The Challenge of Aging

The statistical data and actuarial records relating to aging population trends and profiles throughout the United States are not only credible but astonishing. The life expectancy of a person born in 1900 was 47 years, and there were only 3 million persons 65 or older in that year. For a person today, the life expectancy is 75 years, and there are over 36 million senior citizens. In 1900 pneumonia, tuberculosis and gastroenteritis were the major causes of death. Today, heart disease and cancer are the major causes.

People are living much longer. If a person is already 65 years old, his or her average remaining lifetime is 17 years. If you are a descendent of long-lived ancestors, your genes are coded for an even longer life. It helps to be a woman, too. On average, American women live 8 years longer than men. Today, life expectancy for men is 71 years while life expectancy for women is 79 years. There are approximately four women to every three men in the 65 and over category. By 2030 it is predicted that there will be 58 million persons aged 65 or over and will constitute 17 percent of the entire population.

In most industrialized countries, 65 has become the mandatory age for retirement. This was first started by the Prussian Dictator, Bismarck, in an attempt to institute social reforms for his subjects. Retirement was considered a reward from the state for the worker's many years of toil. During this turbulent period in history a person's life expectancy was substantially shorter than it is today. Few workers spent any time in retirement. This practice continues today because it is the belief that a strong, efficient industrialized society can provide goods and services for all its citizens while "freeing" its senior citizens to enjoy the better aspects of life.

A society is a collection of formally and informally groups organized for mutual survival. The family, as the primary unit in our society, is responsible for child rearing and the social and moral training of our young. The family transmits roles and status to its members and provides a series of rewards, reinforcements, and prohibitions that direct our lives. Our society places a premium on youth. Exalting youth, we devote many years to the care, nurturance, and education of our young. The elderly are neither cherished, like the young, nor productive, like the middle-aged, our society makes them feel like obsolete, unwanted burdens.

The elderly, themselves, consciously or subconsciously subscribe to these prejudices. The most obvious one stems from the Puritan work ethic, "An idle mind (and hands) is the Devil's workshop." It's ironic that the strongest proponents of the work ethic are the senior citizens. This attitude compounds the problems arising from the idleness they face after forced or voluntary retirement. Senior citizens encounter other prejudices as well. If they seek work, most employers will turn them down because they are "too old." Studies indicate that, except when a life is at stake, persons working with or caring for senior citizens do not like their jobs and would prefer working with younger people.

Normally adjusted senior citizens are able to face very grim realities as long as the circumstances of their lives allow them to remain outgoing and communicative. For many, retirement means the opportunity to do the things have never had time to do. A certain amount of loneliness and depression is par for the course in normal aging in dealing with the losses that are inevitable.

Since biblical times, much has been written about the cognitive stability of older persons, and studies have shown that senior citizens are as competent as anybody in making use of long-term memory to arrive at decisions. The fact that it may take a little longer is offset by the greater number of memories they have stored up. Having a wealth of experience to draw on contributes a perspective that the younger person simply can't apply. For practical purposes, therefore, seniors can do anything just as well as their younger counterparts, as long as they are given time.

One of the most common assumptions about senior citizens is their excessive dependence on others. The evidence for dependence can be determined by three indicators-reliance on others for living arrangements, health care and finances, simply doesn't support this idea. According to a study, 75 percent of senior citizens own their own homes. Typically these homes are in urban areas. Most of them are fully paid for, and therefore, relatively cheap to own. Practical problems do arise-for example, lack of transportation and difficulties getting up and down stairs. Certain State Offices of Aging operate programs to help meet the practical needs arising from incapacities that frequently occur after age 75 years and older.

Senior citizens are basically healthier than we think. The aged do suffer more chronic conditions, such as high blood pressure, diabetes, and heart disease but have fewer acute illnesses than younger people. When acute illnesses do occur, they tend to be more serious.

There is an interesting theory on the loss of reserve energy or "second wind." Lack of it seems to be what people allude to when they say they're feeling older. Actually it's stress and daily wear and tear rather than age, that impairs the body's homeostatic (self-balancing) processes. Nonetheless, we blame age for the slowness we sometimes feel. There are many ways to minimize the loss of reserve energy: regular exercise, good nutrition, meditation and avoidance of smoking. All improve circulation of the blood and contribute to general feelings of well-being.

In our country, loss of income means loss of social status and presages loss of independence. Therefore, loss of income is a very strong and realistic source of fear. The four sources of income for senior citizens are: social security, pensions, salaries and public welfare programs. More than 18 percent of senior men and nearly 8 percent women are still working. In the last 30 years, there has also been a large increase in the number and value of pensions available to retirees. Senior citizens though sometimes in straitened circumstances, are remarkably proud and independent. The idea of being financially dependent is an old myth that does not hold water.

In some other cultures, senior citizens are venerated as sages of wisdom and treated with the utmost respect. Our country has to switch its perspective from worshipping youth to valuing its senior citizens and what they have to offer. When this attitude change occurs, then people will stop dreading about "getting old."

Last year, the U.S. government forecast that the nation's health care spending would consume nearly 20 percent of our Gross Domestic Product (GDP). One of the contributing factors to the surge in health care spending is the aging baby boomer population. In the U.S., men and women born between 1946 and 1964 are turning 60.

The human body changes in many noticeable ways with age. Perhaps the first sign of aging occurs when the eye cannot focus easily on close objects (presbyopia). Often by age 40 or so, many people find it difficult to read without using glasses. Hearing also changes with age. People tend to lose ability to hear the highest pitched tones. Therefore, older people may find violin music no longer sounds as exciting as it did when they were younger. Also, because the closed consonants of speech are high tones (sounds such as k, t, s, p, and ch), older people may think that others are mumbling. Sense of smell and taste diminish with age. Older people are not able to detect smells such as delicate fragrances like flower blossoms. Along with the loss of smell is the loss of taste. Taste and smell work in conjunction with each other to help us enjoy the taste of our foods. It is been shown that by the middle of the second decade(before you are 20) of life most people begin losing taste buds.

In most people, the proportion of body fat increases by more than 30 percent with age. The distribution of fat also changes. There is less fat under the skin and more in the abdominal area. Thus, skin becomes thinner, wrinkled and more fragile, and the shape of the body changes with bulging stomachs.

Not surprising, most internal functions, also, decline with age. Some of these changes are:

1. Blood flow to the kidneys, liver and brain decreases.

2. The kidney's ability to clear toxins and drugs decreases. Decreased bladder tone, diminished sphincter control, which results in urinary incontinence.

3. The liver's ability to clear toxins and metabolize most drugs decreases.

4. Cardiovascular system, involving the heart and arteries, changes. Maximum heart rate decreases, but resting heart rate doesn't change.

5. Glucose tolerance decreases. Diminished insulin response to glucose load. Decreased insulin sensitivity, which results in increased fat tissue. Thryoid function diminishes.

6. The lungs' air-moving capacity decreases. This is due to the reduction of muscular tissue in the diaphragm and surrounding areas.

7. Amount of air trapped in the lungs after exhaling increases. Elasticity lung tissues diminishes.

8. Infection-fighting function of cells decreases. Increased susceptibility to infections, malignancies. Impaired response to immunizations.

9. Gastrointestinal system, affecting absorption of nutrients from food, decreases in its ability to digest and move food along the GI Tract. Diminished esophageal mobility and relaxation of sphincter between esophagus and stomach. Diminished intestinal mobility.

10. Bone/muscular system, involving strength and function declines with age. Decreased muscular fiber and diameter. Diminished bone mineral and osteoid. Increased stiffness of tendons, connective tissue. Diminished joint cartilage.

11. Reproductive system function, diminishes, which include menopause (in women) and andropause (in men).

12. Nervous system, responsible for the body's muscular response to stimuli declines. Diminished tolerance to temperature variation. Diminished thrist and drinking. Diminished postural reflexes and autonomic regulation. This causes postural hypotension, dizziness and falls. Sleep patterns are altered.

13. Sensory system, including the senses of touch, taste, smell, sight, and hearing changes. Diminished number of taste buds and salivation. Decreased taste and food enjoyment. There are changes in hearing and sight as described above.

