Common Diseases in Elderly

Dian Susmarini, MN Nursing Program Medical Faculty, University of Brawijaya

Chronic Obstructive Pulmonary Disease

Obstruction of the airways Includes chronic bronchitis and emphysema Most commonly due to tobacco smoking Sign and symptoms
Shortness of breath Chronis cough Wheezing Sleep disturbance Weight loss
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Complications: Physical
Frequent lung infections Weight loss Respiratory failure

Psychological
Depression and anxiety Stress to carers

Social
Social isolation due to shortness of breath and reduced exercise tolerance Financial burden due to frequent hospital admissions and treatments
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Prevention: Stop smoking

Rehabilitation: Disease management training Balance nutrition Exercise

Heart Failure
A complex condition that can result from any disorder that affects the ability of the heart to pump blood adequately to meet the demands of the body Prevalence increases with advancing age Causes:
High blood pressure Heart valve problems Coronary heart disease Alcohol related heart disease

 Symptoms:
Tiredness Shortness of breath Limitation of physical activities

Complications:
Limitation in activities of daily living Frequent hospital admissions High death rate

Treatment
Fluids and salt restriction Regular exercise as tolerated Stop smoking and alcohol Optimize treatment of high blood pressure and coronary 6 heart disease

Parkinsons Disease
One of the commonest neurological diseases affecting the elderly Due to damage to the brain cells resulting in the reduction of specific brain chemical 4 keys signs and symptoms:
Tremor (trembling of hands, arms, legs, jaw and/or face) Rigidity (stiffness of the limbs and/or trunk) Bradykinesia (slowness of body movement) Postural instability (impairment of balance and coordination leading to falls)

Complications: Physical:
Falls, rigidness, constipation, incontinence, difficulty in swallowing, difficulty in speech

Psychiatric:
Mood disorders, impairment of mental health

Social:
Loss of independence, isolation, carers stress
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Treatment: Non pharmacological

The management is multidisciplinary (doctors, nurses, physiotherapist, occupational therapist, speech therapist, psychiatrist, pharmachist). It also involves patient and family education

Pharmacological
There is no cure for Parkinsons disease. Relief symptoms
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Visual Impairment
Common causes: cataract, diabetic retinal disease, refractive errors Complications:
Accidents Falls Fractures Reduced functional status Increased dependency Poor quality of life Social isolation Depression

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Treatment: Refractive errors correction with glasses Cataract cataract removal and lens replacement Glaucoma reduction of intra ocular pressure with medications or surgery in some cases Diabetic retinal disease good blood glucose control and advance stages may require laser treatment Prevention: Diabetes - early screening and optimal treatment of diabetes Glaucoma early screening for those who have family history of the disease 11

Diabetes Mellitus
Signs and symptoms: visual disturbance, chronic skin infections, delayed wound healing, urinary tract or vaginal infections Risk factors: overweight, physical inactivity, hereditary factor, increasing age Complications:
Rapid rise in blood sugar
Drowsy, unconscious

Prolonged high blood sugar

Poor vision, numbness of loss of feeling in the hands and feet, stroke, kidney failure, heart attack
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Ischemic Heart Disease

Blood vessels become hardened and narrowed caused by cholesterol in the inner wall of the vessels blood supply to the heart muscle decreases Major risk: cigarette smoking, high cholesterol level, high blood pressure, diabetes, obesity, family history Symptoms: chest pain during exercise or activity (sometimes the pain may be felt in the shoulder, arms, neck, jaw or back) Complications: heart failure, death
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Treatment: Healthy lifestyle: quit smoking, healthy diet, weight reduction Medicines are given to:
Reduce the tendency of the blood to clot Expand the blood vessels Control of blood sugar level

Rehabilitation: Counseling about disease process, exercise program, nutritional advice, helping the patients modify the risk factors, emotional support
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