Managing health issues of older population
General Nutrition • • 1 minute to read • By Dr Shunmukha Priya, INFS Faculty
Author: Dr. Shunmukha Priya. S
Once kids are grown up and leave home for jobs/ studies/ after marriage, the elderly will be happy on one side and will be sad on the other side. Happiness must be due to their achievements and sadness must be the things that they are depriving. Rapid urbanization is among the leading causes of elderly people being left behind to home themselves when the children migrate to different places in the city in search of jobs/ education. An earlier study reported a higher risk of undernutrition among the elders who are living alone at home. Apart from these are other factors that lead to other health issues among the elderly in spite of living with family.
Most of the health issues must be due to ageing. As all of us know ageing is a natural process, hence there can’t be many changes possible.
Problems Associated with elderly
- Dental problems
One of the leading health issues seen among the elderly in India. This should be due to lack of dental hygiene, nutritional deficiencies, betel chewing as well as lack of dental care facilities. These dental issues will affect the eating pattern and again will lead to nutritional deficiencies. Hence, when there is a plan for health check-ups for the elderly, the dental factor must be taken into consideration.
- Visual impairment
Studies both from India and abroad state that visual impairment/ poor vision is highly prevalent among elderly people. This might also be due to ageing as well as diseases like diabetes. Also, unoperated cataract, adds to the burden of visual impairment.
- Hearing problems
Hearing loss (presbycusis) and increased cerumen production with ageing contribute to difficulty in hearing. There is a need for the evaluation and management of hearing problems among the elderly. Proper hearing aids must be provided to the needed elderly.
- Falls and fractures
These are very common among elderly people. The chances of falling are higher when there is visual impairment or osteoporosis. So, to prevent falls among the elderly, correction of visual and hearing impairments, and taking care of bone health is a must. Avoid slippery restrooms, proper sandals must be provided to the elders.
A common form of arthritis is seen among elderly people. It is one of the frequent causes of physical disability among the elderly. Current treatments for osteoarthritis relieve symptoms such as pain and disability, but there are no treatments that can cure the condition.
- Urinary problems
With advancing age, the muscles of the lower urinary tract weaken leading to urinary incontinence. Apart from these urinary tract infections (UTIs), bladder cancer, and bladder outlet obstruction (BOO) are also prevalent among elderly people. Among elderly men, the prostate gland tends to enlarge and gradually block the flow of urine. If untreated, this may progress to kidney damage.
The dysfunction of the gallbladder and the increased secretion of bile by the liver must be responsible for the formation of stones in the gallbladder.
This is a major concern observed among the elderly. The common causes of constipation in the elderly are related to reduced bowel movements due to aging, improper diet, inadequate water intake, physical inactivity, illness or the use of certain medications and drugs. This condition is also due to loose-fitting dentures or tooth loss that results in chewing difficulty, which directs a person to choose soft foods devoid of fibres. If a person has difficulty swallowing, it might again affect the eating pattern. All these would result in constipation.
This might be due to lack of availability of food or poorly fitted dentures or lack of affordability of nutritious foods. This can result in osteoporosis in the long run. Also affects immunity and thereby frequent infections.
This is common among the elderly and has been reported to be a reason for electrolyte imbalance in older adults. Conditions such as mental and/or physical illnesses, trauma, or surgeries in the elderly may increase the risk of dehydration. Adequate intake of fluids in the form of water, soup, tender coconut water, buttermilk etc will help in resolving the dehydration.
- Non-communicable diseases
Studies reports such as heart disease, diabetes, and obesity are very much prevalent among the elderly. Ageing, sedentary lifestyles, unhealthy eating habits, and environmental factors all lead to NCDs among the elderly. As ageing progresses, other NCDs such as asthma, Parkinson’s, and stroke are also seen among the elderly. These NCDs are very much interdependent.
- Alcoholism / Smoking
Substance use such as tobacco, smoking or alcohol intake is seen among a few elderlies. Few of them have these habits from a young age or a few start later in life due to stress or loneliness. These uses of substances are a concern for the health of the elderly since there might be possible interactions with prescribed medication. Also, it can affect their overall health, and the increased risks of falls, stroke or liver diseases.
- Mental Disorders
The disorders such as depression and anxiety due to physical reasons and conditions such as Parkinson’s and Alzheimer’s disease due to medical reasons are seen among the elderly. As a result of ageing, mental health too deteriorates with age just like physical health. Psychological consultation is a must for depression and anxiety persons. Meditation, Yoga, and engaging in hobbies are a few options to beat depression and anxiety.
- Sleep disturbances
These are associated with various factors such as the use of caffeine, tobacco, alcohol, sleep habits and comorbid diseases. Treating depression, chronic pain and frequent urination may improve sleep in some people.
- Skin Diseases
As age increases, the chances of getting skin diseases also increase as skin undergoes numerous changes. An individual’s skin depends on several factors like lifestyle, diet, genetics and other habits such as smoking, water intake etc. One of the main reasons for skin disease is exposure to the sun's ultraviolet (UV) light, which disrupts the elastic tissue (elastin) in the skin leading the skin to stretch, sag, and wrinkle. Occasionally it may cause pre-cancerous growths and even skin cancer. Another reason for skin ageing includes the loss of fatty tissue between skin and muscle.
- Bed Sores
Among the elderly, bedsores develop due to pressure when he/she lies in bed or sits in a chair for a long time. Bedsores are a common problem in people who have difficulty moving on their own. The use of water beds will be a solution for the ones who find it difficult to move.
Thus, aging is a natural and gradual process that is inevitable. Due to aging, there will be changes in several body functions. These changes sometimes will be very minimal or severe affecting the overall functioning of the body. Hence caregivers must support the elderly with proper diet, provide medication, engage them in-home exercise, etc. Mental health care and psychological rehabilitation must be part of the health care for the elderly.
- Thakur, R., Banerjee, A., & Nikumb, V. (2013). Health problems among the elderly: a cross-sectional study. Annals of medical and health sciences research, 3(1), 19–25. https://doi.org/10.4103/2141-9248.109466
- Tomstad, S. T., Söderhamn, U., Espnes, G. A., & Söderhamn, O. (2012). Living alone, receiving help, helplessness, and inactivity are strongly related to risk of undernutrition among older home-dwelling people. International journal of general medicine, 5, 231–240. https://doi.org/10.2147/IJGM.S28507
- Wood, Elizabeth H. MPAS, PA-C Urinary problems in the elderly adult, JAAPA: October 2005 - Volume 18 - Issue 10 - p 35-41
- Lopushinsky, Steven R; Urbach, David R (2005). Gallstone disease in the elderly: diagnosis and management. Aging Health, 1(3), 441–447. doi:10.2217/1745509x.1.3.441
- Reber, Gomes, Dähn, Vasiloglou, & Stanga. (2019). Management of Dehydration in Patients Suffering Swallowing Difficulties. Journal of Clinical Medicine, 8 (11), 1923. MDPI AG. Retrieved from http://dx.doi.org/10.3390/jcm8111923
- Suzuki, K., Miyamoto, M., & Hirata, K. (2017). Sleep disorders in the elderly: Diagnosis and management. Journal of general and family medicine, 18 (2), 61–71. https://doi.org/10.1002/jgf2.27
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