Some disorders occur almost exclusively in older adults. (See also Overview of Aging.) They are sometimes called geriatrics syndromes (geriatrics refers to the medical care of older adults).
Other disorders affect people of all ages but may cause different symptoms or complications in older adults. The following are some examples:
Underactive thyroid gland (hypothyroidism): Usually, younger people gain weight and feel sluggish. In older adults, the first or main symptom may be confusion.
Overactive thyroid gland (hyperthyroidism): Usually, younger people become agitated and lose weight. In contrast, older adults may become sleepy, withdrawn, depressed, and confused.
Depression: Usually, younger people become tearful, withdrawn, and noticeably unhappy. Sometimes older adults do not seem unhappy. Instead, they become confused, forgetful, and listless, lose interest in their usual activities, or seem lonely.
Heart attack: Usually, younger people have chest pain. Older adults may not have chest pain but may have difficulty breathing or abdominal pain. They may sweat profusely, suddenly feel tired, pass out, or become confused.
Abdominal perforation: An organ in the digestive tract, such as the stomach or intestine, occasionally tears (perforates), causing widespread serious infection in the abdominal cavity. Usually, younger people have severe abdominal pain and fever, and the abdomen feels tight. In contrast, older adults may have none of these symptoms. Instead, they may become confused or feel very weak.
The confusion that these disorders cause in older adults is often mistaken for dementia.
Older adults often have more than one disorder at a time. Each disorder may affect the other. For example, depression may make dementia worse, and an infection may make diabetes worse.
However, disorders no longer have the same devastating or incapacitating effects that they once had in older adults. Disorders that were once likely to result in death for older adults, such as heart attacks, hip fractures, and pneumonia, can often be treated and controlled. With treatment, many people with chronic disorders, such as diabetes, kidney disorders, and coronary artery disease, can remain functional, active, and independent.
Some Disorders That Affect Mainly Older Adults
Disorder | Description |
|---|---|
Memory and other mental functions are progressively lost. | |
The wall of the aorta bulges. If untreated, an aneurysm can rupture and lead to death. | |
Atrophic urethritis and vaginitis (now called genitourinary syndromes of menopause) | Tissues in the urethra thin, sometimes causing burning during urination. Tissues in the vagina thin, sometimes causing pain during intercourse. |
The prostate gland enlarges, blocking the flow of urine out of the bladder. | |
The lens of the eye clouds, impairing vision. | |
The body does not respond to the insulin | |
The optic nerve is damaged because pressure in part of the eye is elevated. Vision is progressively reduced, and blindness can result. Glaucoma usually begins during middle age. | |
The cartilage that lines the joints degenerates, causing pain. Osteoarthritis usually begins during middle age. | |
Bones become less dense and more fragile. As a result, fractures are more likely. | |
Nerve cells in the brain degenerate slowly and progressively, causing tremor, stiff (rigid) muscles, and difficulty moving and maintaining balance. | |
The skin breaks down because prolonged pressure reduces blood flow to the affected area. | |
Cancer develops in the prostate gland and eventually interferes with the flow of urine. | |
The chickenpox virus from an earlier infection is reactivated, causing blisters and sometimes long-lasting, excruciating pain. | |
A blood vessel in the brain is blocked or ruptures. A stroke causes symptoms such as weakness or loss of sensation on one side of the body, problems with vision in one eye, difficulty speaking or understanding, loss of balance or coordination, or sudden severe headache. | |
The flow of urine cannot be controlled, resulting in leakage. |
Looking for the Fountain of Youth
Everyone wants to know how to stay young and live longer. Researchers are looking at genes, cells, hormones, eating patterns, and other factors for clues about what causes aging and how to prevent or slow it. Research has identified three strategies that may help people live longer:
People who exercise are healthier than those who do not. Exercise has many established health benefits: improving and maintaining the ability to do daily activities, maintaining a healthy weight, and helping prevent or postpone disorders such as coronary artery disease, cancer, diabetes, cognitive decline, and early death. Endurance exercises (eg, walking, cycling, dancing, swimming, low-impact aerobics) have many well-documented health benefits for older adults. Muscle strengthening exercises also have well-documented benefits. Exercise programs that are more strenuous than walking may include any combination of 4 types of exercise.
Depending on the person’s medical condition and fitness level, people should be able to select activities they enjoy but should be encouraged to include all 4 types of exercise. People who eat a low-fat diet that includes lots of fruits and vegetables are healthier than people who eat more fat and starch. Also, people who live in Mediterranean countries and consume a so-called Mediterranean diet seem to live longer. This diet is generally thought to be healthier than northern European and American diets because it consists of more whole grains, fruits, vegetables, legumes, nuts, and fish and less red meat. In addition, the main fat consumed is olive oil. Olive oil contains many vitamins and is monounsaturated rather than saturated. Monounsaturated fats do not increase cholesterol the way saturated fats do. Evidence suggests that a Mediterranean diet reduces heart attacks, strokes, cardiovascular death, and development of diabetes. Accordingly, most experts recommend adhering to this diet. (However, consuming too few calories, protein, or nutrients has heath risks that can affect quality of life or have worse effects (such as loss of muscle tissue—a condition called sarcopenia. People should consume enough nutrients but not too much.) Following a low-calorie diet for a lifetime may lead to longer life, possibly because it slows the body’s metabolism, reduces the number of certain damaging substances in the body, or both. These damaging substances, called free radicals, are by-products of the normal activity of cells. The damage done to cells by free radicals is thought to contribute to aging and to disorders such as coronary artery disease and cancer. But no studies to test whether a low-calorie diet could prolong life have been done in people. Levels of some hormones decrease as people age. Thus, people may try to delay or slow aging by taking supplements of these hormones. Examples are testosterone, estrogen, DHEA (dehydroepiandrosterone), human growth hormone, and melatonin. But there is no evidence that hormonal supplements have any effect on aging, and some of them have known risks. Also, some experts believe that decreases in certain hormone levels may actually prolong life by slowing the body’s metabolism. Some people believe that Eastern practices, such as yoga, tai chi, and qigong, can prolong life. These practices are based on the principle that health involves the whole person (physical, emotional, mental, and spiritual) and balance within the body. The practices may include relaxation, breathing techniques, diet, and meditation as well as exercise. They are safe for older adults and probably make them feel better. But whether these practices prolong life is difficult to prove. |
