Diseases of aging: lifestyle and prevention also pay off
Diseases of aging: lifestyle and prevention also pay off
A German proverb says, "Old age is like a hospital that accepts all diseases," and medicine confirms that older people are not only considerably more susceptible to infectious diseases than they were in middle age, but that body and mind are also less resilient and recover slower or not at all from adverse effects or injuries.
"Life is a bell curve: children are particularly fragile, their organism works differently and their immune system still has to learn a lot. We then enter a peak phase and are very robust as adults. With increasing age, we become morbid, develop even multiple morbidities and thus are increasingly susceptible to diseases", explains Nina Meckel, spokesperson of the German Society of Geriatrics (DGG). In older persons, the body is in a degenerate state where all of its mechanisms and systems work slower and on the whole worse than they did in middle age.
This can be seen in the example of the skeleton: due to hormonal changes, many women suffer from osteoporosis during menopause. They lose bone density and have an increased risk of bone fractures. Subsequently, these more frequently lead to additional problems compared to younger patients; for instance, infections, longer healing processes or loss of muscle mass after a long period of immobility. Other health issues that older people increasingly have to struggle with are malnutrition which can be caused by difficulties in swallowing or dental problems, depression in older people related to increasing loneliness and social isolation or neurodegenerative diseases such as Alzheimer’s or Parkinson’s disease. The increasing number of different medications older people often need to take also increases risk due to potential drug interactions or wrong dosages.
Prevention for older adults: we are laying the foundation early on
Having said that, many of the disease patterns we increasingly find in old age, also occur in middle age, when we are more robust. This is generally related to our lifestyle. Excess weight, for example, can lead to many other complications: joint pain caused by stress on the supporting apparatus and musculoskeletal system, type 2 diabetes and cardiovascular diseases like heart attacks and strokes. "When it comes to prevention, the same basic rules apply to all phases of life," explains Meckel. "If you eat healthy, exercise in moderation and do not smoke, you stand the best chance of healthy aging. You can already lay the foundation at 30 for this. It is harder if you wait and start at age 70."
Aside from exercise, diet is also an essential foundation for better health. For instance, there is salt consumption, which nowadays is drastically increased due to industrially processed foods. We have known for a long time that - among other things - there is a correlation between an increased daily sodium intake of more than six grams and high blood pressure - a disease that keeps troubling us in old age and increases the risk of heart attacks, strokes, and organ damage. "Various studies showed that many patients suffering from high blood pressure were able to lower their blood pressure with a low sodium diet," explains Professor Helmut Schatz, Member of the Board of the German Society of Endocrinology (DGE), in an interview with MEDICA-tradefair.com.
This belief was in turn called into question in a recently published study. Adds Schatz, "Instead - and this is the new revelation of the study - it turned out that a daily intake of less than three grams of sodium may actually increase the risk of cardiovascular disease in both people with and without high blood pressure. The result of the study is, therefore, 'if you consume too little salt, it is also bad for you'." Having said that, there is no standard recommendation for or against the consumption of salt, as is the case with all other diet concerns. In fact, Schatz recommends that "If you are healthy, you should consume reasonable amounts of salt, while patients with high blood pressure and cardiac insufficiency should reduce their sodium intake." This already shows that how healthy we are in old age, also depends on how healthy we lived beforehand.
Diseases of aging and diseases of civilization
Type 2 diabetes exemplifies how so-called diseases of civilization caused by lifestyle are related or added to diseases of aging and impact the rest of our lives. In the past, metabolic disorder was seen as a pure aging-associated disease, yet its main causes include excess weight and lack of exercise. Consequently, it also increasingly occurs in younger people and even in adolescents. Respective countermeasures can delay or even reverse the disease course. However, these means are difficult to implement in old age when patients lack the necessary fitness level and mobility. In this case, drugs are used if needed.
Diabetes considerably increases the spectrum of diseases an old person can have. In addition to metabolic disorder which can cause hyperglycemia or hypoglycemia, complications due to continuous high blood glucose levels are also added to this. This includes nerve damage and damage to blood vessels which in turn promote cardiovascular diseases and require additional medications. Both also negatively impact wound healing, especially on the extremities - a mechanism that is already impacted in old age and in turn makes patients more susceptible to infections.
Diabetes might even contribute to causing or worsening cases of dementia. Severe hypoglycemia and disturbed blood flow to the brain are being considered as possible causes, especially for Alzheimer’s disease. Study results on this subject are inconclusive. That being said, it is striking that diabetics are more frequently affected by types of dementia than people who do not suffer from diabetes.
In old age, we are often plagued by a package of diseases and impairments that affect many different parts of our body, on the one hand, while they are related to each other at the same time. "Old people should always be able to visit a geriatrician who looks at a person as a whole and who knows how everything is related to each other. Medical specialists often only look at one aspect," adds Meckel. "It is natural for us to take a child to a specialized pediatrician and to be careful when administering medications. Yet when it comes to older people, society and health care politics have not yet understood these two aspects. The DGG is actively committed to changing awareness of this issue."