The Elderly and Monsoon Challenges: Caring for Senior Citizens

As the monsoon season arrives, it brings relief from scorching heat but also poses unique challenges, especially for senior citizens. The elderly are more susceptible to certain health risks during this time due to weakened immunity and age-related health conditions.

Understanding the Vulnerabilities

1. Weakened Immune System: Aging often leads to a weakened immune system, making senior citizens more susceptible to infections and diseases brought on by the monsoon weather.

2. Respiratory Concerns: Humid conditions can aggravate respiratory diseases like asthma, bronchitis, and chronic obstructive pulmonary disease (COPD).

3. Mobility Issues: Slippery surfaces during rainfall can be a genuine risk factor for falls and injuries for seniors with mobility issues.

Health precautions for seniors

1. Vaccination: Encouraging seniors to get vaccinated against common monsoon-related illnesses like influenza can significantly reduce the risk of infections.

2. Regular Medical check-up: Timely medical check-up can help identify and manage any health issues, allowing for timely intervention during the monsoon season.

3. Hygiene Practices: Emphasise the importance of regular hand-washing and maintaining personal hygiene to prevent infections.

4. Respiratory Care: Provide guidance on using air purifiers, humidifiers and wearing masks to reduce exposure to allergens and airborne pollutants.

Nutrition and hydration

1. Balanced Diet: Advise seniors to consume a balanced diet rich in vitamins and minerals to boost their immunity and overall health.

2. Adequate Hydration: Ensure seniors drink enough water to stay hydrated, even if they may not feel as thirsty during the monsoon season.

3. Food Safety: Educate on proper food storage and hygiene practices to prevent foodborne illnesses.

Home safety

1. Fall Prevention: Implement safety measures such as installing handrails, avoiding loose rugs, and keeping the house clutter-free to reduce the risk of falls.

2. Water-proofing: Check for leaks and waterproof the house to prevent water seepage and dampness, which can lead to mould and respiratory issues.

3. Mosquito Control: Use mosquito nets and repellents to protect seniors from mosquito-borne diseases like dengue and malaria.

Exercise and physical activities:

1. Indoor Workouts: Encourage seniors to engage in indoor exercises like stretching, yoga, or light aerobics to maintain flexibility and strength.

2. Doctor-Approved Activities: Suggest physical activities that are suitable for each senior's health condition, considering any existing ailments.

Mental Health

1. Social Interaction: Facilitate regular social interactions with family members and friends to prevent feelings of isolation and loneliness.

2. Engaging Hobbies: Encourage seniors to pursue hobbies and interests that provide mental stimulation and relaxation.

Caring for senior citizens during the monsoon season requires a combination of preventive measures, health considerations, and safety precautions. Remember, regular medical attention, a balanced diet, a safe home environment, and emotional support are vital components in providing the best care for our senior citizens during this challenging time.

Adapted from Dr. Ambrish Dixit’s article in Internal Medicine on July 31, 2023.

How Seniors Can Manage Osteoarthritis Symptoms

Are you experiencing stiffness, swelling and pain in your joints? It could be caused

by osteoarthritis, or OA, the most common type of arthritis. Even though there is no cure for OA, there are many options to manage OA.

Talk to your health care provider about your treatment options sooner rather than

later. For most people, osteoarthritis could get worse over time if symptoms are not addressed early. People respond differently to treatments, so you may need to try several methods (or a combination of methods) before you find what works best for you.

Also, it is possible that what works for you today may not work as well in the future, so be open to trying new treatments as your symptoms change.

The latest osteoarthritis management guidelines from the ‘American College of Rheumatology and Arthritis Foundation’ recommend using two broad categories of treatment options at the same time: non-medication and treatments.

Non-medication treatments to help manage osteoarthritis

1. Physical activity. There is a common myth that being active could make arthritis worse, but the opposite is true! Physical activity helps increase strength, range of motion, joint stability, and function and can make OA symptoms better. Physical activity can also help you manage your weight and other health conditions like heart disease and diabetes.

Aim for a combination of aerobic, strengthening, and balance/flexibility exercises.

Some joint-friendly activities include: walking, swimming or water aerobics, cycling, tai chi, yoga, resistance bands, light gardening, and even household chores. You can also check with your health insurance plan to see if you might be eligible for fitness centre discounts and free or reduced-price exercise classes. Finally, the most important thing to remember is to move more: try and find ways to be more active throughout the day. 

