Health Tips for the Old

 



Q1. Why are seniors more likely to fall?
There is a direct relationship between fall incidence and age. Research found that balance deteriorates after 50. And with reduced balance, ones are more likely to fall after 80. There are many other causes of falls, e.g. due to pain in the lower limbs such as the knees or ankle joints, some people cannot walk properly and are more prone to fall. Muscle loss can also lead to falls, especially when one with weak muscle steps over objects.  Another factor is vision. Eye problems such as cataract, glaucoma or weak night vision may cause falls, especially in the evening. Other illnesses such as stroke, Parkinson’s disease, nervous system diseases, etc. can lead to reduced mobility and higher fall risk. Some medications may also make one fall, e.g. antihypertensive medications or other blood pressure-lowering drugs. After taking these medications, one may feel dizzy while standing up and fall. There are other potential dangers at home, such as slippery floor, high bathtub level, obstacles on the floor such as rug. In short, fall risk increases with age. 
 
What are the adverse effects of falls? Direct injury or bone fracture, even brain haemorrhage induced by head injury can be life-threatening, and we need to be very careful. Falls can also cause bone fractures. Why do the elderly suffer bone fractures? While falls are common across all age groups, bone fractures tend to be rarer in youth than in the elderly after fall incidents. It may have to do with the impact upon falling or osteoporosis. Osteoporosis is common in postmenopausal women over 50, and mostly occurs a decade after menopause. As a silent disease, osteoporosis is often not diagnosed during routine examination, and patients usually feel no pain either. Thus women over 50 should have bone mineral density test to measure the bone density, and the condition can be treated by exercises, a calcium-rich diet or medications. Osteoporosis affects not only women but also men after 70. Therefore bone mineral density test is also recommended to men over 70 for risk assessment. 
 
Q2. How can I distinguish between amnesia and cognitive impairment?
Many people worry if poor memory suggests cognitive impairment in the elderly and if examination is needed. Some seniors may also feel worried when they cannot remember what happened yesterday, thinking that their memory is failing. In fact, cognitive impairment and age-induced memory disorders are different. From a medical perspective, your memory will impair when you are getting old. Our short-term memory will begin to deteriorate after 40. So how do we define “normal memory”? Let say you made a new friend yesterday and he told you his name and address.  It is normal if you simply forget his name the other day, as research found that new events are less likely to be registered and recalled.
 
So when does memory become “abnormal”? Let say this time you ate with your daughter yesterday, and you chatted with her as well. It would be “abnormal” if you totally forget something as important as this today. Cognitive impairment is more than short-term memory loss. As a memory disorder, it also affects the recent memories. Common problems include confusion about time and places, reduced self-care ability and poorer judgment.
 
So when should we beware of or suspect cognitive impairment in the elderly? It merits attention when they keep leaving objects in wrong places, e.g. when keys are found not in the normal place but inside the fridge or other cabinets.  Or while they can manage to cook on their own, they often forget that they have already bought some fish, and keep buying one after another even though the fridge is full. Or due to memory disorder, they often complain about losing things and even accuse the domestic helpers for theft. These problems are common in early cognitive impairment. And consultation is recommended because cognitive impairment mostly has to do with degenerative conditions, such as Alzheimer's or vascular diseases. While these conditions are not completely curable and account for cognitive impairment in 9 out of 10 cases, it can be treated in 5% of cases due to hypothyroidism, problems related to vitamin B12, brain tumour, hydrocephalus, etc. Cognitive impairment can be controlled effectively if the underlying conditions are considered curable upon diagnosis. In case of dementia or vascular diseases, doctors will make recommendations on daily care and medications to help enhance the quality of life and lower the risk of complications.

Check out YouTube videos from HKSH Medical Group for more health information.