Ageing or senescence is a physiologic process. Generally, senior citizens’ cut-off age is considered to be 65 years (the age of retirement from work). The bright glow and charm of youth gradually give way to the wizened face, greying hair, and frontotemporal hair loss in men and central/parietal hair loss in women. The skin wrinkles, owing to the elastic collagen fibers’ tensile strength, due to the loss of elasticity.
At the molecular level, it has been shown that free-radical mediated injury accelerates the process of ageing (thus, anti-oxidants like Vitamins A, C, and E, Selenium, and Zinc are promoted as anti-ageing agents, however with little therapeutic utility proven by evidence). Also, telomeres’ shortening on chromosomes limits cellular replication: Dead cells cannot be replaced, and differentiated cells no longer replicate. Thus, there is a gradual overall decrease in functional abilities.
Senior citizens account for 13-14 % of the population today, and by 2050, they’d account for 22-25% of the population.
The branch of medical science which deals with the health problems and solutions of old-age persons is called Geriatrics. The main focus of Geriatrics is to emphasize Healthy-Ageing, as one advances through the years of life.
Senior citizens: Some of the problems include:
1. Chronic Non-Communicable Diseases:
Cardiovascular diseases are the most common cause of morbidity and mortality worldwide and have a disproportionate impact on senior citizens.
Heart attacks (myocardial infarction), Paralytic attacks (stroke), Hypertension, endocrine diseases like Diabetes mellitus, and Thyroid diseases are some of the most common diseases. Diseases like hypertension and diabetes require lifelong medications for preventing and reducing their progression.
Also, respiratory diseases like asthma and chronic obstructive pulmonary disease (COPD) may emerge and seriously impair breathing and oxygenation.
The incidence of most cancers increases with increasing age. With changing lifestyles, obesity is emerging as a risk factor for multiple chronic conditions in later life.
Reducing the number of processed foods, reducing salt and sugar and saturated fat intake, and increasing the consumption of fresh fruits, vegetables, and moderate exercise, reduces the risk of developing the above conditions.
2. Gradual Cognitive Decline
Cognition refers to the brain’s higher functions: Generation of thoughts, emotions, the ability to analyze and remember things. Dementia, specifically Alzheimer’s dementia, is in common parlance, termed as memory loss is the most common neurocognitive disorder in the elderly.
Co-morbid conditions such as hypertension, obesity, depression, and smoking habits have been shown to increase the risk of developing dementia. No definitive treatment exists for dementia since it is characterized by neuronal loss (neurons are brain cells that cannot replicate). However, drug therapies intend to retard the progression of the disease.
Other diseases include Parkinsonism, characterized by tremors and a shuffling gait, making it difficult for the person to co-ordinate his daily life activities. It is caused by the absence of a neurotransmitter called dopamine, and thus, drug therapy is aimed at increasing the brain’s dopamine levels. Know more: Parkinson’s Disease-Symptoms and Management
3. Mental Health Conditions:
Older people have their fair share of mental health problems, especially neurotic diseases like depression. Nearly 15% of the elderly have some form of mental health condition or the other. A vast majority are, however, undiagnosed or insufficiently treated.
Providing social support in terms of age-old friends, laughter clubs, senior-citizen forums, and love from family members can help treat and prevent many depressive and mood disorders in the elderly. Read about Mental Health: Stop Exclusion, Dare to Care
4. Increased risk of injury due to trauma:
With increasing age, the joints become stiff, and the bone mass (predominantly calcium stores) decreases. Thus the bone strength is reduced, and the joint mobility is also restricted. The elderly thus have an increased risk for osteoporosis and osteoarthritis.
The elderly are more prone to losing their balance and have a propensity to fall. It can lead to severe injuries, such as fractures (which take more time to heal), a joint tear, or muscle injury.
Calcium and Vitamin D3 supplementation (especially in post-menopausal women), moderate exercise for strengthening the bones, and modifications (such as a handlebar at the lavatory for support) go a long way preventing traumatic injuries.
5. Immunocompromised States:
With age, the immune system of the body gradually weakens and is more susceptible to infections. If the person suffers from HIV-AIDS, there is general immunosuppression, which further weakens the immune system. Thus, they are more prone to developing opportunistic infections like candidiasis, sexually transmitted infections, and other viral and bacterial infections. Know about Genital Infection in Men: Symptoms and Treatment
Use of barrier contraceptives like condoms, regular health checkups like annual screening for diseases helps in early diagnosis and prompt treatment of the conditions.
