Which disease or ailment is often under diagnosed and under treated in the aging population?

Americans are continuing to live longer and healthier lives. As we age, we become more likely to develop different kinds of health problems. These are called geriatric syndromes, which are problems that usually have more than one cause and involve many parts of the body. Doctors called geriatricians—who have advanced training in the care of older adults—and other geriatrics healthcare professionals can play an important role in diagnosing and managing these syndromes.

There are many treatments available for these conditions that can help you maintain your independence and quality of life. 

Geriatric Syndromes: What Should You Do?

Bladder Control Problems

Lack of bladder control, or “urinary incontinence,” is an embarrassing topic. Please know that you are not alone! Urinary incontinence can lead to problems such as falls, depression, and isolation. In most cases, incontinence can be cured or greatly improved with treatment. So don’t hesitate to tell your healthcare provider if you have bladder control problems.

Sleep Problems

Sleep problems can affect your quality of life and can contribute to falls, injuries, and other health problems. If you have trouble sleeping at night or feel sleepy during the day, tell your healthcare provider so they can identify the type of sleep problem you have.

Delirium

Many older adults who go to the emergency room or are admitted to the hospital develop delirium. Delirium is a state of sudden confusion.Delirium is a medical emergency, similar to chest pain. Make sure that you and your friends and family know the signs of delirium and seek medical attention right away at the first sign of any sudden changes in mental function.

Dementia

Dementia, most simply, is a memory problem significant enough to affect your ability to carry out your usual tasks. While the most common cause is Alzheimer’s Disease, there are many other types. Various tests can help determine whether you or someone you care for might have dementia and what type it might be. If so, there are treatments that can improve function and slow down the disease.

Falls

Falls are a leading cause of serious injury in older people. There are many risk factors for falling, including safety hazards in the home, medication side effects, walking and vision problems, dizziness, arthritis, weakness, and malnutrition. Like other geriatric syndromes, falls usually have more than one cause.

Tell your healthcare provider immediately if you have fallen. They will look into what caused your fall and suggest steps to prevent future falls. There are many treatments, such as exercise and physical therapy, that can help improve your gait and walking and prevent falls.

Osteoporosis

Osteoporosis, or “thinning bones,” is a condition that makes the bones of older adults more fragile and easy to break. Women 65 and older, and men over age 70, should get a bone mass density (BMD) test. Increased calcium and vitamin D intake, strength training exercises, and weight-bearing exercises such as walking are important to keeping your bones healthy. Your healthcare provider may also recommend medications or other treatments.

Weight Loss

Weight loss is a very common problem in older adults. Weight loss can be caused by the diminished sense of taste that comes with aging, or it can be a suggestion of an underlying serious medical problem. No matter the cause, weight loss can lead to other problems, such as weakness, falls, and bone disorders.

Your healthcare provider should weigh you each time you visit and check for any changes. Also, be sure to let your healthcare provider know if you have any changes in your weight or appetite.

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The elderly population in the United States is rapidly growing. In fact, the number of people over age 85 is set to triple by the year 2050. And because older adults are more likely to develop one chronic condition or another, it is important that families and the overall health care system are prepared to handle this growing need for healthy aging.

Many age related changes are common, such as a minor decline in vision and hearing, high blood pressure, muscle weakness, or a weakened immune system. But some health problems are not considered a part of the normal aging process for older adults. Chronic conditions affecting kidney function, leading to cognitive impairment, or otherwise undermining the quality of life of an elderly person need to be treated with geriatric medicine.

Geriatric medicine specializes in treating the conditions commonly experienced by older adults. There are numerous variables that make treating older adults different from their younger counterparts, including polypharmacy, vague presentation of symptoms, and challenges with attribution in cases where multiple health conditions are present at once.

Older adults are also more prone to developing age related diseases that younger people do not typically develop. High blood pressure might be an intergenerational problem, but issues like cardiovascular disease, ischemic heart disease, urinary incontinence, vascular dementia, multiple sclerosis, and other diseases are far more common among older adults.

Examples of Chronic Disease

While this is by no means a comprehensive list of ailments experienced by older adults, these and other chronic diseases are among the more common:

• Arthritis
• Cancer
• Chronic Kidney Disease
• Chronic Obstructive Pulmonary Disease
• Dementia, Alzheimer’s, and Parkinson’s
• Diabetes
• Osteoporosis
• Stroke

Arthritis

This chronic disease is one of the most common age related conditions older adults experience. Arthritis causes joint pain and chronic inflammation. The two types are osteoarthritis and rheumatoid arthritis. Osteoarthritis, the more common of the two, is a result of normal wear and tear. Rheumatoid arthritis is an autoimmune disease in which the immune system attacks the lining of the joints.

There is no cure for arthritis, but it can be managed with painkillers and corticosteroids. Symptoms include:

• Pain, stiffness, and tenderness of the joints
• Inflammation around joints
• Limited or restricted movement

Cancer

With over 200 different forms of cancer — prostate cancer, breast cancer, and lung cancer just to name a few — this is one of the most common issues that older people face. Cancer occurs through the rapid and abnormal replication of cells in the body, forming tumors than can spread via the bloodstream.

