Senior Health - Q4 2022

Senior Health

“Cold weather can bring more social isolation, with darker, shorter days making mental health management more of a challenge.”

Caroline Abrahams, Charity Director, Age UK Page 02

www.healthawareness.co.uk

“Every time a diagnosis of dementia is made, it is life-changing for the person and their family.”

Caroline Scates, Deputy Director for Admiral Nurse Development, Dementia UK Page 04

Top tips to aid your recovery following an admission to hospital

‘Deconditioning’ is a common condition, but there are things you can do to aid recovery following hospital admission.

When older people are admitted to hospital, especially for a long time, they can struggle to resume daily activities. They may be weaker, become more easily breathless and tire more easily. These can all be signs of ‘deconditioning.’

What is ‘deconditioning’?

Deconditioning is a decline in physical function and can follow hospital admission of any length. A few hours of lying on a trolley or bed can be enough to cause deconditioning. Keeping moving and eating well whilst in hospital is the best way to prevent deconditioning, but you can aid recovery by what you do at home. There can be risks with moving around but staying in bed is riskier. We can offer tips on what helps with recovery.

Exercise to recover

Aim to get 30 minutes of exercise a day. This can be spread throughout the day. It should be just enough to make you feel slightly warm inside and raise your heart rate. Exercise may have to start relatively modestly.

The key is to gradually increase the intensity and duration of each session. Standing and shifting weight during exercise will help build muscle and improve balance — dancing, tai chi and even carrying groceries can help. If you normally use a stick or frame, ask a physiotherapist about how to safely incorporate exercise into your routine.

Nutrition and hydration advice

We use protein — from dairy products, meat and legumes — to rebuild muscle after deconditioning. But protein is filling, and older people can struggle to eat enough. Spread protein out over the day, rather than in one big evening meal. Around six to eight cups of liquid a day is enough for most older people. Water is best, but many older people find this unpalatable. Other liquids which are more likely to be taken may be preferable.

Social interaction benefits

Social interaction is important for maintaining mental health and can motivate people to be more active. Age UK can provide details on day centres and befriending services in your area.

Learn more at ageuk.org.uk

WRITTEN BY Professor Adam Gordon President, British Geriatrics Society

Taking steps to keep yourself healthy this winter

Winter can be a challenging time for older people and can have a big impact on our physical and mental health. However, there are some things you can do to help stay well this winter.

As we age, our immune systems become weaker, and we gradually lose muscle mass. This makes it more difficult for our bodies to adjust to colder temperatures. This is especially true for older people and those with long-term health conditions.

Cold weather and health Symptoms of health conditions such as asthma, diabetes and arthritis can be worsened by the cold weather; and chilly temperatures can impact the heart and circulatory system, increasing the risk of heart attacks and strokes.

• Make sure you keep moving, to maintain mobility — even small but regular movements can help. Moving is a good way to stay warm, too.

• Eating well is important, and hot food and drinks help to ward off the cold.

• Wash hands regularly with soap and water. Keep antibacterial gel with you.

• Wear plenty of layers when it’s cold, particularly when out and about.

• If you are feeling down or depressed, don’t feel you have to go through it alone. Reach out to friends or family, or contact your GP.

For support, call us on 0800 678 1602

Visit the Cost of Living hub on Age UK’s website or follow this link: ageuk.org.uk/informationadvice/money-legal/ cost-of-living/ Learn more at ageuk.org.uk/ information-advice/

Winter is also when respiratory viruses like flu and Covid-19 increase in numbers, and older people are more vulnerable. As well as affecting physical health, cold weather can bring more social isolation, with darker, shorter days making mental health management more of a challenge than at other times of the year.

Looking after our health Protect yourself, and prepare for winter:

• Everyone aged 50+ is eligible for a Covid-19 booster and a flu vaccine, so make sure you get yours. Check which other vaccines you may be entitled to, such as shingles or pneumonia.

• Keep doing the things you enjoy to improve morale.

