Can you prevent 7 top
diseases
AS YOU AGE?
Brian Banks
From
50PLUS.COM
While we all hope expect to grow old with as much vigour and vitality, many of
us will be hit with at least one major disease along the way. As troubling as it
may be, it’s a fact of life that most of the major diseases we fear are
associated with aging.
While your chances of suffering from a major disease may increase with age,
aging doesn’t automatically mean disease. While it’s clear that some factors
governing your fate are beyond your control, there are many things you can do to
either avoid these afflictions or postpone them for as long as possible.
Here are seven leading culprits, their causes and your best bets for either
coping with or evading them.
Heart disease
Heart disease can take many forms, but the most frequent -- and most relevant to
people over 50 -- is coronary artery disease (CAD). It is the most common cause
of death in both men and women over 65. CAD is generally a lifestyle disease
that can be prevented.
Prevalence
Many people mistakenly think CAD is a man’s disease. While this is true during
your 40s, by age 75, the risk of CAD in men and women is about equal.
Causes and risk factors
CAD commonly results from atherosclerosis, a disease in which plaque, made up of
cholesterol, fats and other materials, builds up in arteries that supply blood
to the heart. High blood pressure, a high-fat diet, and smoking are chief
contributors to the development of plaque.
As plaque accumulates, it begins to restrict blood flow and oxygen to the heart,
leading to pain. When the blockage cuts blood flow by more than 50 per cent, the
heart suffers permanent damage. In especially severe cases, atherosclerosis can
block blood flow entirely or the already narrow channel can be blocked by a
blood clot -- in either case, the result is a heart attack.
Age and a family history of heart disease are uncontrollable risk factors. Most
others, however, are lifestyle-related: smoking, obesity, and lack of physical
activity. High blood pressure, high cholesterol and diabetes as risk factors
fall into both categories: they can be genetic as well as lifestyle.
Treatment and prevention
Angina sufferers take drugs to lower blood pressure as well as heart rate, and
nitroglycerine to alleviate the symptoms. Exercise, stopping smoking and eating
a healthy diet can alleviate the condition somewhat. Angioplasty or bypass
surgery may be needed.
Heart attacks demand rapid action. If the heart has stopped, it can be restarted
with an automated external defibrillator, which shocks the heart into beating
again. If the attack is due to a blood clot, drugs to eliminate clots may be
prescribed.
The best treatment for CAD, of course, is prevention: quitting smoking,
exercising regularly, eating a low-fat diet and drinking alcohol in moderation.
Medication may be prescribed to lower blood pressure, reduce cholesterol levels
and treat diabetes. Low-dose aspirin may be prescribed to discourage blood clot
formation.
Stroke
A stroke occurs when a blood clot stops blood flow to an area of the brain or
when a blood vessel in the brain ruptures and bleeds. In both cases, brain cells
are deprived of oxygen and are either damaged or die. For most sufferers, the
consequences range from temporary loss of functions to permanent paralysis and
death. Some people also have a third type of stroke known as a transient
ischemic attack (TIA). With TIA, blood flow to the brain is interrupted only
briefly. Symptoms go away in minutes or hours and there is no lasting damage.
TIAs are often seen as warning signs of risk for a more serious stroke.
Prevalence
Every 10 minutes, someone in Canada has a stroke -- more than 50,000 people a
year (excluding TIAs). Of these, approximately 80 per cent occur in those 65 or
older. Men are at a 30 per cent higher risk than women.
Causes and risk factors
Non-modifiable: age (risk doubles every decade over 55); gender (men have a 30
per cent greater risk); race (people of African and Oriental ancestry are at
higher risk); family history of stroke or TIA before age 65.
Modifiable: high blood pressure (increases stroke risk four to six times);
atrial fibrillation (a rapid, irregular heartbeat); carotid artery disease;
diabetes; high cholesterol; smoking (doubles risk); excessive alcohol
consumption; being overweight.
When a stroke occurs, it’s now known that brain cell damage often proceeds in a
two-step fashion: there is immediate damage followed by the slower demise of
more remotely affected cells.
Treatment and prevention
The faster a stroke victim receives treatment, the better the odds of survival
and recovery.
The first three hours after onset are critical. Anticoagulants may be
administered to help offset the chances of subsequent strokes. Patients
suffering from blood vessel rupture may undergo surgery to repair the damage.
The impact and degree of recovery is dependent on such factors as the size of
the stroke and its location.
On the preventive side, diet and exercise address some of the modifiable risk
factors. Drugs may be given to lower high blood pressure.
Cancer
While most of us think of cancer as one disease the term actually refers to
scores of different diseases. All involve uncontrolled growth of abnormal cells
(tumours) that begin in one area and, if unchecked, often spread to other parts
of the body via the blood or lymph systems. The most common are skin cancer,
breast cancer (women), prostate cancer (men), lung cancer, colorectal cancer and
lymphoma. While some cancers are more treatable than others, the overall
survival rate is slightly better than 50 per cent.
Prevalence
The chances that you’ll be diagnosed with cancer sometime in your life are
better than one in three but those chances increase substantially with age. In
fact, half of all diagnoses occur in people over 65.
