Five Common Chronic Conditions in Older Adults

After receiving a new medical diagnosis, one can expect to start discussing treatment options, planning follow-up appointments with their primary doctor or specialist, and anticipating the next steps. While receiving a name for the symptoms afflicting one’s life can be valuable, receiving a new label on one’s well-being can be unnerving, especially if they have been living a healthy or otherwise uncomplicated life so far. Adults aged 65 and older are more susceptible to many health conditions in different organ systems that can affect their lifestyle.

1. Hypertension

Blood pressure is recorded as a set of numbers: systolic blood pressure over diastolic blood pressure, representing the maximum and minimum pressure generated in the arteries as the heart pumps blood throughout the body. The target blood pressure is around 120/80 mmHg, and the body constantly adjusts its internal pressure using hormones and receptors to keep it relatively constant. However, when blood pressure rises significantly, either from underlying conditions or gradual onset, the heart works harder to pump blood throughout the body, and receiving blood vessels and organs can be damaged. According to the National Council on Aging (NCOA), nearly 60% of older adults have hypertension, many of whom are not even aware of their condition. Symptoms of chronic hypertension include shortness of breath, headache, and dizziness, but it is often asymptomatic. Once diagnosed, individuals may be prescribed medications such as ACE inhibitors, diuretics, or beta blockers to lower blood pressure by relaxing blood vessels, removing extra fluids, and reducing the heart rate.

2. Type 2 Diabetes

Diabetes, also known as diabetes mellitus, is a condition where one experiences hyperglycemia. This is when the body’s blood sugar is too high, which may cause symptoms such as increased thirst, urinary frequency, fatigue, and blurry vision. When left untreated, it can lead to other complications in the cardiovascular, neurological, and renal systems. When an individual has diabetes, their body either does not make enough insulin or stops responding to insulin, which prevents cells from taking up glucose and leaves the body’s blood sugars high. For that reason, insulin is required to lower blood sugar levels below 100 mg/dL, especially after a meal. Type 2 diabetes is the most common type of diabetes among older adults as their bodies become more insulin resistant. According to a study published in the Journal of Geriatric Medicine and Gerontology, the prevalence of type 2 diabetes has soared over the past decades, with a proportional increase in older adults in the United States. This is important to consider as type 2 diabetes is linked with obesity, lifestyle changes, and progressive decline associated with aging, thus highlighting the role of age as a significant risk factor. Even though most forms of diabetes are chronic, its symptoms can still be managed with changes in diet, medications to control glucose levels, or insulin injections, to name a few.

3. Arthritis

Arthritis is characterized by joint inflammation that affects the hands, knees, and hips. People diagnosed with arthritis may report pain, swelling, and stiffness in these joints, and are diagnosed after undergoing a series of tests with their provider. The most common types of arthritis are osteoarthritis and rheumatoid arthritis. Osteoarthritis is common in older adults, occurring naturally due to the wear and tear of joints from repeated use over one’s lifetime. Rheumatoid arthritis, on the other hand, is an autoimmune disease where the body starts attacking healthy tissues, causing inflammation around joints. Arthritis can lead to disability when the pain becomes severe enough to limit one’s ability to carry out daily tasks. While there is no cure for arthritis, medications can help to ease the pain, and compresses, splints, and massages can assist with other symptoms.

4. Heart Failure

Heart failure is a type of cardiovascular disease where the heart becomes too weak to pump a sufficient amount of blood throughout the body, leading to a body-wide oxygen deficiency. This lack of oxygen, also called hypoxia, leads to symptoms such as shortness of breath, dizziness, fatigue, lightheadedness, and leg swelling. Heart failure is often comorbid with different conditions, such as hypertension and coronary heart disease, which is where the arteries get clogged with fatty substances that make blood flow more challenging. When the heart fails to pump enough blood, it can lead to a heart attack or stroke, making it a serious condition that requires close monitoring. Heart failure is more common in older adults as a byproduct of normal aging, where cardiac function gradually declines and the body loses its ability to repair damage. It can be detected through blood tests and scans, in conjunction with the symptoms one presents with. Given its association with other diseases, creating a care plan is essential and can be managed with changes in lifestyle, medications, or surgery.

5. Chronic Kidney Disease

Chronic kidney disease refers to decreased kidney function and is classified in five stages. The kidneys are the organs that filter blood and remove excess waste to form urine. They should filter blood at least 60 ml/min according to the glomerular filtration rate. When filtration is too low, waste builds up in the blood, leading to conditions such as high blood pressure, heart failure, and kidney failure. Its symptoms include swelling, loss of appetite, nausea, and shortness of breath. Patients with chronic kidney disease can expect to be placed on medications or dialysis, which requires multiple, weekly sessions to filter the blood. According to a review published in the Clinical Practice, at least 11% of individuals in the United States aged 65 years and older have some degree of chronic kidney disease. While treatment helps manage symptoms, patients might require kidney transplants to restore function if their disease continues to progress towards end-stage kidney disease, which is the fifth and final stage of kidney disease.

It should come as no surprise that the body is interconnected, and how deficiencies in one organ system can cause changes in another. Even though people can have distinct diagnoses, hypertension is still the most common condition in adults and can lead to many other conditions, as listed above. Of course, the five chronic conditions described in this review are, by no means, a comprehensive list. Older adults are susceptible to an array of other health concerns, such as dementia, high cholesterol, and depression, which often coexist with other conditions. While most people are not acutely aware of all the changes and functions inside their bodies, physical manifestations should be monitored and managed according to a specialized plan.

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