• Contact your local pharmacist, NHS 111 or your GP for advice and support with any health concerns. In an emergency, dial 999.

Small things make a big difference at home Make sure your heating is set at a comfortable level — high enough for you to stay warm at home, especially in the rooms you use the most. If you are worried about unaffordable energy bills, Age UK can offer advice. You can prepare your home for winter by getting your gas/central heating checked by a Gas Safe registered engineer, to ensure it’s working safely.

or +44 (0) 203 642 0737

Difficulty swallowing is a more common issue than you might think

Dysphagia is the medical term for a swallowing difficulty. Dysphagia can occur in any age group, but it is most commonly experienced by older people.

CONTENT WRITTEN AND PROVIDED BY Rosemont Pharmaceuticals

Swallowing is a surprisingly complex process, which involves the coordinated use of structures in the mouth, throat and oesophagus. A safe swallow ensures that food, drink and medication do not enter the lungs. A swallowing difficulty may occur at any stage of the swallowing process.

Reports suggest up to 50% of the elderly and up to 75% of nursing home residents may be affected by dysphagia. It is also prevalent in people with neurological conditions such as dementia, Parkinson’s disease or stroke.

Effects of dysphagia

This significantly impacts the safe administration of oral medicines. A survey found that a high proportion (almost 60%) of older people find it difficult to swallow their tablets or capsules. A similar proportion reported opening capsules or crushing tablets to make taking them easier — unaware of the negative impacts this may have.

Getting help

Swallowing difficulties can vary in severity and may come and go.

The older population are more prone to swallowing difficulties due to the loss of muscle tone, along with a reduction in saliva production. They are also more likely to have medical conditions which have the potential to cause dysphagia.

Swallowing difficulties can vary in severity and may come and go. Eating and drinking are integral to our everyday lives, so the negative impact can be far-reaching. Common signs of dysphagia include discomfort when swallowing or chewing; coughing before, during or after eating; unexplained weight loss; and recurrent chest infections.

Difficulty swallowing not only impacts eating and drinking but swallowing tablets or capsules presents a challenge too.

Are you missing out because of hearing loss?

Do you have difficulty following conversations or struggle to hear in social situations? You’re not alone.

Hearing loss is common when we get older and affects one in three people over the age of 65.1 Hearing aids often help, but as hearing loss progresses, they are not always enough.1

Social struggles

WRITTEN BY Victoria Soobrayen MsC, CAC Volunteer Programme Manager, Cochlear

Elizabeth, a care worker from Surrey, found that in her late 40s she was struggling to hear. It impacted her family, work and social life. By age 51, she became profoundly deaf and could no longer hear her own voice without wearing powerful hearing aids. She was left feeling isolated, even from her own family.

“It became tiring to keep up with a conversation. Often, I tuned myself out. This was difficult for me but also my children, partner, family and friends.

If you or someone you care for is experiencing difficulties with swallowing, it is best to speak to your GP who can assist in getting the help you need. This may be a referral to a speech and language therapist or another specialist. If you are having trouble swallowing your medication, they may be able to change your prescription to an easier-to-take format such as liquid medicine.

Rosemont Pharmaceuticals has recently launched the Understanding Dysphagia website. This platform offers sufferers and carers all the information needed to help understand dysphagia and what it means for you as well as some simple steps that can be taken to help manage the condition. Visit liquidmedicine.co.uk to find out more.

The Understanding Dysphagia Website has been provided as a service to medicine by Rosemont Pharmaceuticals.

benefits of a Cochlear implant because her mother received one at age 72 and, after talking to her audiologist, she was referred for hearing tests to ensure she was a suitable candidate.

Improving daily life

Since receiving her implant, Elizabeth says her life has changed for the better. “I go to the cinema and concerts or outings I avoided before my implant. I can hear myself breathing, birds singing, my cat meowing, my oven timer and my doorbell.” Most of all, she feels reconnected with the people that matter in her life.

I felt guilty because I was afraid they would think I wasn’t interested in what they were saying to me.”

