Seven Neglected Areas That Sabotage Healthy Aging – P8

When is comes to the elderly, too many have polypharmacy, me included. Diabetes also adds to the medications. In the elderly, the problem can become severe because of the risk of harm from medication side effects. The CDC states that every year, 177,000 older adults visit the emergency room for medication problems. This is not a great thing to happen to the elderly and it is unknown how many deaths happen because people cannot reach the emergency room.

Polypharmacy is often a burden for the elderly because of the cost of medications. Often a decision needs to be made between medications and food and a medication prescription is not filled as a result. In addition, real hassles occur for many of the elderly in timely taking their medications during the day, especially if they have too many medications. This often can make a chronic condition become worse and lead to doctors failing to realize that the patient has not been able to take all medications as directed.

The point to remember for many of the elderly is that doctors are taught to prescribe medications and often it may be a case that some medications need deprescribing. Research has documented that inappropriate prescribing of medications is common. 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.

For more information:

• How to Review Medications for Safety & Appropriateness
• How to Think Like a Geriatrician about Senior Medications
• A Prescription for Confusion: When to Take All Those Pills
• MedStopper.com (Pharmacist-created online resource designed to help with deprescribing)

My blogs:

http://bobsdiabetes.blogspot.com/2014/03/is-polypharmacy-in-your-future.html

http://bobsdiabetes.blogspot.com/2014/04/more-about-my-friend-on-polypharmacy.html

http://bobsdiabetes.blogspot.com/2014/04/polypharmacy-how-i-dislike-you.html

http://bobsdiabetes.blogspot.com/2015/04/polypharmacy-and-diabetes-part-1.html

http://bobsdiabetes.blogspot.com/2015/04/polypharmacy-and-diabetes-part-2.html

http://bobsdiabetes.blogspot.com/2015/10/even-doctors-complain-about-polypharmacy.html

Number 8 of 8 blogs.

Seven Neglected Areas That Sabotage Healthy Aging – P7

Isolation and loneliness are problems for people with diabetes and the elderly. I admit I have not blogged about this topic, as I have not felt isolated. However, lately some of my health problems are starting to make me withdraw from interaction with others. I do have a wife that can make life funny at times and since she also has type 2 diabetes (treated with metformin at present), we do have some tense discussions about my health.

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. A 2012 study found that 43% of older adults reported feeling lonely; over the next 6 years, they were more likely to lose physical abilities or die. Loneliness and isolation have also been linked to decreased immune function and greater risk of depression. I have not felt depression and feel fortunate that my positive attitude has prevented depression, as type 2 diabetes can be a strong risk for depression. In the past, I have had minor bouts of depression, but they have not lasted more than a week to 10 days.

The elderly who live alone or have been bereaved are at particular risk, especially if health problems are interfering with their ability to get out. But, even people who are in proximity to others, such as family caregivers or seniors residing in a facility, may suffer from feeling lonely.

Studies have found that certain psychotherapies, including mindfulness, 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 (including fear of falling, incontinence, or pain) that may be keeping a senior from getting out and socializing.

For more information:

• Isolation V. Loneliness: The Difference And Why It Matters
• What Works for Health: Activity Programs for Older Adults
• 14 Ways to Help Seniors Avoid Social Isolation

My Blog:

http://bobsdiabetes.blogspot.com/2013/11/social-isolation-is-powerful-mortality.html

Number 7 of 8 blogs.

Seven Neglected Areas That Sabotage Healthy Aging – P6

Surveys suggest that about 50% of all adults aged 65+ experience bothersome pain every month, often in multiple parts of the body. Persistent pain is linked to decreased social and physical activity, depression, and taking worse care of one’s own health. Pain can also be a sign of a new health problem that needs attention or a chronic problem that’s being inadequately managed.

Pain can and should be treated with 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 treatments. Treatment with medication may still be necessary, especially for short-term purposes or in combination with other treatments. 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.

People with type 2 diabetes often have neuropathy pain and this should not be treated with NSAIDs. Excellent blood glucose management does more to lessen the pain and will over time greatly reduce the pain. There are other medications that will help more than NSAIDs.

