Aging and What To Do About It - Other health problems

The following health problems might also confront an older person. (Many of these conditions are discussed at greater length elsewhere in the book; in such cases, cross-references are supplied for your convenience at the end of the section.)

Heart Disease

The heart is the strongest, toughest muscle in the body. It is like an engine that could run 70 years or more without an overhaul. The heart has a complete maintenance and repair system, enabling many heart disease victims to continue long and useful lives.

While heart disease is not necessarily a product of aging, some heart and blood vessel problems become more acute as one grows older.

The following symptoms do not necessarily indicate heart disease, but it is wise to see a physician if you notice any of them:

1. • Shortness of breath
2. • A feeling of tightness in the chest or pain directly related to exertion or excitement
3. • Swelling of the feet and ankles
4. • Unusual fatigue

There is much that physicians can do to prevent heart conditions or to relieve them once present. But there is much that you can do to help yourself:

1. • Weight:
2. Extra pounds of fat mean more work for the heart.
3. • Diet:
4. The rules of sound nutrition apply to proper heart care.
5. • Smoking:
6. Heavy cigarette smokers suffer three times as many heart attacks as do pipe or cigar smokers. Non-smokers are safest.
7. • Exercise:
8. Exercise improves the pumping action of the heart as well as circulation, digestion, and general health.

Worry

Worry increases tension and elevates blood pressure. Try to cultivate a philosophical approach to the daily ups and downs. See Ch. 10, Heart Disease .

Strokes

Strokes are not hopeless; even severely paralyzed patients may make remarkable progress. A stroke occurs when the blood supply to a part of the brain tissue is cut off and, as a result, the nerve cells in that part of the brain can't function. When this happens, the part of the body controlled by these nerve cells can't function either.

Whenever the blood supply is cut off from an area, small neighboring arteries get larger and take over part of the work of the damaged artery. In this way nerve cells that have been temporarily put out of order may recover, and that part of the body affected by the stroke may eventually improve or even return to normal.

Once a stroke has occurred, a sound rehabilitation program can help the patient resume as many normal activities as possible. This program can be worked out in cooperation with the physician, patient, family, and local organizations. See Ch. 9, Diseases of the Circulatory System .

Arthritis

There are two main types of arthritis: rheumatoid arthritis and osteoarthritis .

Rheumatoid arthritis—which can cause pain and swelling in joints, nerves, muscles, tendons, blood vessels, and connective tissue in the whole body—can strike at any age, but it occurs mainly in the 25-to-40-year age group. The exact cause of rheumatoid arthritis is unknown.

Osteoarthritis is a degenerative joint disease that affects almost everyone who lives long enough; it is a product of normal wear and tear on the joints over the years. Poor posture and obesity are contributing causes, as are heredity and trauma.

Osteoarthritis is usually mild, and it seldom cripples. Pain is generally moderate. Unlike rheumatoid arthritis, which is inflammatory, spreads from joint to joint, and affects the whole body, osteoarthritis confines its attack locally to individual joints. Rarely is inflammation a problem.

Osteoarthritis is likely to develop in any joint that has been required to take a lot of punishment or abuse: the knee or hip joints of someone who is overweight; joints injured in an accident; joints injured or overused in sports; joints subjected to unusual stresses and strains in work or play; joints with hidden defects that were present at birth.

There is no specific cure for arthritis, but the pain and swelling can be controlled. In other than acute cases, common aspirin has proved the safest and most popular medication.

Adequate rest for both the body and the affected joint is a fundamental treatment. Heat, controlled exercise, hydrotherapy, and massage are all effective if done under a physician's supervision. See “Arthritis and Other Joint Diseases” in Ch. 7, Diseases of the Skeletal System .

Cancer

Cancer strikes at any age, but it does strike more frequently in the later years. Many factors are believed to contribute to cancer; frictional and chemical irritations like cigarette smoking, irritation of the skin and mouth (such as poor dentures), exposure to the sun, X rays, or radioactive elements. Common sites are the lips, mouth, stomach, intestines, rectum, liver, pancreas, lungs, breast, kidney, bladder, skin, uterus, and prostate.

Early detection and prompt treatment are the best protection against cancer. If any of the following seven danger signals lasts longer than two weeks, be sure to get a checkup.

1. • Unusual bleeding or discharge
2. • A lump or thickening in the breast or elsewhere
3. • A sore that does not heal
4. • Change in bowel or bladder habits
5. • Hoarseness or cough
6. • Indigestion or difficulty in swallowing
7. • Change in wart or mole

Great strides have been made in treating cancer through surgery, radiotherapy, and chemotherapy. See Ch. 18, Cancer . For cancers affecting women only, see “Cancers of the Reproductive System” and “Cancer of the Breast” in Ch. 25, .