2. Weight management. Extra weight increases joint pain and damages cartilage of the joints, especially in the hips and knees. Even small amounts of weight loss may help relieve pain. Every 1 pound of weight loss gives you 4 pounds of relief on your knees. We know that losing weight is not easy, and there is not one “best way” to lose weight. Managing your weight through a healthy diet and increased physical activity can help you reduce your joint pain. Like managing OA, finding a healthy weight involves a combination of approaches and sometimes a little trial and error.  In addition to physical

activity and changes in eating habits, other weight loss strategies can include surgery and medications.  Talk to your healthcare provider or a nutrition expert about what the best weight management approach is for you.

3. Education and social support. Managing OA may mean balancing a variety of symptoms, conditions, emotions, healthcare providers, and treatments. Educating yourself about your condition, learning skills that help you cope, and connecting with peers who have similar experiences can help you manage your pain and can help you learn how to manage a chronic condition, prevent its short- and long-term health consequences, and achieve the best possible quality of life.

4. Physical and/or occupational therapy. Physical therapy can help improve your movement, strength, endurance, activity level, balance, and function. Occupational therapy focuses on improving your daily functioning and independence by setting you up with techniques to manage everyday tasks.

Both physical and occupational therapists can also help fit you for braces, orthoses, assistive devices, and walking aids.

5.Assistive devices. Braces and canes may improve pain, joint stability, and balance and can help lower your risk of a fall.

6. Mind-body treatments. Pain and other symptoms from osteoarthritis can lead to feelings of stress, anxiety, frustration and depression; it is important to take care of both your physical health AND your mental health.

Acupuncture, massage, and heat and cold treatments can help reduce pain. Tai chi and yoga can reduce pain, stiffness, and stress and improve feelings of relaxation and well-being. Group or one-on-one counseling can help you manage stress, anxiety, depression, and sleep.

7. Joint protection. Joint protection strategies can help reduce pain and risk of injury and make everyday tasks a little easier. Wear supportive shoes; alternate between sitting and standing; take short stretching breaks throughout the day; use safe lifting practices; try to spread your weight evenly across your joints when walking, climbing stairs, and doing heavy household chores; rethink your household chores to minimize joint strain;

and invest in gadgets that make daily tasks easier. Medication treatments to relieve pain from osteoarthritis All medications should be used in consultation with a health care provider.

1. Oral. Non-steroidal anti-inflammatory medications (NSAIDs) are the most common type of medication recommended for osteoarthritis pain relief.

NSAIDs reduce swelling and inflammation around the joint. These should be used with caution because they can cause stomach bleeding and can contribute to the risk for cardiovascular or kidney conditions. Acetaminophen may help mild cases of OA or when other medications can’t be taken.

Prescription-only medications like tramadol or duloxetine may be recommended for some cases of severe OA or with other medical conditions.

These medications are for symptom management only and should be taken at the lowest dose and for the shortest time possible.

2. Topical. Creams or gels that can be rubbed into the skin around joints may provide temporary pain relief.

3. Injections. For joint injections, a provider will use a needle, with or without ultrasound, to insert medication into the space around the joint.

There are two main types of injections: corticosteroids and hyaluronic acid. Corticosteroid injections help reduce inflammation in the joint, while hyaluronic acid acts like a gel, providing cushion between the joints.

Injections can only be given a few times a year and may not be recommended for people with certain health conditions such as diabetes.

4. Questionable treatments. There is little scientific evidence that the following alternative treatments to address osteoarthritis pain are effective or even safe: CBD products, glucosamine supplements, vitamins and minerals, turmeric, fish oil, and herbal treatments. Combining any medications (over-the-counter or prescription) carries risk. It is important that you discuss ALL prescribed AND non-prescribed medications or supplements with your healthcare provider.

5. Surgery. If all other types of treatments have been tried and you are still experiencing severe pain and disability from osteoarthritis, surgery may be a consideration.  The most common types of surgery for OA are total joint and partial joint replacements. An orthopedic surgeon will examine your x-rays, conduct a full health history and exam, and ask about your experiences with OA to determine the most appropriate timing and type of surgery for you.

We asked people with osteoarthritis to tell us what they do to help manage their joint pain. Maybe some of these ideas will inspire you:

• Strive to stay physically active throughout the day, even if you have to try shorter “bursts” of activity.

• Losing weight is hard. When the going gets tough, remember that any weight loss amount can help relieve some of your pain by decreasing pressure on your joints.

• Keep a positive mindset. This might be easier said than done, but small moments of joy can have big impacts. Consider starting a daily gratitude journal or taking time to reflect on the things that have gone well recently.