For more information:

• Dealing with Persistent Pain in Older Adults
• Pain Management in Older Adults: Tools & Tips
• Experts Warn Against Long-Term Use of Common Pain Pills
  

My blogs:

http://bobsdiabetes.blogspot.com/2015/09/do-you-have-needle-phobia-or-just.html

http://bobsdiabetes.blogspot.com/2014/08/leg-cramps-and-possible-prevention.html

http://bobsdiabetes.blogspot.com/2013/01/tips-to-make-testing-less-painful.html

http://bobsdiabetes.blogspot.com/2012/05/what-is-diabetic-neuropathy-part-1.html

Number 6 of 8 blogs.

Seven Neglected Areas That Sabotage Healthy Aging – P5

This is one topic I have not written much about, but it does affect the elderly. Having chronic difficulties controlling one’s bladder is a common problem for older adults, and tends to get worse with aging. It affects both men and women, although it may have different underlying causes, such as prostate enlargement in men. It is often embarrassing, can cause seniors to restrict their social or physical activities, and has been linked to depression.

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 or underwear to manage leaks can also make a big difference. They are definitely not all equal, and doctors have little idea which is best. Remember that medications to treat bladder spasms are usually quite anticholinergic, hence risky for brain function. To help a doctor evaluate incontinence, it’s helpful to log your symptoms in a voiding diary for 3 days prior to the appointment.

For more information:

• What to Know About Bladder Control for Women
• Urinary Incontinence in Men

Other blogs:

http://www.mendosa.com/blog/?p=377

http://bobsdiabetes.blogspot.com/2015/03/nephropathy-part-5.html

http://bobsdiabetes.blogspot.com/2012/01/diabetic-neuropathy-part-1.html

Number 5 of 8 blogs.

Seven Neglected Areas That Sabotage Healthy Aging – P4

People with type 2 diabetes are more susceptible to depression. Although healthy older adults have lower rates of depression than the general public, depression is still a common problem that is easily missed. It’s more common in those who are struggling with illness, involved in caregiving, or socially isolated. It’s important to spot and treat depression, as this is key to better quality of life and greater involvement in social activities. It can also enable older adults to better manage any health problems they have, such as chronic diseases, type 2 diabetes, or pain.

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. Among medications, the selective serotonin reuptake inhibitors (SSRIs) sertraline and escitalopram tend to have fewer side effects and drug interactions. Avoid paroxetine (Paxil) as it is anticholinergic, which means it dampens brain function.

For more information:

• Depression in Older Adults and the Elderly
• Pharmacological Treatment of Depression in the Elderly (review article written for family physicians; walks the reader through a nice real-life example)

My blogs:

http://bobsdiabetes.blogspot.com/2015/02/do-you-understand-depression-part-1.html

http://bobsdiabetes.blogspot.com/2015/02/do-you-understand-depression-part-2.html

http://bobsdiabetes.blogspot.com/2015/02/do-you-understand-depression-part-3.html

http://bobsdiabetes.blogspot.com/2014/11/lessons-for-people-new-to-type-2_30.html

http://bobsdiabetes.blogspot.com/2014/05/five-distinct-types-of-depression.html

http://bobsdiabetes.blogspot.com/2012/01/some-blogger-suggestions-for-handling.html

http://bobsdiabetes.blogspot.com/2012/01/depression-and-diabetes-cycle.html

http://bobsdiabetes.blogspot.com/2012/01/types-of-depression.html

http://bobsdiabetes.blogspot.com/2011/08/depression-under-diagnosed.html

Number 4 of 8 blogs.

Seven Neglected Areas That Sabotage Healthy Aging – P3

Memory concerns often cause anxiety for older adults and their families. They may, or may not, reflect decreases in thinking abilities.

This is when 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. Remember that diabetes has a link to Alzheimer's disease.

People are often reluctant to have memory concerns evaluated because they are worried that it could be Alzheimer’s disease or another dementia. They also may believe that “nothing can be done.” It can help to tell people that we can often find ways to improve a person’s brain function, either by identifying and treating an underlying health problem or by encouraging the activities that promote brain health.

