HIV: Not Just a Young Person’s Disease

Sangarlangkarn

Aroonsiri Sangarlangkarn, MD MPH
Geriatrics Fellow
Brookdale Department of Geriatrics and Palliative Medicine
Icahn School of Medicine at Mount Sinai
New York, New York

Did you know that by 2015, fifty percent of people with HIV (human immunodeficiency virus) in the United States will be over 50 years old? Or that 17% of new HIV infections happen to older adults?

People living in the 1980s would be surprised to hear these facts. When HIV was first discovered in 1981, we did not have effective medications to treat HIV, and many people died young, soon after they were diagnosed.

The good news is that healthcare has come a long way since then. Today, we have effective medications for HIV, called antiretroviral therapy, and people rarely die from HIV anymore. Now that people with HIV are living longer, we have more and more older adults who have HIV.

The bad news is that we still cannot cure HIV, and aging with HIV is not easy. Chronic HIV infection and long-term effects of HIV medications can lead to other health problems. For example, patients with HIV may be at higher risk for bone loss, making them more prone to getting osteoporosis compared to people without HIV. Osteoporosis is just one of the problems— chronic HIV infection increases risks for many other chronic diseases. It can also carry a stigma that can make it hard for older adults to make new friends or keep their social network.

So, what can you do to protect yourself from HIV as you age? Here are some tips:

Stay updated on safe sex practices: Unprotected sex with an infected partner is the most common way people get HIV.Practicing safe sex is a must. Even if you no longer worry about unwanted pregnancies, you still need condoms to protect you from sexually transmitted diseases, HIV included. If you are recently rejoining the dating scene, make sure to stay up to date with new information on HIV and safe sex practices—information might have changed from the last time you heard about it.

Get more information from HealthinAging.org’s section on Sexual Health and the Safe Sex Tip sheet.

Get tested: Knowing your HIV status is important, and everyone should get tested. This is because HIV infection is hard to detect without a test.  Its symptoms mimic many other diseases, including symptoms related to advancing age. Moreover, after the initial infection passes, you might not have any symptoms until it is too late.  Untreated HIV weakens your immune system and leaves you open to getting  sick from infections.  Do not wait until it is too late—get tested today.

If you have HIV:

  • Find a healthcare provider and a pharmacy that specialize in HIV. HIV is a complicated disease, so you want to make sure your healthcare professionals have experience dealing with HIV.
  • Take your medications as prescribed. If you do not take medications correctly, your HIV pills may be less effective in the future.
  • Exercise and eat a healthy diet. This helps your immune system stay healthier and keep HIV under control.

Aging with HIV is a new experience, and it is an important topic in medical research. In fact, the American Geriatrics Society has partnered with other organizations to develop a website about HIV and Aging to help provide updated research and treatment guidelines to HIV doctors. Feel free to share this website with your healthcare provider, and visit it often to find out the latest updates on this topic.

Dealing with Delirium: Families Share their Stories

If your loved one suffers a bout of delirium, it can be a frightening and unsettling experience for all concerned. Delirium, a sudden change in mental function, can cause an extreme variety of behavioral changes, ranging from aggressive and agitated to sleepy and inactive—sometimes, even a combination of both.

When delirium occurs after an older person has had surgery, it’s called postoperative delirium. It’s good to know that your hospital’s healthcare providers and your family can work together to help manage and improve delirium, as these family caregivers discovered:

“After he had heart surgery, I noticed that my 86-year-old father was confused and not behaving like himself. Based on the delirium prevention information I found on HealthinAging.org, I was able to talk with my family and my father’s healthcare team about the signs of delirium and ways we could help my father feel more oriented in his hospital surroundings. We made sure to have family members around him. We read him the newspaper, got him walking, and kept him engaged as much as possible.

I’m pleased to say his recovery has been remarkable. Had his delirium not been addressed so quickly, I know the outcome could have been very different. As a caregiver, I was thrilled to have reliable health information that guided me in asking the right questions of my father’s healthcare providers.”
– Vivien, A Family Caregiver

Continue reading

Get Involved: Live Happier Longer

Coleman, Jessica 4x6Jessica L. Coleman, DO
Geriatrics Fellow
Summa Health System
Akron, Ohio

 

We all know that volunteering for local organizations is a great use of free time. But did you also know that it can not only improve your mood, but also help prolong your life and prevent memory loss?

Volunteering has been shown to be one of the most effective ways for older adults to stay active, learn new skills, make new friends, and be healthier.