Implant technology

What helped Elizabeth was a Cochlear implant, which she describes as “life-changing.” Unlike hearing aids, which only make sounds louder, a Cochlear implant can make sounds clearer.2,3

It consists of a small, internal implant that pairs with an external device that looks like a hearing aid.

Together, they provide a different way of hearing, bypassing the parts of the ear that no longer work. Cochlear implants are available on the NHS for people with severe hearing loss who are unable to hear well with hearing aids.

Elizabeth knew of the potential

“I don’t have to focus all my attention on trying to hear what is being said, and I am told I smile more when I speak with others.”

References

1. World Health Organization. Deafness & Hearing Loss Factsheet. Available at https://www.who.int/news-room/ fact-sheets/detail/deafness-and-hearing-loss 2,3. Visit hearmore.cochlear.com/CI

Cochlear, Hear now. And always, and the elliptical logo are either trademarks or registered trademarks of the Cochlear group of companies

© Cochlear Limited 2022. D2060796

To find out more if a cochlear implant may be the solution for you, talk to your audiologist or visit hearmore.cochlear.com/CI

Please seek advice from your health professional about treatments for hearing loss. Outcomes may vary, and your health professional will advise you about the factors which could affect your outcome. Always follow the directions for use. Not all products are available in all countries. Please contact your local Cochlear representative for product information.

Views expressed are those of the individual. Consult your health professional to determine if you are a candidate for Cochlear technology.

Paid for by Cochlear

INTERVIEW WITH

Elizabeth Cochlear Implant Recipient

Paid for by Rosemont Pharmaceuticals

ImageprovidedbyCochlear

Understanding the many symptoms of Parkinson’s and how to spot it

Parkinson’s is the fastest-growing neurological condition in the world.

Around 145,000 people in the UK have the condition, but everyone’s experience is different due to there being more than 40 symptoms.

Parkinson’s is a progressive neurological condition and there is currently no cure. The condition develops when nerve cells — that are responsible for producing the chemical dopamine — die.

Dopamine allows messages to be sent to the parts of the brain that coordinate movement. With the loss of dopamine-producing nerve cells, these parts of the brain are unable to work normally, causing symptoms of Parkinson’s to appear. As dopamine levels continue to fall, existing symptoms will further develop, and new symptoms will appear.

Symptoms of Parkinson’s

The three most recognised symptoms of Parkinson’s are a tremor (shaking), slowness of movement and rigidity or muscle stiffness. However, there are over 40 symptoms, and how they first present themselves can vary from person to person.

that control their facial muscles. They might struggle with low mood and fatigue, or their handwriting could become smaller and difficult to read. Insomnia, apathy and anxiety can also be early signs of Parkinson’s.

What treatments are available? There’s currently no cure for Parkinson’s; but medication, physical activity and physiotherapy, speech and language therapy and occupational therapy can all be used to manage symptoms.

There are over 40 symptoms, and how they first present themselves can vary from person to person.

Deep brain stimulation (DBS) is a type of surgery that people may be offered if drug treatments become less effective at easing movement symptoms. It doesn’t stop Parkinson’s from progressing, but in many cases, it gives people with the condition better control of their motor symptoms.

Finding the right support at the different stages of dementia

A dementia specialist nurse charity has published guidance to help families understand the three stages of dementia.

There are over 200 different types of dementia — all of which can present in various ways and can be difficult to identify and diagnose in the early stages.

What is dementia?

Dementia is an umbrella term for a range of conditions affecting the brain, which gradually worsen over time. As dementia progresses, it can affect a person’s thinking, behaviour and understanding of the world. This may happen quickly or slowly, depending on a variety of factors including the type of dementia, the person’s age, their general health and their lifestyle. It can be helpful to think of dementia progressing in three stages: early, middle and late stages. However, the condition will affect everyone differently.

and can have a bigger impact on daily life. Changes that might occur include difficulty getting to sleep, restlessness with the inability to sit still and sundowning — a state of intense anxiety that typically occurs around sunset.