The Eyes

The eye does age. After age 40, failing vision is usually caused by natural hardening of the lens, making it difficult to see close objects. However, failing vision may also be the first symptom of a serious bodily disorder, or of glaucoma or of a cataract, which requires a physician's immediate attention.

Both glaucoma and cataract can be treated effectively. About 90 percent of glaucoma cases can be checked with eye drops and about 95 percent of cataracts can be removed by a painless operation.

Other diseases that may develop in later years affect the blood vessels of the eye. A common condition is senile macula degeneration which causes a blind spot to appear when the victim looks directly at something. The exact cause of senile macula degeneration is not known. See under Ch. 16, Diseases of the Eye and Ear .

Diabetes

Most likely candidates for diabetes are overweight persons past 40, particularly those who have a hereditary history of diabetes, and especially older women.

The exact cause of diabetes is not known, but it is a functional disorder in which the body cannot handle certain foods—mainly sugars and starches. Symptoms include increased thirst, constant hunger, frequent urination, loss of weight, itching, easy tiring, changes in vision, and slow healing of cuts and scratches.

Treatment and control consist of planned diet, exercise, and, in many cases, insulin shots or oral medication. Well-controlled diabetics can lead active lives. See Ch. 15, Diabetes Mellitus .

Constipation

There is no truth in the notion that a daily bowel movement is necessary for good health. A movement every day or twice a day may be all right for one person; for another every three or four days may be enough.

The two most common causes of chronic constipation are physical inactivity and poor food and water habits. Ironically, constipation may be caused by swallowing a cathartic nightly to induce a bowel movement. The habit eventually leads to chronic constipation because normal bowel movement ceases and bowel evacuation depends on using a cathartic.

To maintain proper bowel movement, try the following:

1. • Drink eight to ten glasses of water a day. Take two glasses of water on an empty stomach as soon as you get up.
2. • Drink more fruit juices and eat more dried and fresh fruits.
3. • Get at least one-half hour of moderate exercise daily. Walking, for example, is excellent, particularly if you relax while you walk.
4. • Give yourself enough time for normal bowel movement and set up a regular time for evacuation.
5. • If you are constipated, consult your physician to make sure it is simple and functional. See under Ch. 23, Aches , Pains , Nuisances , Worries .

Back Problems

As we grow older, the back muscles—weakened by inactivity, poor posture, and almost unavoidable wear and tear—start to complain.

Other causes of back problems are muscle and joint strain, changes in the spine, psychological tension, and internal diseases. Here are some tips to help avoid backache:

1. • Learn to lift correctly. Use your leg muscles, which are stronger than back muscles, by placing your feet closer to the base of the object, bending your knees outward, and pushing up with your legs.
2. • Avoid subjecting your back to any sudden, erratic motion.
3. • Try to improve your posture when sitting and walking.
4. • Sleep on a firm bed; a bed board may be helpful.
5. • Get regular exercise of a type that stimulates all your muscles rather than just a few.
6. • If you sit for a long period, get up and stretch occasionally.
7. • Beware of excess weight. Extra weight on the abdomen pulls on the vertebrae at the small of the back, increasing the spine's normal curve and causing pain.
8. • Try never to become overfatigued or exhausted, either physically or mentally. Emotional pressure, from work or personal problems, causes muscle tension. See “Backaches” in Ch. 23, Aches , Pains , Nuisances , Worries .

Because the feet are farthest away from the heart's blood supply, they are often the first areas affected by circulatory diseases. Also, arthritis and diabetes might first show up in the feet.

Warning signs include continued cramping of the calf muscles, pain in the arch and toes, and unusually cold feet—especially if accompanied by a bluish skin. Brittle or thickened toe-nails or burning, tingling, and numbness may also signal a circulatory disease.

Foot ulcers may be one of the first signs of diabetes. Some bunions —swollen, tender, red joints—are caused by arthritis. Swelling around the feet and ankles suggests a possible kidney disorder.

If you have these symptoms, go to a podiatrist (a foot doctor) or to your own physician. They are trained to recognize these symptoms.

Most older people, however, suffer from minor aches and pains in the feet that are caused by poor foot care or abuse. See “The Vulnerable Extremeties” in Ch. 23, Aches , Pains , Nuisances , Worries .

Care of the Feet

To prevent these problems, treat yourself to daily foot care. Dry your feet thoroughly and gently after bathing and inspect the skin for abrasion, rough spots, or cracks. Dry carefully between the toes. If the skin is dry or scaly, lubricate it with lanolin or olive oil. If recommended by your physician, apply a medicated foot powder as a preventative measure against athlete's foot.

