Leslie Kernisan, MD MPH
Healthy aging is not just about preventing problems. It’s also about spotting them and addressing them before they get worse, or drag down the rest of your health and independence.
Here’s what to look for:
Falls are very common in older adults. They can cause life-changing injuries such as broken hips and head injuries, and are a major reason for people having to leave their homes.
Most falls in older adults are due to a combination of underlying risk factors or health problems. Insufficient strength or balance is usually one of the problems — which can be addressed with the right exercises — but it’s good to check for other factors, such as medication side-effects or even a new illness.
2. Memory Concerns
Memory concerns often cause anxiety for older adults and families. They may — or may not — reflect substantial decreases in thinking abilities. Evaluation helps by providing a more objective measure of whether a person is cognitively impaired, and to what extent. Even more importantly, evaluation can uncover treatable causes of decreased brain function, such as medication side-effects, thyroid problems, and a variety of other problems which are common in older adults.
One important sign of depression in seniors is “anhedonia,” which means one stops enjoying activities that used to bring pleasure. If you notice this in an older person — or yourself — it’s important to get help. Studies show that medication and psychotherapy are generally equally effective in mild-moderate depression, but non-drug treatment often isn’t offered unless you ask.
4. Urinary Incontinence
Incontinence comes in different “types,” each of which can have different causes. Correctly identifying the type and causes is key to effective treatment. Finding suitable pads to manage leaks can also make a big difference. Do remember that medications to treat bladder spasms are usually quite anticholinergic, hence risky for brain function.
Pain can and should be managed by non-drug approaches whenever possible. Studies have found that pain can often be lessened through certain types of psychotherapy, exercises or physical therapy, and many other approaches. Treatment with medication may still be necessary, especially for short-term purposes or in combination with other approaches. Bear in mind that many over-the-counter pain medications (such as Advil and Motrin) are non-steroidal anti-inflammatory drugs (NSAIDs), which are risky for older adults when used chronically or in high doses.
6. Isolation and loneliness
Both isolation (not having a lot of social contact with others) and loneliness (the feeling of lacking social connection) have been linked to declines in physical health. Studies have found that certain psychotherapies can help reduce feelings of loneliness and even inflammation in the body. However another study found that isolation seems to be a stronger risk factor for premature death than loneliness, so it’s important to relieve social isolation as well. Arranging more social contact usually helps. It’s also vital to address any health concerns that may be keeping a senior from getting out and about.
7. Polypharmacy (Taking Multiple Medications)
Polypharmacy is a problem mainly because as people get older, they become especially at risk for harm from medication side-effects or interactions. According to the CDC, every year 177,000 older adults visit the emergency room due to medication problems.
The main thing you should know is that many older adults are taking medications they don’t really need. A careful medication review will often identify medications that are marginally useful or no longer necessary, but you may not get such a review unless you request it.
With good effort, improvements can be made for an older person’s ability to be out in the world, doing the things they want to be doing, and doing things that are good for their health. And that promotes healthy aging. So don’t let these problems fester and sabotage late-life health.
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