Below are just six of the most common health concerns facing the elderly. Information provided is not to be substituted for professional medical advice. Please consult a doctor on the health and wellbeing of your loved one.
What is dementia?
Dementia describes a set of symptoms that may include memory loss, difficulty in processing thoughts, problem-solving, speech and behaviour swings.
What causes dementia?
Alzheimer’s is the number one cause of dementia. Other conditions that can cause dementia include stroke. The brain is damaged by these diseases and unable to function as normal. To what degree a person suffers from dementia is dependent on the part of the brain that is damaged and the type of disease causing the dementia.
Every person is unique and there is no one-size-fits-all symptomatic diagnosis. Dementia symptoms focus on thinking or memory related activities:
- Recent day-to-day memory
- Depth perception – judging distances
- Speaking difficulties – sentence structure
- Disorientation – location, time and date
- Decision making, problem solving, and planning an activity in order
NOTE: Many people have memory loss issues — this does not mean they have Alzheimer’s or dementia. Please consult your doctor for more information.
There is no one single test to determine dementia. Doctors need to review the patient, their medical history, conduct a physical examination and undertake a number of tests.
Most types of dementia cannot be cured and will gradually cause more severe problems. However, dementia caused by vitamin and thyroid hormone deficiencies can be treated with supplements.
Meanwhile, brain tumours, excess fluid on the brain, or head injury can be treated with surgical procedures.
For types of dementia that involve degeneration of nerve and brain tissue, preventative action such as managing high blood pressure, high cholesterol, type 1 diabetes and stopping smoking can further reduce the risk. This should be discussed with a doctor to establish whether it will be beneficial.
With dementia often leading to depression, it is important that treatment is accompanied by care and support from a doctor, family, and friends.
It is prudent to discuss power of attorney (link to our article on it) with family members to ensure your loved one gets the best care available.
The elderly are vulnerable to malnutrition. This section will focus on the undernutrition aspect of malnutrition, given that it is the most common type of malnutrition found among the elderly.
What causes malnutrition?
Malnutrition occurs when an individual does not consume enough food or has a poor diet resulting in an nutrient imbalance of basic food groups.
Malnutrition is often a combination of physical, social and psychological issues.
Health plays a leading role. Dementia, chronic illness, and dental issues are contributing factors. Depression can result in a loss of appetite, while a lack of social interaction and isolation can lead to a decline of interest in food.
For lower income groups, a limited monthly income may contribute to the elderly not being able to afford to buy the ingredients needed to prepare a healthy and nutritious meal each day.
With age it becomes harder to clearly identify malnutrition. Look out for the following:
- Eating habits. Spend time with your loved one while they are eating; whether that be at home, in a nursing home, or hospital. Watch for them shifting their food around the plate but not eating it.
- Weight loss is not always easy to gauge given the elderly are not always keen to jump on the scales, so a key indicator is essential. Take note how well their clothes are fitting. Be conscious of the fit. This will provide a good guideline.
- The elderly tend to be prone to bruising. Should a cut or scrape take a while to heal after treatment, seek advice from a doctor.
- Know whether your loved one’s medication will affect their appetite and eating habits.
A full nutrition assessment will provide a comprehensive overview. Doctors or healthcare professionals may look to a body mass index test (reviewing weight and height) which predicts disease risk. However, given many elderly people suffer from vertebral compression, loss of muscle tone, and postural changes, this may prove not as effective.
Routine blood tests may identify dehydration, low blood sugar, and signs of infection.
Treatment for undernutrition depends on the underlying cause and the level of malnourishment.
Seeking advice from a dietitian is a great starting point. They can support by developing a tailored dietary plan to support your loved one and ensure they receive the right nutrients, the ideal food portion, and that any diabetic considerations are taken into account.
Managing the elderly’s daily activities is an important part of tackling malnourishment. Here are just some areas/ideas where you can look into to help improve the day-to-day living conditions of your loved one:
- Family, friends, helper, or home care visitors who can help shop for food or cook a nutritious meal. Preparing soups and meals to freeze for later use in the week is perfectly acceptable and is easy to prepare.
- Consulting an occupational therapist will help to provide simple solutions to making daily activities easier. The input can remove obstacles and simplify daily activities.
- Consult a speech therapist if you suspect dysphagia, which is a difficulty with swallowing. A speech therapist would be able educate and work on simple strengthening exercises, enabling them to swallow with confidence. They would also be able to suggest changes to their diet to compensate for their difficulty in swallowing.
High Blood Pressure a.k.a Hypertension
Hypertension is a common condition among older people. Blood pressure typically increases with age, yet someone with high blood pressure is at a greater risk of serious health problems including heart failure, stroke, kidney disease, and damage to the arteries.
What causes high blood pressure?
There is no definitive cause for high blood pressure, but there are contributing factors. Those at highest risk of high blood pressure are those who suffer from obesity, diabetes, and kidney disease.