14. Brain function, including memory and cognition, changes. This will be discussed more fully in another module.

These functions generally peak shortly before age 30 and then begin a gradual but straight-line decline. Even with this decline, however, most functions remain adequate throughout life, because most organs have considerably more reserve than the body needs (functional reserve). For example, even if half of your liver is destroyed, more than enough liver tissue remains to maintain normal function. Disease, rather than aging, usually accounts for loss of function in old age. Even so, the decline in function means that older people are more likely to experience adverse effects from medications, changes in the environment, toxins and illnesses.

Although the decline in function of many organs has little effect on how people live, the decline some organs can greatly affect health and well-being. For example, although the amount of blood that heart can pump at rest is not greatly reduced in old age, the heart cannot pump as much when pushed to its maximum. This means that older athletes will not be able to perform as well as younger athletes. Changes in kidney function can dramatically affect how well older people eliminate certain medications from their body.

Determining which changes are purely age-related and which is the result of how person has lived is often difficult. A sedentary lifestyle, poor diet, cigarette smoking, and alcohol and drug abuse can damage many body organs over time, often more so than aging alone. People who have been exposed to toxins may experience a more significant or more rapid decline in the function of some organs, especially the kidney, lungs and livers. People who worked in loud environments are likely to lose more of their hearing.

Fighting the Natural Aging Process:

The good news is the diseases and disabilities of human aging are largely preventable and treatable. Evidence suggests we can delay or minimize these age-related changes with appropriate diet, exercise and lifestyle modifications. Here are a few natural ways to maintain youth and vitality with age, according to the latest research.

Maintain Your Metabolism:

Loss of strength and muscle mass are common consequences of aging, as is the tendency to gain body fat due to our metabolism slowing down. Maintaining muscle mass is critically important for older adults, as frailty increases the risks of disability and disease. In a study, Bret Goodpaster, from the University of Pittsburgh, investigated whether increased physical activity could prevent or reverse losses in strength and skeletal muscle mass as well as reduce weight gain in older adults. In a study involving 11 older men and 31 older women, all of whom were overweight and sedentary at the start of the study. At the conclusion of the study period, all three groups lost weight, but only the diet-plus- exercise group improved their fitness levels, boosted their fat-burning capacity and minimized loss of muscle mass. According to the researchers, "Exercise seems to be key for maintaining muscle mass when older adults lose weight through dieting."

Go With the Flow:

Studies have shown that people with relaxed personalities have a more stable mood and are better able to handle stressful situations without anxiety. They also may be better positioned to prevent age-related cognitive decline, suggests recent research.

In a recent study, it was discovered that men and women who were socially outgoing, but not easily distressed by circumstances, were 49 percent less likely to develop dementia over time, as compared to those who were extroverted but neurotic. A calm personality also was associated with a 49 percent reduced dementia risk in those who were not socially active compared to those who were stay-at homes, but prone to distress. According to the researchers, these results "provide further evidence that certain personality traits may play a role in dementia development, and that personality lifestyle interactions may be especially important for determining dementia risk."

Live the Anti-Aging Lifestyle:

Another study discovered that the most important predictors of excellent health were absence of chronic illness, never having smoked, and drinking alcohol only in moderation. In addition, maintaining a positive outlook and managing stress levels were positive contributors to health with age. According to the research team, the important point here is, "Many of these factors can be modified when you are young or middle-aged. While these findings may seem like common sense, now we have evidence of which factors contribute to exceptional health.

Aging poses a costly burden to this nation, in terms of both financial and socioeconomic costs. Anti-aging medicine addresses aging as a treatable condition, aiming to reduce or eliminate the disabilities, diseases and dysfunctions we have grown used to assuming are a part of growing older. Take control of your health today by understanding how your body systems age and what you can do about it. Talk to your doctor for more information on natural ways to maintain health into your "golden years".

Getting older brings with it a wealth of new physical, emotional and mental challenges. Later life can be a time of rest, relaxation and retirement, and a time to enjoy life with one's spouse, children and grandchildren. It can also be a time to embark on a new adventure, whether it is travel, a new hobby or a fun job.

Aging can also bring with it a lot of anxiety. This stems often from issues of health and well-being, significant social and emotional changes, such as the loss of loved ones, isolation after retirement, or boredom and loneliness. The unforeseen nature of the aging process often makes people feel nervous and scared. Normal activities like eating, sleeping and exercise may become more difficult because of health reasons. New events and big changes in your life, such as your children relocating out of state because job conditions, may lead to depression, anxiety or loneliness.

"Research shows that older people can, and do, learn new things. Three key factors predict strong mental function in old age: (1) regular physical activity; (2) a strong social-emotional support system; (3) belief in one's ability to handle what life has to offer."

Measures which Promote Healthy Aging:

There are a number of ways you can partake in the aging process to give yourself a better likelihood for success by increasing your knowledge about how your body works and what makes it run more effectively.

Attitude - The number one way you can improve the aging process is to take charge of your attitude. Your sense of hope, humor and confidence will determine the tone of your experience. It is true that changing one's attitude is not easy. But your attitude is one thing you have full control over. Research has shown that people who worry about losing their memory fulfills their own prophesy. It is important to have a sense of humor and be able to laugh at yourself. If you forgot where you placed the keys to the house, instead of being upset and saying, "how stupid can I be for losing my keys, say to yourself, "Oh well, I am having one of those senior moments" smile to yourself and move on.

Mental Activity - Stimulating your mental faculties can significantly improve the aging process. Memory is like a muscle in your body. The more you work your brain, the better you will be able to handle and remember information. Trying to keep active mentally can help you improve your memory and combat boredom. Simple and fun things like games and puzzles, reading or taking a new route to the store are easy ways to keep your mind active and engaged.

Exercise - Regular exercise is another cornerstone of healthy living as you age. As your body slows down, you might be tempted to skip the exercise because of it is harder to do things and plus it just takes too much effort to get going. This is the wrong thing to do. The most important thing to remember about exercise as you get older is that it does not need to be strenuous; it just needs to be consistent. Studies have shown benefits for older people who walked a total of 90 minutes a week. It really is never too late to start exercising. Even people who remain sedentary most of their life can benefit from participating in an exercise regimen. Walking at a steady pace 3 days a week for 30-45 minutes each day "is enough to actually enhance cognitive function and reverse some of the deficits that may be occurring with old age. Regular physical activity will help your body function more effectively in many ways. It helps with weight loss and maintenance, combats anxiety and depression, keeps bones, muscles and joints working properly, relieves symptoms of arthritis and reduces the risk of heart disease, high blood pressure, diabetes and some types of cancer. As you age, you might need to change the types of exercise you do, but anything that gets you moving is good. Walking, housework, gardening and even babysitting the grandchildren can count as exercise. Finding a way to build regular physical activity into your daily routine will yield great results. Click here to learn if Does Exercise Really Keep Us Healthy

Staying Connected With Family/Friends - Safeguarding and nurturing your emotional well being is as important, if not more important, than taking care of your physical body. Isolation is dangerous to your health as it can lead to your mental deterioration. Contact with others, whether it be at work, church activities, or family get-togethers, will feed your mind and spirit and can provide purpose and meaning in your life. Furthermore, social involvement can help combat loneliness and depression and keep you active physically.

Diet -The importance of a balanced and healthy diet to healthy aging cannot be overstated. Eating well can make you: feel and look better; help your body run more smoothly; fight off colds and other illnesses; and, contribute to lowering blood pressure and cholesterol levels, which contribute to lowering your risk for having a stroke or heart attack. On the most basic level, your eating habits should reflect a desire to eat healthy. Fruit, vegetables, protein, complex carbohydrates, and healthy fats should make up your meals. It is important to lose weight if you are overweight. As we age, our metabolism slows down. This means that your body needs fewer calories than when you were younger. Changes to your diet should reflect the changing needs of your body as an older person. Your doctor or a dietitian should be able to help you develop a diet plan that fits your needs. The best way to lose weight is through reduction of calories and exercise. Click here to learn more about Weight Loss Guides without Gimmicks

Sleep - Achieving quality sleep becomes more difficult for many people as we get older. On average, people aged 50 to 85 sleep about 6 hours per day. Over 50% of men and women over age 65 complain of at least one chronic sleep problem. Many people accept sleep difficulties as a fact of aging. It is true that as we get older, our sleep patterns change, but it is equally true that good restorative sleep is essential to our physical health and emotional well-being. The number one cause of poor sleep at night is napping for too many hours or napping too late in the day. You should limit your napping time to no more than 45-60 minutes and not after 3 PM. Other possible causes of poor nighttime sleep may be big changes in life situation, health issues, medication, stress or anxiety. If getting a good night's rest has become more difficult then you need to be more conscious of your sleep environment and your sleep routine. Schedule yourself to go to bed and wake each morning around the same time. Make sure your sleep area is conducive to sleep with good ventilation, quietness, and dark enough to accommodate sleep.

