When Christopher Callahan examines older patients, he often hears a similar refrain.
“I’m tired, doctor. It’s hard to get up and about. I’ve been feeling kind of down, but I know I’m getting old and I just have to live with it.”
This fatalistic stance relies on widely held but mistaken assumptions about what constitutes normal aging.
In fact, fatigue, weakness and depression aren’t to-be-expected consequences of growing older, said Callahan, director of the Center for Aging Research at Indiana University’s School of Medicine.
Instead, they’re a signal that something is wrong and a medical evaluation is in order.
“People have a perception . . . that aging equals decline,” said Jeanne Wei, a geriatrician who directs the Donald W. Reynolds Institute on Aging at the University of Arkansas for Medical Sciences. “That’s just wrong.”
Of course, peoples’ bodies do change as they get on in years. But this is a gradual process. If you suddenly find your thinking is cloudy and your memory unreliable, if you’re overcome by dizziness and your balance is out of whack, if you find yourself tossing and turning at night and running urgently to the bathroom, don’t chalk it up to normal aging.
Go see your physician. The earlier you identify and deal with these problems, the better.
Here are four common concerns that should spark attention – only a partial list of issues that can arise:
– Fatigue. You have no energy. You’re tired all the time.
Don’t underestimate the impact: Chronically weary older adults are at risk of losing their independence and becoming socially isolated.
Nearly one-third of people age 51 and older experience fatigue, according to a 2010 study in the Journal of the American Geriatrics Society. (Other estimates are lower.) There are plenty of potential culprits: Sleep problems, pain, gastrointestinal reflux and medications for blood pressure can induce fatigue, as can infections, arthritis and other conditions, an underactive thyroid, poor nutrition and alcohol use.
All can be addressed, doctors say. Perhaps most important is ensuring that older adults remain physically active and don’t become sedentary.
“If someone comes into my office walking at a snail’s pace and tells me, ‘I’m old; I’m just slowing down,’ I’m, like, ‘No, that isn’t right,’ ” said Lee Ann Lindquist, a professor of geriatrics at Northwestern University’s Feinberg School of Medicine in Chicago.
“You need to start moving around more, get physical therapy or occupational therapy and push yourself to do just a little bit more every day,” she said.
– Appetite loss. You don’t feel like eating, and you’ve been losing weight.
This puts you at risk of developing nutritional deficiencies and frailty, and it raises the prospect of an earlier-than-expected death. Between 15 and 30 percent of older adults are believed to have what’s known as the “anorexia of aging.”
Physical changes associated with aging – notably declines in vision, taste and smell, all of which make food attractive – can contribute. So can other conditions: decreased saliva production (a medication-induced problem that affects about one-third of older adults); constipation (affecting up to 40 percent of seniors); depression; social isolation (people don’t like to eat alone); dental problems; illnesses and infections; and medications (which can cause nausea and reduced taste and smell).
If you had a pretty good appetite before and that has now changed, pay attention, said Lucy Guerra, director of general internal medicine at the University of South Florida in Tampa. Treating dental problems and other conditions, adding spices to food, adjusting medications and sharing meals with others can all make eating a more enjoyable and healthy experience.
– Depression. You’re sad, apathetic and irritable for weeks or months at a time.
Depression in later life can have profound consequences, compounding the effects of chronic illnesses such as heart disease, leading to disability, affecting cognition and, in extreme cases, resulting in suicide.
Half a century ago, it was believed that “melancholia” was common in later life and that seniors naturally withdrew from the world as they realized that their days were limited, Callahan explained. Since then, researchers have shown that older adults tend to be happier than people in other age groups: Only 15 percent have major depression or minor variants.
Late-life depression is typically associated with a serious illness such as diabetes, cancer, arthritis or stroke; deteriorating hearing or vision; and life changes such as retirement or the loss of a spouse. While grief is normal, persistent sadness that is accompanied by apathy, withdrawal from social activities, disturbed sleep and self-neglect is not, Callahan said.
With treatments such as cognitive behavioral therapy and antidepressants, 50 to 80 percent of seniors can expect to recover.
– Weakness. You can’t rise easily from a chair, screw the top off a jar or lift a can from the pantry shelf.
You may have sarcopenia – a notable loss of muscle mass and strength that affects about 10 percent of adults older than 60. If untreated, sarcopenia will affect your balance, mobility and stamina, and raise the risk of falling, becoming frail and losing independence.
Age-related muscle atrophy, which begins when people reach their 40s and accelerates when they’re in their 70s, is part of the problem. Muscle strength declines even more rapidly – slipping about 15 percent per decade starting around age 50.
The solution: exercise, including resistance and strength training exercises, and good nutrition, including getting adequate amounts of protein.
Other causes of weakness can include inflammation, hormonal changes, infections and problems with the nervous system.
