One of the primary health issues in the United States that significantly affects the older adult population is diabetes mellitus. Not only is this disease related to premature aging, chronic diabetes is related to serious physical and cognitive problems as well, particularly among people with poor blood glucose metabolism. Furthermore, the danger of uncontrolled diabetes is reduced quality of life and increased healthcare expenses.
Diabetes is characterized by high blood glucose levels and is the most common age-related disorder of the endocrine system. Diabetes is found in an estimated 10% of people between the ages of 56 and 64, 20% in those ages 65 to 74, and 40% in those over the age of 85. Approximately 24 million people in the US have this disorder.
Urinary and faecal incontinence are serious health problems that are detrimental to overall health and quality of life and commonly affect older adults. Both types of incontinence are prevalent among the elderly population all over the world. According to statistics, nearly 800,000 people residing in the Netherlands suffer from some level of incontinence, although the actual statistic could be greater due to reluctance to disclose such personal information and get help. It is common among people to find incontinence a difficult topic to discuss, even with a general practitioner. One of the reasons why people may be uncomfortable talking about incontinence is because of the stigma that the health issue is associated with ageing. It is commonly believed that there are no available treatment options for incontinence, as well, which is a myth. Often times, patients appear to have suffered from incontinence for a long duration of time prior to seeking help from a general practitioner.
As the older adult population continues to grow worldwide, age-related health issues will further increase the high clinical, economic, and social challenges of caring for the elderly. Alzheimer’s disease and dementia are two cognitive health problems that are increasing in prevalence among older adults. Currently, no cure for dementia exists, and available treatment options provide primarily symptomatic reliefs. Therefore, finding ways to prevent or delay the development of dementia through implementing lifestyle changes, such as diet, is critical.
A long-held, popular belief in the health stratosphere is that supplements such as ginko biloba, fish oil, and many others have the power of boosting memory and preventing cognitive-related illnesses. In fact, millions of dollars are spent on these memory supplements every year. According to the Nutrition Business Journal, Americans spent almost $91 million on ginkgo biloba in 2015. However, many of the positive cognitive effects revolving around these supplements have been refuted by scientific experts and recent studies.
The prevalence of age-related frailty is high in older adults, ranging from 7% to 16.3%. The prevention and treatment of frailty has long been a major concern in geriatrics, especially in the clinical medicine. Frailty is the primary determinant of longevity and quality of life in the older adult population. Frailty is defined as an age-related, biological syndrome that causes a reduction of biological reserves due to the dysfunction of various physiological systems, which increases an older adult’s vulnerability to minor stressors, and is related to adverse health outcomes (such as disability, hospital admission, and death). Frailty is a stronger indicator for negative outcomes in older ages than chronic disease. It is important to note that frailty is reversible in its early stages. Importantly, a frail person can become nonfrail if frailty is identified and addressed at the onset.
Animal assisted interventions (AAI) have become a growing topic of interest in research in recent years. The possibility of AAI was first realized when a psychiatrist named Boris Levinson recognized the benefits that AAI produced as his dog accompanied him when he would visit a behaviorally disturbed child under his care. In later years, interest in the therapeutic use of animals in long-term care grew. The Alzheimer’s Association encourages the use of AAI with patients suffering with Alzheimer’s disease as a management strategy. According to the Association, “Meaningful activities, such as those that involve music, art and pet visits, can help enrich the lives of people with Alzheimer’s disease. Pets, for instance, have been shown to reduce depression and boost self-esteem.” A study conducted in 2003 found that animal-assisted therapy significantly decreased agitated behaviors in elderly patients with severe dementia and increased meaningful social interactions during the intervention. However, both of these positive effects stopped once the intervention was removed. Studies found that, in general, therapy using pets appeared to lower levels of aggression, promote prosocial behavior, and enhance health outcomes in patients with dementia.
According to a recent report by the International Psychogeriatrics Association, one in five older adults living in Europe with a functional impairment receives long-term care in a long-term care facility. Over 50% of these older adults suffer with dementia and often are challenged by some kind of neuropsychiatric symptoms throughout the progression of the disease. These patients commonly express challenging behaviors that include verbal and physical aggression, depression, agitation, wandering, sleep disturbances, oppositional behaviors, and psychotic symptoms. Presently, not many pharmacologic options exist for the treatment of neuropsychiatric symptoms. However, elderly residents with dementia are frequently prescribed psychotropic medications.
Loneliness isn’t just a feeling, it’s a powerful syndrome that affects many older adults worldwide. According to a recent article published in the Journal of the American Medical Directors Association (JAMDA), loneliness can promote the deterioration of health and cognitive function, lower quality of life, and increase the rate of mortality. The term constitutes a subjective feeling, a state in which an individual’s social network in reality does not meet their own expectations. Thus, a person can suffer from loneliness even while surrounded by others. Older adults commonly experience feelings of loneliness. According to recent statistics, 4% to 9% of older adults living in the community experience continual loneliness, and an additional one-third could suffer from some degree of loneliness. However, not much research has been done to understand the prevalence of loneliness in older adults living in nursing home facilities, even though it is known that residents in these long-term care settings are suggested to be at high risk for loneliness. One Norwegian study found that more than half of nursing home residents who were cognitively intact suffered from loneliness. It is important to note though, that cognitively intact residents make up a small fraction of the nursing home population.
Ensuring that dependent older adults with complex health problems receive high quality long-term care has been a long-standing challenge for the health care systems around the world. Currently, the need is greater than ever, considering that older adults battling with a multiple of chronic diseases and functional and/or cognitive disabilities are becoming more prevalent as the elderly population worldwide continues to expand. Nursing home facilities provide 24-hour intensive care for individuals who are commonly physically or cognitively disabled, or both. The delivery of quality of care and maintenance of quality of life in nursing homes are often unsuccessful, however, and has long been a great concern to consumers, providers of care, and policy makers. The evidence that nursing home residents frequently suffer from preventable adverse outcomes (such as negative drug events, bed sores, falls resulting in serious injury, physical and pharmaceutical restraint use, delirium, and elder abuse) continues to grow and increase the risk of morbidity and mortality.