Vision Is Vulnerable With Age: Here’s What to Look For

Cara Murez wrote . . . . . . . . .

Routine eye checks can help ensure seniors know if they’re developing any age-related vision issues.

An expert from Baylor College of Medicine spells out what seniors need to know.

“Don’t blame vision issues on just aging eyes. Get your eyes checked out because it can be a more serious issue that can be treated,” said Dr. Sumitra Khandelwal, associate professor of ophthalmology at Baylor. “If you wait too long, there may not be ability to treat it.”

Among the issues is dry eye. As the skin gets drier with age, so do eyes. Artificial tears can help.

“If your skin is dry and you wait until it’s very papery to put lotion on it, it won’t help as much as if you put lotion on the skin daily to prevent dryness — the same goes for your eyes. As you get older, you notice dryness and irritation. This is when you should start using artificial tears,” Khandelwal said in a college news release.

Artificial tears are available as over-the-counter drops, ointments and prescription eye drops.

It’s also possible to get a prescription medication to reduce eye inflammation and increase tear production, Khandelwal said. Catching problems early is important. Otherwise, the dry eye can become so advanced it may not be treatable.

Cataracts are one of the most common age-related eyesight issues. With these, the clear lens becomes cloudy, which affects focusing. Vision can be blurry even with glasses and driving at night can be difficult.

Outpatient surgery can fix cataracts. The surgeon will remove the clouded lens and implant a clear artificial one, curing vision issues.

“Everyone develops a cataract in time. Some people develop them earlier in life, while most develop age-related cataracts,” Khandelwal said. “You start to see signs of cataracts in your late 50s and 60s and they continue to grow throughout the decades.”

Presbyopia is loss of near vision that also cannot be prevented. As people age, around 45 or so, they may need more lighting or reading glasses to see up close. Treatments include prescription glasses, special contact lenses and laser surgery. Prescription eye drops can make the pupil smaller to help someone see up close for six to eight hours.

Macular degeneration is less common. The retina develops areas of thinning. There are both dry and wet forms. The dry form is most common and affects central vision slowly. About 20% of dry patients will develop wet macular degeneration, which can require eye injections.

Taking eye vitamins that assist with vision loss and making lifestyle changes can help prevent worsening. Eating leafy greens and avoiding smoking are especially important.

A person experiencing macular degeneration should see an eye doctor annually.

“You can develop early signs of macular degeneration and not know it,” Khandelwal said. “If you have a family history of it, that may be a reason to see your eye provider earlier in life.”

In glaucoma, the nerve in the eye is damaged because of high pressure in the eye. This nerve is crucial because it sends messages from the eye to the brain.

“One of the most important parts of our ability to see is the optic nerve because it allows what we see to actually register to the brain,” Khandelwal said.

Most types of glaucoma do not cause pain, so there is no indicator it is developing until a visit to the eye doctor. He or she will perform a painless eye pressure check and catch signs of early glaucoma before it begins to impair vision.

Though glaucoma cannot be prevented, prescription eye drops can help control the pressure that help prevent the worsening of vision.

Source: HealthDay






Surgery Holds Danger for Seniors. Who’s Most at Risk?

Amy Norton wrote . . . . . . . . .

Surgery can be a daunting prospect at any age. Now, researchers say they’ve spotted two key factors upping the odds of a poor surgical outcome in seniors.

Older adults who are either frail or suffering from dementia have high rates of death in the year following a major procedure, a new U.S. study finds.

Researchers found that among Americans aged 65 and older who underwent major surgery between 2011 and 2017, 13% died in the following year. And some seniors were at particular risk: One-year death rates were 28% among older adults who were frail, and nearly 33% among those with probable dementia.

The extent to which the surgery, itself, precipitated those deaths is unclear.

“Over a year, it’s harder to make a direct linkage to the surgery,” said lead researcher Dr. Thomas Gill, a professor of geriatric medicine at Yale School of Medicine.

