Drugs and the Elderly

What Do We Mean By Aging?

Aging isn't just "getting old." It's a process that involves biological, emotional, social, and even financial changes that affect a person's overall health. Disease and mental attitude are the wild cards that affect the speed of the aging process. Certainly, we all know people over age 65 who differ widely in their ability to get around. Some run marathons in their eighties and beyond, and others are so debilitated by illness that just getting up in the morning is a major effort. How do we explain this disparity among older people? Age is less a chronological marker than a combination of factors that determine the overall functioning of people in their mid-sixties and beyond.

First, genetics plays an important part in the aging process. Aging is associated with the development of chronic diseases such as high blood pressure that contribute to wear and tear on the body. Most of us who develop a chronic condition do so because we have a genetic predisposition to the disorder. High cholesterol, heart disease, cancer, diabetes, and other problems "run in families," just as eye color and hair color do. Some experts feel that our body's immune system is also affected by aging, gradually losing its ability to recognize outside threats--a virus, for example--and hence putting us at greater risk of disease.

Emotional and psychological issues have a major impact on overall health and the aging process. Even though an older person is well physically, he may still be at risk for mental illnesses such as Alzheimer's disease, depression, and anxiety. According to the American Psychiatric Association, 15 to 25 percent of the elderly in the U.S. suffer from "significant symptoms of mental illness." The aged--especially elderly men--are more likely to commit suicide than the rest of the population (some 6,000 do each year), but most do not seek professional help. Despite the fact that over one million elderly have some sort of abnormal memory loss (senility or dementia), they are often too embarrassed or too ill to seek help.

Social and financial changes are commonly overlooked as part of the aging process, but they can contribute to both physical and mental illness in the elderly. First of all, many elderly live on fixed budgets. If their income is modest, then every fluctuation in the economy, change in interest rates and cutback in government care has an impact on their lives. This can affect their nutrition (the elderly often skip meals to save money), which can lead to reduced body weight and, in turn, a change in the effects of medications they are taking. If their budget problems are too severe, they may even skip doses or stop their medications entirely.

Many older people also suffer severe stress from radical changes in life-style. Frequently this happens to aging widows who outlive their spouses. Retirement itself can be a source of stress for the elderly, whether financially secure or not. Some who have worked all their lives have no idea how to "slow-down" or may find it hard to adjust to full-time life with their spouses. These massive changes, when added to a heart condition, for example, increase stress on already inefficient organ systems.

Next: How Does Aging Affect Medication Use?