What role does diet play in senior health?

A good and healthy diet has numerous potential benefits in the health of seniors.

Heart disease, vascular disease, diabetes, high blood pressure, high cholesterol, strokes, memory problems, osteoporosis, certain cancers, skin, hair and nail diseases, and visual problems are examples of conditions which can be impacted by diet.

Proteins, carbohydrates, fats, vitamins, minerals, and water are all essential nutrients that make up most cells and tissues in human body. Thus, these essential components need to be provided in moderation through the diet for maintenance of good health.

A balanced diet consisting of fruits and vegetables, whole grains, and fiber is generally recommended to provide these necessary nutrients. Avoidance of saturated fats (animal fat), supplementation with minerals and vitamins, and consumption of plenty of fluids are considered an important component of a healthy diet.

Although the quality of food is important, its quantity should not be overlooked. A large portion of a very healthy diet can still lead to a high caloric intake. Moderate portion sizes to achieve daily caloric goals of 1500 to 2000 are generally advised. Avoiding empty calories are also important. These are foods which lack good nutritional value but are high in calories. Examples include sodas, chips, cookies, donuts, and alcohol.

Special dietary restrictions for certain conditions are also important to follow. Restricted salt and fluid intake for people with heart failure or kidney disease, or carbohydrate controlled diet for people with diabetes are general examples of such guidelines.

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What are some concerns regarding hospitalization of the elderly?

With increasing medical issues in seniors, their medical care becomes more complex and difficult to manage. Subsequently, seniors become ill more severely and frequently compared to younger people. As hospital visits and admissions become more frequent, the overall health status can decline as a result. Although hospitalization is often necessary for seniors, it is not always free of risk.

Episodes of waxing and waning confusion (delirium) is a common feature in hospitalized elderly. Even though delirium is typically reversible, it can sometimes linger for a long time and possibly reset one's mental function at a lower baseline. Delirium can be caused from several reasons:

·         Effects of the medical illness itself
·         Being in an unfamiliar environment
·         Interacting with unfamiliar people
·         Noisy and brightly lit hallways and hospital rooms during the night
·         Frequent awakening at night time for blood draws and vital signs
·         Medications for pain and sedation which can alter thoughts and mental judgment
·         Intravenous lines, urinary catheters, and other medical devices attached to the body

Other potential dangers of hospitalization of seniors are as follows:

·         Hospital related infections
·         Medication and procedure side effects and complications
·         Interaction between home medications and new hospital drugs
·         General decline in function and deconditioning
·         Falls and injuries

Although there are many problems that seniors may encounter, both in and out of the hospital, understanding the problems and then forming a plan to address them is a first large step in making the senior years still productive and enjoyable. Seniors should consider finding a geriatrician who is as special training in the care of seniors to help manage their special medical problems and concerns.

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What are the most common diseases and conditions seniors face as they age?

Medical problems in the elderly can involve any organ system in the body. Most conditions result from decreased function or degeneration of the involved organ.

Most commonly encountered medical conditions in seniors based on organ system are listed below:

Musculoskeletal: osteoarthritis (inflammation of joints due to wear and tear), osteoporosis (bone loss), gout, loss of muscle mass, fractures.

Hormonal: Diabetes (impaired control of blood glucose), menopause, thyroid dysfunction, high blood cholesterol, slower overall metabolism.

Neurologic: dementia (Alzheimer or other types), Parkinson's disease, strokes, poor vision, hearing impairment, balance problem.

Visual: macular degeneration, glaucoma, cataracts, diabetes and hypertension related eye disease.

Cardiovascular disease: heart attacks, congestive heart failure, irregular heart rhythm (atrial fibrillation), high blood pressure (hypertension), atherosclerosis (hardening and narrowing of blood vessels) and peripheral vascular disease or peripheral artery disease (poor blood flow as a result of narrow blood vessels).

Lungs: chronic obstructive pulmonary disease (COPD), loss of lung volume.

Kidneys: poor kidney function (kidney or renal disease) from long standing diabetes and hypertension.

Skin and Hair: hair loss, dry skin, itching, infections.

Cancers: prostate, colon, lung, breast, skin, bladder, ovary, brain, pancreas, only to name a few.

Bone marrow and immune system: inability to produce sufficient blood cells (anemia, myelodysplasia).