When you cut your nails, do it with a strong light and be careful to cut straight across the nail to prevent ingrown toenails. Avoid the use of strong medications containing salicy-late and strong antiseptics like iodine, carbolic acid, lysol, or bleach. Harsh chemicals that attack toughened skin can irritate normal tissue and cause infection. Avoid using hot water bottles, electric pads, or any form of extreme heat or cold. Diabetics should visit a podiatrist regularly.

The Prostate

Men over 50 may have an enlarged prostate , a condition known as benign prostate enlargement. (This is not caused by sexual excesses or venereal disease.) The exact cause is not known, but it's estimated that some type of enlarged prostate afflicts 10 percent of 40-year-olds and up to one half of all men over 60.

The prostate is a rubbery mass of glands and muscle tissue about the size and shape of a horse chestnut. It is wrapped around the urethra and base of the bladder at the point where they join. The prostate functions as part of a man's sexual apparatus, providing a fluid that transports and nourishes the spermatozoa.

Symptoms of an enlarged prostate include difficulty in urination. There might be an initial blocking of the urine, or the stream may lack force. You may feel that you can't empty the bladder, and you may have urgent needs to urinate. You may have pain or blood in the urine from straining.

If you have any of these symptoms, your physician can easily check for enlarged prostate by a simple rectal examination. If he discovers an enlargement, he can usually treat it in early stages with simple massage. But if it has progressed too far, he may have to operate, although other options exist, including drug therapy, electrovaporization, laser therapy, balloon dilation and stents.

If surgery is chosen an operation is usually performed through the urethra or by an incision in the lower abdomen. The choice depends upon the individual problems of the patient and the judgment of the surgeon. In either case, the patient usually recovers completely in a short time.

A rectal examination can also discover early stages of cancer of the prostate, the second most common form of cancer among men after skin cancer, and the second leading cause of cancer death among men after lung cancer. Some 20 percent of men over 60 have this condition, and it is most common in men over 70.

Unfortunately, this disease does not manifest itself early, so it is important that men over 40 have the diagnostic rectal examination. If the disease is detected early and treated—usually by surgery, hormonal therapy, and possibly radiation—the cure rate is very high. If found late, the cure rate is low.

When treatment is by surgery, the entire prostate and upper urethra may be removed. In some cases, the disease may be retarded or relieved by treatment with female hormones.

In both enlargement and cancer of the prostate, early detection is vital to a successful cure. That is why it is important to have a rectal examination. See also “Cancer of the Prostate” in Ch. 18, Cancer .

Alzheimer's Disease

Alzheimer's disease is a group of brain disorders marked by progressive deterioration and affects both memory and reasoning abilities. Victims of Alzheimer's, which is a form of dementia, or mental deterioration (see “Dementia” in Ch. 8, Diseases of the Muscles and Nervous System ), undergo various behavioral changes. These include an inability to concentrate, anxiety, irritability, agitation, withdrawal, and petulance. Persons suffering from Alzheimer's may wander about and lose their way. They may have temper tantrums and engage in obsessional behavior, such as repeatedly washing dishes. Time and place disorientation may be accompanied by delusions and depression. In the later stages of the disease, bladder and bowel control may be lost.

Diagnosing Alzheimer's in its early stages is difficult despite its numerous symptoms. Laboratory tests that could identify the disorder do not exist. Adding to the problems of diagnosis, various other disorders have similar symptoms. The best medical alternative, a complete physical examination, generally includes a review of any drugs or medications the patient has been taking as well as standard laboratory tests. The latter help to rule out other diseases or disorders that may be treatable. A clinical evaluation can include a CT (computed tomography) scan, an EEG (electroencephalogram), and assessment of evidence from family members and the patient regarding the latter's (or patient's) mental state.

Even when diagnosed with relative certainty, Alzheimer's disease cannot be cured. But some symptoms, including depression and delusions, can be treated. The effect is to slow the progress of the disorder. Where Parkinson's disease or heart problems accompany Alzheimer's, treatment can focus on alleviation of those conditions.

A small proportion of Alzheimer's cases have been linked to the possession of a flawed gene that causes cells to produce too much of a protein called beta amyloid. It is not known, however, whether excess beta amybid protein is the cause, or the result, of brain cell devastation.

Scientists have also linked the possession of another gene, apolipoprotein E4, to an increased susceptibility to the most common form of Alzheimer's. It is not known whether the likelihood of a person with the E4 gene contracting Alzheimer's is affected by environmental factors. There is some evidence that persons on estrogen replacement therapy or anti-inflammatory drugs are less likely to develop the disease.