10 conditions that ail the elderly

By | May 11, 2015

How many times have you wondered if your aging family member is doing OK?

For the most part our elderly tend to be subjected to various types of ailments and the causes range in varying degrees. But what are the most common ailments afflicting our elderly today.

Alzheimer’s: This is a condition that is characterised by the loss of memory. According to Dr Arjun Srivatsa, leading neurologist, ‘Alzheimer’s is a kind of dementia that causes problems with memory, thinking and behaviour. It is found in close to 80% of those suffering from dementia and is therefore the most common type.’ Commonly seen in the elderly, this condition is largely misdiagnosed since loss of memory is commonly thought to be due to old age. Dr Srivatsa says, ‘The patient suffers damage in areas of the brain that control language, reasoning, sensory processing, and conscious thought. Memory loss and confusion become worse, and the person begins to have problems recognising family and friends.’

Advancements in its treatment: Currently, doctors have identified that the earlier the condition is identified, the better the prognosis of the patient is. Current treatment of the condition is based on treating the symptoms of Alzheimer’s but they do not eradicate the cause of the condition. Newer drug therapies that will target the affected area and will be administered as a cocktail of medications, much like therapy for HIV, are being researched. Since they are only in the animal testing phase and have not been tested on humans, these drugs are still shrouded by speculation.

Parkinson’s: According to Dr Vijay Chandran, renowned neurologist, ‘Parkinson’s disease is an illness, which affects the brain, in which certain nerve cells – which play an important role in motor functions of the body – are lost or die.  The loss of nerve cells takes place slowly, and gradually spreads to several areas of the brain, as a result, new symptoms gradually develop over time and the initial symptoms become more difficult to control.’ This condition is commonly seen in the elderly due to the fact that as we age, our body tends to degrade as well. Classified by the presence of tremors, the hallmark of this disease is the presence of tremors even while the patient is still. Dr Chandran says, ‘Patients with Parkinson’s disease may also have difficulty maintaining balance, walking and tend to fall even when they are slightly off-balance, however, this usually occurs much later in the disease. Other common symptoms include a change in the quality of voice, stooped posture and change in handwriting.

Advancements in its treatment: Earlier, patients were treated with medication and physiotherapy to beat the symptoms of the disease. Medication to increase the dopamine (a neurotransmitter) in the brain was replaced since it was believed that the disease was due to its absence. Today, treatment has advanced in leaps and bounds. One of the leading therapy modalities is DBS (Deep Brain Stimulation). Dr Srivatsa says, ‘DBS  is the surgery done for Parkinson’s, where the surgeon implants electrodes in the brain and it automatically stimulates the part of the brain affected by Parkinson’s. In certain cases, lesioning some areas of the brain also helps in controlling the disease at a lower cost.’ 

Arthritis: People usually develop osteoarthritis after the age of 40. It is a condition that is caused due to the wear and tear of cartilage. Although there are other reasons for this condition, like an over-active autoimmune system that causes rheumatoid arthritis, the one caused due to old age (osteoarthritis) is most commonly seen in the elderly. As a person grows, the cartilage that is present between two bones, slowly starts to degrade. Soon it reaches a point where it becomes extremely thin and allows the bones to rub against each other. This causes pain, inflammation and difficulty in moving the joint.

Advancements in its treatment: The current treatment modalities revolve around providing the patient relief from swelling and the pain. Newer treatments include surgical procedures like chondroplasty (where the rough cartilage is smoothed out to reduce friction), abrasion or micro-fracture (where a small part of exposed bone is stimulated to grow scar tissue in that area, helping reduce friction), Osteochondral Autograft (or allograft) transplant (OATS procedure) where the cartilage is replaced with that from another region in the body or from a donor (cadaver).

Diabetes: Approximately 6.13 million people suffer from diabetes in India. Although the numbers on the record are high, the untreated and undiagnosed numbers could be much more. In the elderly, the most common type of diabetes seen is type 2 diabetes. It is believed that this condition is due to the decline in their body’s ability to use insulin. Dr Rajiv Kovil, leading diabetologist says, ‘The reason controlling diabetes is so important is because it directly translates to reducing the risk of developing problems like heart attacks, stroke, loss of blood circulation in the limbs, kidney disorders and eye disorders.’

Advancements in its treatment: Currently there are a number of drugs in the market that help control one’s blood sugar successfully, some of them are Pioglitazone, Metformin etc.