Just as there is no definitive cause of high blood pressure, there are no reliable or conclusive symptoms.
There are several key steps to take to manage high blood pressure:
- stop smoking.
- lower the amount of salt in your diet. Better yet, replace salt with a healthy alternative by incorporating a variety of herbs and spices into your recipes.
- regular exercise is important. The World Health Organisation (WHO) recommends at least 150 minutes per week of moderate intensity physical activity for people aged 65 years or older.
- manage weight loss – blood pressure rises as your body weight increases. Losing just half a kilogram can lower your blood pressure. Weight loss has proven to have the biggest effect on those who are overweight and have hypertension.
- a doctor will advise you if it is recommended to take medication to lower your blood pressure to a safe level.
The risk of Type 2 diabetes increases with age. In fact, diabetes is one of the main diseases (apart from high blood pressure) affecting the elderly community.
What causes diabetes?
High blood pressure, high LDL cholesterol and triglycerides, decreased mental activity, feelings of depression, and decline in ability to perform activities of daily living are all contributing factors for the elderly with diabetes. In a study of seniors with diabetes, one-third of patients aged over 70 years of age showed signs of dementia correlating with high blood sugars.
Low blood sugar levels can cause a decrease in mobility, increase the risk of falls, and lead to a decline in the quality of life for the elderly.
Diagnosing diabetes can be challenging among the elderly. Symptoms may include confusion, urinary incontinence, dry mouth, or other vague signs.
Watch for signs of hypoglycemia, i.e. low blood sugar. Signs include shakiness, sweatiness, dizziness, weakness, a feeling of intense hunger, and blurred vision. Hypoglycemia can prove to be fatal when blood sugar plummets rapidly causing a person to collapse, lose consciousness, and may even lead to a loss of life.
Hypoglycemia is often caused by:
- being prescribed five or more medications
- having chronic kidney problems
- having poor food intake
- having other illnesses or conditions.
A change in lifestyle habits and patterns is crucial to manage Type 2 diabetes. However, it is important to note that the elderly may struggle to adjust to new routines and habits. Therefore, treatment should be tailored accordingly – focus on diet and exercise. If blood sugar levels still maintain high, oral medications can be used to help the body use its own insulin more efficiently. In some cases, insulin injections are necessary.
Mobility refers to a person’s difficulty in performing basic movements which support their day by day functions. Basic mobility issues may include walking, getting out of bed, and bending down.
Causes of Immobility
Immobility is caused by one or a contributing number of problems. The number one mobility problem that older people experience is falls. Falls result in broken bones, bruises, and a fear of falling. Older bones break more easily and tend to heal slower and imperfectly. If a hip is fractured, canes, walkers, or wheelchairs might be needed on a permanent basis. Falls are a major cause of injury and death, so prevention is important.
Muscle weakness, joint problems, and pain are potential signs of current or pending mobility issues. Immobilisation can be the trigger of other health problems. If the elderly is unable to reach the toilet, they may inadvertently develop incontinence and subsequently urinary and skin infections. It’s important to spot the signs and seek treatment early.
Significant loss of mobility is not part of normal aging. With regular exercise, strength and flexibility can be preserved well into old age. If you have noticed a reduction in a relative’s mobility, visit the doctor to determine the cause. The doctor is likely to recommend physiotherapy in order to increase mobility and confidence.
Dysphagia (difficulty swallowing)
Dysphagia is the medical term for swallowing difficulties.
Some people with dysphagia have problems swallowing certain foods or liquids, while others can’t swallow.
Dysphagia is one of the leading causes of malnutrition in the elderly.
Conditions that cause an obstruction in the throat or a narrowing of the oesophagus (the tube that carries food from your mouth to the stomach) can make swallowing difficult.
Damage to the nervous system can interfere with the nerves responsible for controlling swallowing.
This can lead to dysphagia. Causes include stroke, Parkinson’s disease, multiple sclerosis, dementia, and motor neuron disease among other neurological conditions.
As you get older, the muscles used for swallowing can become weak resulting in difficulty swallowing. This is relatively common in elderly people. Any condition that affects the muscles used to push food down the oesophagus and into the stomach can cause dysphagia, although such conditions are rare.
Two muscular conditions associated with dysphagia are:
- Scleroderma – where the immune system (the body’s natural defence system) attacks healthy tissue, leading to a stiffening of the throat and oesophagus muscles.
- Achalasia – where muscles in the oesophagus lose their ability to relax and open to allow food or liquid to enter the stomach.
Watch for the following signs that signal a problem with swallowing:
- pain while swallowing
- refusal to eat
- being sick while or after eating
- frequent heartburn
The type of treatment depends on whether the swallowing problem occurs in the mouth and throat, or from the oesophagus. High (oropharyngeal) dysphagia is swallowing difficulties caused by problems with the mouth or throat, while Low dysphagia is swallowing difficulties caused by problems with the oesophagus.
Consult your doctor on how to treat both.