Healthy Habits - Smoking and drinking are two big habits that can affect your health and the way you feel. Smoking, in particular, is one habit to quit if you haven't already because it greatly increases the risk of heart disease and cancer. Alcohol can be fine in moderation, but it also can contribute to sleep problems and suppress your appetite, preventing you from eating well. As you age, it is important to think about your lifestyle and identify habits which are helpful and harmful. Making a conscious effort to change the harmful habits will make your aging process more enjoyable.

Neighborhood /Outside Involvement - Sharing your interests and passions with others by volunteering, joining community groups, etc. helps keep you connected, exposes you to people of all ages, gives meaning and purpose to your life, and challenges you mentally. When you are busy thinking about others, it is much easier to put your own problems in perspective or forget about them altogether. It is the like old saying, "I felt sorry for myself because I had no shoes until I met a man who had no feet." Being involved in outside activities is a constant reminder that you still have a lot to offer. Seniors, who are active, engaged and feel good about their abilities generally feel better and live longer.

The process of healthy aging starts with being informed and staying active and believing that you can handle any problems that life may offer you.

Based on current nutritional science, here are simple tips that can add up to dramatic dividends in your health. A few simple substitutions and easy dietary changes can point you down the path to eating right and living better. Here are some simple ways to get started eating better for right now.

1) Use the smallest plate that will accommodate your food. For most of us, the number-one nutrition concern is controlling calories, so nutrition experts emphasize portion control. A large plate begs to be filled edge to edge; smaller plates train your eyes to serve up smaller portions.

2) Forget "family style." Instead of putting a platter and large serving bowls on the table, which encourages second helpings, fill the plates directly at the stove.

3) Make double vegetables - and serve them first. Instead of making vegetables an afterthought, try making veggies the focus of your cooking creativity. Whatever vegetable dish you whip up, make extra for a return engagement later in the week, so you can serve two vegetables. Serve the veggies first, so they dominate the plate and there's less room for the meat.

4) Think before you use spread. Newer whole-grain breads are tasty, without the added calories and fat of butter or margarine. A tablespoon of butter, olive oil or margarine adds 90 calories; even "heart-healthy" spreads contain 70 calories that your waistline might be healthier without.
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5) Go vegetarian one night a week. Nutrition experts suggest planning one meatless meal a week. Vegetarian meals can help you cut back on saturated fats and increase your intake of fiber.

6) Brew your own cold beverages. It means iced tea, of course. Nutritionists suggest avoiding high-calorie soft drinks and sweetened juices by keeping home-brewed iced tea in the fridge and serving with lemon. Iced tea has no calorie or artificial ingredients, and provides beneficial phytochemicals.

7) Drink flavored water. Another beverage strategy is cold water on hand and drinking it, with a wedge of lemon or lime, in lieu of caloric sodas.

8) Switch from whole milk to low-fat or skim. If you're already drinking 2% milk, see if you can make the change to skim. While it's important to get dairy in your diet, whole milk also contains saturated fat and excess calories that you definitely don't need. Research from the Women's Health Study showed that increased intake of low-fat dairy products reduced the risk of developing high blood pressure; those consuming high-fat dairy, however, saw no similar benefit.

9) Take your coffee "black." This means skip the cream and sugar. Dosing your coffee rather than sipping it straight is a prime example of "drinking your calories." In moderation, caffeine has been associated with a range of possible health benefits - but any such pluses are quickly outweighed by the minuses of added calories. It is estimated that only about 35 percent of people drink their coffee black, which means the rest of us are starting the day with extra calories (33 from two teaspoons of sugar and another 20 from a tablespoon of half-and-half) and saturated fat (one gram per tablespoon of half-and-half). Can't stand it straight? Try gradually shifting to 2% and then skim milk instead of cream.

10) Don't put a salt shaker on the table. Fine restaurants often omit the salt shaker, reasoning that the chef has seasoned the food just right back in the kitchen. If you follow their example, you can remove some of the temptation to increase your dietary sodium intake. Too much sodium is associated with a risk of high blood pressure. One recent study found that even people who don't have hypertension can benefit from a diet low in salt such as the Dietary Approaches to Stop Hypertension (DASH) eating plan, reducing their risk of heart disease and stroke.

11) Eat fish every Friday. Eating fish instead of meat on Fridays (or whatever day of the week you chose) makes good nutritional sense. Most experts advise eating fish - especially varieties like salmon, which is rich in omega-3s, twice a week, so designating one weekly "fish night" is a good start.

12) Cook in vegetable oil instead of butter. This simple switch can slash your intake of saturated fat, which contributes to unhealthy cholesterol levels and heart disease. Opt for monounsaturated fats like olive oil or polyunsaturated fat like canola and soybean oil, which have the added advantage of a higher "smoke point" than olive oil or butter.

13) Start the meal with soup. It is a good choice to start with a light vegetable broth soup. Besides getting the nutrients and fiber from the soup, it also fills you up so that your eat less of your main course.

14) Put your meat on a diet. Buying leaner cuts - along with trimming visible fat - avoids calories as well as saturated fat. The leanest beef cuts include round steaks and roasts, top loin, top sirloin, chuck shoulder, and arm roasts. The leanest pork cut choices include pork loin, tenderloin, and center loin.

15) Dress your salads lightly. A heavy hand with salad dressing, especially the creamy kind, can turn a "healthy" salad into an artery-clogging bowl of calories. Go light on the salad dressing, relying on more flavorful vinegars. Tossing the greens with the dressing in a salad bowl, rather than pouring dressing on top of greens on the plate, coats the greens more evenly while using less dressing.

16) Drain and rinse canned beans. One simple salt-fighting strategy is to drain and rinse canned beans before using. Processed foods are one of the biggest sources of sodium in our diet, so when you must open a can for convenience, get rid of as much of the added salt as you can. For instance, draining and then rinsing canned beans for 30 seconds under running tap water can reduce the sodium content by 43 percent.

17) Eat breakfast. Studies have consistently shown that people who eat a healthy breakfast are less likely to gain weight.

18) Put away the TV trays. Studies have associated higher levels of TV watching with a greater risk of obesity, and only part of that is due to couch potatoes' lack of physical activity. It's also partly because of mindless eating, not really paying attention to the food and savoring it. A good rule is to eat only in your kitchen or dining room.

19) Slow down. It can take 20 minutes for the food you eat to be digested enough for the glucose to enter the bloodstream and your body to start registering a sense of "fullness." Practicing mindful eating - pausing to really taste and savor your food - can give your body time to give the "stop" signal.

20) Don't expose yourself to excess. Sounds obvious, but it's obviously not always adhered to. "All you can eat" buffets and other sumptuous banquets that offer a surfeit of choices encourage overconsumption of foods as well as beverages. It's only natural to try "just a bite" of everything and all those bites add up. When eating out, skip the buffet and order from the menu.

Age-related physical changes occur gradually as we age and are not always visible. Some scientists have stated that we begin to age as soon as we are born, and this continues throughout our lifetime. It is impossible to generalize about the physical, psycho-social and emotional changes that occur with aging. Each one person is unique. There are many factors that contribute to aging, such as family history, occupation, nutritional status, social-economic status and so forth. What I am going to discuss is the more common health problems which occur among our aging population.

