Take Charge of Your Health - Chronic Diseases II

Never let the things you cannot do prevent you from doing the things you can.
-John Wooden

According to the National Council on Aging (NCOA) 80% of people in the U.S. over the age of 65 have at least one chronic condition and 68% have two or more. As we said earlier this month, we thought we should dedicate a couple of blogs to let everyone know what conditions are on the Top 10 list so then perhaps we can take steps to avoid or manage them. The ten most common conditions are: high blood pressure, high cholesterol, arthritis, coronary heart disease, diabetes, chronic kidney disease, heart failure, depression, Alzheimer’s/dementia, and chronic obstructive coronary disease. Our first blog this month reviewed the five most common conditions; here we will provide an overview of the final five.

Chronic kidney disease: Proper kidney function is critical to remove excess fluids and waste products from our body. Approximately eighteen percent of adults over the age of 65 receive treatment for either chronic kidney disease (CKD) or the gradual loss of kidney function. People who smoke, are obese, have diabetes, or high blood pressure are at greater risk of kidney damage and also have an increased chance of developing heart disease.

The tests for kidney disease include blood and urine tests which reveal the level of waste products such as creatinine and urea in the body.

Fortunately, there is a long list of medications that can help control the complications of kidney disease. These include: blood pressure medicine, diuretics to relieve swelling, statins to control cholesterol, and vitamin supplements to help prevent weak bones. In terms of self care, lowering the amount if salt in the diet is helpful, which means avoiding frozen dinners, fast foods, and processed foods. In addition to reducing sodium, it is beneficial to avoid high potassium foods such as bananas, potatoes, and tomatoes as well as limiting the amount of protein in your diet.

People with end stage kidney disease require either dialysis – a mechanical or peritoneal procedure which drains waste from the body, or a kidney transplant to surgically place a healthy kidney from a donor.

Heart failure/Heart Disease: About fourteen percent of older adults are treated for heart failure, that is, when the heart fails to adequately provide blood and oxygen to the organs in the body. Coronary artery disease is the most common cause of heart failure. The buildup of fatty deposits in the arteries restricts blood flow and can lead to heart attacks and/or heart failure. Heart failure is linked to a range of heart conditions including congenital heart defects, arrhythmias, blood vessel disease, heart valve disease, heart infections, and disease of the heart muscle.

Heart failure can occur on the right or left side of your heart or both sides can fail. It can also be classified as diastolic or systolic. Diastolic is when the heart muscle becomes stiff and prevents the heart to fill with blood. With systolic heart failure, the heart loses its ability to contract and pump blood out to the body.

Risk factors for heart failure include a family history of heart disease, smoking, a diet high in fats and salt, high blood pressure, high cholesterol levels, diabetes, obesity, and stress. People commonly complain of chest pain, feeling tired, light headed or dizzy, nausea, confusion, lack of appetite, and shortness of breath. To diagnose heart disease and heart failure, physicians utilize blood tests, chest x-rays, electrocardiograms, echocardiograms, stress tests, and cardiac MRIs.

The best way to prevent heart failure is to follow the doctor’s recommendations to decrease the risks for coronary heart disease and high blood pressure. As with so many health conditions, good nutrition, daily exercise, maintaining a healthy weight, managing stress, and getting regular checkups are important.

Depression: There are many types of depression. Major depressive disorder, bipolar depression, postpartum depression, persistent depressive disorder, premenstrual dysphoric disorder, psychotic depression, and seasonal affective disorder. In turn, a wide array of factors can cause depression, including abnormalities in the brain chemistry, genetics, tragic life events, pain and chronic medical conditions, and medications which bring on depression as a side effect.

Depression is a serious condition and can cause persistent feelings of sadness, pessimism and hopelessness; fatigue; anxiety; difficulty with cognitive thinking and memory; loss of interest in activities; loss of appetite; sleep issues; and thoughts of suicide. The good news is that there are very effective treatments for depression ranging from exercise to release endorphins, socialization and support groups, psychotherapy and counseling, acupuncture and hypnosis, to antidepressant medications and brain stimulation therapy.

If you or someone you know is having thoughts of suicide, immediately call the National Suicide Prevention Lifeline at 1.800.273.8255 (TALK).

Dementia and Alzheimer's disease: Between five to eight percent of all people over the age of 65 have some form of dementia and this number doubles every five years above the age of 65. While Alzheimer's Disease accounts for 50-75% of all dementias there are a number of other types of dementia as well.
 
Dementia is caused by changes in or damage to the nerve cells and connections in the brain over time and due to many factors that are beyond our control including age, family history, and genetics. Dementia can cause changes in personality and mood, memory loss, and difficulty with cognitive thinking and problem-solving. Managing daily activities can become challenging. Some recent studies provide hope as they suggest that a healthy lifestyle with proper sleep, good nutrition, and active daily exercise may help to slow dementia.

According to the Cleveland Clinic, “Dementias are often broken down into two main categories -- Alzheimer type or non-Alzheimer type. Dementias of the Alzheimer’s disease type are defined by the symptoms of memory loss plus impairment in other brain functions, such as language function inability to move the muscles associated with speech (lips tongue and jaw; apraxia); or perception, visual or other inabilities to recognize speech or name objects.
Non-Alzheimer dementias include the frontotemporal lobar degenerations, which are further broken down into two main types. One type primarily affects speech. An example is primary progressive aphasia syndromes. The other type is defined by changes in behavior, including lack of feeling, emotion, interest or concern; loss of a “social filter, personality change and loss of executive functions (such as the ability to organize and plan ahead). In both of these frontotemporal lobe dementias, memory loss is relatively mild until later in the course of the disease.”
 
Doctors can diagnose dementia by interviewing the patient, reviewing their current symptoms and their medical history, through brain and cognitive testing, lab tests, and imaging scans. Although doctors can help patients manage some of the symptoms of dementia, for the most part dementia remains both incurable and irreversible. Currently, there are a few medications available that may improve or stabilize memory function in some patients. Meanwhile, a huge commitment to research is ongoing aimed at enhancing and improving brain health.
 
Chronic obstructive pulmonary disease (COPD):  About eleven percent of patients over the age of 65 receive treatment for chronic obstructive pulmonary disease (COPD).  COPD is chronic inflammatory lung disease which includes two primary conditions -- emphysema and chronic bronchitis. Both make it difficult to breathe and cause tightness in the chest, shortness of breath, wheezing, and coughing.
 
Emphysema occurs when the air sacs at the end of the smallest air passages of the lungs are destroyed. Chronic bronchitis is inflammation in the lining of the bronchial tubes causing mucus production and coughing.
 
The best way to prevent or slow COPD is to avoid or quit smoking and be cautious of things which irritate the lungs such as second-hand smoke, chemical fumes, and dust. 
 
There are several kinds of medications to help with the symptoms and side effects of COPD, For instance, long and short acting bronchodilators which come in inhalers to make breathing easier, inhaled steroids to reduce inflammation, combination inhalers, short courses or oral steroids, and antibiotics. Lung therapies such as oxygen therapy, pulmonary rehabilitation, and breathing devices can also help those with moderate to severe COPD.
 
Self-care steps such as breathing and relaxation techniques, use of a humidifier, regular exercise to strengthen respiration, and drinking plenty of water can help in managing symptoms. It is also wise to speak with a doctor about COVID, flu, and pneumonia vaccines for the prevention of respiratory illnesses.