest that certain inclusions may be only side effects of an underlying disorder.

Risk factors for dementia include advancing age, genetics (family history), smoking, alcohol use, atherosclerosis, high cholesterol, diabetes, certain high plasma amino acid levels, mild cognitive impairment, and Down syndrome.  Somewhat surprisingly, there are studies that show UTI is the most common cause of a sudden increase in confusion in an older person with dementia.

There are different types of dementia, the common of which is Alzheimer’s disease.  Current thinking is that build-ups of protein (amyloid plaques and neurofibrillary tangles) are the primary causes of Alzheimer’s. It affects almost all functions of your brain.  Those afflicted are most commonly over the age of 70.  Alzheimer’s usually causes a gradual decline in cognitive abilities.  The progression of the disease typically spans 7 to 10 years. Nearly all brain functions, including memory, movement, and language.  Over time, memory and language problems worsen and you may have difficulty performing activities of daily living.  Remembering and following directions become difficult and you may experience disorientation.  Some people even have episodes of disillusion and mood swings.  Sadly, someone with Alzheimer’s eventually lose the ability to recognize people, including their own family members.  Find games and puzzles to help cognitive performance at Amazon.  You can also obtain a copy of the Alzheimer’s Primer (some people consider their Alzheimer’s bible), HOW IN THE WORLD… AND NOW WHAT DO I DO by clicking the below link.

Alzheimer's Primer

Vascular dementia is the second most common cause of dementia.  It causes brain damage from problems such as a stroke or other problems that affect vascular function. The risk of vascular dementia is strongly correlated with risk factors for stroke, including high blood pressure, diabetes, elevated cholesterol levels, and smoking.   Inflammation of the blood vessels, severe hypotension, and effects on the brain from a hemorrhage have been known to cause vascular dementia.  This can prevent normal blood flow to the brain without which they die.  This condition has many symptoms in common with Alzheimer’s but any effects on personality occur much later in the progression of the disease.  Although, depending on the cause, there may not be a progression, such as vascular dementia as a result of a stroke.  People with vascular dementia often wander around and experience depression and incontinence.

Lewy body dementia is common and is progressive in nature.  Once again, symptoms overlap with Alzheimer’s but also includes hallucinations and changes in physical posture.  The life expectancy of someone with Lewy body dementia is 7 years following symptomatic appearance.  Patients have shown some improvement with application of drugs used to treat Parkinson’s Disease.  In fact, Lewy body dementia is often found in people with Parkinson’s.

Front temporal dementia is dementia is associated with the nerve cells in the frontal and temporal brain.  People suffering from this type of dementia may exhibit poor judgment and social behavior problems such as stealing, neglecting responsibilities, and compulsive behavior.  Eventually symptoms may expand to include motor skill problems and memory loss.  The age of occurrence is typically 40 and 65.  There appears to be a strong genetic link in the disease.  People with front lobe dementia live, on average, 5 to 10 years after diagnosis.  However, there are specific types of frontal lobe dementia that progress slowly and impacts a person’s ability to speak, understand verbal language, recognizing everyday objects and eventually experience personality and behavior changes.

Less common are dementia pugilistica that is caused by head trauma (symptoms often manifest as dementia, tremors, and specific affects associated with the site of trauma), corticobasal degeneration that is caused by progressive nerve cell loss in multiple areas of the brain (symptoms may begin one side of the body and include poor coordination, memory loss, hesitant speech and difficulty in swallowing) and Creutzfeldt-Jakob disease which is a rare and fatal brain disease (symptoms include personality changes and reduced coordination, impaired judgment and vision).

Secondary dementias may also occur in patients with other disorders affecting motor skills such as Parkinson’s disease or multiple sclerosis.   Adverse reactions to medications can also be the culprit for symptoms of dementia.  Interactions between medications can also be the culprit.  Thyroid problems, infections, low level of oxygenated organ tissue, and heart and lung issues can cause symptoms of dementia.  Even more obscure causes could be due to poisoning and in rare cases brain tumors.   With such a diverse range of potential causes and types of dementia, diagnosis is not only important but a tedious and comprehensive medical process.