Disk prolapse: This is a condition where the cartilage present between the vertebrae shift out of position, leading to the compression of the spinal column and the nerves extending out into the rest of the body. The most common symptoms of this condition are a tingling feeling in the hands or legs, lower back pain, numbness in the arms or legs etc. This is again a fairly common condition in the elderly because the cartilage tend to degrade making them thinner and therefore more vulnerable to slipping out of place.

Advancements in its treatment: There are a number of advancements in the treatment of this condition, they include prosthetic intervertebral disc placement, endoscopic laser discectomy (involves cutting the prolapsed part of the disc using a laser).

Urinary incontinence: This is a condition where the person cannot hold or control the flow of his/her urine. The most common symptom is that when the person laughs or sneezes a small amount of urine leaks out. Eventually leading to them wetting themselves. Urinary incontinence is a condition that is caused due to the weakening of the sphincter muscles (muscles that control the flow of urine). One of the most common methods of resolving this condition is to use adult diapers that can soak the excess urine. Other methods include the use of exercises like the Kegel exercise to strengthen the muscle.

Advancements in the treatment: While there are a few drugs to treat this condition, there are therapies that have shown better results. Percutaneous tibial nerve stimulation is a technique where the nerve at the ankle is stimulated using an electrode. This impulse in turn stimulates the spinal nerve responsible for bladder stimulation. Other options include the stimulation of the sacral nerve which works the same way as the tibial nerve stimulation (here the electrode is applied to the lower back region) and BOTOX treatment (BOTOX is injected into the muscles of the bladder to reduce sensitivity of the bladder offering better control).

Stroke: This is a condition where there is a block in one of the arteries leading to brain. This causes the brain to suffer from lack of blood and oxygen causing that region to stop functioning. Elderly people are more likely to suffer from this condition since they might have other co-morbid conditions that lead to the formation of blood clots within the blood vessels. The common symptoms of this condition are sudden numbness or weakness of the face, arm or leg on one side of the body, sudden confusion, trouble speaking or understanding, sudden trouble seeing on one side, sudden, severe difficulty walking, dizziness, loss of balance or coordination, sudden, severe headache with no known cause.

Read more about causes, symptoms, diagnosis and treatment of stroke.

Advancements in the treatment: One of the most recent advancements in treating this condition is intravenous tissue plasminogen activator (t-PA) where the blood clot is broken down by the use of a specific agent. Although this treatment has been tested by the FDA, it still has not shown any benefits in human subjects.

Cancer: The prevalent types of cancers seen in the elderly are prostrate, colon, breast, lung and stomach cancer. According to the paper, people above the age of 65 are more prone to these types of cancer. Although the exact reason as to why it occurs is unknown, many believe that it is due to the gradual degradation of the cells, mutations in the cells and the gradual drop in one’s immune system make elderly people more prone to the disease.

Advances in its treatment: Although cancer is a grave disease, it does not essentially mean the end of one’s life. Advances the treatment of various cancers are under way and the lives of patients afflicted with this disease have been increased considerably.

Tremors: This is a condition where the person’s hands or legs shake or shiver uncontrollably while they are performing functions like writing, lifting objects, etc. Tremors are seen in most elderly and the condition is called essential tremors. It is caused due to the slow degradation of the nerves and passage of impulses between the brain and the limb that is at work. Tremors may also be a symptom of other conditions like movement disorders, Parkinson’s, etc. According to Dr Srivatsa, ‘Tremors can be because of deficiencies in vitamins, stress or be essential tremors. Tremors are accompanied with imbalance, and are commonly due to mild strokes in the part of the brain controlling balance. Here, physical aids and gait training helps. Treating the primary cause of the stroke is of course mandatory.’

Advancements in its treatment: Although this condition does not have any treatment right now, there are a number of drugs that are being tested.

Dementia: This is  a condition where the person loses cognitive ability and starts to act unlike himself/herself. It is a progressive condition and is one of the hallmark symptoms of conditions like Alzheimer’s. Some of the common symptoms of this condition are memory loss, problems performing everyday functions, problems with language, disorientation to time and place and  poor or decreased abilities of judgement. This condition afflicts the elderly due to the breakdown of their brain and its normally functioning pathways.

Advancements in its treatment: While dementia does not have any treatment modalities right now, there are medications that can help alleviate the symptoms.

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