Changes in health of older people

Many people fear being diagnosed with dementia when the get older. Lifestyle is a key factor in preventing dementia. There are many types of dementia.

Alzheimer's

Alzheimer's is the most common form of dementia. This is a neurodegenerative disease which is most common in older people, but younger people are also diagnosed. Symptoms appear slowly, often unclear and often delay a long diagnosis. Evidence includes:

• Forgetfulness that has recently been noticed and affects the ability to work.

• Things are not put in their right place.

• Increasing difficulty with planning and more complex activities of daily living.

• Difficulty knowing time and space.
  

Lewy body

Lewy body dementia can cause a range of symptoms such as dyskinesia comparable to those associated with Parkinson's disease.

Personality changes such as sudden anger and delusions can accompany this disease. It can therefore prove particularly difficult for the bereaved.

Vascular dementia

Vascular dementia is caused by diseases of the blood vessels such as bleeding, calcification and blood clots that cause oxygen deficiency. The symptoms can be different and depend on where the brain damage is.

The Alzheimer's Association offers comprehensive education about dementia. The dementia app has also proved to be a success. It is available for all types of telephones. It contains detailed information on anything related to dementia.

Analysis

When you suspect that you or someone close to you may be developing dementia, it is very important to see a doctor.

• First stop is always the GP. He or she may submit examinations and evaluate what the next steps will be. Those who are 65 years of age and younger are usually referred immediately to the Memory clinic where a thorough diagnosis is made.

• The Memory clinic is carrying out tests on CT scans of the brain and spinal fluid. PET has been shown to be an effective diagnostic tool.

• The diagnosis process can take a long time or up to one year.

Immediate medical attention is very important, as symptoms may suggest something other than dementia, such as a tumour or bleeding.

Treatment - drugs

To date, no new drugs for common dementia have been on the market in Iceland for more than 20 years. A change is expected, starting next year, to give a drug that has been effective and slowed the progression of the disease by about a third.

The drug is given intravenously but there is a danger that not many people will receive an approved subsidy because it is very expensive.

Treatment - lifestyle

Good news came at the same time as the new drug was announced.
They are related to a Finnish study called FINGER. Results indicate that the method reduces Alzheimer's progression by one third, as does the new drug.

This is the first time that results from scientific research related to activity and lifestyle have yielded similar results.

Important factors:

Physical activity

• Physical activity should be performed at least three times a week. It needs to be so intense that your pulse rises, you get shortness of breath and sweat a bit.

Cognitive functioning

• It is important to regularly challenge the brain by learning a new language or to play an instrument. There are apps with recognised puzzles that need to be solved regularly and then crossword puzzles, sudoku and jigsaws are also good preventions.

Social activity

• Meeting other people either in a community centre, club or group of friends is extremely important. Among other things, it preserves the activity of conversing, while aphasia is often seen as progressing in the disease. It is also important to have hearing impairment treated if necessary.

Other factors that can be mentioned are the importance of good sleep, healthy diet and moderate consumption of alcohol.

Carers

Living in a home with an individual who has begun to show severe symptoms of dementia often takes a lot of effort. The individual needs great assistance with all the activities of daily life, is disoriented and and even does not know his next of kin any more. A problem with the circadian rhythm occurs rapidly and nights can be difficult.

It is important that relatives seek help and support.

It is important for all older people to consider their diet and make sure that it is nutritious enough. With age, our need for energy changes because of muscle atrophy and less exercise. The need for vitamins and minerals is not reduced, while the need for protein is increased.

The Directorate of Health has official dietary recommendations based on each individual's situation.

As people get older, their appetite can decrease. Then, for example, it can be very important how the food is served and that it is beautifully placed on the table.

It is common in nursing homes to have to mash food. Then it is important that each one on the plate is mashed and presented beautifully.

The Alzheimer's Association has, among other things, an educational lecture on nutrition, quality of life and well-being Nutrition, quality of life and well-being (in Icelandic) that everyone can benefit from viewing.

Already in the fifties, people's musculoskeletal systems begin to change. Muscle mass declines and so does bone density. Furthermore, stiffness increases as the flexibility of joints and tendons decreases.

It is important to respond to this and do exercises specifically aimed at strengthening the musculoskeletal system. Among other things, it will contribute to increasing well-being, reducing the risk of falls and enabling people to stand up from chairs without support.

Vision

The eye undergoes age changes and loses its flexibility in the forties. The flexibility allows the eye to adjust and thus be able to see all distances. Most people that get older experience the first signs of distant vision, of seeing things that are close.

The main characteristics of age-distance sampling are:

• The focus point changes when it comes to close-work

• Fatigue of the eyes

• Blurring vision

• Time to switch distances is longer

Various diseases can appear in the eyes:

• Glaucoma - is an eye disease that leads to damage to the optic nerve that connects the eye to the brain. If glaucoma is not treated, it can cause blindness.