But, he added, it is likely the procedures often played an important role in those older adults’ deteriorating health.

Gill said the overall death rate in the study group, at 13% over one year, is substantially higher than would be expected for Americans that age.

Does that mean many older people were having operations that should not have been done?

That might be true in some cases, said Gill. But he thinks the bigger issue is that the most vulnerable seniors need better care both before and after surgery.

To start, Gill said, geriatric patients should be assessed for frailty or early dementia (which is often undiagnosed, he noted) ahead of an elective surgery.

Those with signs of frailty — such as low weight, slow movement or fatigue — might benefit from therapy to improve their fitness, for example. And anesthesiologists, Gill said, might make different decisions on the type of anesthesia used during the procedure, based on information from those pre-surgery assessments.

For patients with probable dementia, he said, it’s particularly important to prevent and treat delirium. That’s a common post-surgery complication for older adults, but it can be especially serious and long-lasting in those with dementia.

Those pre-surgery assessments are critical, agreed Dr. Daniel Anaya, chief of gastrointestinal surgery at Moffitt Cancer Center in Tampa, Fla. All patients need to be evaluated ahead of surgery, he noted, but geriatric patients have unique concerns.

“This study brings to light how important that process is,” said Anaya, who wrote an editorial published with the findings in JAMA Surgery.

But besides assessing patients’ health, Anaya said it’s also important to discuss their expectations and goals, and figure out how to best support their quality of life.

The findings are based on a nationally representative sample of 992 older Americans, 65 and up. All underwent at least one major surgery between 2011 and 2017 — “major” being defined as any invasive procedure done in an operating room under general anesthesia. (It did not include minimally invasive procedures done via thin scopes.)

Not surprisingly, one-year death rates after emergency surgery were much higher than after elective procedures: about 22% versus 7%. Similarly, age made a big difference: People in their 80s and 90s were anywhere from 2.5 to six times more likely to die than people in their 60s.

But age was not the whole story. Frailty was a major factor, the study found: Of older people who were not frail, only 6% died in the year following surgery — versus 28% of those who were frail.

Meanwhile, the death rate among people with no signs of dementia was just under 12%, compared with nearly 33% among those with probable dementia.

None of that means that elderly adults with those conditions should not have surgery.

But Gill said that when surgery is recommended, patients and families should make sure there is a “clear indication” for it, and discuss the potential benefits, risks and alternatives. If they do decide on surgery, he said, they should ask whether there are any ways to optimize their health ahead of the operation.

As for post-surgery care, Gill suggested asking whether a geriatrician — a specialist in elder care — can be part of the team.

Older adults and their families not only care about how many years they have, but the quality of that time, Gill pointed out. He said his team plans to study other post-surgery outcomes for elderly patients, including their daily functioning and time spent at home rather than a health-care facility.

Source: HealthDay





Good Sleep Could Keep Illness at Bay as You Age

Alan Mozes wrote . . . . . . . . .

As men and women enter their golden years, those who regularly fail to get a good night’s sleep face a higher risk for developing not one but two serious chronic illnesses at the same time, new research shows.

Researchers from France, Finland and United Kingdom tracked the self-reported sleep routines and health status of nearly 8,000 Britons from ages 50 to 70.

While the new analysis can’t prove cause and effect, “the breadth of observational and interventional studies are strongly suggestive of inadequate sleep compromising good health,” concluded Dr. Virend Somers, who reviewed the findings. He’s a professor of cardiovascular medicine at the Mayo Clinic College of Medicine in Rochester, Minn.

For the study, researchers first looked at how much sleep study participants were getting back in 1985, when they were 50 years old and disease-free.

At the time about 4 in 10 reported regularly getting fewer than seven hours sleep a night, with nearly a third getting five hours or less.

For most people, seven hours is the minimum needed for a healthy night of sleep, said lead author Séverine Sabia, a research associate with the National Institute of Health and Medical Research (Inserm) at the University of Paris.

Her team then looked at which participants were routinely sleeping no more than five hours a night as they entered their 60s and 70s.