In the late stage of dementia, changes can become more pronounced to the point that a person is unable to live independently. They may require longer-term support such as live-in care from professional carers or residential care. Seeing significant changes in someone you care for can be upsetting for family and friends, and making decisions about long-term care can cause feelings of guilt and loss.

Seeing significant changes in someone you care for can be upsetting for family and friends, and making decisions about long-term care can cause feelings of guilt and loss.

What are the different stages of dementia?

Someone might start having balance or coordination problems. They could lose their sense of smell or experience gait changes, where they lean forward slightly or shuffle when walking. Other people have fixed facial expressions (or a ‘mask’) due to changes in the nerves

Everyone’s Parkinson’s is unique, so different treatment combinations will suit different people. Anyone concerned that they may have Parkinson’s should see their GP. Getting information about the condition and finding support can be a huge help for people who are diagnosed.

WRITTEN BY Dr Rowan Wathes Associate Director of the

Support is available for everyone affected by Parkinson’s on the Parkinson’s UK website: parkinsons.org.uk and via the free, confidential helpline (0808 800 0303) and online forum.

Early-stage dementia occurs when a person begins to show early symptoms. For many people, this stage will last for months or years. In some, rare cases, it may progress much quicker. A person at this stage might experience mild difficulties with memory and concentration, language and communication and decisionmaking.

In the middle stage of dementia, symptoms become more pronounced

What support is available to families with dementia?

Dr Hilda Hayo, Chief Admiral Nurse and Chief Executive at Dementia UK says: “We understand the complex challenges associated with a diagnosis of dementia and how the condition may change through stages over time. Every time a diagnosis of dementia is made, it is life-changing for the person and their family; and it can be difficult to know where to turn to for support. Our Admiral Nurses are best placed to deliver specialist support to families navigating the different stages of the condition. They can offer practical and emotional guidance for the whole family.”

If you need advice or support around dementia, you can visit dementiauk.org/get-support for information resources and find out how to access Dementia UK’s Admiral Nurse Dementia Helpline and Clinics services.

Parkinson’s Excellence Network

WRITTEN BY Caroline Scates Deputy Director for Admiral Nurse Development, Dementia UK

Alzheimer’s research embraces the benefits of the digital world

Virtual clinical trials (VCTs) are an exciting development in cognitive research. Certain tests needed for clinical or academic studies are taken out of the clinic and brought into participants’ homes.

Digital cognitive assessments are changing how we conduct Alzheimer’s studies. Cognitive tests are used in clinical and research studies to understand a participant’s brain function.

WRITTEN BY Francesca Cormack Chief Scientist, Cambridge Cognition

Making clinical trials virtual

Digital cognitive tests can be completed at home on tablets, computers and even smartphones. They can be taken daily or weekly, delivering a more realistic picture of changes over time.

Digital cognitive assessments have been available for over 30 years and are now widely used in healthcare research. However, at first, there was

reluctance to adopt them in clinical studies over concerns that older people may prefer a paper version of the test. However, when an Australian study compared digital with paper methods of assessing cognitive health in participants aged 55–96 years, they reported that 54.3% of participants preferred the computerised cognitive assessments.1

Important tool for Alzheimer’s research Drugs targeting Alzheimer’s are thought to be most effective early in the course of the disease when symptoms are very subtle or even absent in standard assessments. Therefore, enrolling people in the earliest stages of Alzheimer’s in trials

is a priority to help find a cure. This is where digital assessments offer promise, as they can detect and monitor the earliest stages of the disease. An example is CANTABTM

Paired Associates Learning (PAL), which tests episodic memory. In PAL, different images flash up in boxes on the screen. One image then appears in the middle of the screen, and the participant must select the box that conceals the same shape. Research has shown that PAL activates areas of the brain involved early in the course of Alzheimer’s disease.

Another exciting, new development is the use of voice to understand early cognitive changes. Voice analysis technology such as NeuroVocalixTM uses machine learning techniques to identify subtle changes in speech which may indicate early cognitive decline.

