Falls are a major cause of both disability and death in senior citizens. They occur frequently. More than one third of people over age 65 have at least one fall each year. After a fall, elderly patients frequently voluntarily restrict their activity because they fear another fall. The occurrence of falls is a strong predictor of nursing home placement. Reduction in exercise leads to further weakness that, in turn, increases the risk of another fall, a vicious circle. Older patients need protection while walking after a fall to allow them to retain an adequate level of physical fitness.
Drooping of one or both of the eyelids is called ptosis or blepharoptosis. It may involve one or both eyes. There are many causes of a drooping eyelid, some of which are particularly common in the elderly. Often the drooping comes on very gradually and the patient is not aware of the change.
After a lifetime of walking on feet that are bound in ill- fitting shoes, several potential problems develop. Much can be done to avoid the difficulties that occur with the aging foot. Careful treatment and thoughtful selection of footwear can slow or arrest these changes. It is also possible to adapt to changes that are irreversible with proper footwear. This occasionally requires the use of prescription footwear.
Dietary fiber is a plant product that is commonly present in food but cannot be digested by the intestinal tract. It adds bulk to the diet but does not offer nutrition. Much time and money are spent by the food industry to eliminate fiber from prepared foods. Fiber is important in the normal function of the intestinal tract.
The normal function of the digestive tract is marvelously coordinated. Food and fluids enter at the top for digestion and absorption. The waste moves smoothly down the digestive tract for timely elimination. Not surprisingly, in some people a certain amount of incoordination in this process oc
A great deal of public and scientific interest has been generated in a recently discovered infection that occurs in the stomach. Usually the acid in the stomach keeps this organ free of infections. One bacterium, Helicobacter pylori, has evolved a mechanism to tolerate this harsh environment.
As the skin ages, it loses some of the defensive mechanisms involved in preventing fungal infection. Fungi that infect the skin are not particularly virulent, and they need breakdowns in the normal skin defenses to invade successfully.
The condition in which the fluids within the eye develop a higher than normal pressure is called glaucoma. If glaucoma is not treated, the increased pressure is transmitted to the optic nerves and can produce irreversible loss of vision, even complete blindness.
Gout is a cause of acute joint pain and occurs at an earlier age in men than in women. Patients with gout have elevations in the blood of a component called uric acid. Most often these elevations occur because the kidney fails to excrete the uric acid as fast as it is made. Gradually crystals of uric acid deposit in the tissues. These deposits occur around joints, and the release of the crystals into the joint may cause the sudden development of arthritis. The joint becomes red, swollen, hot, and tender. The tenderness is extreme, and patients with fully developed gouty attacks are unable to sustain even a light touch on the joint such as from clothing or bedclothes.
Hearing loss has many possible causes. If there is interference in the ear itself, the hearing loss is conductive deafness. The other major cause for hearing loss, neural hearing deafness (nerve deafness), is interference with the transmission from the ear to the brain. Both types of hearing loss occur with increased frequency in elderly patients.
When the circulation of blood through the coronary arteries—the arteries that feed blood to the heart muscle—decreases too much, a portion of the heart muscle dies. This is a myocardial infarction, or a heart attack. Hardening of the coronary arteries occurs because of the deposition of cholesterol in the walls of the blood vessels. These deposits prevent the blood vessel from relaxing and opening wider when necessary, and they also may narrow the existing opening in the blood vessel, impairing the flow of blood.