DEAR DOCTOR K:
Every time I complain about a new medical issue, my husband says, “You’re 84. What do you expect?” How do I know if my complaints are just a consequence of aging or if there’s an actual problem?
I’m not 84, but I ask myself that question regularly. You don’t have to be a doctor to understand that new symptoms develop as we age. But some changes aren’t a normal part of the aging process. I’ll discuss some common age-related health changes, as well as changes that suggest there might be a problem.
- VISION. With age, the lenses in the eyes of most people become cloudy. As a result, we need more light to see, read and avoid falling. Impaired close-up vision is also normal, as is an increase in “floaters.” However, it is not normal to lose your side vision. If you do, that could be a symptom of glaucoma. A sudden increase in floaters, accompanied by flashes, is also cause for concern. It could mean problems with the retina, such as a detached retina.
- HEARING. It may be harder to hear someone speaking, especially with background noise, in later years. This normally happens in most people, but whether it is a problem is up to you to decide. But when it sounds like everyone is mumbling, or you no longer hear the phone or the doorbell ring, that’s not normal; don’t ignore it. A simple earwax buildup may be causing the problem. If not, talk to your doctor about getting your hearing tested.
- URINARY HABITS. As we age, bladder muscles weaken, causing a more frequent and urgent need to urinate. But if frequent bathroom breaks interfere with your daily activities or sleep, see a doctor. He or she can check for a bladder infection or an overactive bladder.
- SLEEP. Older adults spend less time in deep sleep. As a result, you may wake up feeling unrested. But age should not affect your ability to fall asleep, stay asleep or fall back to sleep after awakening in the middle of the night. These changes may be due to a breathing disorder such as sleep apnea or a medication side effect.
- FATIGUE. You may not have the energy you once did. But you should not feel constant exhaustion, which may be a sign of a medical condition.
- THINKING SKILLS. It’s normal to misplace your keys, forget someone’s name or take longer to learn something new. Again, whether you define it as a problem is a matter of degree.
I once had a patient who was upset because he had misplaced his wallet. I reassured him that we all do that occasionally. Then he told me he’d found his wallet placed on the top shelf of his freezer. I decided he needed testing for Alzheimer’s disease. Unfortunately, he was in the early stages.
There clearly is a problem if you’re confused about directions when driving in what should be familiar places, or if you’re having trouble doing your finances. While it could be an early sign of dementia, it also could be a simply treated medication side effect.