Dementia is diagnosed by using various methods including medical and family history, physical exam, neurological evaluations, cognitive and neuropsychological testing, scans, cognitive exams, and a number of medical tests.  It is important to eliminate other conditions that may result in overlapping symptoms before diagnosing dementia.  But early diagnosis allows early treatment of symptoms.  While most treatments for dementia will not reverse or stop the disease, they may reduce the symptoms and slow the disease progression.

Dementia should not be confused with age-related cognitive decline. This is a common and natural part of aging.  With age, information may be processed slower, the brain may actually shrink in size and nerve cells may be lost.  These are not considered signs of dementia.  Mild cognitive is also different from dementia.  While many people with mild cognitive impairment may eventually suffer from dementia, the condition is not severe enough to be categorized as such. Some people mistake depression, delirium, mild cognitive impairment and age-related cognitive decline for dementia.   Knowing the difference between dementia and other conditions is important because treatments are very different.    It is critical to report any changes in your cognitive abilities, overall physical status, or accidents to your doctor.

Other conditions that may be confused as dementia are depression and delirium.  People with depression are often passive, confused, and/or forgetful.  While delirium will likely cause the patient to experience confusion, there will also be a rapidly fluctuating mental state. Both of these conditions are typically treatable which should eliminate these symptoms.

While most forms of dementias cannot be cured or reversed, a patient may benefit from treatment.  Quality of life may improve, the level of care required may be reduced, and skilled care may be delayed.  Performance based training and use of memory aids can be very helpful.  While there is no way to guarantee you will not suffer from dementia sometime in your life, studies have shown that controlling your glucose level, lowering your cholesterol level, and maintaining a good blood pressure or lowering high blood pressure, and engaging in intellectually stimulating activities can either reduce your risk of developing dementia or result in higher cognitive function.  Research is also focusing on folic acid, B12 and B6 that appear to slow the progression of Alzheimer’s.  While you should never take medication without your doctor’s approval, research indicates that long-term use of ibuprofen, naproxen, and similar drugs, may prevent or delay Alzheimer’s.  Vascular dementia may be prevented by changing your lifestyle to prevent excessive weight and/or high blood pressure.  And for those who already exhibit mild cognitive impairment, there is some evidence that taking the drug donepezil may delay the onset of Alzheimer’s.   And lastly, beyond the standard benefits you realize from regular exercise, the stimulation generates chemicals called growth factors that help neuron survival that may help delay dementia.

If you are experiencing symptoms of dementia, be sure to discuss them with your doctor.

Arthritis

Arthritis is actually a group of over 100 medical conditions that combined affect tens of millions of adults. One common aspect of these medication conditions is they all affect the musculo-skeletal system, and more specifically the joints.  Symptoms of arthritis include pain, stiffness, inflammation and damage to joint cartilage and surrounding structures. You may also experience leg pain.  But your doctor should ensure leg pain is not associated with arteriosclerosis, atherosclerosis, peripheral arterial disease or thrombophlebitis instead of arthritis. Be sure to mention new or unreported pain and discomfort to your physician so a proper diagnosis can be made.  The damage from arthritis can lead to joint weakness, instability and visible deformities impacting your ability to perform activities of daily living such as walking, climbing stairs, using a computer keyboard, cutting your food or brushing your teeth.

The two most common types of arthritis are osteoarthritis and rheumatoid arthritis.  In osteoarthritis, the cartilage loses its elasticity over time due to heavy use.  Those who were athletes or involved in other physically demanding activities or careers often experience osteoarthritis later in life.  Previous joint injury and high body weight also contribute to the likelihood of getting osteoarthritis.  Not surprisingly, arthritis often occurs in the joints that bear weight such as the knees, hips, feet, and spine. Once the cartilage is stiff, damage is more likely due to lack of a buffer and gradual damage to surrounding tendons and ligaments.  When the bones rub against one another, it can cause severe pain.  Aside from the pain, you may have difficultly dressing, gripping, sitting, bending or walking which can make osteoarthritis very debilitating.  The joints may swollen or even feel warm to the touch.

