Seniors can present multiple pathological lesions without specific symptoms. Thus, some or all of the symptoms can be attributed to old age and we may think there is nothing we can do. Geriatric Medicine tries to refute such negative visions.
According to the World Health Organization, HEALTH is „a state of wellbeing, physically, mentally and socially”.
Ageing is viewed as an accumulation of persistent changes which are happening during our life time and has two components:
- Adaptive physiological modification
Senescence does not arise due to the deregulation or illness of a single system, organ, tissue or cell type. Senescence affects the processes involved in the functional integration between cells, tissues, organs. If the processes which maintain the homeostasis are malfunctioning, organism’s vulnerability to external and internal factors may arise.
A few diseases and illnesses typical for old age:
- Rheumatic polymyalgia
- Prostatic cancer
- Neurodegenerative Syndrome
- Stroke Syndrome
- Parkinson’s Disease
- Accidental Hypothermia
- Urinary Incontinence
- Bowl angiodysplasia, and others.
Many studies have shown that in old age multiple medical problems may coexist. For example, a study has shown that people aged 65-74 suffer from some chronic symptoms: 50% suffer from arthritis, 34% have memory problems, 33% have persistent back pain, 32% have poor eyesight, 29% have problems with indigestion etc.
Only 10% of those who are over 75 years old have reported NONE of these symptoms.
In the old age multiple diseases may coexist, so that many of the symptoms can be attributed to various diseases.
The atypical reporting of the signsof a specific disease reported by an old person is due to multiple factors: malfunctioning of the mechanisms responsible of the adaptive answer to the action of external or internal factors, presence of another disease etc.
Various changes happening in senescence may influence the effects of various drugs.
Neurodegenerative disease is an acquired syndrome, manifesting through loss of memory and other cognitive functions, which leads to the dysfunction of daily life.
The most frequent neurodegenerative diseases of old age are: Mild Cognitive Disorder, Alzheimer’s Disease, Parkinson’s Disease, Neurodegenerative Vascular Disease, Mixed Neurodegenerative Disease, Frontotemporal Neurodegenerative Disease, Lewi Bodies Neurodegenerative Disease.
The inappropriately or totally uncured depression and anxiety, as well as vascular diseases, craniocerebral injuries, emotional and affective challenges including war or post-war shocks, and co-morbidities such as diabetes are incriminated as risk factors. Women are more prone than men for developing a neurodegenerative disease. Currently, the management of neurodegenerative diseases pays special attention to preventive and predictive approaches, as well as to a battery of appropriated interventions.
Many old people are free of neurodegenerative diseases symptoms, but a thorough investigation may reveal pathological features specific to Alzheimer, Parkinson, Lewy Bodies or cerebrovascular diseases.
When must we be concerned about the normal signs of human cerebral ageing?
The usual age-related signs that may appear are:
- Difficult retrieval of appropriate words
- Easier remembering of far past events than recent ones
- More difficult uptake of new information.
In case of neurodegenerative diseases, the more difficult retrieval of appropriate words and uptake of new information may arise before reaching third age.
Nowadays, dementia pathological signs are arising at lower and lower ages. Especially in people facing chronic stress at work or in their current life, signs may appear well before the age of 40.
In 2009, a study on 5000 American Pharma industry workers seeking for the causes of their visits to the doctor over a year has shown that the main cause was the panic attacks.
The second was the oscillation of blood pressure in the young people, as an expression of their anxiety, while the third cause was related to anxious and depressive disturbances and infections of the upper respiratory ways.
Thus, we can talk about a pandemic of neurodegenerative diseases, even among the young.
In the context of modern life, the brain is the most abused of our organs, to which we unfortunately forget to provide the necessary care.
Our emotional equilibrium is the result of the fine coordination exerted by our brain. Fifty years ago scientists believed that “the rational brain would dominate the emotional one”. But that’s not true at all. Because, in fact, the emotional brain is the true dominant , to which we are indebted with the respect and introspection that it deserves. In fact, the introspection and respect that we deserve ourselves.
So, can we do that within the current lifestyle context?
Yes, we can! First of all, through taking a break for at least several minutes from daily over-demanding tasks and challenging milieu.
In order to improve the productivity of their employees, the big corporations equipped themselves with clubs or other relaxation spaces where people can relax for 30 minutes to one hour. In the USA and in Scandinavian countries breaks are held diligently.
The lack of ability to cope with stress may lead to one’s identity loss and even suicide. In Romania, where the struggle for survival is dramatic, this picture is particularly obvious and challenging.
The diagnosis of depression in elders is difficult, mainly when that person suffers from a neurodegenerative disease.
Depression is one of the most frequent mental diseases in old people, and is associated with various psychiatric (neurodegenerative) diseases, as well as a geriatric poly-pathology and various effects of the currently prescribed drugs. Depression rate is very high in hospitalized old people and those living in medicalized or non-medicalized elderly homes.
The clinical symptoms of depression in the old people are concentration and decision making difficulties, loss of motivation, memory problems.
In the elders, specific depression symptoms can be masked by those of other diseases, may be accompanied by physical functionality changes, or can be medication side effects.
Depressed patients are excessively concerned about their health, and may have physical, anxiety and memory complaints. The exogenous form of depression, usually lesser responsive to antidepressant medication, is prevailing among elders, while the endogenous form makes them highly prone to suicide.
Some antidepressants have higher toxicity, therefore treatment must be initiated with low doses and maintained for at least 6 months. Psychiatric and geriatric evaluation are equally needed for the diagnosis and proper case management in such persons.