Common Health Concerns in Older Adults: Diagnosis, Treatment, and Management
Common Health Concerns in Older Adults
Frailty
Frailty is a geriatric syndrome characterized by a decline in physiological reserves, making individuals more vulnerable to stressors. Diagnosis requires the presence of at least three of the following criteria:
- Unintentional weight loss
- Self-reported exhaustion
- Weak grip strength
- Slow walking speed
- Low physical activity
Parkinson’s Disease (PD)
PD is a progressive neurodegenerative disorder affecting movement. It is characterized by the death of neurons in the substantia nigra, leading to dopamine deficiency. The classic triad of symptoms includes:
- Cogwheel rigidity
- Bradykinesia/dyskinesia
- Resting tremors
Treatment focuses on dopamine replacement or dopamine agonist therapy.
Osteoporosis
Osteoporosis is a bone disease characterized by low bone mass and increased fracture risk. Non-modifiable risk factors include age, gender, and family history. Modifiable risk factors include low body weight, calcium and vitamin D deficiency, and inadequate exercise. Treatment involves weight-bearing exercise, calcium and vitamin D supplementation, and bisphosphonates.
Osteoarthritis (OA)
OA is a degenerative joint disease caused by wear and tear of cartilage. It typically affects weight-bearing joints such as the knees, hips, and spine. Treatment includes weight management, exercise, pain relievers, and joint injections.
Rheumatoid Arthritis (RA)
RA is a chronic, progressive autoimmune disease causing inflammation of the joints. It is characterized by symmetrical joint involvement, prolonged morning stiffness, and pain that worsens with inactivity. Treatment involves disease-modifying antirheumatic drugs (DMARDs) and biologics.
Diabetes Mellitus (DM)
DM is a metabolic disorder characterized by high blood sugar levels. Older adults with DM may present with atypical symptoms such as confusion and incontinence. Treatment includes lifestyle modifications, oral medications (e.g., metformin, SGLT2 inhibitors), and insulin therapy.
Dementia
Dementia is a decline in cognitive function that interferes with daily activities. Alzheimer’s disease (AD) is the most common form of dementia. Treatment focuses on managing symptoms and providing supportive care.
Malnutrition
Malnutrition is a condition resulting from inadequate intake or absorption of nutrients. Diagnosis requires the presence of at least two of the following criteria:
- Insufficient energy intake
- Weight loss
- Loss of muscle mass
- Loss of subcutaneous fat
- Edema
- Diminished functional status
Treatment involves addressing the underlying cause and providing nutritional support.
Urinary Incontinence
Urinary incontinence is the involuntary loss of urine. Types include urge incontinence, stress incontinence, and functional incontinence. Treatment depends on the underlying cause and may include behavioral interventions, medications, and surgery.
Insomnia
Insomnia is a sleep disorder characterized by difficulty falling asleep or staying asleep. It is diagnosed when sleep difficulties occur for at least one month and impair daytime functioning. Treatment includes sleep hygiene measures, cognitive behavioral therapy, and medications.
Sleep Apnea
Obstructive sleep apnea (OSA) is a sleep disorder characterized by repeated episodes of upper airway obstruction during sleep. Treatment includes weight loss, continuous positive airway pressure (CPAP) therapy, and surgery.
Fall Prevention
Falls are a major cause of morbidity and mortality in older adults. The Centers for Disease Control and Prevention (CDC) recommends six steps for fall prevention:
- Begin a balance or exercise program.
- Talk to your healthcare provider.
- Review your medications.
- Get your vision and hearing checked.
- Make your home safer.
- Talk to your family members.
Physical Activity
Regular physical activity is essential for maintaining health and preventing chronic diseases. Older adults should engage in at least 150 minutes of moderate-intensity aerobic activity per week and muscle-strengthening activities on two or more days per week.
Hyperthyroidism
Hyperthyroidism is a condition characterized by excessive production of thyroid hormones. Graves’ disease is the most common cause. Symptoms include weight loss, rapid heart rate, tremors, and anxiety. Treatment options include antithyroid medications, radioactive iodine therapy, and surgery.
Hypothyroidism
Hypothyroidism is a condition characterized by insufficient production of thyroid hormones. Symptoms include fatigue, weight gain, cold intolerance, and constipation. Treatment involves thyroid hormone replacement therapy.
Thyroid Storm
Thyroid storm is a life-threatening complication of hyperthyroidism. Symptoms include high fever, rapid heart rate, and altered mental status. Treatment involves supportive measures and medications to reduce thyroid hormone levels.
Myxedema Coma
Myxedema coma is a rare but life-threatening complication of hypothyroidism. Symptoms include hypothermia, bradycardia, and altered mental status. Treatment involves supportive measures and thyroid hormone replacement therapy.