Greater patient benefit

The most exciting thing about virtual clinical trials is the benefit to patients and their carers. At-home testing enables greater accessibility as people who find leaving home difficult can still participate in this important aspect of the research process. It’s wonderful to see the clinical and research world embracing this opportunity for people wishing to participate in Alzheimer’s studies.

References 1. Earl, J. K., Gerrans, P., & Hunter, M. (2017). Better ways of assessing cognitive health. Brisbane: National Seniors.

cognition.com

WRITTEN BY Professor Deborah Eastwood President, British Orthopaedic Association

As we get older, one of the biggest signs of ageing is aching joints. While this is part of the normal process of ageing, there are some things you should look out for which could be signs of something more serious such as arthritis. The symptoms of arthritis are pain, stiffness, swelling and a feeling of grating within the joint — often in the knees and hips. While there is no way to avoid arthritis completely, there are a few simple things that can help keep your joints healthy and lessen the chances of symptoms developing from joint degeneration.

Exercise and diet

As we get older, it’s important to continue to be active and exercise. Anything you enjoy is worth continuing, although it may be best to avoid highimpact sports and activities. Walking, gentle strengthening exercises and swimming are perhaps better exercises to undertake as we age.

Remember that what’s great for you and your overall health is also best for your joints. So, try to maintain good habits like not sitting too long during the day and avoiding junk food and smoking. A sedentary lifestyle can make joint pain and stiffness worse — so people, then, end up exercising less. It all becomes a vicious spiral.

Mental health

We must also not forget our mental health. Do what you can to keep a happy, positive mindset — for yourself as well as your joints. Research suggests low mood can worsen the experience of joint pain, which can, in turn, put you off exercising.

If you can maintain a positive mental attitude, then your ability to cope with aches and pains is improved. As a consequence, you can get out and enjoy an active social life and get the benefits that joint movement and gentle exercise bring.

Joint replacement surgery

If you do find that you need joint replacement surgery, be reassured as hip and knee replacements are some of the most effective of all medical and surgical treatments. Research has found that healthier patients have better outcomes from their surgery. It is therefore important to keep as active as you can while you wait, so you can stay as healthy as possible — which will help you recover faster too.

At the British Orthopaedic Association, we have put together some resources for patients while they are waiting for surgery. These are available on our website at boa.ac.uk/patients In addition, charities Versus Arthritis and Arthritis Action have some excellent advice on exercise, diet and wellbeing.

Someone dies of pancreatic cancer every hour in the UK

Despite being the deadliest common cancer, only 8% of people can name the most common symptoms of pancreatic cancer.

Approximately 80% of people with pancreatic cancer are diagnosed too late for life-saving treatment. That’s because the symptoms are often vague and unrecognised. And GPs don’t have access to the tools needed to diagnose pancreatic cancer early enough for treatment to be possible.

Early

diagnosis

can save people

Despite being the deadliest common cancer, only 8% of people can name the most common symptoms of pancreatic cancer. That means people might delay seeking help, not knowing the symptoms could be a cause for concern. If you know the symptoms of pancreatic cancer, it means there’s a better chance you, or someone close to you, gets diagnosed early enough for treatment.

The symptoms of pancreatic cancer include:

• Indigestion

• Tummy pain or back pain

• Changes to your poo — including diarrhoea (runny poo) constipation (when you find it harder to poo) or large, pale, smelly, floating poo

• Unexplained weight loss

• Jaundice (yellow skin or eyes and itchy skin)

• Loss of appetite

Someone with pancreatic cancer may not have all the symptoms listed, as they can vary for each person. If you have any of these symptoms and you don’t know why you have them, go to your GP, or contact NHS 111. If you have jaundice, go to your GP or A&E straight away. Remember that symptoms could be due to more common causes, but it’s important to get them checked out.

Working to improve early diagnosis

Late diagnosis is one of the biggest issues in pancreatic cancer. Sadly, more than half of people diagnosed with pancreatic cancer die within three months.