Getting involved in your community can be as easy as heading to your local library to read to children after school, volunteering at your local hospital,or joining a service league in your area to meet others who also enjoy giving back.

Consider some of the following ways to connect with and contribute to your community:

  •  Foster Grandparent Programs: Connect with local children who need the love and support of an older adult to guide or comfort them. Work with troubled teens, young mothers, or premature infants—everyone can benefit from having an involved and caring grandparent.
  • Retired and Senior Volunteer Programs: Using the skills and talents you have gained over a lifelong career, serve as a volunteer in your community rebuilding homes, tutoring, or organizing neighborhood watch programs.
  • Senior Companions: Help keep a fellow senior independent and in their own home by assisting with daily tasks such as shopping or paying bills. You can provide respite for caregivers, family members, and make valuable friendships. Continue reading

It’s Not Normal: Urinary Incontinence

Cleveland, MaryJo 4x6Maryjo L. Cleveland, MD
Medical Director, Post Acute & Senior Services
Chief, Division of Geriatric Medicine
Summa Health System
Akron, Ohio

 

This month we are going to talk about one of those problems that no one wants to talk about. Urinary Incontinence. There, I said it. Now you can too.

Urinary incontinence is the involuntary loss of urine and boy, is it common. Probably 50% of older women and 15% of older men suffer from this problem. But most older adults don’t tell their healthcare provider about it. Why? If you have followed this blog at all, you already know the answer. Because people think it’s normal, and that nothing can be done about it. Fortunately, this thinking is wrong!

If you have episodes of involuntary loss of urine, please talk to your healthcare provider. Your healthcare provider should begin to ask you questions about your experience. Don’t be embarrassed to answer these frankly!  Honest answers will help determine the cause and the approach to treatment.

Some of the questions will likely include:

  • How frequently is it happening?
  • Is it affecting your work, social life, or sex life?
  • Do you lose small amounts or do you soak your clothing or pad?
  • Is it worse when you cough or sneeze?
  • Do you have to rush to the bathroom to avoid and accident?

There are basically five types of incontinence:

1.  Stress incontinence – also called stress urinary incontinence, this is not caused by emotional stress or being nervous.  This type of incontinence is the loss of small amounts of urine when you exert pressure on your abdomen and bladder-coughing, sneezing, laughing, lifting heavy objects. This happens because the muscle that keeps the bladder closed has weakened over time. In women, this is usually due to pregnancy and childbirth and in some men it can happen after their prostate has been removed.

2.  Urgency urinary incontinence – also called urge incontinence or overactive bladder, this type is the loss of larger amounts of urine with little or no warning. You may have seen television commercials for this type of incontinence.  This is often caused by infections, bladder irritants, or brain diseases such as Alzheimer’s disease or strokes.

3.  Overflow incontinence  this is a frequent dribble of small amounts of urine and the inability to completely empty the bladder. This is often a complication of diabetes and is more common in men due to prostate problems.

4.  Mixed incontinence – this is combination of the above types.  It is mostly a combination of stress and urgency urinary incontinence.

5.  Functional incontinence – this is incontinence due to something outside of the bladder. In older adults it is because of physical or mental impairments that prevent them getting to the bathroom in a timely manner. Continue reading

Summer Travel Tips for Older Adults

Krupa Shah, MDKrupa Shah, MD, MPH
Assistant Professor

University of Rochester School of Medicine & Dentistry
Division of Geriatrics & Aging, Department of Medicine
Rochester, New York

According to a survey conducted by AARP, those age 50 or older take on average six non-business related trips at least 50 miles from home each year.  And Travelzoo, Inc, a global internet media company, tells us that 40% of Americans are planning to take more summer vacations compared to last year.  The most popular type of vacation is the road trip, both for a short weekend or for a longer period of time.

Going on vacation can be a much more enjoyable experience with a little advance planning to make sure that we all stay safe and healthy.

  •  Be sure to pack all your medications.  Before you leave, check if you need refills during your trip.  Most pharmacies will accommodate flexible refills when they know you will be travelling away from home. Also carry a list of your current medications, their doses, and the time of day you take them.
  • Remember to actually take all your medications. Vacations often change our normal daily routine. It is important to make time for correct medication use during all the fun and new places that a summer vacation may bring.  Asking others who are with you to help remember, or setting a small timer, carrying a calendar or using a pill organizer may be helpful.
  • Be aware of side effects.  Some medications can cause side effects related to more time outside in the sun, like increased sensitivity to ultraviolet (UV) rays. It may be helpful to review all medications with your pharmacist, and ask for further consultation with your doctor if you have any questions. Continue reading