Aging and Body Changes

09/23/2010

Aging and Physical Change

To do well with Parkinson’s one must age well.

Some Parkinson’s symptoms can aggravate changes with age such as slowness in movement and thinking, flexed posture, stiffness, joint and muscle and back pain. Understanding how the body changes, what is preventable and what it means to us and our activities with age is important to our health with Parkinson’s. This article is part of a two part series- Aging and Our Senses and Aging and Our Body.

Bones

Your bones can become less dense and more brittle (osteoporosis- see Bone Health) leading to increase risk of fractures from falls and injury. Your spine can compress causing your posture (see accompanying article, Posture) to change, shoulders to slouch or even height to shorten. This is caused by a combination of density loss in vertebral bones and a los in height of the disks that serve to cushion the vertebrae. More information about osteoporosis and what you can do about it is available in the article Bone Health.

· See your doctor for a bone density screen especially if you are postmenopausal women, or have a risk of falling and injury regardless of gender.

· Be sure you get the required amount of calcium and magnesium in your diet.

· Get your vitamin D level checked as it has been found to be lower in people with Parkinson’s.

· Exercise, outside if you can. Your bones get stronger with weight bearing.

Joints

There are of course many causes of joint problems causing pain or limitation in movement as we age. Our joints become stiffer and less flexible with age. The synovial fluid that bathes are joints can decrease and cartilage that cushions the joint can wear down; both leading to pain and bone degeneration. Calcium can deposit in our joints.

Hips, knees, shoulders, and fingers show more change than other joints such as elbow or ankle.

Degenerative joint disease otherwise known as osteoarthritis or wear and tear arthritis is a common cause of joint pain in older people. It is caused by a breakdown in cartilage at the joint. Cartilage is necessary to cushion and lubricate the joint. The hands, feet, spine, hips and knees are the most common joints affected. This type of arthritis can run in families and is more common in med under the age of 45 years and women over the age of 55 years. More information on arthritis will be posted in a future article.

Pain from arthritis is often a combination of true joint pain and pain that results from inactivity. Inactivity leads to muscle atrophy, decreased strength in muscles, ligaments and tendons, mood problems all further worsening pain. A medically supervised, slow and gradual exercise and strengthening program can improve this pain!

Morning stiffness can be a sign of your Parkinson’s and arthritis. Stiffness from arthritis is located in the joint area and is usually present for 30 minutes but then improves. Stiffness from Parkinson’s rigidity can be present in the morning especially before your medicine is due but typically is felt more in the muscle and less in the joint. You can of course have stiffness from both causes.

· Talk to your healthcare provider about treatment.

· Ask for a physical therapy referral.

· Take an honest look at your diet if you are overweight. Even five pounds of weight loss will reduce the pain from a joint that is required to work with the extra weight.

· Get exercise. You might first consider gentle exercise- such as gentle stretching, yoga (look for gentle, therapeutic or restorative yoga), or water therapy. Overtime added strengthening; flexibility and aerobic activity will increase stamina, joint mobility and reduce pain.

Muscles

Muscles atrophy or become smaller due to changes in neurologic control, reduced activity and change in muscle itself. Muscles fibers become smaller with fat deposited in the muscle. Muscles change before the age of 40 and to some degree this is genetically determined. It is interesting to note that although these changes reduce the ability to sprint or perform fast quick movements, endurance is actually improved. This is why many endurance athletes such as marathon runners can perform well even in older years.

· Add muscle strengthening and stretching exercise to your daily routine.

· See a physical therapist or personal trainer to help you design and maintain an exercise routine, respectively.

· Be sure you get the protein you need (0.36g/weight in pounds for people without other medical conditions). People with Parkinson’s sometimes skimp on their protein due to concerns of interference with levodopa (see article on protein and levodopa).

Stamina

Change in stamina and endurance is caused by many factors. The joint and muscle changes described above can play a role. Changes in movement control due to conditions such as Parkinson’s not only make your movement slower but also increase the work or energy that is exerted to move. Inactivity is a significant cause of reduced endurance. Other medical conditions such as heart disease, lung disease, blood pressure control problems, cancer, obesity, thyroid conditions, and diabetes to name a few are medical conditions that affect stamina.

· See your primary physician to be sure your medical problems are well treated.

· Talk to your provider about a heart healthy lifestyle.

· Drink plenty of fluids to avoid dehydration or low blood pressure.

· Avoid rapid swings in blood glucose by eating a diet high in fruits, vegetables and whole foods and low in processed, high fat foods.

· Ask for a nutrition consult if you are a diabetic. Also be sure you know how to manage your blood glucose levels and know your hemoglobin A1C, a long range marker for glucose control, and what your target range should be.

· Talk to your healthcare provider about weight loss if you are overweight.

· Ask your Physical therapist to design an exercise program with stamina and endurance in mind.

Walking and Balance

As we age, changes in walking and balance have many causes include change in muscle strength, joint, coordination, stamina and neurologic changes such as that seen in Parkinson’s disease, peripheral neuropathy or stroke like conditions (all conditions that increase in frequency as we age). There is debate in the scientific literature as to whether there is truly a senile gait, that is does our walking have to change with age and some researchers believe that the answer is no- that is, not everyone is destined to experience change in walking simply due to aging. Work on your balance now whether you have a problem or not.