Pancreatic Cancer UK is funding cutting-edge research to develop new ways of detecting pancreatic cancer earlier, which could save thousands of lives every year. We’re also working to improve treatments for pancreatic cancer to make them kinder and more effective.

A diagnosis of pancreatic cancer can be a terrible shock. But you don’t have to face it alone. Our specialist nurses are here to support everyone affected now.

Research has found that healthier patients have better outcomes from their surgery.

As we get older, it’s important to continue to be active and exercise. Anything you enjoy is worth continuing, although it may be best to avoid high-impact sports and activities.

Why self-management is key to a better life for heart failure patients

It’s important to know the signs and symptoms of heart failure and understand your risk of developing it because it is treatable. Just remember B.E.A.T. — Breathless, Exhausted, Ankle swelling, Time to see your GP or practice nurse.

In 2010, Nick Hartshorne-Evans was diagnosed with heart failure. At the time, he was just 39 years old. “I was in such a state because I’d had symptoms for six weeks,” he remembers. “My whole body was shutting down, so when I was told what the issue was — I felt relieved, quite honestly. It was only after I left the hospital three weeks later that it sunk in, and I started to think: What is going to happen to me?”

Living with heart failure

Heart failure means that your heart isn’t pumping as it should. It is either not pumping enough blood around the body or is not filling with blood properly. It doesn’t mean that your heart is about to stop, but it is undoubtedly serious and can lead to pump failure.

Yet, Nick is proof that with the right treatment and management, people with the condition can still live fulfilling lives. His experience even prompted him to become the founder of the UK’s only dedicated, patient-led heart failure charity — the Pumping Marvellous Foundation — where he is now the CEO.

“Heart failure is treatable,” he says. “You might not find it easy at the start — or even later because good management requires effort. But my message is that you can live with it. In fact, I know of some people in the heart failure community who have been living with it for 25 years.”

There is a range of causes, but risk factors include hypertension; a previous heart attack that has damaged your heart; a disease of the heart muscle or heart valve; type 2 diabetes; or a viral infection that affects the heart (for example, Nick’s condition was caused by the swine flu virus).

Symptoms can include breathlessness after minimum exertion, fatigue and — in many, but not all, cases — swollen ankles and/or swollen legs and tummy and unexpected weight gain. If you are concerned, Nick’s advice is to see a GP as quickly as possible. “It’s important to catch heart failure early as there are some very good treatments available that can help manage the condition,” says Nick.

The link between heart failure and iron deficiency Unfortunately, around 50% of heart failure patients deal with a double burden because they can also be affected by iron deficiency (a topic that is surely ripe for exploration on Iron Deficiency Day on 26 November).

Focusing on the risks and symptoms of heart failure

Nick notes that heart attack and cardiac arrest get more coverage in the media whereas “heart failure has become their sort of distant relative.” That has to change, he insists, because it’s estimated that around 1 million people in the UK are affected by heart failure. It can happen to anyone at any age, although it’s mainly prevalent in older age groups.

“This means they are having to manage heart failure symptoms and iron deficiency symptoms,” explains Nick. “Their GP may prescribe them iron tablets, but they may also need a specialist to administer intravenous iron therapy. I know people with heart failure who have been treated this way, and they feel much better afterwards.”

Ultimately, the key to living with heart failure is effective self-management. “Know how to identify the signs and symptoms, and know what to do if they get worse,” adds Nick. “Take your medication, improve your mobility and have a balanced diet. Make sure you have a good health team — and, above all, try to live your life. Don’t let heart failure rule it.”

To find out more about Iron Deficiency Day, please visit takeironseriously.com/uk

For further information on Heart Failure, please visit pumpingmarvellous.org

Unfortunately, around 50% of heart failure patients deal with a double burden because they can also be affected by iron deficiency.

INTERVIEW WITH Nick Hartshorne-Evans Pumping Marvellous Foundation

WRITTEN BY Tony Greenway