In 2001:
an estimated 115,000 Canadians age 50 and over were diagnosed with cancer.
in the 50 to 59 age group: approx. 12,000 women and approx. 9,500 men
in the 60 to 79 age group approx. 30,000 women and approx. 40,600 men
above 80, approx. 11,500 women and approx. 11,300 men
Causes and risks
Cancer’s chief instigators are agents known as carcinogens. Cancer appears when
carcinogen-induced damage accumulates to the point where unchecked cell growth
begins. In five to 10 per cent of all cases, heredity also plays a role -- some
people are born with mutations that promote the growth of certain cells or lead
to more mutations.
All this exposure and damage takes time to develop – which explains why most
forms of cancer are more common as we age.
Lung cancer: nine out 10 lung cancers are due to smoking, which results in
one-third of all cancer deaths in North America. Smoking is also definitively
linked to cancer of the esophagus, upper respiratory tract, bladder and
pancreas.
Skin cancer: exposure to sun and ultraviolet light; history of blistering
sunburn in youth; fair skin, fair hair, freckles.
Breast cancer: family history, especially if it occurred before menopause in a
woman’s mother, grandmother or sister; early menstruation and/or late menopause;
obesity. Even so, 80 per cent of women who get breast cancer have no known risk
factors.
Prostate cancer: family history in a father or uncle; African ancestry; high-fat
diet.
Colorectal cancer: family history; diet high in saturated fat (red meat, in
particular) and low in fibre-rich fruits, whole grains, fresh vegetables. A
high-fat diet is second only to smoking as a cause of cancer in North America.
Treatment and prevention
The usual cancer treatment is surgery to remove the cancer and surrounding
tissue, followed by either chemotherapy or radiation therapy in an effort to
destroy remaining cancer cells. Because cancer often spreads via the lymph
systems, lymph nodes are often removed.
In breast cancer and prostate cancer, hormone therapy is increasingly common.
The consensus is that prevention is the best medicine: don’t smoke; avoid the
sun’s harmful rays; eat five to 10 servings of vegetables and fruit a day; avoid
foods high in saturated fat; drink less alcohol; and exercise regularly to keep
weight down and bolster your immune system.
On the supplement side, many people put stock in antioxidants -- especially
vitamins E and C, beta carotene and selenium. While many studies support the
belief that antioxidant supplements reduce cancer risk, there is just as much
credible research to suggest they are unnecessary. Talk to your health care
provider.
Arthritis
Say arthritis and many people think about stiff knees in the morning or that
nagging shoulder pain when you reach for a jar on a top shelf. But arthritis is
actually an umbrella term for about 100 different, mostly chronic conditions.
The two best known and most widespread are osteoarthritis (OA) and rheumatoid
arthritis (RA), but arthritis includes other well-known ailments such as gout,
fibromyalgia and lupus. Symptoms can be as mild as the stiffness noted above to
severe and constant crippling pain, swelling and disfigurement.
Prevalence
Of the two major forms, OA is by far the most common, afflicting an estimated
three million Canadians. It's also the form most likely to set in after a person
reaches 50. In fact, 50 per cent of all Canadians over 65 have OA; in those aged
75 and up, the incidence is about 75 per cent.
In contrast, most of the approximately 300,000 Canadians with RA experience the
first onset between ages 25 and 50.
Causes and risk factors
No one yet knows exactly what causes arthritis, although in the case of RA,
researchers say the key lies in the body’s own immune system mistakenly
attacking normal body tissue. Some even believe that OA may have an autoimmune
element or a bacterial link, given the strong relationship between the degree of
joint inflammation and the severity of symptoms.
OA: age (onset usually occurs after age 45); heredity (predisposition to weak
cartilage, ill-fitting joints); excess weight; injury or overuse; presence of RA
or other forms of arthritis.
RA: heredity (many people with RA have a certain genetic marker) but others get
it who have no prior family history; having the gene does not guarantee you’ll
get RA.
Treatment and prevention
OA: weight loss can reduce stress on joints. Sufferers must also be careful not
to put excessive stress on joints while lifting, moving or working.
Range-of-motion exercises help reduce stiffness and keep joints moving.
Acetaminophin relieves pain; to ease pain and reduce inflammation, non-steroidal
anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, are commonly
used.
Recently, dietary supplements glucosamine sulfate and chondroitin sulfate have
gained popularity as NSAID alternatives; instead of just relieving symptoms,
there is evidence these supplements treat the underlying degenerative disorder
itself. Surgery is sometimes needed in advanced cases.
RA: exercise and painkillers are strongly recommended for RA sufferers. However,
the medicinal arsenal is extensive. Surgery is often required for advanced
cases.
Diabetes
Diabetes refers to a group of diseases in which the body has problems converting
food to energy. To do this, cells use insulin produced in the pancreas. However,
when people have diabetes, they either produce little or no insulin (Type 1
diabetes) or their production declines with age and/or their body becomes
resistant to it (Type 2 diabetes).
