– Gerontology and Geriatric care –
The work of the gerontologists is becoming increasingly important with the ageing of society – in the US this is related to the ageing of the baby-boom generation, while in many European countries it is due to demographic changes and low birth rates in the last decades.
I am geriatrician in St. Anna Hospital, where I diagnose and manage a wide range of conditions common for the elderly patients, help them maintain a healthy life and treat the specific disabilities and diseases.
Gerontology is a science of the old-age, while Geriatrics, sometimes also called Medical Gerontology, is focused on treating and preventing the diseases in the elderly. The gerontologists only conduct scientific research with their knowledge in many medical fields, including: psychology, biology, rheumatology, neurology, anaesthesia and even dentistry, while the work of a geriatrician is focused on the care for the elderly.
The geriatricians must first be certified in Family or Internal medicine and then must attend a fellowship program of 2 years – unlike gerontologists they are physicians and directly treat and manage all age-related diseases and conditions.
Age-related diseases, treatment and prevention:
As people get older, the functions of many organs in the body are decreased. The new medication and ongoing research helps extend the lifetime and improve the quality of life of the elderly, however the human body after the age of 55 functions in an entirely different way. When I work with elderly patients I use the broad knowledge of my specialty to diagnose the specific for their age psychological, cardiological, rheumatological, oncological diseases and age-related hearing and vision degenarion.
One of the most common conditions are the various forms of arthritis, with over 70% percent of the elderly having joint pains and limited mobility due to wearing out of the joints. Physical exercises and therapy would be recommended in most cases with some medication.
I would redirect some of the patients to a rheumatologist, who can further investigate the condition and prescribe medication or suggest a surgery for replacement of joints with artificial implants in the cases of severely damaged joints and unbearable pain.
As people age, many start having trouble concentrating, suffering loss of memory, difficulties using language and finding words increase. These are all signs of Dementia and Alzheimer’s disease which are caused by the degeneration of the brain with the years. As this condition, which has no cure, progresses the patients loose their short-term memory and often repeat questions, easily get lost in new places and have difficulties in performing everyday tasks.
Genetics may have a part in the occurrence of Alzheimer’s but there are a few simple advises that help for prevention, including: maintaining a healthy weight and proper diet, no smoking and alcohol abuse and physical activity.
Chances of developing cancer in any part of the body also increase as we get older – age is the most significant risk factor. Geriatric oncology has a focus on diagnosing and treating cancer in the elderly – after the age of 65 the treatment is a challenge for a number of reasons: the body’s ability to handle most of the cancer treatments decreases, while recovering takes longer and usually the patients have other serious medical problems in addition – high blood pressure, heart diseases and arthritis among others.
Besides the physical challenges of treating a cancer in an elderly patient, there are numerous practical issues that the we have to deal with. Older people have different concerns when it comes curing cancer – some may choose not treat their condition at all.
It is also important to take in account ability of the patient to tolerate the stress of the chemotherapy or radiotherapy, life expectancy, the chances of the tumor to be life threatening and if treatment is going to do more harm than good. When there is no Geriatric oncologist available, the patient may be managed by a Geriatrician and an Oncologist.
The risks of cardiovascular diseases also increase with age – changes in all organs of the body occur as we age and the cardiovascular system is no exception. The heartbeat may become slower, some blood vessels thicken and even the blood changes slightly – red blood cells respond slower to stress. The more serious conditions are easily preventable and I would recommend to all of my patients regular exercises and a hearth-healthy diet with low cholesterol and saturated fats, regular monitoring of the blood pressure.
Some of the symptoms that should be taken in account include shortness of breath, chest pain, numbness or coldness in the legs and arms. However, medication, emotional stress and illness could make make the work of the heart harder. Cardiac disorder like the Coronary artery disease which is caused by high blood cholesterol and arteriosclerosis are one of the major reasons for mortality in the elderly. Other common health problems include anemia, which is caused by malnutrition and abnormal heart rhythms. The treatment plan is always individually chosen.
Many of the patients have some form of age-related hearing loss – this condition affects about 40% of people above the age of 70 and is caused by changes in the inner ear which occur as we age and affects both ears, this is caused by the slow degeneration of the acoustic sensors, but it can also be caused by exposure to loud noises. Some of the early signs include difficulty in following conversations and often asking people to repeat themselves, ringing in the ears and hearing issues in noisy areas.
When these symptoms are present, medical attention should be sought as early as possible, since the gradual loss of hearing can be caused by certain medication or other condition and if treated on time further damage can be prevented. The patients with hearing problems often start to feel isolated and suffer depression. There is no way to reverse this condition, but hearing aids and amplifiers are a solution for many.
Age-related vision problems are also common for the majority of the people over 65. Conditions like Macular degeneration are caused by gradual degeneration of cells in the retina (central vision loss, however, may be sudden in the wet type of Macular degenataion), resulting in hazy vision, trouble recognizing faces and reading – this is not something that must be addressed to an eye specialist as soon as diagnosed.
There is no cure for MD, however the progression of the disease may be slowed down with vitamin supplements in its early stage to prevent further damage of the retina.