In contrast, Rheumatoid arthritis (RA) is an inflammatory form of arthritis and is in fact the most common type of inflammatory arthritis. It is an autoimmune disease that attacks your body, joints in particular.  If left untreated, this form of arthritis can lead to deformity of the joints.  Patients are also at a higher risk of blood clots.  Many people with RA develop lumps on their skin called rheumatoid nodules. These often form over joint areas that receive pressure, such as over knuckles, elbows, or heels.  RA typically appears between the age of 40 and 60.  Symptoms of rheumatoid arthritis can appear gradually or appear suddenly.  Symptoms are often more severe, causing pain, fatigue, loss of appetite, stiffness.  Stiffness and swelling may occur in your hands, wrists, elbows, shoulders, knees, ankles, feet, jaw, and neck.  Sometimes the pain occurs in one body part but is usually symmetric, i.e. appears in both wrists. But more commonly, rheumatoid arthritis pain occurs in combinations of several joints such as in the hands, knees, and feet.  If RA affects non-joint parts of the body you may get a fever, have a rash, and even experience involvement of the heart or lungs and eyes.

Gout, which is caused by a build-up of uric acid in the blood and collection of the crystals in joints, is another common type of arthritis.  A gout attack is typically a sudden, severe attack of pain, with redness and tenderness in joints, and often originates at the bottom joint of the big toe.  The sensitivity of the joint may be extreme.  Thankfully gout is treatable with medication.  But it may take several days to get past the pain from crystals already in the joint.  There are some things you can do to help prevent a gout attack.   You are more susceptible to gout if you have untreated high blood pressure, diabetes, high fat and cholesterol levels in your blood or arteriosclerosis.  Some medications can also be a factor such as some diuretics and aspirin.  There are indications of a genetic link so if someone in your family has had gout, you may be more likely to get it yourself.  This is especially true for males.   Once you experience a gout attack, try to drink a lot of fluid, water in particular.  It is also recommended that you avoid alcohol and try to get your protein from sources other than meat, such as fish, poultry, nuts, and eggs.  Depending on who you ask, coffee, vitamin C and cherries can help to lower your uric acid levels.

Your Diet and Arthritis

Cutting back on fried and processed foods can reduce inflammation and help to restore your body’s natural defense system.

Lower your advanced glycation end products (AGEs) intake by reducing the amount of foods cooked at high temperatures in your diet.  In doing so you could potentially help reduce blood AGE levels which can actually damage certain proteins in the body and lead to arthritis or other types of inflammation.

A diet high in sugars and refined carbohydrates can cause an increase in AGEs.  Avoid candies, processed foods, white flour baked goods, and sodas to reduce the pain associated with arthritis.

Dairy products contain a protein that can irritate the tissue around joints.  If you already have arthritis, this would cause additional discomfort and pain.  It is better to get your protein from spinach, beans, lentils and other leafy greens.

Smokers are more at risk for developing rheumatoid arthritis, while those who consume alcohol have a higher risk for developing gout.  Smoking and heavy drinking have other negative impacts on your health so avoiding them to help your arthritis will have other positive effects on your overall health.

Excess salt can lead to inflammation of the joints.  Read food labels for salt content.  Many processed, canned and frozen food have more salt than you realize.

Food high in omega- fatty acids can lead to inflammation.  Corn oil is one such source.  In contrast, omega-3 has been found to relieve arthritis pain.  You can find this type of fatty-acid fish oil, olive oil, nuts, flax seeds, and pumpkin seeds.

There are other foods that can help to reduce inflammation.  For instance, garlic is great for swollen joints as are chocolate and green tea.  Remember to always talk to your doctor before changing your diet, adding supplements or otherwise treating conditions that may require medication.

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Heart Disease

The likelihood of heart disease and heart failure increases as you age and become more vulnerable to injuries and/or lose heart functionality as part of the aging process.  Everyone’s heart experiences a decrease in elasticity and loses its ability to handle changes in pressure with age.   The onset of heart disease results in thickening (and stiffness) of the arterial wall.  The stiffening of the arteries leads to high blood pressure.  This thickening may be a sign of future cardiovascular disorders.

Ultimately, an increased load on the heart can cause an increase in the size of the heart.  For elderly patients in particular, the upper (systolic) pressure increases, the lower (diastolic) pressure decreases, and the difference between the two, increases. The difference between the two is a known risk factor for developing cardiovascular disorders.