• Recognize, understand, and accept that OA will affect how you move your body, which will impact your life. Assistance in the form of a cane, walker, braces, cushions, or a body pillow may be needed to help reduce the amount of pressure on your joints.

• Work with a trusted physical therapist/physiotherapist to learn safe exercises to keep your muscles strong and joints flexible.
  

Adapted from: https://www.ncoa.org/article/how-seniors-can-manage-osteoarthritis-symptoms

Dementia diagnosis can be tricky, but bloodtests could help predict it years earlier

In the largest study of its kind, scientists have discovered that a blood test detecting specific proteins could predict dementia up to 15 years before a person receives an official diagnosis. The researchers found 11 proteins that have a

remarkable 90% accuracy in predicting future dementia.

Dementia is the UK’s biggest killer. Over 900,000 people in the UK are living with the memory-robbing condition, yet less than two-thirds of people receive a formal diagnosis. Diagnosing dementia is tricky and relies on various methods.

These include lumbar punctures (to look for certain tell-tale proteins in the cerebrospinal fluid), PET scans and memory tests. These methods are invasive,time-consuming and expensive, putting a heavy burden on the National Health Service.

This means that many people are only diagnosed when they have memory and cognitive problems. By this point, the dementia may have been progressing for years and any support or health plan may be too late.

Those with undiagnosed dementia, and their families, cannot attend clinical trials, have an organised healthcare plan or access essential support. So improving dementia diagnosis would provide earlier support and give patients a longer, healthier and more prosperous life.

In this latest study, researchers at the University of Warwick in England and Fudan University in China examined blood samples from 52,645 healthy volunteers from the UK Biobank genetic database between 2006 and 2010. Over the ten- to 15-year follow-up period, around 1,400 developed dementia.

The researchers used artificial intelligence and machine learning to analyse 1,463 proteins in the blood. They identified 11 proteins associated with dementia, of which four could predict dementia up to 15 years before a clinical diagnosis.

When combining this data with more regular risk factors of age, sex, education and genetics, the dementia prediction rate was around 90%.

These proteins found in the plasma (the liquid component of blood) are biological markers for the changes that occur in dementia sufferers over a decade before clinical symptoms first appear. They act as warning signs of the disease.

Why these proteins

The four proteins most strongly associated with all-cause dementia, Alzheimer’s disease (accounting for 70% of all dementias) and vascular dementia (accounting for 20%) are GFAP, NEFL, GDF15 and LTBP2.

Scientists showed GFAP to be the best “biomarker” for predicting dementia. GFAP’s function is to support nerve cells called astrocytes.

A symptom of Alzheimer’s disease is inflammation, and this causes astrocytes to make a lot of GFAP. Consequently, people with dementia display increased inflammation, resulting in higher levels of GFAP, making it a prominent biomarker.

The study showed that people with higher GFAP were more than twice as likely to develop dementia as people with low levels. Smaller studies have also identified GFAP to be a potential marker for dementia.

NEFL is the second protein that is most strongly associated with dementia risk. This protein relates to nerve fibre damage. Combining NEFL or GFAP with demographic data and cognitive tests significantly improves the accuracy of dementia prediction.

Proteins GD15 and LTBP2, both involved in inflammation, cell growth and death, and cellular stress, are also strongly linked to increased dementia risk.

But despite the study’s discovery, other scientists warn that the new biomarkers require further validation before they can be used as a screening tool.

The bigger picture

Other initiatives are also promoting the adoption of blood tests as a widespread screening method in diagnosing dementia, including the Blood Biomarker Challenge, a five-year project aiming to use NHS blood tests to diagnose diseases that lead to dementia by looking at traces of brain proteins leaked into the bloodstream.

The exciting advent of new dementia drugs such as  lecanemab  and  donanemab, not yet approved for use in the UK, has the potential to slow the progression of Alzheimer’s disease.

Patients seeking lecanemab or donanemab treatment would require an early-stage diagnosis of Alzheimer’s disease. Alzheimer’s Research UK estimates that only 2% of patients undergo such diagnostic testing.

The study shows that blood tests are an effective way to detect dementia early by identifying specific proteins, providing the patient with the best possible opportunity to receive life-changing treatment.

Early diagnosis of dementia would result in a more effective treatment. A simple blood test has the potential to replace the costly, time-consuming and invasive tests currently used for dementia patients, ultimately improving the quality of many lives.

Source:

https://scroll.in/article/1064141/dementia-diagnosis-can-be-tricky-but-blood-

tests-could-help-predict-it-years-before