Also, senior citizens with rheumatologic problems like osteoarthritis may be on long-term medications like corticosteroids. They lead to a compromised immune status as well, further predisposing to opportunistic infections in them.
Urinary Tract infections are the most common cause of nosocomial/ hospital-acquired infection among senior citizens. They have more chances of developing pneumonia (due to bacterial or viral infection) as the body’s defense mechanisms cannot ward off the offending agent.
6. Senior citizens and Malnutrition
Malnutrition includes both: Overnutrition-obesity and undernutrition- resulting in muscle weakness and a weakened immune response.
While lifestyle habits like smoking and alcoholism severely affect nutrition by causing liver diseases (which synthesize body proteins), cognitive disorders like dementia may forget about his meals. Also, financial constraints may limit the serving portion and nutritional intake.
Healthy food options (as mentioned above, including nuts and fresh fruits and vegetables) can help with nutrition.
7. Visual and Auditory Impairments
A cataract is the most common cause of treatable blindness in the elderly. Regular cataract camps are held, which, through cataract surgery, offer a new lease of vision to the patient. Also, hypermetropia (far vision) or difficulty in reading nearby lines can be corrected using appropriate spectacles.
Glaucoma, with increased intra-optic pressure or age-related macular degeneration, may also predispose the senior citizens to develop vision loss.
Hearing impairments due to sensorineural hearing loss or other reasons can be problematic. Hearing loss assessment and the provision of suitable hearing aids enhances the quality of life.
8. Neglect of Oral Hygiene in Senior citizens
Oral Hygiene and health are often neglected among the elderly. Thus toot caries, tooth extraction, root canal procedures, or dentures are fairly common in the elderly. Years of tobacco abuse can manifest as oral cancer in later life, which may be distressing.
They are associated with a decreased sense of self-esteem and can also complicate other health conditions by compromising nutrition.
Regular dental checkups and care of dentures go a long way in promoting good oral hygiene.
9. Drug and therapeutic misuse
Substance abuse mainly involves the excessive consumption of alcohol and smoking. They have deleterious effects on the body by exacerbating conditions like hypertension, liver cirrhosis, and substantially increase the risk of cancers in senior citizens.
At times, the elderly may take medications prescribed to their spouses or family members for similar treatment. However, this has deleterious consequences since they may be suffering from renal or hepatic impairments which require dose readjustments. Thus, drugs should never be interchanged except on the advice of a medical professional.
10. Bladder and Bowel Problems:
Senior citizens often complain of the urge to pass urine more frequently (urge incontinence) and post-voiding urine dribbling. Also, the incidence of benign enlargement of the prostate, which may cause similar symptoms, increases with age. Read Prostate Enlargement: a cause of concern in Men
Constipation is another important problem in the elderly, leading to bloating and straining. It may also increase the chances of a hernia since the increased abdominal pressure can push the contents out of the abdomen.
Medical and surgical treatment modalities with excellent results are available, which help the senior citizens to lead a healthy life later.
Helping senior citizens with social support:
By volunteering for activities, such as at a nursing home, one can help the elderly. Also, everyone needs a break. Their mood is uplifted by helping them engage with moderate outdoor activities like a walk or some games like carom or chess.
Helping them with using electronic devices is another way in which we can help them with simplifying their tasks, like contacting their friends and distant relatives.
Helping them with their household chores or a simple gesture like buying groceries for them when you go out to buy your own is one of the simple yet profound altruism acts.
Also, helping them manage their finances (light bills, medication bills, grocery, etc.) and mapping out a schedule (daily routine activities like meditation, spiritual activities, going for a walk) will help them remember better and prevent a cognitive decline.
Thus, for healthy ageing, a holistic view needs to be taken: Overcoming and preventing health problems while simultaneously improving the quality of life via allied activities.
Several NGOs, including HelpAgeIndia, ManavLok, and Abhoy Mission, work in various fields related to the needs and challenges of the elderly in India. However, those of us who have grandparents, taking good care of them and providing them with our time and attention would be the best gift! For those who do not have grandparents, adopting a senior citizen is another viable alternative.