Watch for sudden changes. “If you’re not as strong as you were yesterday, that’s not right,” Wei said. Also, watch for weakness on only one side, especially if it’s accompanied by speech or vision changes. That could be a sign of a stroke, which would require immediate medical attention.
Taking steps to address weakness doesn’t mean you’ll have the same strength and endurance as when you were in your 20s or 30s. But it may mean that doctors catch a serious or preventable problem early and forestall further decline.
Christopher Callahan anapochunguza wagonjwa wazee-wazee, mara nyingi husikia maneno kama hayo. Mimi ni uchovu, daktari. Ni vigumu kuamka na kuzunguka. Nimekuwa nikihisi vibaya, lakini najua ninazeeka na ni lazima niishi na hilo. Msimamo huu wa bahati unategemea dhana zilizopitishwa sana lakini zisizo sahihi kuhusu kile kinachohusisha kuzeeka kwa kawaida. "Kwa kweli, uchovu, udhaifu na unyogovu si matokeo ya kutarajiwa ya kuzeeka, ""alisema Callahan, mkurugenzi wa Kituo cha Utafiti wa Kuzeeka katika Chuo Kikuu cha Indiana cha Shule ya Tiba." Badala yake, ni ishara kwamba kuna jambo lisilofaa na kwamba uchunguzi wa kitiba ni wa lazima. <unk>Watu wana maoni fulani. . . "Kama vile ilivyoelezwa hapo juu, ""kuzeeka ni sawa na kupungua,"" alisema Jeanne Wei, daktari wa wazee ambaye anaongoza Taasisi ya Donald W. Reynolds juu ya Kuzeeka katika Chuo Kikuu cha Arkansas kwa Sayansi ya Matibabu." <unk>Hiyo ni tu makosa.<unk> Bila shaka, miili ya watu hubadilika kama wao kupata juu katika miaka. Lakini hii ni mchakato wa hatua kwa hatua. Kama wewe ghafla kupata kufikiri yako ni cloudy na kumbukumbu yako unreliable, kama wewe ni kushinda na kizunguzungu na usawa wako ni nje ya whack, kama wewe kupata mwenyewe tossing na kugeuka usiku na kukimbia haraka kwa bafuni, si chalk ni juu ya kuzeeka kawaida. Nenda ukamwone daktari wako. Kadiri unavyoona matatizo hayo mapema na kuyashughulikia, ndivyo inavyokuwa bora. Hapa ni wasiwasi nne za kawaida ambazo zinapaswa kuamsha tahadhari - orodha ndogo tu ya masuala ambayo yanaweza kutokea: Huna nishati yoyote. Wewe ni uchovu wakati wote. Usiidharau athari: Watu wazima walio na uchovu wa kudumu wako katika hatari ya kupoteza uhuru wao na kujitenga na jamii. Karibu theluthi moja ya watu wenye umri wa miaka 51 na zaidi wanapata uchovu, kulingana na utafiti uliofanywa mwaka 2010 katika jarida la American Geriatrics Society. (Hesabu nyinginezo ni za chini.) Kuna sababu nyingi za ugonjwa huu: matatizo ya usingizi, maumivu, reflux ya tumbo na dawa za shinikizo la damu zinaweza kusababisha uchovu, kama vile maambukizo, ugonjwa wa viungo na hali nyingine, ugonjwa wa tezi-kibofu, lishe mbaya na matumizi ya pombe. Madaktari wanasema kwamba matatizo yote yanaweza kushughulikiwa. Labda muhimu zaidi ni kuhakikisha kwamba watu wazima wazee kubaki kimwili hai na si kuwa sedentary. "Ikiwa mtu anakuja ofisini mwangu akitembea kwa kasi ya konokono na kuniambia, ""Nina umri; nina polepole tu,"" mimi ni, kama, ""Hapana, hiyo si haki,"" alisema Lee Ann Lindquist, profesa wa geriatrics katika Chuo Kikuu cha Northwestern cha Feinberg Shule ya Tiba katika Chicago." "Unahitaji kuanza kusonga zaidi, kupata tiba ya kimwili au tiba ya kazi na kujisukuma kufanya kidogo zaidi kila siku", alisema.  