· Perform balance exercises every day. These exercises often take little time and energy so can be done easily if you make the habit.

· See a physical therapist to get started to tailor these exercises to your needs and to keep you safe while exercising. The therapist will focus on:

o Safe exercise and avoiding injury

o Developing a program that meets your needs today and can grow with your needs

o Core strengthening for posture, balance, and prevent back injury/pain

o Posture and spine.

o Strengthening, flexibility and balance/coordination

o Routine that is fun

o Tips and follow-up to insure motivation and follow through is strong.

· Think general health and be sure you get the sleep you need, eat the right foods, and

· Take a walk everyday if you are able.

Author: Monique Giroux, MD

Medical Information Disclaimer and Legal Agreement

Please read this agreement entirely and carefully before using the Northwest Parkinson’s Foundation website (nwpf.org).By using www.nwpf.org site, you agree to be bound by the terms and conditions below and in the www.nwpf.org Privacy Policy.

Disclaimer About Medical Information:
The information and reference materials contained here are intended solely for the general information of the reader. It is not to be used for treatment purposes, but rather for discussion with the patient's own physician. The information presented here is not intended to diagnose health problems or to take the place of professional medical care. The information contained herein is neither intended to dictate what constitutes reasonable, appropriate or best care for any given health issue, nor is it intended to be used as a substitute for the independent judgment of a physician for any given health issue. All content, including text, graphics, images and information, contained on or available through this web site is for general information purposes only. The major limitation of informational resources like www.nwpf.org is the inability to take into account the unique circumstances that define the health issues of the patient. If you have persistent health problems or if you have further questions, please consult your health care provider. All visitors to this and other www.nwpf.org associated web sites agree to read and abide by the complete terms of this agreement.

Legal Disclaimers

Summary:
 * www.nwpf.org web site does not constitute an attempt to practice medicine.
 * The use of the site does not establish a doctor-patient relationship.
 * Individuals should consult a qualified health care provider for medical advice and answers to personal health questions.
 * While the site attempts to be as accurate as possible, it should not be relied upon as being comprehensive or error-free.
 * www.nwpf.org is under constant development and changes may be made in the articles and programs at any time.
 * The web site reserves the right to change its disclaimer or privacy policy, so users should review these periodically.

No Medical Advice.
The information posted here by www.nwpf.org is not to be considered medical advice and is not intended to replace consultation with a qualified medical professional. We may answer and post medical questions solely on our own discretion. We do not have the resources or the capability to answer all visitor questions. In general, the questions we choose to answer are (in our opinion) of value to other readers. The answers to these questions should in no way be considered specific medical advice or a plan for disease management. Our goal is to provide sufficient information so that www.nwpf.org visitors are able to become knowledgeable participants in their disease management plan. The primary responsibility of your disease management plan is with your treating physicians and you should only follow your treating physicians advice. DO NOT change/modify your disease management plan on your own without consulting your treating physicians.

No Warranties.
This web site is provided on an "as is," "as available" basis without warranties of any kind, express or implied, including, but not limited to, those of TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE or NON-INFRINGEMENT or any warranty as to accuracy, timeliness, completeness or arising from a course of dealing, usage, or trade practice. No oral advice or written information provided by the www.nwpf.org shall create a warranty; nor shall members or visitors to the site rely on any such information or advice.

Disclaimer of Liability.
The user assumes all responsibility and risk for the use of this web site. Under no circumstances shall www.nwpf.org or its contributors/employees or its affiliated organizations such as the University of Illinois at Chicago or its employees or anyone else involved in creating or maintaining this web site be liable for any DIRECT, INDIRECT, INCIDENTAL, SPECIAL or CONSEQUENTIAL DAMAGES, or LOST PROFITS that result directly or indirectly from the use or inability to use the web site and/or any other web sites which are linked to this site - or that result directly or indirectly from mistakes, omissions, interruptions, deletion of files, viruses, errors, defects, or any failure of performance, communications failure, theft, destruction or unauthorized access.

In states which do not allow some or all of the above limitations of liability, liability shall be limited to the greatest extent allowed by law.

Online Conduct.
Visitors agree to use the web site only for lawful purposes and are prohibited from posting on the web site any unlawful, harmful, threatening, abusive, harassing, defamatory or obscene material of any kind, including, but not limited to, any material which encourages conduct that would constitute a criminal offense, give rise to civil liability or otherwise violate any applicable local, state, national or international law. This applies to any posting that could be termed as Sexual Harassment and or Discrimination. Although in the absence of a specific complaint the postings are not monitored for compliance with this provision, in an effort to discourage such conduct, please note that all postings in the Comments area will list the author's name--no anonymous postings are permitted!

Disclaimer of Endorsement.
Reference to any products, services, hypertext link to the third parties or other information by trade name, trademark, supplier or otherwise does not constitute or imply its endorsement, sponsorship or recommendation by www.nwpf.org or its contributors/employees. They are for convenience only.

Link Disclaimer.
Links are provided only as an informational resource. Please note that many of the links provided are not on our servers and are not maintained by us or affiliated with any services provided by us. These links are provided simply as a service, and it should not be implied that we recommend, endorse or approve of any of the content at the linked site(s), nor are we responsible for their availability, accuracy or content.

Have a nice day.