While cures have been discovered for many types of cancer, cancer treatment can be extremely invasive and takes a major toll on the body. However, the earlier it is detected, the better the chance of beating it. It is a good idea to consider conducting a periodic cancer screening. Here are the common symptoms:

• Discovery of an unexpected lump or mass
• Inexplicable weight loss
• Blood in a person’s stool, urine, vomit, or when coughing

Chronic Kidney Disease

Kidney infections, kidney inflammation, high blood pressure, and diabetes can all lead to chronic kidney disease. This condition affects the kidneys and can lead to kidney failure, and there is presently no cure. Another unfortunate reality is that early symptoms do not commonly appear — instead, the condition is usually identified through urine tests ordered for other medical conditions.

Older adults must therefore be diligent in reporting the following later-stage symptoms to their doctor as soon as they discover them:

• Bloody urine
• Shortness of breath
• Swollen ankles, hands, or feet
• Tiredness or a feeling of sickness

Chronic Obstructive Pulmonary Disease

The best known condition under this category of illness is chronic bronchitis. Bronchitis is caused by an infection affecting the lungs and airways, contributing to a buildup of excessive mucus. The body tries to displace this buildup through coughing.

Smoking is one of the biggest contributing factors to the development of chronic bronchitis, which means that quitting is the best way to overcome it. A healthy diet is also important — as are rest, hydration, and the treatment of headaches.

Symptoms of bronchitis include:

• Chest pain
• Fatigue
• Hacking, productive cough
• Headaches
• Runny nose or congestion
• Sore throat

Dementia, Alzheimer’s Disease, and Parkinson’s Disease

Dementia is an umbrella term used to describe a syndrome — or a collection of chronic conditions — in older adults that lead to problems with memory and cognition. This occurs when there is damage to brain cells or a loss of connection between cells that causes them to die. Symptoms of dementia include:

• Memory loss
• Difficulty with verbal expression
• Struggles with visual or spatial abilities
• Trouble with problem-solving or reasoning
• Difficulty managing complex tasks, critical thinking skills, planning, and organization
• Decline in coordination with motor functions
• Confusion and disorientation
• Personality changes
• Inappropriate behavior
• Depression, anxiety, paranoia, and agitation
• Hallucinations

Alzheimer’s disease is a specific type of dementia, accounting for up to 70% of cases. Caused by disruptive buildups of proteins in the brain, the symptoms of Alzheimer’s include:

• Trouble remembering details about people, places, or events
• Difficulty concentrating
• Changes to one’s personality like disinterest, suspicion, or aggression
• Apathy and depression
• Mood changes
• Confusion
• Impaired judgement or decision-making abilities
• Difficulty with speaking, swallowing, or walking

Parkinson’s disease is another type of dementia. This progressive disease is caused by a loss of nerve cells in the brain, which reduces the amount of dopamine necessary for normal cognitive functioning. While there is no cure, the symptoms can be treated. Here is what to look out for:

• Involuntary shaking of particular parts of the body
• Muscles that are stiff and inflexible
• Slow movement

Diabetes

Diabetes can develop during middle age — and sometimes even younger. But it most commonly develops among older adults, and it has to be managed as a lifelong condition. This disease occurs when the body is not able to produce enough insulin to ensure normal functioning.

The most common type of diabetes is Type II diabetes. This is when the pancreas is no longer capable of producing the appropriate amount of insulin. A person’s chance of developing diabetes can be reduced through lifestyle changes, including:

• A healthy diet
• A healthy weight
• Regular exercise

Type I diabetes accounts for about 10% of overall cases. It is an autoimmune disease, in which the body attacks the cells that produce insulin.

Osteoporosis

Osteoporosis is one of the most common conditions among older adults. This condition presents as a reduction in bone density, and it often goes undetected until a fall causes a break or fracture. Like losing muscle mass, losing bone strength is part of the normal aging process, but people with osteoporosis experience this decline more quickly than most people.

Osteoporosis can be treated with medication and supplements like calcium and vitamin D. Weight-bearing exercises and exercises designed to increase muscle strength can also help older adults manage the condition.

Stroke

A stroke occurs when the brain’s vital blood flow is cut off. This causes brain cells to die, it can lead to permanent disability, and it can be life threatening. Strokes are very common among older adults, so it is important to know the signs and symptoms so you can seek medical attention as soon as possible. A helpful acronym (FAST) makes it easier to remember.

• Face: Is the face drooping on one side?
• Arms: Is the person unable to lift both arms
• Speech: Is their speech slurred?
• Time: If so, do not waste time — seek medical attention immediately.

How to Manage Chronic Illness

Chronic diseases are persistent — sometimes even permanent — and so they require regular attention. Older adults should consider having a chronic care management team in place to help them achieve their health goals and maintain their quality of life. This is especially true of elderly patients who are managing multiple chronic conditions at a time.

As more older adults experience more age related changes, geriatric medicine will become an increasingly important part of their medical regimen. Older patients who are managing a chronic condition can benefit from the support of a home health care team. In addition to healthy eating and a healthy lifestyle, regular contact with reliable health professionals can help prevent poor health.

Keystone Health offers support for older patients in Idaho by providing house calls and other forms of care. Learn more about how we can help you maintain your quality of life throughout the aging process.

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