Aging and Disabilities - Impact, Comorbidities, Management, and Prevention

Introduction:

Disability is a limitation in a person's ability to perform activities due to physical impairment. It is a complex phenomenon that reduces individual participation in society. It affects the activities of daily living like bathing, climbing stairs, walking, using public transport, finances, etc. An example of disability in the elderly is osteoporosis which limits their movement by decreasing bone strength, and vision impairment can cause difficulties in living alone. Due to disabilities occurring in older adults, it is risky to leave them alone to stay and survive. This forces us to admit them to long-term care and old-age homes. Many older adults admitted to such healthcare facilities end up here due to their disabilities.

What Are the Changes Causing Disability in Old Age?

Age-associated physiological changes are:

• In old age, muscle, bulk, mass body reduction, and fats in the body increase, causing reduced strength.

• Osteoarthritic changes in the joint and reduction in bone density can lead to frequent fractures.

• Postural changes can weaken the spine and cause disc collapse.

• Reduction in blood volume and slowing down of all body organs are seen as age progresses.

• There is a decrease in ventilatory capacity.

• Vitamin D deficiency and a decrease in calcium absorption can cause the weakening of bones and fractures.

• Hearing impairment and vision impairment are very commonly noticed in old age.

• Bladder control problems in the elderly can lead to difficulty in performing daily activities.

• The nervous system-associated changes can lead to disabilities by reducing cortical nerve function and sensory and peripheral nerve function.

• Reduced appetite can cause malnutrition and functional impairment in the elderly.

• Early life disabilities can get worsened with age.

• Poor lifestyle choices in the past and having an unhealthy sedentary lifestyle at a young age can increase the risk of developing any kind of disability in old age.

• Preexisting chronic diseases like diabetes, hypertension, depression, osteoporosis, etc., can cause disability in old age.

• Physical inactivity plays a major role in keeping oneself healthy. Lack of physical activity in our life can lead to many health-related problems, especially in old age.

• Stability and coordination problems in the elderly lead to falls and accidents, causing disability to them.

What Are the Comorbidities Leading to Disability in Older Adults?

As an individual age, people develop many chronic medical conditions due to various reasons which can temporarily cause disabilities in older adults. A few commonly seen comorbidities seen in old age, especially above 70 years, are:

• Vision impairment.

• Diabetes along with diabetic neuropathy and gangrene.

• Alzheimer's disease is one of the most common neurodegenerative diseases seen in the aging population.

• Bladder control problems can be disabling.

• Hearing and visual impairment cause social isolation and decreased activity.

• Falls are frequent in elderly people, and the presence of osteoporosis can cause an increase in fractures.

• Depression can either cause disability or worsen an existing disability.

• Strokes can lead to weakness, coordination problems, and communication problems in older adults.

What Are the Four Major Aspects of Assessing Disability in Older Adults?

• Physical assessment.

• Functional, social, and environmental assessment.

• Psychological aspect.

• Medical and medication history.

How To Manage Disability in Older Adults?

The following five important aspects of management should be administered while managing geriatric disability care:

• Treat the underlying causes. Do not neglect any disease that could be an underlying cause of the disability. Look for the chronic illnesses causing the disability and treat them like heart conditions, diabetes, hearing, and vision loss, depression and any other psychological disorders, osteoporosis, bladder control problems, neurological tumors, etc.

• While certain medications cause disability due to their side effects, some of them can prove to improve the condition of disability. Openly share problems with the respective doctor and health care provider since they can prescribe some helpful medications to reduce early symptoms and improve the quality of life. Thus, visit the professional at the earliest. Any deficiencies like vitamin D deficiency should be checked for, and supplements should be prescribed. Consulting a doctor will help eliminate multiple drug side effects.

• Surgical intervention can be opted for; age is not always a contraindication of surgery. Surgeries like tumor excision, cataracts, surgery for prostatic hypertrophy, and joint replacement can be performed. All the necessary precautions should be taken by the healthcare team to perform surgery on older adults.

• Special appliances and aids can help older adults overcome their disabilities. Providing specialized aids can improve the quality of life for older people. Some homes remove any dangers like slippery flooring; houses can have stair lifts and grip rails. Hearing aids should be given to those with hearing disabilities. For vision impairment, glasses are prescribed, and bright light from the television, night driving, etc., should be avoided. Having a smoke alarm on the telephone can be useful.

• Management of pain is very crucial in older patients as they do not have the ability to withstand a lot of pain for a longer duration. In case of pain due to osteoarthritis, physiotherapy and exercises can reduce the pain. Medications are very effective in pain control, both painkillers and medications aimed at causative diseases. Stress reduction and cognitive therapies can help relieve pain in some situations.

• Social and environmental intervention may reduce the impact of disability. Some day centers, long-term care centers, and social groups have proven to be healthy for older people. Housing arrangements according to their needs can help improve independence in performing their daily activities.

What Are Some of the Ways of Preventing Disability?

• One of the key factors to healthy living is physical exercise and activities from a younger age. Individuals must involve themselves in physical activities; which will help keep the mind and body fit.

• Nutrition is another key factor in improving health and preventing diseases. Individuals must have a proper diet chart that includes all the nutrients. This will keep at bay, any malnutrition and deficiencies.

• Avoiding obesity and meeting nutrient requirements.

• Taking more dietary fiber in daily meals.

• Going for regular medical and dental checkups.

• Preventing falls and fractures.

Conclusion:

Disability is a major concern in elderly people. Many long-term ad home care centers are available to help them with their limitations. A holistic approach can help older adults live normal lives despite their disabilities. Steps should be taken to improve the lifestyle from a young age. Always keep a positive attitude to deal with any kind of disability because our mind plays an important role in the healing process.