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The causes—and symptoms—of fatigue in older patients

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This article was originally KHN.

Linda C. Johnson of Indianapolis wasn’t prepared for the fatigue that befell her after being diagnosed with stage 4 lung cancer in early 2020.

Initially, Johnson, now 77, thought he was depressed. She could barely summon the energy to get her dressed in the morning. Some days she couldn’t get out of bed.

But as she began to sort out her problems, Johnson realized something else was going on. I was. Even doing nothing during her day made her feel drained.

“People would say to me, ‘You’re old.’ because,” she told me.

Fatigue is a common cause of many ailments that plague older people, including heart disease, cancer, rheumatoid arthritis, lung disease, kidney disease, and neurological disorders such as multiple sclerosis. It is one of the most common conditions associated with chronic diseases, affecting 40% to 74% of older adults with these conditions. 2021 review by researchers at the University of Massachusetts.

This is more than exhaustion after a very busy day or a sleep-deprived night. I feel like my battery is draining all the time,” wrote a user named Renee on a Facebook group for people with polycythemia vera, a rare blood cancer. “It’s like a wrung out rag.”

Fatigue does not describe a “tired day.” Kurt Kroenke, Ph.D., a research scientist at the Regenstrief Institute in Indianapolis, specializing in medical research and a professor at the Indiana University School of Medicine, said:

when he and his colleague About 3,500 elderly patients were questioned At a large primary care clinic in Indianapolis, 55% cited fatigue as a bothersome symptom, followed by musculoskeletal pain (65%), followed by back pain (45%) and shortness of breath (41%). more than

Apart from 2010 survey The Journal of the American Geriatrics Society estimates that 31% of people over the age of 51 reported feeling tired in the past week.

The impact can be severe. Fatigue is the main reason people over the age of 70 limit their activity, according to one study. 2001 study By researchers at Yale University.Other studies have shown an association with fatigue movement disorders, Restricted ability to perform daily activities, development or worsening of disabilityand premature death.

Fatigued older people often become inactive and ill, leading to muscle loss and weakness and increased fatigue. Gene Kutner, Ph.D., Professor of Medicine and Chief Medical Officer, University of Colorado Hospital, said:

To prevent that, Johnson made a plan after learning her lung cancer had returned. One day she got up and washed her face. Then she takes a shower. Another day she went to the grocery store. After each activity she rested.

Three years after the cancer returned, Johnson’s fatigue has been constant. But “I’m functioning better,” she told me. Because I learned how to pace myself and find things that motivate me, like teaching virtual classes to students in training to be teachers, or exercising under the supervision of a personal trainer. That’s why.

When should seniors worry about fatigue? Palliative medicine.

“Fatigue is a warning signal that something is wrong with your body, but it is rarely one thing.

Things your doctor should check: Are your thyroid levels normal? Are you having trouble sleeping? If there are underlying medical conditions, are they adequately controlled? Are there underlying infections? Are you chronically dehydrated? Do you have anemia (lack of red blood cells or hemoglobin), an electrolyte imbalance, or low testosterone levels? Are you eating enough protein? Have you been feeling more anxious or depressed lately, and could the medications you’re taking be contributing to your fatigue?

“Drugs and doses may be the same, but the body’s ability to metabolize those drugs and eliminate them from the body may be altered,” Hashmi said, noting that such changes in the body’s metabolic activity. We noted that changes are common with age.

Many factors that can contribute to fatigue can be addressed.but most of the timethe reason for fatigue cannot be explained by the underlying disease.

That happened to Teresa Goodell, 64, a retired nurse who lives just outside Portland, Oregon. When she visited Arizona in December, even though she was in perfect physical condition, she suddenly became exhausted and short of breath while hiking. At the emergency room she was diagnosed with an asthma exacerbation and she was put on steroids, but to no avail.

Soon, Goodell was spending hours in bed every day and was overcome with severe fatigue and weakness. Even her little activity exhausted her. However, none of the medical tests she underwent in Arizona and later in Portland (chest X-ray and her CT scan, blood work, cardiac stress test) showed any abnormalities.

“There was no objective evidence of illness, so no one could believe you were sick,” she told me.

Goodell has started visiting lengthy covid websites and chat rooms for people with chronic fatigue syndrome. Today, I’m sure she has post-viral syndrome from an infection. One of her most common symptoms of long-term COVID-19 is fatigue, which interferes with her daily life. according to Centers for Disease Control and Prevention.

There are several strategies for dealing with persistent fatigue. Christian Sinclair, M.D., an associate professor of palliative medicine in his system at the University of Kansas Health, said that in cancer patients, “the best evidence is in favor of physical activity such as tai chi, yoga, walking, or low-impact exercise.” I’m here. The goal, he said, is to “increase the patient’s stamina gradually.”

However, when covid is long, doing too many things at once can lead to “fatigue after exercise” It is often recommended to pace the activity. Do only the most important things when your energy levels are at their highest, then rest. “You learn how to set realistic goals,” says Dr. Andrew Esch, Senior Educational Advisor at the Center for Advancement of Palliative Care.

Cognitive-behavioral therapy can help older people with fatigue learn how to adjust their expectations and deal with intrusive thoughts such as “I could do more.” At The University of Texas MD Anderson Cancer Center, management plans for older patients with fatigue typically include strategies to address physical activity, sleep health, nutrition, emotional health, and support from family and friends. increase.

Dr. Ishwaria Subbiah, Physician in Palliative Care and Integrative Medicine at MD Anderson, said: “It’s important to realize that this won’t happen quickly. It will take time.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. KHN is one of his three major operational programs in the United States, along with policy analysis and polling KFFMore (Kaiser Family Foundation). KFF is a donated non-profit organization that provides information on health issues to the public.

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