chronic conditions

LIFE EXPECTANCY GAINS THREATENED AS MORE OLDER AMERICANS SUFFER FROM MULTIPLE MEDICAL CONDITIONS.

Posted by

0


NEARLY EIGHTY PERCENT HAVE MORE THAN ONE SERIOUS AILMENT

With nearly four in five older Americans living with multiple chronic medical conditions, a new study by researchers at Johns Hopkins Bloomberg School of Public Health finds that the more ailments you have after retirement age, the shorter your life expectancy. The analysis, one of the first to examine the burden of multiple chronic conditions on life expectancy among the elderly, may help explain why increases in life expectancy among older Americans are slowing.

140723105951-large

A report on the findings, based on an analysis of 1.4 million Medicare enrollees, appears in the August issue of the journal Medical Care.

“Living with multiple chronic diseases such as diabetes, kidney disease and heart failure is now the norm and not the exception in the United States,” says Eva H. DuGoff, a recent PhD recipient at the Johns Hopkins Bloomberg School of Public Health and lead author of the report. “The medical advances that have allowed sick people to live longer may not be able to keep up with the growing burden of chronic disease. It is becoming very clear that preventing the development of additional chronic conditions in the elderly could be the only way to continue to improve life expectancy.”

For their analysis, researchers used the Medicare 5% sample, a nationally representative sample of Medicare beneficiaries, enrolled as of January 1, 2008, which included 21 defined chronic conditions and the records of nearly 1.4 million people 67 and older.

Life expectancy in the U.S. is rising more slowly than in other parts of the developed world and many blame the obesity epidemic and its related health conditions for the worsening health of the American population.

The analysis found that, on average, a 75-year-old American woman with no chronic conditions will live 17.3 additional years (that’s to more than 92 years old). But a 75-year-old woman with five chronic conditions will only live, on average, to the age of 87, and a 75-year-old woman with 10 or more chronic conditions will only live to the age of 80. Women continue to live longer than men, while white people live longer than black people.

It’s not just how many diseases you have, but also what disease that matters. At 67, an individual with heart disease is estimated to live an additional 21.2 years on average, while someone diagnosed with Alzheimer’s disease is only expected to live 12 additional years.

On average, life expectancy is reduced by 1.8 years with each additional chronic condition, the researchers found. But while the first disease shaves off just a fraction of a year off life expectancy for older people, the impact grows as the diseases add up.

“We tend to think about diseases in isolation. You have diabetes or you have heart failure. But many people have both, and then some,” says senior author Gerard F. Anderson, PhD, a professor in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. “The balancing act needed to care for all of those conditions is complicated, more organ systems become involved as do more physicians prescribing more medications. Our system is not set up to care for people with so many different illnesses. Each one adds up and makes the burden of disease greater than the sum of its parts.”

The researchers say their findings could be useful to Social Security and Medicare planners as they make population and cost predictions for the future. Policymakers are facing a different landscape as so many more people are living with multiple chronic conditions than before: 60 percent of those 67 and older in the U.S. have three or more of these diseases, the researchers found. Eventually, there may be a tipping point, when the medical advances that have boosted life expectancy for so long can no longer keep pace with the many illnesses people are collecting as they age.

“We already knew that living with multiple chronic conditions affects an individual’squality of life, now we know the impact on quantity of life,” DuGoff says. “The growing burden of chronic disease could erase decades of progress. We don’t want to turn around and see that life expectancy gains have stopped or reversed.”

7 Hidden Causes of Fatigue .

Posted by

0


Fatigue can signal anemia, diabetes, hypothyroidism or hepatitis C. But once your doctor rules out major medical causes of fatigue, it’s time to consider hidden ones.

“We look for the less obvious roots of fatigue — that’s our job,” says Tanya Edwards, MD, Medical Director of Cleveland Clinic’s Center for Integrative Medicine.

Hidden causes include:

1. A junk food diet

Diets that are high in trans fats, saturated fats, processed foods and added sugars can sap your energy. Dr. Edwards recommends switching to a diet high in good sources of protein — mainly fish, nuts, seeds and beans — with eight to 10 servings of fruits and vegetables per day.

Watch out for grains, though. These complex carbs affect insulin. “Insulin is the storage hormone that makes us heavier. The heavier we are, the higher our blood sugar becomes, and the more insulin resistance (prediabetes) we develop,” she says.

2. Lost nutrients

Today’s industrial farming practices rob the soil of key fatigue-fighting minerals, says Dr. Edwards, who recommends taking a multivitamin and mineral supplement. Supplements contain minerals rarely found in food, such as:

  • Selenium, important for thyroid function and metabolism
  • Iodine, present in the iodized salt that many people with heart disease and high blood pressure avoid. “Low iodine states can result in fatigue,” she says.

3. Not enough omega-3

Fish are rich in omega-3 fatty acids — but most of us don’t eat enough. “I recommend about 1,000 mg of an omega-3 supplement,” says Dr. Edwards. “My preference is fish oil because it is the long-chain form that our body needs.”

4. Vitamin D deficiency

Vitamin D gives us energy. Low levels of this vitamin can cause low energy and depression. “Vitamin D and omega-3 are necessary for every single cell in the body — including brain cells — to work properly,” says Dr. Edwards. If blood tests reveal low vitamin D levels, she recommends supplements.

5. Low magnesium

We are born with a finite amount of magnesium — also needed for energy production — in our bones and muscles. The vast majority of Americans get less than half the required amount of this mineral from their diet.

“Magnesium is still leaching out of our bones and muscles in our 40s and 50s,” says Dr. Edwards. She recommends magnesium replacement for those with symptoms of a total body deficit: insomnia, fatigue, constipation, muscle cramps and pain, joint pain, anxiety and elevated blood pressure.

6. Poor sleep

When it comes to sleep difficulties, “we’ve got the perfect storm happening in our 40s and 50s,” says Dr. Edwards. Reasons for lost sleep include increased work responsibilities, living with teens, aging parents and falling magnesium levels.

For women, menopause and perimenopause are also factors. Falling levels of progesterone (a female hormone that helps with sleep) and hot flashes can cause insomnia. A change in caffeine metabolism doesn’t help.

“Women who have had two cups of coffee a day since age 20 suddenly can’t metabolize it as fast at age 50,” says Dr. Edwards. Caffeine can take eight to 10 instead of five hours to clear the system. For these women, she recommends scaling back to one cup of coffee before 10 a.m.

7. A sedentary life

Ironically, not getting enough exercise can make you feel tired, says Dr. Edwards. Regular exercise will boost your energy as well as your mood and fitness level.

If healthy changes in diet, sleep and exercise don’t improve fatigue after a couple of months, she often recommends:

  • B complex vitamins — these help our bodies make energy, especially in times of stress
  • Coenzyme Q10 — this cofactor, which helps enzymes produce energy in our cells, is often blocked by statins (common heart disease drugs)

In addition, “acupuncture can be huge for fatigue, sleep, pain and hot flashes,” says Dr. Edwards.