From Depression to Incontinence, Here’s What to Do About Age-Related Health Disorders

As we age, many of us will face some common health challenges. Here’s what they are – and how to handle them.

1. Dysphagia

 

What it is: Up to 35 per cent of older adults have difficulty swallowing, says Jen Raman, a speech language pathologist at Baycrest, a Toronto health sciences centre for older adults. While dysphagia is related to diseases that affect the swallowing muscles, like Parkinson’s and dementia, certain medications such as antidepressants, as well as head and neck surgeries, can cause it, too. The danger is, people with dysphagia can easily aspirate food into the lungs, leading to pneumonia. They are also at risk of dehydration and malnutrition, says Raman.

Symptoms: Coughing, sputtering and choking while eating; drooling; losing weight; avoiding certain foods or family dinners to prevent social embarrassment; taking longer to eat; frequent chest infections. 

How to handle it: “Many seniors don’t immediately seek help because they think it’s a normal part of aging,” says Raman, “but it can be a first sign of serious disease.” She suggests seeing a doctor and employing strategies that can help, such as drinking with food, using a technique called “swallowing hard” and eating softer food. 

 

2. Seborrheic Keratoses 

 

What it is: Harmless, wart-like growths that can be mistaken for skin cancer. About 75 per cent of people by the age of 70 will develop one – or even hundreds – measuring 1 to 2.5 centimetres across.

Symptoms: Often itchy, with round or oval shapes. Can be brown, black or light tan, and scaly or slightly raised – on the back, face, neck or chest.

How to handle it: These skin patches may resemble melanomas, so they need to be checked by a doctor. A physician can safely remove large, irritated or multiple keratoses in the office, using liquid nitrogen or by scraping off the lesion.

 

3. Diverticulitis 

 

What it is: As people age, their intestines may develop marble-sized, bulging pouches called diverticula, which can trap stool, according to Dr. Lindy Romanovsky, staff geriatrician and clinical associate with Toronto’s Sinai Health and the University Health Network. If these pouches become inflamed or infected, it’s called diverticulitis. 

Symptoms: Severe abdominal pain, fever, nausea and changes in bowel habits. Twenty-five per cent of people can develop complications such as an abscess, when pus becomes trapped in a pouch; a bowel blockage; or a fistula, when an abnormal passageway forms between the bowel and another organ. Romanovsky says complications may result in surgery, which could include removing parts of the colon.

How to handle it: Antibiotics fight the infection and prevent sepsis, when the body overreacts to an infection. To prevent diverticula, she suggests eating a fibre-rich diet, drinking plenty of water, exercising and, if constipated, taking osmotic laxatives, which draw water from the body to help stool pass through.

 

4. Incontinence

 

What it is: At age 85 or older, 19 per cent of men and 22 per cent of women experience incontinence, or loss of bladder control. It is caused by weak pelvic floor muscles, diseases like diabetes or multiple sclerosis, or an enlarged or inflamed prostate in men.

Symptoms: Leaking or gushing urine when coughing, sneezing, laughing or lifting; an increasing or sudden urge to pee. 

How to handle it: Avoiding diuretics like coffee, tea and carbonated beverages can help reduce the urge to urinate. Pelvic floor exercises, medications and medical devices, such as pessary rings for women, can also help. Leak-proof underwear, adult diapers or incontinence pads can absorb urine. 

 

5. Depression

 

What it is: Depression is so much more than feeling sad. A multi-factorial mood disorder, which can be caused by genetics, trauma, brain chemistry and seasonal changes, it affects an estimated 15 per cent of adults 65 years or older, according to a 2018 Mental Health Association of Canada report. And it can have a profound effect on a person’s day-to-day life. “It’s quite a prevalent illness,” says Dr. Robert Madan, the chief of psychiatry and executive medical director at Baycrest. “There was a doubling of depressive disorders during the pandemic,” he adds. Madan says the risk factors for developing depression include having few friends, multiple chronic conditions and pre-existing depression.

Symptoms: Loss of appetite, insomnia or sleeping too much, a lack of interest in activities that were once enjoyable, an inability to experience pleasure, negative thoughts, poor concentration and the feeling of not wanting to live.

How to handle it: Because of the stigma, many people are reluctant to discuss isolation, sadness and disinterest in life, and hide their symptoms. As a result, friends and family members often miss the signs. “Other conditions, such as arthritis, diabetes and dementia, can also confound symptoms of depression,” says Madan. Yet, there are effective treatments, such as psychotherapy or antidepressant medications, and lifestyle remedies – regular exercise, meditation, socializing. 

 

6. Inguinal Hernia

 

What it is: Caused by lax abdominal muscles, some of the intestines push between muscles, becoming trapped. Hernias affect three to four per cent of the population, although 27 per cent of men will experience it in their lifetime. “The muscles can relax with age,” explains Romanovsky, adding that obesity, chronic obstructive pulmonary disorder (COPD) and asthma can be risk factors. She warns bulging intestines can be deprived of blood flow, a dangerous situation that can lead to necrosis, where the tissue dies. This is considered a life-threatening medical emergency.

Symptoms: A bulge in the groin between the lower abdomen and thigh. “If the intestine is strangulated, the pain will be significant,” says Romanovsky, adding that vomiting and nausea may also be present. 

How to handle it: Preventing a hernia involves having regular bowel movements, maintaining a healthy weight, getting treated for a persistent cough. “If the hernia gets too big, it needs to be surgically managed.” 

 

7. Heavy-leg Syndrome 

 

What it is: Also known as chronic venous insufficiency (CVI), it occurs when blood pools in the legs because small or narrowed veins don’t allow blood to flow back up to the heart. It is most prevalent in people who are overweight, smoke, have a family history of heavy-leg syndrome or have had previous leg injuries or blood clots. It affects 40 per cent of people over age 50, and strikes more women than men.

Symptoms: Leg swelling, pain, muscle cramps, leg ulcers and varicose veins. Difficulty moving the legs. Skin can also turn brown near the ankles.

How to handle it: CVI can be exacerbated by standing or sitting for long periods, so it’s good to walk around as much as possible. You can also get relief by raising your legs when lying down or wearing compression socks or stockings. Treatments include medications that dilate blood vessels; radio frequency ablation, when a catheter is inserted that burns off tissue and closes a vein; sclerotherapy, when a chemical is injected into the veins to prevent blood from pooling; and ligation, when veins are surgically tied off.  

A version this article appeared in the Oct/Nov 2022 issue with the headline ‘Body Work, p. 18.

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