Cardiovascular Disease:

As we age, our cardiac output decreases. The heart muscle is less effective as a pump. The heart rate remains the same or slightly lower at rest, but the heart requires more time to recover after physical exertion or an extremely stressful situation. Also, the electrical conductive system functions less perfectly, leading to cardiac arrhythmias, such as atrial fibrillation. Blood pressure frequently rises with age as the blood vessels become sclerotic and narrowed.

Heart disease is the leading cause of death in the United States. Contributing factors are probably obesity, smoking, poor diet, more sedentary lives, stress and our longer lifespan. Common cardiovascular problems are: angina, heart attack, arrhythmias, congestive heart failure, hypertension, stroke and ASHD (arterial sclerotic heart disease) or "hardening of the arteries" of the extremities (arms and legs).

With moderate to severe heart disease, there is a marked change in the person's tolerance for physical activity as exhibited by shortness of breath and fatigue. He is unable to perform many of the tasks or roles that he could easily do at one time. Due to these changes, it is not uncommon to find these individuals are depressed and feeling like a "burden" on their families. These individuals tend to be anxious over the loss of their role as the "breadwinner" and are fearful about dying. It is imperative that they be involved in rehabilitative programs to cope with the changes in their lives.

Respiratory Diseases:

Many respiratory changes occur with aging. The efficiency of the entire respiratory system is decreased. The capacity for adequate air exchange is diminished due to the reduction of muscular tissue in the diaphragm and intercostals (muscles between the ribs). Additional deficits are caused by smoking and prolonged exposure to polluted air in urban and certain environmental occupations, such as coal mining.

Common respiratory diseases are chronic obstructive pulmonary disease (COPD) and pulmonary fibrosis. COPD's predisposing factors are recurrent or chronic respiratory infection, allergies and hereditary factors. Smoking is the number one and most important cause of COPD. COPD is ranked third only to heart disease and cancer for causing death or disability in the United States.

Behavioral characteristics associated with respiratory diseases may include: dependence on others because of inability to perform activities of daily living, depression and anxiety because of the fear of not getting enough oxygen to breathe (a feeling of suffocating). When oxygen intake is decreased, there are signs and symptoms of confusion, weakness and irritability. Like the cardiac person, rehabilitation and oxygen programs are required for the person to live comfortably.

Digestive System:

Malnourishment is the number one digestive problem among senior citizens. A substantial number of older people are considered malnourished. Many require assistance in preparing meals but have no one to assist them. Other causes are: Fixed incomes do not keep up with the rising cost of food, lack of an appetite, poor dentition and loneliness ("I do not enjoy eating by myself.")

Poor nutrition affects all body systems but especially the cardiovascular, nervous and musculoskeletal systems. It is demonstrated by weakness, listlessness, depression and irritability. These individuals should be encouraged to eat at least one meal per day with family members, or go to senior centers that serve hot lunches or other places that serve meals in a communal atmosphere. Meals on wheels program can be ordered for individuals, who need assistance with meals, as the program delivers between one to two hot meals daily to clients.

Cancer:

Cancer affects people in all age groups but is more common among very young children and older people. Cancer ranks second to cardiovascular disease as the leading cause of death in the United States. One out of four deaths is from cancer. Some epidemiologists predict that cancer will out rank cardiovascular disease by the year 2015.

In most cases, early detection of cancer enables more effective treatment and a better prognosis for the person. Some risk factors are: smoking, family history of cancer, and exposure to potential hazards. Cancer is an uncontrolled growth. There is no single cause but probably results from a complex interaction between viruses, physical and chemical carcinogens, and genetic, dietary, immunologic (body's ability to fight off infection) and hormonal factors.

A cancer diagnosis is devastating. To most people, cancer still means a "death sentence". Cancer patients have to cope with changes in body image, weakness, and anorexia from surgeries and radiation and chemotherapy treatments. These individuals frequently experience stress and lowered self-esteem. Listlessness, loneliness and feelings of isolation frequently occur after receiving the diagnosis of cancer. Anticipatory grief may occur as the person grieves for the "loss of his former life and body image."

Caregivers must pay particular attention to how the person is coping and try to understand the cancer patient's feelings and encourage him to continue with his therapy as well as attending support groups to discuss his concerns about his cancer and treatment modalities.

Musculoskeletal Diseases:

Aging is frequently accompanied by increased fragility and degeneration of the bones and joints throughout the body resulting in chronic pain and diminished activity. Additionally, muscle strength and function also decline due to loss of muscular fiber and diameter.

In osteoporosis, the bones become weaker and thinner due to interference in the bone rebuilding process, with backache and other skeletal pain as common symptoms. Osteoporosis affects one out of three women and one out of five men over the age 50 years. Persons with osteoporosis tend to be very irritable due to constant, nagging pain. They may tire easily, feel weak and shaky when standing, and become extremely apprehensive about falling. Depression may occur due to their inability to perform activities of daily living due to pain and the resulting immobility. Osteoporosis is treated with a diet high in calcium, phosphorus, protein, Vitamin D and exercise.

Osteoarthritis is the most common musculoskeletal disease as people age. It results from the degeneration of the cartilage that lines the joints, but occurs most frequently in the knees, hips, fingers and spine. The most common symptom is a deep, aching joint pain, particularly after exercise or weight bearing that usually is relieved by rest. Other signs and symptoms of osteoarthritis are: stiffness in the morning and after exercise, aching during changes in the weather, "grating" of the joint during motion, altered gait and limited movement. Depending upon severity of pain and degree of loss of mobility, there are three treatment modalities: drug therapy; strengthening exercises developed by Physical Therapists and stabilization of the joint through braces, traction, etc.; and surgical intervention.

Endocrine Diseases:

Diabetes mellitus is the most common endocrine disease in the United States, affecting several million people. It occurs more frequently in those individuals who have relatives with the disease and in overweight persons over the age of 40. Diabetic complications may significantly older person. It is the number cause of blindness in the United States today. Chronic kidney disorders, increase susceptibility to infections, peripheral neuropathy, cardiovascular disease, and vascular degeneration resulting in gangrene and loss of limbs are common complications.

Most people who develop diabetes as adults have what is called Type 2 diabetes. This type of diabetes is usually controlled by diet to control blood glucose level and to reach optimal weight, oral anti-diabetic medications and exercise. For many older diabetic patients, diet becomes a major score of frustration, depression and anxiety due to the fact that many of their favorite foods like ice cream, sweets, etc. are restricted. Education and counseling are critical in helping the individual regain control of his life situation.

Central Nervous System Diseases:

It is normal for the brain to age like the rest of our body does, and with aging there are changes in our memory, too. We do not learn as quickly as we did when we were younger but we are able to learn new information. We do have moments where we forget what we were doing or cannot recall someone's name, but all this is a normal part of the changes that occur with aging.

Between four and five million people in the United States have some degree of cognitive impairment, and this number is increasing as the population referred to as "Baby Boomers" increases in age. Alzheimer's is just one kind of dementia. In recent years, Alzheimer's disease has been widely publicized through the media and within health-care professionals.

Clinicians can now diagnose Alzheimer's with up to 90 percent accuracy, but can only be confirmed by autopsy, where the pathologists look for disease's characteristic plaques and tangles in brain tissue. Clinicians diagnose "probable" Alzheimer's disease by taking a complete medical history and conducting lab tests, a physical exam, brain scans and neuropsychological tests that gauge memory, attention span, language skills and problem-solving abilities.

The most common symptom of Alzheimer's disease is memory loss, which is accompanied by mood swings, behavior and personality changes, impaired judgment and speech, confusion and restlessness. As the disease progresses, the patient becomes more and more a shell of a person as he loses his awareness of what makes us human-sense of self and his identity, memories, awareness of family and friends, etc. Not only is the patient a victim but so is the family as they watch daily their loved one physically and mentally deteriorate before their eyes and become a "stranger" they no longer know and who no longer knows them. In the middle and late stages, Alzheimer's patients require total, custodial care. Both patient and family require intense support and direction in coping with the ravages of Alzheimer's. Many family members feel very guilty about placing their loved one into a facility. It is not uncommon for family members to run down their health in a desperate attempt to care for the patient at home.

