An Eye Disorder Associated with Aging
Age-related macular degeneration (AMD), an eye disease associated with aging, gradually destroys the sharp, central vision that is needed for seeing objects clearly and for such common daily tasks as reading and driving. It’s the leading cause of vision loss in Americans 60 and over.
In some cases, AMD advances so slowly that people notice little change in their vision. In others, the disease progresses faster and may lead to a loss of vision in both eyes. Affecting the part of the eye called the macula, which is located in the center of the retina, AMD is not accompanied by pain.
The greatest risk factor for AMD is age. Other risk factors include smoking, obesity, race (African Americans have the greatest likelihood), gender (women more than men) and family history. Although it may occur during middle age, it affects most people over age 60, with a risk of about 30 percent for those over 75.
There are two types of age-related macular degeneration – wet and dry. Wet AMD occurs when abnormal blood vessels behind the retina start to grow under the macula. These new blood vessels, which tend to be very fragile, often leak blood and fluid. The blood and fluid raise the macula from its normal place at the back of the eye and incur damage. Loss of vision can occur quickly. An early symptom is that straight lines appear wavy.
Dry AMD occurs when the light-sensitive cells in the macula slowly break down, gradually blurring central vision in the affected eye. As the condition grows worse, it often causes a blurred spot in the center of one’s vision. Over time, as less of the macula functions, central vision is gradually lost. With the dry condition, you may have difficulty recognizing faces and may need more light for reading and other tasks. While it generally affects both eyes, vision can be lost in one eye while the other eye seems unaffected.
Wet age-related macular degeneration is typically treated with laser surgery, photodynamic therapy, or injections into the eye. None of these is a cure. In laser surgery, the fragile, leaky blood vessels are destroyed by aiming a high energy beam of light directly at them to prevent further loss of vision. However, laser treatment may also destroy some surrounding healthy tissue and some vision. The risk of new blood vessels developing after laser treatment is high. Repeated treatments may be necessary and, in some cases, vision loss may progress despite repeated treatments.
In the case of photodynamic therapy, a drug called verteporfin is injected into the arm. It travels throughout the body, including the new blood vessels in the eye. The drug “sticks” to the surface of new blood vessels. A light is then shined into the eye for about 90 seconds, activating the drug. This destroys the new blood vessels and leads to a slower rate of vision decline. Unlike laser surgery, this drug does not destroy surrounding healthy tissue. The therapy is relatively painless.
Wet AMD is also treated with new drugs that are injected into the eye (anti-VEGF therapy). Abnormally high levels of a specific growth factor occur in eyes with wet AMD and promote the growth of abnormal new blood vessels. This drug treatment blocks the effects of a growth factor that promotes the growth of abnormal blood vessels. This treatment, which involves the need for multiple injections, can help slow down vision loss and in some cases improve sight.
In the case of dry AMD, once it reaches the advanced stage there is no form of treatment available to prevent vision loss. However, treatment can delay and possibly prevent intermediate AMD from progressing to this stage. This involves the use of a specific high-dose formulation of antioxidants and zinc.
Dealing with Aging Joints
Getting older is inevitable, but that doesn’t mean aging joints have to keep one from leading an active lifestyle.
Exercise, proper diet and good posture all play a role in keeping joints young as long as possible. However, with age, often comes osteoarthritis. Ostheoarthritis is one of the ten most disabling diseases in the developed world. Worldwide estimates are that 10% of men and 18% of women over 60 years have symptomatic osteoarthritis, including moderate and severe forms. Age is the strongest predictor of the development and progression of osteoarthritis and joint replacement is becoming an ever more common treatment.
The number of hip and knee replacements has increased rapidly as a result of dramatically improved outcomes due to more effective surgical procedures and better replacement devices. In the United States, both hip replacement and knee replacement rates have nearly doubled since 2000. Joint replacement is often the answer for those who experience constant pain when walking or climbing stairs.
Following hip or knee replacement, patients often stand or begin walking the day of surgery. At first, a walker or crutches are used and some temporary pain is experienced in the new joint because muscles are weak from not being used and the body is healing from the surgery. Pain is usually controlled by medication. In many cases, physical therapy begins the day after surgery to help strengthen the muscles around the new joint and help regain motion. Joint replacement works well even for older people – it has a success rate of greater than 90 percent.
Obesity is on the Increase
Obesity has become the #2 cause of preventable death in the U.S (behind smoking). It contributes to such health conditions and diseases as breast cancer, coronary heart disease, Type II diabetes, sleep apnea, gallbladder disease, osteoarthritis, colon cancer, and hypertension and stroke. Sixty million American adults are considered obese.
Here are five things you may not know about obesity:
- Being obese is different from being overweight. It’s not good to be either. However, a person with a body mass index (BMI) of between 25 and 29.9 is considered overweight. One who has a BMI of over 30 is obese.
- Obesity is not all about a lack of will power. Although it is true that eating too much can contribute to obesity, there are multiple risk factors. In addition to poor dietary habits and lack of physical activity, genetics and social and cultural factors can also play a role in one becoming obese. Also, some medications and medical problems can make a person more likely to gain excess weight.
- Treating obesity is about more than simply losing weight. Obesity treatment is multi-faceted and involves making changes in eating habits and activity levels. It also involves becoming better educated about the risks of obesity. A doctor needs to investigate potential risks, complications, and underlying health conditions that may require treatment. In some cases, obesity treatment may also require medication or surgery.