Kupoteza hamu ya kula. Huna hamu ya kula, na umekuwa ukipunguza uzito. Hii inakuweka katika hatari ya kuendeleza upungufu wa lishe na udhaifu, na huongeza uwezekano wa kifo cha mapema kuliko inatarajiwa. "Kati ya asilimia 15 hadi 30 ya watu wazima wazee wanaamini kuwa na kile kinachojulikana kama ""anorexia ya kuzeeka"" - mabadiliko ya kimwili yanayohusiana na kuzeeka - haswa kupungua kwa maono, ladha na harufu, ambayo yote hufanya chakula kuvutia - inaweza kuchangia." Matatizo mengine ya kawaida ni kama vile: kupungua kwa utengenezaji wa mate (ugumu unaosababishwa na dawa ambao huathiri karibu theluthi moja ya watu wazima); ugonjwa wa kuvimba (unaathiri hadi asilimia 40 ya wazee); kushuka moyo; kutengwa na jamii (watu hawapendi kula peke yao); matatizo ya meno; magonjwa na maambukizo; na dawa (ambazo zinaweza kusababisha kichefuchefu na kupungua kwa ladha na harufu). "Ikiwa ulikuwa na hamu ya kula na sasa umebadilika, makini, ""alisema Lucy Guerra, mkurugenzi wa matibabu ya ndani ya jumla katika Chuo Kikuu cha Florida Kusini huko Tampa." Kutunza matatizo ya meno na hali nyingine, kuongeza viungo kwenye chakula, kurekebisha dawa na kushiriki chakula na wengine, yote yanaweza kufanya kula kuwa uzoefu wa kufurahisha na afya.  Mshuko wa moyo. Wewe ni huzuni, apathetic na irritable kwa wiki au miezi kwa wakati mmoja. Kujificha katika maisha ya baadaye kunaweza kuwa na matokeo makubwa, kuimarisha athari za magonjwa ya muda mrefu kama vile ugonjwa wa moyo, kusababisha ulemavu, kuathiri utambuzi na, katika kesi kali, kusababisha kujiua. "Kilele cha karne hiyo, ilidhaniwa kwamba ""melancholia"" ilikuwa ya kawaida katika maisha ya baadaye na kwamba wazee kwa kawaida walijiondoa kutoka kwa ulimwengu walipotambua kuwa siku zao zilikuwa na kikomo,"" alielezea Callahan." Tangu wakati huo, watafiti wameonyesha kwamba watu wazima wenye umri mkubwa huwa na furaha zaidi kuliko watu wa makundi mengine ya umri: asilimia 15 tu wana unyogovu mkubwa au tofauti ndogo. Kwa kawaida, unyogovu wa mwisho wa maisha unahusishwa na ugonjwa mbaya kama vile kisukari, kansa, ugonjwa wa viungo au kiharusi; kuharibika kwa kusikia au kuona; na mabadiliko ya maisha kama vile kustaafu au kupoteza mwenzi. "Wakati huzuni ni ya kawaida, huzuni ya kudumu ambayo inaambatana na kutojali, kujiondoa kutoka kwa shughuli za kijamii, usingizi uliovurugika na kujidharau sio, ""alisema Callahan." Kwa matibabu kama vile matibabu ya tabia ya utambuzi na dawa za kukandamiza, asilimia 50 hadi 80 ya wazee wanaweza kutarajia kupona.  Udhaifu. Huwezi kuamka kwa urahisi kutoka kwenye kiti, kuondoa kifuniko cha chupa au kuinua chupa kutoka kwenye rafu ya chumba cha kulia chakula. Sarcopenia ni ugonjwa wa kupoteza nguvu na misuli ambayo huathiri asilimia 10 ya watu wazima wenye umri wa miaka 60. Ikiwa haitibiwa, sarcopenia itaathiri usawa wako, mwendo na nguvu, na kuongeza hatari ya kuanguka, kuwa dhaifu na kupoteza uhuru. Uharibifu wa misuli unaosababishwa na umri, ambao huanza wakati watu wanapofikia miaka ya 40 na huongeza kasi wakati wanapokuwa na miaka ya 70, ni sehemu ya tatizo. Nguvu za misuli hupungua kwa kasi zaidi - karibu asilimia 15 kwa kila muongo kuanzia umri wa miaka 50. Uwezekano wa kufanya mazoezi ya nguvu, pamoja na mazoezi ya nguvu na nguvu, na lishe nzuri, ikiwa ni pamoja na kupata kiasi cha kutosha cha protini. Sababu nyingine za udhaifu zaweza kutia ndani uvimbe, mabadiliko ya homoni, maambukizo na matatizo ya mfumo wa neva. Jihadharini na mabadiliko ya ghafula. "Ikiwa wewe si nguvu kama wewe walikuwa jana, kwamba si haki", Wei alisema. Pia, angalia udhaifu wa upande mmoja tu, hasa ikiwa unaambatana na mabadiliko ya usemi au ya kuona. Hii inaweza kuwa ishara ya kiharusi, ambayo inahitaji matibabu ya haraka. Kuchukua hatua za kukabiliana na udhaifu haimaanishi kuwa utakuwa na nguvu na uvumilivu sawa na ulipokuwa na miaka ya 20 au 30. Lakini huenda ikawa kwamba madaktari huona mapema tatizo zito au linaloweza kuepukwa na kuzuia kupungua zaidi.