The earlier the onset of Alzheimer's disease, the shorter the patient's life expectancy is. For example if someone is diagnosed with Alzheimer's at age 50, he may have a life expectancy of ten years. While someone who is diagnosed at age 70 may have a life expectancy of 20 years or more. In the final stage of Alzheimer's, death usually results from a combination of factors. The most common cause of death is pneumonia. Currently, there is no known cure, but there are several new medications that slow down the process of Alzheimer's in the early stages.

Psychological Disorders:

Most psychological disorders occur later in life usually precipitated by the crises of aging and the changes that occur physically, cognitively and socially. There is significant alteration in body image with aging and its' accompanying diseases; decrease in self-esteem due to retirement and role change status; and, loss of family and friends because of death or physical separation in another state. All these factors impact greatly on the psychological well-being of senior citizens. Another aspect that contributes to psychological disorders is that many senior citizens accept these disorders, such as depression and pain, as part of the aging process and do not seek help until acute or severe problems appear.

Common symptoms of psychological disorders include: withdrawal from activities that were enjoyed before, lack of interest in physical appearance, insomnia, loss of appetite, constipation or diarrhea, suspiciousness, hostility, delusions, feelings of inferiority and a wide variety of somatic complaints. If an elderly parent or friend is exhibiting any of these symptoms, it is imperative that this person be physically assessed by a medical person first hand before any other treatment modalities are instituted as many of these symptoms are associated with medical diagnoses.

Many gerontologists believe that disease causes aging rather than vice versa. Treatment of underlying pathologic conditions will frequently remove many of the characteristics attributed to old age.

For many people, reaching the age of 50 years, means that they no longer consider themselves as "young". They have passed the "magic" threshold and are now moving towards becoming "senior citizens." Getting greetings from the American Association of Retired Persons (AARP) further solidifies that the person's perception of "being old". Unfortunately, our society reinforces this view with its great emphasis on being young and beautiful.

As people age, there are many changes which occur to their bodies, appearance and thinking processes. For many, their greatest concern is retaining their mental facilities and being able to handle their own affairs as they advance in age. A recent study proved that people who worry about losing their memory do suffer memory loss. It is a self-fulfilling prophesy. The person continuously worries that he is losing his memory, which increases his stress level and which contributes to increased memory loss.

What is normal brain aging? It can begin as early as the forties in some people. It may include:

1. Taking longer to learn or remember new information.

2. Having difficulty concentrating or staying focused on a task, such as paying bills, in the midst of distractions.

3. Forgetting such basics as an anniversary or the names of friends. This is sometimes referred to a "senior moments."

4. Needing more reminders or memory cues, such as prominent appointment calendars, reminder notes, a phone with a well-stocked speed dial.

Most people as they age retain their ability to do their errands, handle money, maintain their households and live independently.

How does normal brain aging differ from dementia, especially Alzheimer's disease? The severity and the speed of the memory loss distinguish aging from Alzheimer's disease. Indeed, some scientists argue that Alzheimer's is a form of accelerated but otherwise normal aging.

With Alzheimer's disease, people begin to lose their ability to:

1. Remember recent events or conversations. They retain old memories like where they were born or their first job. But they won't remember what they ate for dinner a few minutes earlier. As the disease progresses, they begin to lose even their old memories.

2. Plan, start, or organize tasks. May turn on the stove to boil water for tea and then forget it, which results in the pot being burned and the water boiled down to nothing.

3. Find the right words or name everyday things, such as a clock or a stove. May describe the clock as that round thing over there.

4. Comprehend or follow even simple directions. You may ask the person to hang up his coat and come back a few minutes later and find him just standing there with his coat still on.

5. Keep track of the time and where they are. He may walk out the front door of the house and have no idea of where he is or how to get back into the house. There is no differentiation between past, present and future. Time is all rolled up into one.

In summary, it is normal for the brain to age like the rest of our body, and with aging there are changes in our memory, too. We do not learn as quickly as we did when we were younger but we are able to learn new information. We do have moments where we forget what we were doing or cannot recall someone's name, but there are so many more memories filling our mind that it is not easy keeping all the information straight. Keeping your brain active is the most important factor in preventing memory loss.

OPINION By LEE DYE May 1, 2009

Know someone who's about to turn 50? The mail will soon bring greetings that can strike terror in many a heart: An invitation to join the American Association of Retired Persons (AARP). That dreaded condition known as the normal aging process has arrived. A new study suggests that obsessing about memory loss could be a self-fulfilling prophesy

If your friend, or you if you're a baby boomer, dwells too long on that fact, it could make those gray hairs even more tragic. A new study shows that fearing the loss of memory, one of those so-called "normal" symptoms of aging, can actually make a person more forgetful. Especially if he or she is highly educated.

Worrying about aging and memory loss, according to psychology professor Tom Hess of North Carolina State University in Raleigh, can become a "self-fulfilling prophesy." He suspects those concerns begin earlier for many, partly because of that subtle invitation to join the growing ranks of seniors. "If you worry about this [loss of memory and other cognitive functions], it might become part of your psyche and have this pervasive effect, regardless of what's happening," Hess said in an interview.

He is the lead author of a study in Experimental Aging Research, co-authored by Joey Hinson and Elizabeth Hodges, also of North Carolina State.

It's not a large study and the findings cannot be considered conclusive. But they are consistent with earlier work by Hess and others showing that seniors are particularly concerned and, thus, more likely to show anxiety when confronted with questions about memory loss.

Fear of Age-Related Bias Affected Test Subjects' Performance:

The researchers conducted several experiments with 103 seniors in two groups, ages 60 to 70 and 71 to 82, to see how certain cues would affect their ability to perform tasks in math and memorization.

Some participants, for example, were told they were going to take a test that would explain why younger and older adults perform so differently on memory tests. They were also told to write down their age just before taking the test. Those are considered "threats" in psychological research.

Other participants, however, were told that the test was "free of age-related biases" and adults of various ages should perform similarly on the test, considered a "non threat" status.

As expected, the "threatened" participants performed much more poorly on a memorization test than the non-threatened participants, especially in the 60-70 group. Participants in the older group were less affected by the threat, possibly because they already knew they were old and have adjusted to that fact.

Those With More Education More Affected By 'Threat' of Memory Loss:

But here's a finding that may seem surprising, although the experimenters expected it. Participants with more education were more affected by the "threat" of losing their memory than participants with less education. That was true in all the experiments, and across all age groups.

Yet numerous other studies have shown that more educated people are better equipped to deal with the stresses of aging, and even delay the onset of such debilitating conditions as cognitive impairment and Alzheimer's disease. Hess said the two are not inconsistent.

In his experiments, he said, it is likely that more educated people were more affected by worrying about their memory because "they, perhaps, are more sensitive to negative stereotyping of their cognitive skills, because they are more important to them."

So, initially at least, they perform worse on memorization tests than people with less education because they worry more about losing it.

But ... More Education Also Fights Age-Related Mental Deterioration:

But more education should help people meet cognitive challenges head on, exercising their brain well into old age, which has been shown to delay age-related mental decline.

That's one of the reasons for a significant decline in mental impairment among older Americans in recent years, according to a study last year of 11,000 elderly people by the University of Michigan Health System.

That study found that among people 70 and older, cognitive impairment went down by 3.5 percentage points between 1993 and 2002, from 12.2 percent to 8.7 percent, a difference that affected hundreds of thousands of people.

The researchers attributed that large decline to "more formal education, higher economic status, and better care for risk factors such as high blood pressure, high cholesterol and smoking that can jeopardize their brains."

"We know mental stimulation has an impact on the way a person's brain is 'wired,' and that education early in life likely helps build up a person's cognitive reserve," Kenneth Langa, associate professor of internal medicine, said in releasing the Michigan study. "So what we may be seeing here is the accumulated effects of better education and better cardiovascular prevention among the people who were over age 70 in 2002, compared with those who were over age 70 in 1993."

People More Aware About Consequences of Aging:

That would suggest that the people in Hess' study are a bit too worried about mental decline and aging. Things are getting better, not worse, according to the Michigan study.