- Physical activity is the key to preventing obesity. While there are many reasons why people become obese, lack of physical activity is one of the strongest risk factors and predictors. An exercise program, starting slowly and under a doctor’s supervision, can work effectively for even older people who suffer from obesity (see story on exercise).
- Obese older adults may be more likely than those who are thinner to suffer potentially disabling falls. Although falls are often seen as a problem for thin, frail older adults, since their bones are especially prone to fracture, obesity carries its own risks. People who are obese may have a harder time with balance, and when they lose their footing they may be less able to react quickly and stop a fall.
Myths about Exercise
Many seniors have a difficult time starting an exercise regimen. This is certainly to be expected – getting involved in an exercise program is not easy at any age, much less for someone who is older. To mentally get over the hurdle of getting started, it makes sense to begin by first separating fact from fiction when it comes to exercise. Here are some common myths that need to be dispelled (along with the realities):
It’s too late (at my age) to start exercising.
Exercise, in fact, is beneficial for individuals regardless of age, even for those who are in their 70s, 80s, or even 90s. Muscle mass naturally decreases after age 40; however, it is possible to build muscle at any age. Strong muscles help make daily tasks easier, and provide balance and stability to prevent falls. Bottom line: it’s never too late, even if it means finding an exercise program that is performed without ever leaving a chair (or wheelchair).
I will get injured.
Injuries can happen during exercise for someone at any age. However, attending fitness classes designed specifically for seniors, or working with a trainer who is proficient in senior fitness, will minimize this risk. Low impact, light resistance classes work best for seniors just beginning a fitness program.
I am not flexible enough to exercise.
Decreased range of motion is not unusual. However, this should not be viewed as an obstacle to exercising. Exercise, especially classes that specifically incorporate stretching, improves range of motion and function in seniors. This can relieve muscle and joint pain associated with stiffness and lack of circulation.
Since I have osteoporosis I cannot exercise.
Osteoporosis should not prevent exercise at any age. In fact, exercise actually strengthens the bones by stimulating bone growth, therefore combating osteoporosis. The risk of breaks or fractures has been found to be reduced among seniors that exercise. It also improves overall function.
How About Doing Some Gardening?
Gardening is an excellent way for aging bodies to get plenty of fresh air and a moderate-intensity aerobic workout that can help shed calories and help one stay flexible from the bending, lifting, kneeling, squatting, weeding and pruning.
Here are some things to consider when gardening this summer:
- Protect against pests and the elements by slathering on sunscreen with an SPF of at least 30 and insect repellent before putting on clothes.
- Add benches or chairs under shady trees.
- Create raised beds to improve drainage and make harvesting easier. Lightweight plastic landscape timbers can be stacked to form raised beds at waist or wheelchair height, if necessary. Make the beds narrow, so anyone can reach into the center without straining.
- Make vertical gardens by growing vining plants upward using trellises, tomato cages, bamboo stakes, fences, walls or arbors as supports. This will cut down on bending and make harvesting easier.
- Avoid hanging baskets, since they dry out quickly, require frequent fertilization, and can be difficult to reach.
- Work in the morning and evening, when it’s coolest.
- Bring a water bottle to prevent dehydration.
- Wear sturdy shoes, a broad-brimmed hat and gardening gloves.
- Bend at the knees and hips to avoid injury.
- Use manual shears instead of power hedge clippers to avoid accidents.
Preventing Memory Loss
Here are six things that doctors say can help seniors prevent memory loss:
- Keeping your brain active. Challenging your brain and mental abilities is believed to stimulate brain cells and keep your thinking sharp. This may include reading, writing, developing a new skill, or relearning old skills. Various brain games, puzzles and problem solving can help.
- Letting go of stress. It’s been shown that prolonged stress over many weeks can cause memory loss by altering brain chemistry and damaging the hippocampus, which is where the brain stores new memories.
- Staying socially active. Relationships with other people can improve mental performance. Social activities often are intellectually stimulating, which prompts good memory function. Friends also can provide support when feeling stressed. Research has linked loneliness with an increased risk of memory loss and dementia.
- Exercising regularly. This can keep blood flowing to the brain, leaving the brain cells well-nourished with oxygen and nutrients.
- Staying away from smoking and alcohol. Smokers have been shown to perform worse than nonsmokers in memory studies and tests of thinking skills. Heavy alcohol use is also known to cause memory loss.
- Not suffering head trauma. Head trauma is one of the major causes of memory loss, and has been shown to cause dementia later in life (as shown in studies of professional football players and boxers).
Favorite TV characters
We all had favorite TV characters growing up. Here are some popular TV shows from the 1950s, ‘60s and ‘70s. Can you match character and show?
- Car 54 Where Are You?
- Dick Van Dyke Show
- Leave it to Beaver
- Donna Reed Show
- The Flintstones
- I Dream of Jeannie
- The Fugitive
- Gomer Pyle
- All in the Family
- Hop Sing
- Mr. Slate
- Officer Francis Muldoon
- Eddie Haskell
- Dr. Alex Stone
- Mike Stivic
- Buddy Sorrell
- Sgt. Vincent Carter
- Major Anthony Nelson
- Lt. Philip Gerard
A-3, B-1, C-7, D-4, E-5, F-2, G-9, H-10, I-8, J-6