And at each milestone, regularly sleeping those fewer hours was linked to a 30% to 40% higher risk of developing multiple illnesses, compared to regularly clocking seven hours a night.

Included among the list of possible illnesses were diabetes, cancer, coronary heart disease, stroke, heart failure, chronic obstructive pulmonary disease, chronic kidney disease, liver disease, depression, dementia and a variety of other mental disorders, Parkinson’s disease, and arthritis/rheumatoid arthritis.

Notably, those who slept five hours or fewer at age 50 faced a 30% higher risk — compared with good sleepers — for simultaneously developing two of those illnesses. At age 60, poor sleepers saw their relative risk rise by 32%. By 70, the increased risk hit 40%.

Those who failed to get enough shut-eye at age 50 also faced a 25% spike in their risk of early death, largely because of an increased risk for getting sick, researchers found.

Sabia acknowledged that it’s possible that poor sleep could be a function of disease, rather than the cause. But she expressed confidence that her team “used a comprehensive approach to reduce the risk that the findings reflect the impact of the disease on sleep duration.”

Adam Krause, doctoral candidate in cognitive neuroscience at the Center for Human Sleep Science at the University of California, Berkeley, said the study makes sense.

“These findings are not too surprising, in showing that short sleep can predict higher incidence of chronic disease later in life,” Krause said. “Sleep processes touch every system of the body, so a lack of sleep, especially when experienced long-term, will impact multiple systems whose chronic dysregulation can lead to the development of these common chronic diseases.”

As for limiting one’s risk of disease, Sabia emphasized the importance of trying to maintain “good sleep hygiene.”

That, she said, generally “includes a comfortable bedroom, being physically active and exposed to light during the day, having a sleep routine, avoid screen time and reduce light in the 30 minutes before sleep.”

Somers offered one more important tip.

“If there is any likelihood of a sleep disorder — such as disruptive snoring, sleep apnea or insomnia — it would be helpful to be evaluated and treated by a sleep physician,” he said.

The findings were published in the journal PLOS Medicine.

Source: HealthDay





Research: Healthy Aging Requires An Understanding Of Personality Types

New research shows that older adults may be better supported as they age when their personalities are considered—for example, are they more like orchids or dandelions?

Researchers from Simon Fraser University’s Circle Innovation examined the potential effects of lifestyle activities on the cognitive health of more than 3,500 adults aged 60+, and found that personality–using psychology’s orchid-dandelion metaphor—can be a factor in how well supportive programs work.

Their results, published this month in the journal Frontiers in Aging Neuroscience, make a case for policy-makers to consider designing programs tailored to personality types rather than a one-size-fits-all approach.

“These discoveries offer new possibilities to support aging adults and provide substantial evidence for new social prescribing programs,” says Circle Innovation CEO and scientific director Sylvain Moreno. “Understanding how personality differences affect an aging population can help decision-makers provide older adults with solutions that fit their individual needs.”

People who may be considered ‘orchid adults’ thrive best under ideal circumstances, since they are more sensitive and biologically reactive, while ‘dandelion adults’ are thought to be resilient and can easily adapt to any environment.

That means orchid individuals could require more nurturing solutions, researchers say. “These older adults are more fragile, like the delicate flower they represent, and hence prone to overreact to ongoing health and housing problems, disturbing news about the economy or global pandemics,” says SFU PhD student and study researcher Emma Rodrigues. “On the other hand, dandelion retirees are relatively less environment-sensitive and also more resilient to deterioration in poor environmental conditions.”

“The lesson here is that we should stop pigeonholing aging adults into one group of our population. These results demonstrate how aging trajectories can differ depending on whether a person is influenced by the environment.”

According to researchers, understanding how modifiable lifestyle factors may maintain or promote cognitive health can lead to a healthier aging population.

Source: Simon Fraser University





Fish Oil Could Strengthen Your Aging Brain

Amy Norton wrote . . . . . . . . .