In either case, the result is abnormally high blood glucose levels and cells
that are starved of energy. Left unchecked, it damages blood vessels and nerves
and can lead to such complications as heart disease, stroke, kidney disease,
blindness, even death. While there is no cure, diabetes can usually be treated
quite effectively.
Prevalence
While some people over 50 have Type 1 diabetes, onset always occurs early in
life. Type 2 diabetes is a different story. Also known as “mature onset”
diabetes, it seldom occurs before age 40, with first diagnosis most likely to
take place between ages 50 and 59. Type 2 diabetes is also far more common,
accounting for approximately 90 per cent of all diabetes cases in Canada - and
one of the most common diseases Canadians should watch out for once they turn
50.
Causes and risk factors
As noted, Type 2 diabetes is caused either by a decline in insulin production or
the body’s growing resistance to insulin. The actual underlying cause or trigger
for this process is not known. Unlike Type 1 diabetes, however, it is believed
that a person’s lifestyle often plays a role in the development of Type 2
diabetes.
Risk factors include:
age
being overweight
aboriginal, Hispanic, Asian or African ancestry; family history
high cholesterol; high blood pressure
higher than normal blood glucose levels
having given birth to at least one baby weighing more than 4 kg (9 lb)
a sedentary lifestyle.
Treatment and prevention
Glucose-lowering drugs are available for both the prevention (for those with
pre-diabetes) and treatment of Type 2 diabetes. However, recent research shows
that a program of proper diet, exercise and weight loss can be even more
effective in both managing and preventing the disease.
Osteoporosis
Bone density typically peaks around age 30 and then declines. While most of us
suffer no ill effects from this decline, a large minority of people experience
bone density loss so severe that something as simple as a hard sneeze or a
stumble can cause sudden fractures. Unchecked, osteoporosis can cause disability
and death, although recent advances in treatment and prevention now make it far
less debilitating.
Prevalence
According to the latest estimates, osteoporosis affects as many as 1.4 million
Canadians -- all of them over age 50. While many people think of osteoporosis as
a women’s disease, some 20 per cent of its sufferers are men. Women get it
earlier, starting at about age 55, following menopause but, by age 75,
osteoporosis strikes both sexes equally.
Causes and risk factors
While bone density loss is the culprit with osteoporosis, the exact mechanism is
not totally understood. In women, it’s commonly triggered by the loss of
estrogen after menopause and, in men, diminishing testosterone production.
However, because everyone loses bone density but not everyone gets osteoporosis,
the entire explanation lies somewhere in the related risk factors.
Numerous risk factors have been identified for osteoporosis:
age
a diet low in calcium or vitamin D during adolescence/early adulthood
a slim build and/or small bones
family history
having diabetes or other medical disorders
long-term use of corticosteroids; smoking, heavy drinking, lack of regular
weight-bearing exercise.
Treatment and prevention
Treatment usually starts with hormone replacement therapy, which can reduce the
rate of bone loss or halt it completely. Certain drugs have shown the ability to
increase bone density, rebuild bones and reduce fracture rates. Regular
weight-bearing exercise has the potential to reduce, halt and, in some cases,
reverse bone loss.
Prevention is still much easier than treatment. This starts with a proper
bone-building diet high in calcium, vitamin D and phosphorous. Continued healthy
eating and weight-bearing exercise will also help reduce bone loss at all stages
in life.
Alzheimer's disease
The most common of a group of dementias causing deterioration of brain
structures and functions, Alzheimer’s is progressive and ultimately fatal. Its
hallmarks are symptoms once dismissed as a normal part of aging -- memory loss
and a decreasing ability to think, communicate and take care of oneself.
Prevalence
Alzheimer’s rarely strikes people under 60. Even at age 70, the number of
sufferers is estimated at only two per cent. From there, however, the risk
doubles every five years. By age 85, an estimated 20 per cent to 30 per cent of
the population has some degree of Alzheimer’s.
Causes and risk factors
Researchers still can’t say exactly what causes Alzheimer’s. But there are
clues. In Alzheimer’s sufferers, certain levels of chemicals in the brain are
much lower than normal. Researchers also believe Alzheimer’s is related to the
formation of amyloid plaque deposits that show up in the brains of people with
the disease. As the disease progresses, nerve cells in the brain die off and the
brains of sufferers actually shrink in size. Other research suggests that
Alzheimer’s and other forms of dementia may be a consequence of hypertension
(high blood pressure) or nutrient deficiencies.
Age is the primary risk factor. However, Alzheimer’s also has a genetic
component; researchers have identified as many as four genes thought to play a
role in the disease. People who have a family history of Alzheimer’s (especially
if onset occurred before age 65) are at higher risk for developing the disease.
Treatment and prevention
There is currently no way to prevent, stop or reverse Alzheimer’s disease.
However, two drugs -- Donepezil and Rivastigmine -- have recently come on the
market in Canada that offer some respite from mild to moderate symptoms. While
they do nothing to halt the progression of underlying cell damage, they can
temporarily improve brain function and thus offer some improved quality of life.
Several pharmaceutical companies are also working on drugs that might one day be
used as vaccines, based on the goal of halting the build up of amyloid plaque in
the brain.
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