Maybe people are just more aware of what happens as they age than they used to be and, thus, they worry about it more, and it doesn't just depend on learning that the age of senior discounts is approaching. It's hard to ignore sore joints, aching muscles and, of course, those occasional "senior moments" when memory temporarily fails.

"Negative stereotypes seem to be particularly strong in people who are just entering old age, starting around 60 or 65," Hess said. "When you find yourself at that particular age, there may be cues in the environment that make you overly sensitive" to aging.

He's not suggesting that people ignore the obvious signs of aging. But, according to his research, worrying about it too much could backfire.

By Michelle O'Brien
May 1, 2009

Pick up a newspaper, magazine or watch the news and you are likely to hear about the many studies that show that mental exercise is just as important as physical exercise for overall health and well being. Pumping iron is beneficial for your muscles and your bones, but you have to exercise your brain as well. The key to keeping the brain sharp as we age is to keep it stimulated. Use it or lose it applies to the mind as well as the muscles. Memory loss does not have to be just another side effect of aging, and it sure does not have to be as noticeable, especially if you choose to take action and minimize the effects.

Online memory games are an ideal mental workout, providing you with entertaining, thought-provoking exercises that stimulate your brain and keep it feeling young and vibrant. Many of the games are simple recall, while others become more complex and challenging. The higher the level you get to, the more challenging the game gets.

Some feature music, and others words or numbers. Whether playing board games, working cross word puzzles, or participating in a card game, all will help keep your brain healthy. The Key is to find games that suits you. Do not choose a game that will frustrate you and make you angry. A game can only be effective if you actually play it. Remember, it is just a game. If you are not having fun you are probably working too hard.

Some of the most popular memory games features musical notes that you must repeat in a pattern. For some people recalling the musical tones are easier than attempting to remember words or a pattern of numbers. Some people remember numbers easier than words and find number games exhilarating. There are games that feature more than just remembering patterns, some will flash an image and then hide it and ask you to recall as many details as possible, while others will ask you to read a story and then fill in the blanks on the next page. Regardless which memory game you use, be sure that you understand that there is only so much you can expect from them, they are not a cure and if you have concerns about memory-loss, you should consult your physician.

Your first question may be "What does Cognitive Functioning mean? Cognitive functioning includes all of the following: Orientation to Person, Place, Time and Situation, Attention Span and Concentration, Memory, General Intelligence, Abstract Thinking, Insight and Judgment, and Perception and Coordination. Two ways of testing a person's abstract thinking is by proverbs and similarities, such as what does it mean "a stitch in time saves nine?" Or what are the similarities between a cat and a mouse. Judgment is defined as the ability to compare and evaluate ideas, and choices, to understand their relationships, and to draw appropriate conclusions.

As we age, we do sustain some degree of cognitive functioning loss. There are many theories on why our brains' age normally from such hypotheses as there are physical changes occurring in the human brain resulting in loss of neurons and neural connections, to memory lapses occurring due to the overabundance of memories stored in our brain from the many years of living experiences and the time it takes the brain to sort out the correct response. It is diseases like Alzheimer's and strokes and brain injuries due to alcoholism and accidents that are the major contributors toward moderate and severe cognitive functioning loss.

Most people are not as concerned with why cognitive functioning is lost as much with how much will it affect them and their being able to live independently and handle all their business affairs. Like sunburn, cognitive functioning occurs in degrees. With first degree (minor) cognitive functioning loss, there are episodes of forgetting what you are saying in the middle of a conversation or walking into a room for something and then saying to yourself why am I here. With third degree (severe) cognitive functioning loss, the person becomes only a shell of his former self, losing his orientation to who he is, where he is at, unable to care for himself and has no interest in his surroundings.

Let us examine the different degrees of memory loss:

Minor Cognitive Functioning Loss:

1. May appear to be "absentminded." Forgetting such basics as an anniversary or the names of friends.
a. Compensates with increasingly rigid schedules and routines.
b. Notepads, calendars, speed dial loaded with all important phone numbers.

2. Decreased efficiency in absorbing and retaining new information.

3. Learning is slower and requires greater effort, but this is only evident in comparison with past learning capabilities.

4. Tends to speak mostly about past events. This occurs as result of the individual seeing himself as vital and active when he was younger. Most memories from the past are pleasant and bring a sense of 'well-being." Current events are more centered on illnesses, loss of friends and family, and so forth.

5. Has difficulty concentrating or staying focused on a task, such as paying bills, in the midst of distractions, such as grandchildren playing their boom box loudly in the same room.

6. This group is able to live independently, handle their own finances and maintain their own households. With reminder cues, they are able to keep track of their appointments, important phone numbers, and so forth.

Moderate Cognitive Functioning Loss:

1. Difficulty remembering events of the recent past, such as what the doctor told him three days ago about changes in diet to reduce his blood pressure, but has accurate and detailed recall of learning and events in the past, such as his first car and what he got paid on his first job.

a. Attempts to compensate for memory loss become more difficult. This leads to increased rigidity and compulsiveness, such as always eating dinner at 5 PM-not one minute earlier or later.

2. Thinking becomes more slowed and less effective. The individual finds it more and more difficult to solve even the simplest of problems, such as there is no milk for breakfast tomorrow. In the past, the individual would have just gone to the grocery store or would have planned on a breakfast that did not require milk. In the present situation, the individual with moderate memory loss becomes quite distraught and immobilized over trying to find a solution for no milk for breakfast.

3. Has greater difficulty keeping attention focused on the task at hand, such as cooking dinner. Wife puts the food in the frying pan. Lights the burners at the correct temperature and then walks into the living room where the TV is playing an old movie. She sits down and completely forgets about the dinner she is cooking until the smoke alarm goes off.

4. Has difficulty telling what day of the month it is or what year it is. When asked the date, the person may respond June 23, 1989. Or if asked who the president is, he may respond Bill Clinton or Ronald Reagan.

5. There is an initial loss of orientation to place. Unable to identify unfamiliar locations. The person may have lived in Chicago all his life and had travelled around the city several times during his lifetime, but now only recalls areas that are familiar to him-his neighborhood, places he visits often and so forth.

6. Difficulty identifying unfamiliar people. He knows people that he sees on an everyday basis, such as his wife, children, grandchildren, friends, neighbors and so forth. But cannot remember people that he met in the past but has not seen often like fellow co-workers. He has great difficulty remembering names-- even of his wife and children.

7. Has increased difficulty in seeing similarities and differences in similar objects, such as a child and a "small person." Becomes very concrete in thinking. If asked to explain the proverb, "people who live in glass houses should not throw stones," he would answer, "Don't throw stones at glass houses."

8. Overlooks the obvious. Judgment becomes impaired and increasingly unreliable. Individual is driving down the wrong way on a one way street, and does not realize it despite several drivers honking their horns and saying, "You idiot, you are going the wrong way."

9. Behavior becomes increasingly inappropriate which is often reflected in:
a. Deterioration of grooming and personal hygiene-does not comb hair, does not brush teeth or use deodorant, wears dirty clothes, etc.
b. Deterioration of eating habits and manners-begins eating with his hands, spilling food and drink all over himself, etc.
c. Decreased ability to manage financial affairs.

10. Wide changes in mood.
a. Irritability
b. Depression
c. Wide mood swings between depression and euphoria within a short time span without any reason for the change in mood.
d. Hysteria
e. Diffuse physical complaints-constipation, knee pain

11. Diminished Vitality. The essence of the person greatly disappears. You will commonly hear "Jack is not like he use to be. He was so full of life."

12. People with moderate memory loss require supervision of their daily activities, financial and personal affairs. These individuals can live at home but under direct supervision of a family member, caregiver, etc. or placed in an assisted living environment.

Severe Cognitive Functioning Loss:

1. Includes all the changes listed in Moderate Memory Loss plus.

2. Memory loss extends further and further into the remote past until all memory is totally lost. (This occurs with Alzheimer's disease.)

3. No sense of time. There is no past, present or future.

4. Increased difficulty identifying familiar surroundings. He does not recognize his home or his neighborhood.

5. Does not remember current location where he lives (even though he has lived there 50 years) or his address.

6. Does not remember other people's relationships to him, such as his wife, children, etc.

7. Has difficulty remembering his own name or identifying who he is.

8. Unable to care for himself.

9. Has no interest in the environment or his surroundings.

10. Tends to be suspicious of others and their intentions.

11. Is negative about any requests made of him. His answer (if he can speak) to everything is "No." Or he just pulls away.