Fish has been dubbed “brain food,” and a new study suggests that may really be true for middle-aged adults.

Researchers found that among more than 2,000 middle-aged people, those with higher blood levels of omega-3 fatty acids performed better on tests of certain thinking skills. They also had thicker tissue in a brain area related to memory — one that typically thins when older adults develop dementia.

Omega-3 fatty acids — particularly two known as DHA and EPA — are most abundant in fatty fish like salmon, bluefin tuna, mackerel, herring and sardines. They can also be taken via fish oil supplements.

A number of studies have linked higher omega-3 intake to better brain function, and even a reduced risk of dementia. But for the most part, they have involved older adults.

The new study — published in the journal Neurology — focused on middle-aged adults who were mentally intact. The idea was to see whether even at that age, omega-3s might make a difference in brain structure or function.

Middle age is when the earliest indicators of abnormal brain aging may start to appear, noted lead researcher Claudia Satizabal.

“So we need to think about what things we can do in middle-age to support our brain health,” said Satizabal, an assistant professor at the University of Texas Health Science Center at San Antonio.

Her team looked at data on 2,183 people in the Framingham Heart Study, a long-running research project on risk factors for heart disease and stroke. The participants, who were 46 years old on average, underwent MRI brain scans and standard tests of memory and thinking skills. Their blood levels of DHA and EPA were also measured.

Overall, the researchers found, the 75% of study participants with higher omega-3 levels fared better, brain-wise, than the bottom 25%.

That former group showed greater tissue volume in the brain’s hippocampus — an area involved in memory, and among the first brain regions to show damage when people develop dementia.

People with higher omega-3 levels also outperformed their peers in tests of abstract reasoning. That’s a kind of higher-order thinking that, for example, allows a person to solve new, unfamiliar problems.

Of course, people who consume more omega-3s, from food or supplements, may differ in many ways from those who do not.

The researchers accounted for as many of those differences as they could — including age, weight, smoking habits, and whether people had health conditions like high blood pressure or diabetes.

Even then, omega-3 levels were tied to brain volume and test scores.

That is not enough to prove cause-and-effect, Satizabal said. But, she added, other studies have linked omega-3s to greater mental prowess, and basic research points to potential reasons: In lab animals, the fatty acids have been shown to reduce inflammation, and protect cells in the hippocampus from dying, while fostering the generation of new ones, among other benefits.

Emma Laing is director of dietetics at the University of Georgia, and a spokeswoman for the Academy of Nutrition and Dietetics.

In general, she said, adults should strive for two 4-ounce servings of fish per week.

“If eating fish is not an option for you, omega-3 fatty acids can be obtained from fish oil, seaweed, or microalgae supplements,” added Laing, who was not involved in the study.

She offered a caution for supplement users, though: There is such a thing as too much, due to potential side effects like bleeding.

“The U.S. Food and Drug Administration advises consuming no more than 3 grams of EPA and DHA per day from foods and dietary supplements, unless medically prescribed,” Laing said.

Another important point: Brain health depends on more than omega-3s.

According to Laing, a brain-wise diet also includes plenty of vegetables (particularly ones like broccoli and leafy greens), fruits (especially berries), fiber-rich grains, nuts and other “good” fats, like those in olive oil and avocados.

Your brain will also thank you for limiting alcohol and getting enough sleep, Laing noted.

Satizabal said it is best to get omega-3s from food rather than supplements, but acknowledged that can be hard. Fish is too expensive for some people, while others — like vegetarians — choose not to eat it.

Satizabal noted that another omega-3 called ALA is present in some foods, like walnuts, flaxseeds and chia seeds. The body can convert some ALA into EPA and DHA, but only in small amounts, she said.

Based on the findings, though, it does not take a lot of EPA/DHA to benefit the brain: People in the top 75% had blood levels that would reflect moderate omega-3 intake, the researchers said.

Source: HealthDay

Read also at UT Health:

Study links omega-3s to improved brain structure, cognition at midlife . . . . .