In addition, blood flow through the heart can eventually lead to a build-up of calcium.  The innermost wall of an artery is particularly susceptible to a calcium build up due to smoking, diabetes, high blood pressure or high cholesterol levels.  When the build-up gets bad enough, the reduced blood flow due to blockage will lead to cardio vascular symptoms.  A stint (stays in the vessel to enlarge constricted area) or angioplasty (procedure to enlarge the constricted vessel) may address the immediate issue.  When calcium build-up occurs in the valves, it leads to stenosis (narrowing) and could mean a heart valve replacement will eventually be needed.

Pain or tightness in the left chest, especially when caused by physical or emotional stress, is very common in senior citizens.  Fatigue, shortness of breath, and swollen legs are the most common symptoms when the heart begins to fail.  These symptoms, along with a fast/slow/irregular heartbeat, pain or discomfort in the left chest, or dizziness may indicate a new or worsening heart condition and should be immediately reported to your doctor.

Vision Problem

There are two vision problems that are common in adults as they age, glaucoma and cataracts. The increased pressure of glaucoma can cause nerve damage and loss of vision.  There are several medications that come in the form of an eye drop that can often control glaucoma.  Cataracts are also treatable, but instead of medication, you will need to undergo a fairly simple procedure. Eyesight can also be affected by disease.  Diabetes can cause serious vision problems. My father lost some, but not all, of vision in both eyes due to his diabetes.  So regular eye examination are critical and should  not be skipped.  Let your eye doctor know if you have experienced any changes in your vision.  If you are a diabetic, make sure to consult with your regular physician if you experience any visual problems.  Great vision aids.

Hearing

As reported, about one-third of Americans between the ages of 65 and 74 have hearing problems.  This increases to fifty percent by the time seniors reach the age of 85.   Hearing loss is frustrating and can also be dangerous.  For instance, issues hearing the phone or your doctor can mean missing a call from a neighbor in need or critical health related orders. There are many designs and features of hearing aids, one of which should meet you needs. There is no reason to feel embarrassed or worry about the device having a negative impact on your appearance.  Some products are so small they are barely visible.  It is important to have regular hearing checks and seek hearing device assistance, if needed, from or as directed by your doctor.

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Sundowner’s Syndrome

Sadness, agitation, fear, as well as other mood and behavior changes just before dark are called Sundowner’s Syndrome, or sundowning.  Doctors and researchers aren’t sure what causes sundowning, but it may have something to do with the onset of darkness due to the timing of symptoms.  If you have Alzheimer’s or dementia, you might be more likely to have Sundowern’s Syndrome and become agitated at twilight.  To minimize the likelihood of this agitation and to address on beginning of this agitation, you should draw the curtains, prevent excessive noise, play soothing music, turn on lights and nightlights so that changes in lighting are less dramatic and the overall environment is more soothing and reassuring.   By planning more active days, that help lead to restful sleep, and planning activities during the critical hours of sundown can distract you and minimize symptoms.   If sleeping in a certain room or chair is more comforting, then a change in sleeping arrangements may be helpful.  As with any medical condition, you should work with your physician who may be able to prescribe medication that helps with relaxation and sleep.

UTI

In older adults, hygiene may be more difficult, either because of confusion or physical limitations, such as arthritis or suffering a stroke, both of which can make it difficult for a person to keep clean.    A lack of proper hygiene can easily lead to a urinary tract infection. The infections sometimes resolve on their own, but when treatment is needed, they are easily treated with antibiotics. When left untreated, UTIs can lead to chronic incontinence. UTIs can also spread to the kidneys and cause damage. If that happens, you will likely experience a fever and severe pain. More importantly, the infection could spread to the bloodstream and cause sepsis or even death in severe cases.  As noted above, there are studies that show UTI is the most common cause of a sudden increase in confusion in an older person with dementia.  So be sure to discuss with your doctor any upper tract concerns and any issues with dimentia.

Cancer

Advancing age is a major risk factor for cancer, with those over 65 making up over 60% of newly diagnosed malignancies and cancer deaths.  This age bracket is more than 10 times likely to get cancer than the general public.   The most common forms of cancers are prostate, bladder, colon, uterus, pancreas, stomach, rectum and lung.  Eating right, getting enough rest, exercising, and voiding know risky behaviors such as smoking tobacco, and keeping regular doctor appointments can reduce your chances of getting cancer or delaying the onset of cancer.

 

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