12. People with severe memory loss require constant 24 hours supervision in a special facility which provides care for individuals with dementia.

There is probably no diagnosis or disease that strikes more fear in the hearts of people than the diagnosis of Alzheimer's. It is the dread of truly "losing one's mind" that scares people the most.

Alzheimer's disease is a progressive, degenerative disorder that attacks the brain's nerve cells, resulting in loss of memory, thinking and language skills, and behavioral changes. Alzheimer's disease is the most common cause of dementia, among people 65 and older.

Dementia is the broad general diagnosis given to a person whose thinking, particularly memory, is so impaired that it affects day-to-day functioning. Not all dementia is due to Alzheimer's, but everyone with Alzheimer's has dementia. However, the term Alzheimer's is often used incorrectly to refer to different types of dementia that impair memory and occur in older individuals. More than a hundred different medical disorders cause dementia, and their different symptoms depend on what parts of the brain they attack.

Warning Signs:
If someone exhibits these symptoms, this person should be medically checked by a healthcare professional to ensure that the person is suffering from Alzheimer's disease rather than from many other illnesses which may mimic signs and symptoms of Alzheimer's disease.

1. Memory Loss, especially of recent events, names, placement of objects, and other new information.

2. Confusion about time and place.

3. Struggling to complete familiar actions, such as brushing teeth or getting dressed.

4. Trouble finding the appropriate words, completing sentences and following direction and conversations.

5. Poor judgment when making decisions, such as driving the wrong way on a highway against traffic.

6. Changes in mood and personality, such as increased suspicion, rapid and persistent mood swings, withdrawal, and disinterest in usual activities.

7. Difficulty with complex mental assignments, such as balancing a checkbook or other tasks involving numbers.

How Is Alzheimer's Diagnosed:

1. Clinicians can now diagnose Alzheimer's with up to 90 percent accuracy, but can only be confirmed by autopsy, where the pathologists look for disease's characteristic plaques and tangles in brain tissue.

2. Clinicians diagnose "probable" Alzheimer's disease by taking a complete medical history and conducting lab tests, a physical exam, brain scans and neuropsychological tests that gauge memory, attention span, language skills and problem-solving abilities.

3. Proper diagnosis of Alzheimer's disease is critical since there are dozens of other causes of dementia that could exhibit these symptoms. Some dementias, such as those caused by vitamin B deficiency, thyroid problems and depression, are reversible. Alzheimer's is not a reversible dementia.

Symptoms:

Symptoms are divided into two categories: cognitive or intellectual and psychiatric

I. Cognitive:

A. Amnesia is defined as loss of memory, or the inability to remember facts or events. We have two types of memories: short-term (recent, new) and long-term (remote, old). In Alzheimer's disease, short-term memory is destroyed first.

B. Aphasia is the inability to communicate effectively. The loss of ability to speak and write is called expressive aphasia. An individual may forget words he has learned and has increasingly more difficult time communicating. With receptive aphasia, an individual may be unable to understand spoken or written words or may read and not understand a word of what is read. Sometimes aphasic individuals pretend to understand and even nod and smile in agreement.

C. Apraxia is the inability to do pre-programmed motor tasks, or to perform activities of daily living, such as brushing teeth and dressing. An individual may forget all motor skills learned during development. Sophisticated motor skills that require extensive learning, such as job-related skills, are the first functions that become impaired. More instinctive functions, like chewing, swallowing and walking are lost in the last stages of the disease.

D. Agnosia is an individual's inability to correctly interpret signals from their five senses. Individuals with Alzheimer's disease may not recognize familiar people and objects. Common yet often unrecognized agnosia is the inability to appropriately perceive visceral, or internal information, such as a full bladder or chest pain.

II. Psychiatric:

A. Personality changes can become evident in the early stages of Alzheimer's disease. Signs include irritability, apathy, withdrawal and isolation.

B. Individuals may show symptoms of depression at any stage of the disease. Depression is treatable, even in the latter stages of Alzheimer's disease.

C. Psychotic symptoms include hallucination and delusions, which usually occur in the middle stage of Alzheimer's disease. Hallucinations typically are auditory and/or visual, and sensory impairments, such as hearing loss or poor eyesight, tend to increase hallucinations in the elderly.

D. Hallucinations and delusions can be very upsetting to the person with Alzheimer's disease. Common reactions are feelings of fear, anxiety and paranoia, as well, as agitation, aggression and verbal outbursts.

E. Individuals with psychiatric symptoms tend to exhibit more behavioral problems than those without psychiatric symptoms. It is important to recognize these symptoms so that appropriate medications can be prescribed and safety precautions can be taken.

F. Psychotic symptoms can often be reduced through the carefully supervised use of medications. Talk with your doctor about the symptoms because they are treatable.

Life Expectancy:

1. Alzheimer's disease stretches from two to twenty years, and individuals live on average for eight to ten years after being diagnosed with Alzheimer's disease.

2. Individuals with Alzheimer's disease are likely to develop co-existing illnesses and most commonly die from pneumonia.

3. Alzheimer's disease is the sixth leading cause of death in the U.S.

Treatment:

Currently, there is no cure for Alzheimer's disease. Researchers are continually testing the effectiveness of various drug therapies that will control symptoms; slow, reduce and/or reverse mental and behavioral symptoms; and prevent or halt the disease.

This information is based on facts developed by the Alzheimer's Foundation of America.

Stroke is the third-leading cause of death in the United States and the leading cause of serious, long-term disability. A stroke occurs when a blood vessel (artery) that supplies blood to the brain leaks, bursts or is blocked by a blood clot. Within an hour, the nerve cells in that area of the brain become damaged and die. As a result, the part of the body controlled by the damaged area of the brain cannot work properly.

Symptoms:

A person having symptoms of a stroke needs immediate emergency care. The sooner medical treatment begins, the less damage done to the brain.

The effects of a stroke may range from mild to severe and may be temporary or permanent. A stroke can affect vision, speech, behavior, the ability to think and the ability to move parts of the body. Sometimes it can cause coma or death. The effects of a stroke depend on the specific part of the brain that is damaged, how much of the brain is affected and how fast blood flow is restored to the affected area.

There are two major types of strokes. Ischemic stroke is caused by a blocked or narrowed artery. Hemorrhagic stroke is caused by sudden bleeding from an artery in the brain.

General symptoms of a stroke include sudden onset of:

1. Numbness, weakness or inability to move (paralysis) of the face, arm or leg, especially on one side of the body.
2. Trouble seeing in one or both eyes, such as dimness, blurring, double vision or loss of vision.
3. Confusion or trouble speaking.
4. Trouble walking, dizziness or loss of balance or coordination.
5. Severe headache with no known cause.

Causes and Risk Factors:

Ischemic stroke occurs when blood flow through a blood vessel (artery) that supplies blood to the brain is blocked. Blockage may develop from a blood clot in an artery leading to the brain or one formed in another part of the body, usually the heart. The clot travels with the blood until it blocks an artery in the brain.

Hemorrhagic stroke is caused by sudden bleeding from a blood vessel inside the brain (cerebral hemorrhage) or in the spaces around the brain (subarachnoid hemorrhage). Sudden bleeding may result from the bursting of a blood vessel that has stretched and thinned (aneurysm). The most common cause of bleeding inside the brain is high blood pressure.

Over the past several decades, doctors have learned more and more about the factors that lead to strokes.

The American Heart Association has identified several factors that increase your risk of stroke. The more risk factors you have, the greater your chances for a stroke.

These factors fall into two categories: 1) factors that cannot be modified, and 2) factors that you can modify by changes in your lifestyle. Your personal healthcare provider can help you assess your risk for stroke and recommend ways to control your risk factors and reduce your risk of getting a stroke.

Risk factors that you cannot modify include:

1. Age. While strokes can happen to a person of any age, even children, the older you are, the more at risk of having a stroke you are.