For more information:

• What’s Causing Your Memory Loss? It’s not necessarily Alzheimer’s
• Is It Really Dementia?
• How We Diagnose Dementia: The Practical Basics to Know
  

My blogs:

http://bobsdiabetes.blogspot.com/2015/04/alzheimers-disease-part-1.html

http://bobsdiabetes.blogspot.com/2015/04/alzheimers-disease-part-2.html

http://bobsdiabetes.blogspot.com/2015/04/alzheimers-disease-part-3.html

Number 3 of 8 blogs.

Seven Neglected Areas That Sabotage Healthy Aging – P2

This series is important and everyone needs to know something about this as they age and/or their parents age. I will be using people (including myself) with type 2 diabetes as examples and for most of the discussion. I will be listing some of my blogs that are on topic where I have blogs. I found this information in a blog by Dr. Leslie Kernisan.

Falls are problems for many as they age. People with type 2 diabetes are at risk and risk generally more severe injuries because of diabetes. Falls are common for the elderly. Many falls cause only minor injuries, but they are scary and can cause older adults to restrict their activities. In fact, fear of falling is common and has been linked to decreased involvement in activities. It is also a risk factor for future falls.

More injurious fall can cause life-changing injuries such as broken hips and head injuries. These falls are a major reason for people having to leave their homes.

Most falls in the elderly are due to a combination of underlying risk factors or health problems. Insufficient strength or balance is usually one of the problems. This 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.

For more information:

• CDC STEADI Materials for Older Adults (see here for PDF to check your risk factors)
• Why Older People Fall
• How to Prevent Falls: 5 Proven Approaches to Ask the Doctor About
• 8 Things to Have the Doctor Check After an Aging Person Falls
• NIHSeniorHealth Balance Exercises for Fall Prevention (includes videos)
  

My blogs:

http://bobsdiabetes.blogspot.com/2014/05/this-may-be-partial-cause-of-falls-in.html

http://bobsdiabetes.blogspot.com/2014/06/new-glasses-for-elderly-often-equals.html

http://bobsdiabetes.blogspot.com/2015/10/more-causes-for-elderly-falls.html

Number 2 of 8 blogs.

Seven Neglected Areas That Sabotage Healthy Aging - P1

A Healthy Aging Checklist summarizes the six fundamental activities recommended when asked what to do to maintain the best possible health while aging.

The following are some of the points promoted for healthy aging:

1. Promote brain health and emotional well-being.
2. Promote physical health.
3. Check for and address common senior health problems (such as falls, memory concerns, depression, incontinence, pain, isolation, polypharmacy).
4. Learn to optimize the management of any chronic conditions.
5. Get recommended preventive health services for older adults.
6. Address medical, legal, and financial advance care planning.

In the next seven blogs, I’ll cover the third item above addressing commonly neglected senior health problems that routinely sabotage healthy aging.

These issues are sometimes referred to as geriatric syndromes. They affect health and quality of life, and although they happen more in people who are older or frailer, they affect countless people in the 60s and 70s as well.

Virtually all of these issues affect a senior’s ability to socialize, be physically active, and take good care of himself or herself. So discussing these is key to helping you be healthier while aging, or help you guide a parent to be healthier in their aging.

Unfortunately, these issues routinely fall through the cracks of usual medical care. People often suffer from these problems for years without anyone taking effective action. This may be because many people, doctors, seniors themselves, or family members, assume nothing can be done about these, and that they are just “part of getting old.”

Don’t believe that. These problems are studied in geriatrics and most of the time, correctly evaluating and then managing these problems helps older adults and their families feel better, live better, and sometimes even live longer.

Remember, 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. So, for healthier aging, be proactive in checking for these oft-neglected problems.

Then remember: sub-optimal treatment of these problems is all too common. So you’ll need to be proactive about getting them correctly managed, which might mean either seeing a geriatrician (if you can find one) or making sure your usual doctor is thinking like one.

Now, I’ll admit that it can be very difficult to completely eliminate the problems talked about, in some older adults. You have to try, especially if the problem is bothering you or interfering with life activities. In addition, you have to find professionals who will use the best-available knowledge to help you, do so.

When we make a good effort, we can almost always improve our (yes, I am considered in the elderly group) ability to be out in the world, doing the things they want to be doing, and doing things that are good for our health. This promotes healthy aging. So don’t let these problems fester and sabotage late-life health. Let me know below if you have questions.

Number 1 of 8 blogs.