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Differentiating normal aging from disease

With changing times, people change – their appearances change and personalities change. Though a well-known fact, this realization dawned on me recently, when I visited some of my older relatives in India.

With changing times, people change – their appearances change and personalities change.

Though a well-known fact, this realization dawned on me recently, when I visited some of my older relatives in India. An aunt and an uncle exhibited striking changes in their appearance and personality, erroneously attributed to aging.

An uncle, who used to be very eloquent and outgoing, now in his seventies, seemed reticent and reclusive.

His wife said that since his retirement and subsequent relocation to their son’s house in the town, he has been missing the companionship of his peers.

He was always tired and was having sleep problems, for which his doctor has prescribed some pills. A casual enquiry revealed that he preferred to spend most of his waking hours in bed, napping. I strongly suspected that my uncle had depression.

However, my aunt explained this way “You see he is getting old, so he tires easily.”

I heard this explanation again when I visited one of my aunts in the village. Since the last time I saw her, this aunt has developed a curve in her spine, which made her hunch-backed.

She also complained of heartburn and loss of appetite. My aunt remarked in a resigned tone, “What can I do, I am getting old.”

I suggested that she see a doctor and take some medications for her osteoporosis and acid-reflux, and she would feel well again.

Surely, aging is clearly associated with small decrements in energy, exercise tolerance, muscle strength, vision, hearing, taste, smell, and memory and changes in sleep patterns.

But these changes are subtle and gradual, and majority of older adults learn to adapt their activities to their environment so that quality of their life is not significantly compromised.

Several myths exist in our society about aging, and there is a tendency to attribute all ailments occurring in older people to aging. The most prevailing myth is that aging involves degenerative changes in the body that inevitably lead to disability, frailty, total dependence on others, and finally institutionalization. While this may be true for some individuals, it is usually not so until the last few months or years before one’s death. Disabilities and frailties can be observed at any age, because of genetics, injuries, diseases, environmental factors and lifestyle.

Disability refers to reported difficulty in performing the activities of daily life, such as getting out of bed, getting dressed, self-grooming, eating, using the toilet, or performing activities required for independent functioning, such as shopping, banking, maintaining a home, and driving a car. Disability is not an inevitable consequence of aging. According to the 2006 Census, 43 per cent of adults aged 65 years and over reported disability.

Similarly, frailty is a disease state and not an accompaniment of normal aging.

So, why is it important to distinguish changes associated with aging from disease-related changes? Such an understanding will help older individuals, family members, and care-providers in the early detection and treatment of any disease condition that is compromising their quality of life. Such an understanding may also help to alleviate some of our own fears of aging, as well as positively influence our personal and professional interaction with older adults.

Padmaja Genesh, who holds a bachelor degree in medicine and surgery as well as a bachelor degree in gerontology, has spent several years teaching and working with health-care agencies and health clinics. She has been a board member of Red Deer Golden Circle and has been a resident of Red Deer for the past six years. Her column appears every second Sunday. Please send your comments to padmajaganeshy@yahoo.com.