Gastrointestinal: stomach ulcers, diverticulosis (small pockets forming in the wall of colon), colon inflammation or colitis from infection or ischemic (poor blood flow) , swallowing difficulty (dysphagia) , constipation, bowel incontinence, hemorrhoids.

Urinary: urinary incontinence, urinary urgency, difficulty urinating.

Oral and dental: gum disease, dry mouth, loss of teeth, poorly fitting dentures.

Infections: urinary tract infection, pneumonia, skin infection, shingles, colon infection (diverticulitis, colitis).

Psychiatric: depression, anxiety, sleep disturbance, insomnia.

General problems: fatigue, general deconditioning, forgetfulness, medication side effects, diminished appetite, weight loss, falls.

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What changes occur in the body as we age?

A wide range of changes can happen in the body to different degrees as we age. These changes are not necessarily indicative of an underlying disease but they can be distressing to the individual. Even though the aging process cannot be stopped, being aware of these changes and adopting a healthy lifestyle can reduce their impact on overall health.

Expected bodily changes of aging include change in:

Skin: With aging, skin becomes less flexible, thinner, and more fragile. Easy bruising is noticeable, and wrinkles, age spots, and skin tags may become more apparent. Skin can also become more dry and itchy as a result of less natural skin oil production.

Bones, joints, and muscles: Bones typically lose density and shrink in size making them more susceptible to fractures (breaks). Muscles shrink in mass and become weaker. Joints can suffer from normal wear and tear; joints become inflamed, painful, and less flexible.

Mobility and balance: A person's mobility and balance can be affected by various age related changes. Bone, joint, and muscle problems listed above in conjunction with changes in nervous system are the major contributors to balance problems. Falls may occur resulting in further damage with bruises and fractures.

Body shape: As a result of bony changes of aging, body stature can become shorter and curvature of the back vertebrae may be altered. Increased muscle loss and reduced fat metabolism can also occur. Fat can redistribute to the abdominal area and buttock areas. Maintaining an ideal body weight becomes more difficult.

Face: Aging changes also take place in the face. Other than wrinkles and age spots, the overall facial contour can change. Overall loss of volume from facial bone and fat can result in less tightness of the facial skin and sagging. The face becomes droopier and bottom heavy.

Teeth and gums: Teeth can become more weak, brittle, and dry. Salivary glands produce less saliva. Gums can also recede (pull back) from the teeth. These changes may result in dry mouth, tooth decay, infections, bad breath, tooth loss, and gum disease.

Hair and nail: Hair can become thinner and weaker as a person ages. Dry hair may lead to itching and discomfort. Nails may become brittle and unshapely. Nails can also get dry and form vertical ridges. Toe nail thickening (ram's horn shape) is common. Nail fungal infections may occur frequently.

Hormones and endocrine glands: Hormonal changes are seen commonly in the elderly. Most common is the hormonal control of blood sugar and carbohydrate metabolism leading to diabetes. Thyroid dysfunction and problems with fat and cholesterol metabolism are also commonly encountered. Calcium and vitamin D metabolism may also become altered. Sexual hormones reach a low level and can lead toerectile dysfunction and vaginal dryness.

Memory: Problems with memory are common in seniors. However, it is important to realize that minor memory problems do not constitute dementia or Alzheimer's disease. Simple lapses of memory such as not remembering where you left a key or whether you locked the door are a normal part of aging.

Immunity: The body's immune system can get weaker with age. Blood cells that fight infections (white blood cells) become less effective leading to more frequent infections.

Hearing: changes in nerves of hearing and ear structures can dim hearing and cause age-related hearing loss. Higher frequencies become harder to hear.

Vision: Eyes can become drier and the lens can lose its accuracy as we age. Vision can be affected by these changes and can become blurry and out of focus. Glasses or contact lenses can help correct these problems.

Taste and smell: Sense of smell and, less commonly, sense of taste may fade leading to poor appetite and weight loss.

Bowel and bladder: Bowel and bladder control can cause problems with incontinence (involuntary loss of feces or urine). Additionally, bowel and bladder habit can change. Constipation is common in older adults, as are urinary frequency and difficulty initiating urine.

Sleep: Sleep patterns can significantly change with age. Duration of sleep, quality of sleep, and frequent night time awakening are commonly seen in seniors.

These changes are different in every individual. Some people may experience more changes in a particular area compared to others

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