• AMD is an age-related disease that causes macular degeneration. The aetiology of this adverse event is not known but risk factors include smoking and increasing age.

• Clouding of the eye - is the condition when the lens is no longer clear. This limits the way light enters the retina of the eye and causes blurred vision. The disease is most common in older people. Treatment is a procedure where a new prosthetic lens is inserted to replace the old one.

Other diseases of the eye include problems with the eyes of diabetes and detachment of the retina.

Hearing

Hearing impairment may be either congenital or acquired. It usually increases slowly over the years. Hearing loss usually follows increasing age. You can read about the main types and causes of hearing loss at Heilsuveru (in Icelandic).

It is very important to treat hearing impairment, as new research shows that there is a link between hearing impairment and dementia. This is quite obvious, but when hearing gets worse, people become less socially connected and lose contact with their environment.

Treatment:

• Hearing aids when you need to amplify external environmental noises such as speech.

• The hearing aids come in different types, sizes and colours. They also exist in different price categories. Iceland Health contributes to costs (in Icelandic) if hearing is measured within certain limits. It is also possible to apply for a subsidy to the sickness funds of the main trade unions.

Falls are a common problem among older individuals, and can have serious consequences.

Research suggests that approximately one third of people aged 65 and older experience a fall at least once every year, and around 50% of those aged 85 and over experience such falls once a year or more. Furthermore, roughly 10% of falls result in injuries, and about 50% of these injuries include fractures that can significantly affect the quality of life of the individual who falls.

However, there are certain measures that can be taken to reduce the risk of falls, such as regular exercise, balance exercises and more.

For additional information on this topic, please visit Heilsuvera.

Alcohol problems of older people is a hidden problem and little discussed. The consumption of alcohol and drugs has increased in general, also in older age groups according to information from emergency departments and other hospital departments. The abuse of addictive drugs is also a problem in these age groups.

It is not uncommon for those who previously had control over their consumption of alcoholic beverages to lose control as they age. Over 50% of those who are over 60 years old and admitted to Vogur, drink alcohol daily.

It's a good idea to start by contacting your healthcare provider or family doctor regarding help with tapering off. If inpatient detoxification is needed, contact SÁÁ, either by calling 530 7600 or viewing information on the organization's website

When older people enter a geriatric unit and during an interview it often becomes clear that drinking is a problem. That can be difficult and sensitive to discuss.

The reason for the increased consumption of alcohol in later years can be, among other things, that when people retire, they are not adequately prepared for everyday life without a paid job. Therefore, it is important to continue to make a difference on the weekends and to create new habits in between without alcohol.

More information about alcohol on Heilsuvera and about alcohol and drug prevention – recommendations from the Directorate of Health. (in Icelandic)

A number of diseases can affect people as they get older. Many of these are not classified as ageing diseases, although age is a certain risk factor.

This includes Parkinson's disease, a neurodegenerative disease that affects the neurons in the brain that control movement. Symptoms begin slowly and are the main:

• Slow and stiff movements

• Tremor

• Muscle stiffness

• Balance loss

Research also shows that the symptoms that cause the most difficulties in daily life are those that are not related to physical activity, such as cognitive symptoms such as difficulties with memory and language use. You will experience less smell, depression, tiredness and sleep disturbances.

More information can be found at Heilsuvera (in Icelandic) and also educational material at
The Parkinson's Association (in Icelandic).

Analysis

When Parkinson's disease is suspected it is best to see your GP first. Sometimes it is possible to diagnose quickly, but often it takes longer.

The subject is:

• Health history

• Typical symptoms such as movement, shaking and stiffness.

• Walk and talk

Treatment

General functioning is important in all treatment of Parkinson's patients and, for example, specialized physiotherapy is provided at the Parkinson's Association Takti - Centre for Disease Control.

Treatment usually involves administration of medication. She alone will not cure the disease but can keep symptoms down. They can be very personal.

There is also the possibility of brain surgery where electrodes are inserted.

Urinary incontinence is when people do not have full control over their bladder and therefore lose urine. The problem can be of varying degrees and is known in both women and men. Urinary incontinence is more common in older people.

It is important to find ways so that urinary incontinence does not have a negative effect on people's quality of life.

Useful information about urinary incontinence on Heilsuvera. (in Icelandic)

Many people experience various traumas during their lifetime. They can be related to the loss of a close relative, losing a job or being diagnosed with a serious illness, to name just a few.

It is important to know the symptoms of trauma and post-traumatic stress disorder so that you know what can be done and that you can seek help, because serious consequences can occur as a result of such trauma, soon or many years later.

What is a trauma? It triggers a strong stress response following certain, unexpected events where a sense of security is threatened? The result is often chronic stress. On Landspítlan's website (in Icelandic) you can find detailed information about trauma, trauma care and psychological support.