2. Gender. While more men than women have strokes, more women die from strokes when they occur. More than half of the total deaths from stroke occur in women. Using birth control pills and being pregnant are special concerns for women.

3. Race. African Americans have a much higher risk of death from a stroke than Caucasians do. In part this is because blacks have higher risks of high blood pressure, diabetes and obesity.

4. Family History. How can you tell if you have a family history of stroke? Your stroke risk is greater if a parent, grandparent, sister or brother has had a stroke.

5.Personal health and medical history. Someone who has had a stroke is at much higher risk of having another one. If you have had a heart attack, you are at higher risk of having a stroke, too.

Risk factors that you can modify include:

1. High blood pressure. This a blood pressure of 140/90 or above for a period of time.

2. Diabetes mellitus. While diabetes is treatable, having it still increases a person's risk of stroke. People with diabetes often also have high blood pressure, high blood cholesterol and are overweight. This increases their risk even more. If you have diabetes, work closely with your doctor to manage it.

3. Carotid or other artery disease. The carotid arteries in your neck supply blood to your brain. Peripheral arteries are the blood vessels carrying blood to leg and arm muscles. These arteries are narrowed by fat plaques, which in turn is caused by atherosclerosis. This increases the risk for stroke.

4. Atrial fibrillation. This heart rhythm disorder raises the risk for stroke because the heart's upper chambers quiver instead of beating effectively. This lets the blood pool and clot. If a clot breaks off, enters the bloodstream and lodges in an artery leading to the brain, a stroke results.

5. Other heart diseases. People with coronary heart disease or heart failure have more than twice the risk of stroke as those with hearts that work normally.

6. Transient ischemic attacks (TIAs). TIAs are "mini-strokes" that produce stroke-like symptoms but no lasting damage. Recognizing and treating TIAs can reduce your risk of a major stroke. Call 911 to get medical help immediately if they occur!

7. Certain blood disorders. A high red blood cell count thickens the blood and makes clots more likely. This raises the risk of stroke. Doctors may treat this problem by removing blood cells or prescribing "blood thinners." Another blood disorder, sickle cell anemia, mainly affects African Americans. In this condition, sickle-shaped red blood cells are less able to carry oxygen to the tissues and organs. They also tend to stick to the blood vessel walls, which in turn can block arteries to the brain and cause a stroke.

8. High blood cholesterol. A high level of total cholesterol in the blood (240 mg/dL or higher) is a major risk factor for heart disease, which raises your risk of stroke.

Lifestyle changes that can reduce your risk of stroke include:

1. Stop using tobacco. Cigarette smoking is the top preventable risk factor for stroke. Both the nicotine and carbon monoxide found in tobacco smoke lower the amount of oxygen in your blood. They also damage the walls of blood vessels, making clots more likely to form. Combining the use of some kinds of birth control pills with smoking greatly increases a woman's stroke risk.

2. Maintain a proper weight and exercise. Being inactive, obese or both can increase your risk of high blood pressure, high blood cholesterol, diabetes, heart disease and stroke.

3. Drink moderately. An average of more than one alcoholic drink a day for women or more than two drinks a day for men raises blood pressure and can lead to stroke.

4. Illegal drug abuse. Intravenous drug abuse carries a high risk of stroke. Cocaine use has been linked to strokes and heart attacks. Some have been fatal even in first-time users.

Simple Test To Check If the Person is Having A Stroke:

1. Have person smile. Notice if the possible stroke victim is able to smile at all or has a lopsided smile

2. Have person raise both arms over his/her head. Notice if the possible stroke victim can only raise one or no arm(s) over his/her head

3. Have say a simple sentence like, "the cow jumped over the moon." Notice if the possible stroke victim's speech is incoherent, garbled or non-existent.

If a person exhibits exhibits one or more of these signs, get him/her emergency medical care immediately. It is better to error on the side of being too cautious rather than having someone suffer serious permanent effects of a stroke.

Treatment:

People who have symptoms of a stroke need to seek emergency medical care. Prompt medical attention may prevent life-threatening complications and is critical for the best recovery. If emergency treatment is sought within the first one to two hours after symptoms begin, some people with a stroke caused by a blood clot may be able to receive a medication to dissolve the clot, helping to increase the chance of a full recovery. Or may require emergency surgery to stop the bleeding into the brain.

The following is issued by The American Stroke Association:

1. It's better to find out than miss out. Be aware of the medications that have been prescribed to your loved one and their side effects. Ask if your home should be modified to meet the specific needs of the stroke survivor. Ask a doctor, nurse or therapist to clarify any unanswered questions or to provide written information that explains what occurs after the stroke and during recovery or rehabilitation.

2. Reduce risks, or stroke may strike again. Survivors who have had one stroke are at high risk of having another one if the treatment recommendations are not followed. Make sure your loved one eats a healthy diet, exercises, takes medications as prescribed, and has regular visits with their physician to help prevent a second stroke.

3. Many factors influence recovery. Recovery depends on many different factors: where in the brain the stroke occurred, how much of the brain was affected, the patient's motivation, caregiver support, the quantity and quality of rehabilitation, and how healthy the survivor was before the stroke. Because every stroke and stroke survivor is unique, avoid comparisons.

4. Gains can happen quickly or over time. The most rapid recovery usually occurs during the first three to four months after a stroke, but some stroke survivors continue to recover well into the first and second year post-stroke.

5. Some signs point to physical therapy. Caregivers should consider seeking assistance from a physical or occupational therapist if their loved one has any of these complaints: dizziness; imbalance that results in falls, difficulty walking or moving around in daily life; inability to walk six minutes without stopping to rest; inability to do things that he/she enjoys like recreational activities or outings with family or increased need for help to engage in daily activities.

6. Don't ignore falls. Falls after stroke are common. If a fall is serious and results in severe pain, bruising or bleeding, go the Emergency Department for treatment. If a loved one experiences minor falls (with no injury) that occur more than two times within six months, see your physician or the physical therapist for treatment.

7. Measuring progress matters. How much acute rehabilitation therapy your loved one receives depends partly on his/her rate of improvement. Stroke survivors on an acute rehabilitation unit are expected to make measurable functional gains every week as measured by the Functional Independence Measure Score (FIMS). Functional improvements include activities of daily living skills, mobility skills and communication skills. The typical rehabilitation expectation is improving 1 to 2 FIM points per day.

8. A change in abilities can trigger a change in services. Medicare coverage for rehabilitation therapies may be available if your loved one's physical function has changed. If there appears to be improvement or a decline in motor skills, speech or self-care since the last time the patient was in therapy, he/she may be eligible for more services.

9. Monitor changes in attitude and behavior. Evaluate whether your loved one is showing signs of emotional liability (when a person has difficulty controlling their emotions). Consult a physician to develop a plan of action.

10. Stop depression before it hinders recovery. Post-stroke depression is common, with as many as 30-50 percent of stroke survivors developing depression in the early or later phases post stroke. Post-stroke depression can significantly affect your loved one's recovery and rehabilitation. Consult a physician to develop a plan of action.

11. Seek out support. Community resources, such as stroke survivor and caregiver support groups, are available for you and your loved one. Stay in touch with a case manager, social worker or discharge planner who can help you find resources in your community.

12. Learn the ins and outs of insurance coverage. Be sure to consult with your loved-one's doctor, case manager or social worker to find how much and how long insurance will pay for rehabilitation services. Rehabilitation services can vary substantially from one case to another. Clarify what medical and rehabilitation services are available for hospital and outpatient care. Determine the length of coverage provided from your insurance (private or government supported) and what out-of-pocket expenses you can expect.

13. Know when to enlist help. If rehabilitation services are denied due to lack of "medical necessity," ask your loved one's physician to intervene on his or her behalf. Ask the physician to provide records to the insurance carrier and, if needed, follow up yourself by calling the insurance company.

14. Know your rights. You have rights to access your loved-one's medical and rehabilitation records. You are entitled to copies of the medical records, including written notes and brain imaging films.

15. Take care of you. Take a break from caregiving by asking another family member, friend or neighbor to help while you take time for yourself. Keep balance in your life by eating right, exercising or walking daily, and getting adequate rest.