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Inadequate Sleep Can Lead to Senior Health Problems

Q. My 80-year-old mother stays up half the night watching old movies or playing Solitaire. I can’t convince her that this isn’t good for her health. Sometimes I think she doesn’t have enough to do during the day, but I work full-time so I just can’t get over there regularly.

Here’s a sobering note: lack of sleep has been found to be a new risk factor for colon cancer. A study finds individuals who averaged less than six hours of sleep at night had an almost 50 percent increase in the risk of colorectal adenomas – a precursor to cancer tumors – compared with those sleeping at least seven hours per night. These untreated adenomas polyps can become malignant.This new research just adds to the list of risks associated with lack of sleep such as obesity, heart disease, diabetes and even death.

Of the 1,240 patients studied – who were receiving routine colonoscopies – 338 were diagnosed with colorectal adenomas at their tests. The patients with adenomas were found in general to have reported sleeping less than six hours compared with those patients without adenomas (control) patients. The association between amount of sleep and adenomas remained even when adjusted for family history, smoking and waist-to-hip ratio (a measurement of obesity).


Researchers reported the magnitude of the increase in risk due to less hours of sleep as comparable to the risk associated with having a first-degree relative (parent or sibling) with colon cancer, as well as with high, red meat intake.

Try to encourage your mother to visit her doctor. There could be health or medication-related reasons why she is having trouble sleeping. It sounds like the two of you also could benefit from a caregiving companion for Mom. A caregiver could provide companionship and activity options for your mother during the day that may help keep her so busy that she would be ready for bed at night. A professional caregiving service also provides a welcome respite for busy family caregivers like you.

Lifestyle More Important Than Genetics, Study Reveals

Q.    As an active 75-year-old widower, I am worried about the role of genetics in my future. Neither of my parents lived passed 77 and I would like to enjoy a longer life on this earth with my family and friends. I try to lead a much healthier lifestyle than that of my parents. What can you tell me about the latest research?

There has been some conflicting data on this topic throughout the years, but the latest research is good news for seniors like you. A study from the University of Gothenburg, Sweden, has concluded that lifestyle has the biggest impact when determining longevity.



The latest study, published in the Journal of Internal Medicine, runs counter to what many people just assume – that those with parents who lived to be very old are more likely to live to a grand old age themselves.


“But that's just not true,” says professor emeritus Lars Wilhelmsen. “Our study shows that hereditary factors don't play a major role and that lifestyle has the biggest impact."


The study group consisted of men born in 1913 that have participated in health and longevity studies in Gothenburg for many years. Those in the 1913 Men Study who did not smoke, consumed moderate amounts of coffee and had a good socio-economic status at the age of 50 (measured in terms of housing costs), as well as good physical working capacity at the age of 54 and low cholesterol at 50 had the greatest chance of celebrating their 90th birthday. "The study clearly shows that we can influence several of the factors that decide how old we get," Wilhelmsen said.


This is good news that you can share with your friends. It’s important to see your doctor regularly to ensure that your blood pressure and cholesterol remain at healthy levels. Companionship or help around the house also could have a positive impact on you as well. Contact Home Instead Senior Care® to learn how a CAREGiverSM could assist you.

For more about the study, visit http://www.rush.edu/webapps/MEDREL/servlet/NewsRelease?id=1471.

Research Says Socially Active Seniors Avoid Disability

Q. I can’t convince my 82-year-old dad that he will feel better and stay healthier if he remains socially active. Since Mom died he doesn’t seem to want to do anything.

Tell your dad about the latest news, which reveals that those who are socially active are at least one and one-half times as likely to avoid disability. According to research, published in the Journal of Gerontology: Medical Sciences and conducted at Rush University Medical Center, higher levels of social activity are associated with a decreased risk of becoming disabled.


"Social activity has long been recognized as an essential component of healthy aging, but now we have strong evidence that it is also related to better everyday functioning and less disability in old age," said lead researcher Bryan James, Ph.D., from the Rush Alzheimer's Disease Center.


"The findings are exciting because social activity is potentially a risk factor that can be modified to help older adults avoid the burdens of disability," he noted.


The study included 954 older adults with a mean age of 82 who are participating in the Rush Memory and Aging Project, an ongoing longitudinal study of common chronic conditions of aging. At the start of the investigation, none of the participants had any form of disability. They each underwent yearly evaluations that included a medical history and neurological and neuropsychological tests.


Results showed that a person who reported a high level of social activity was about twice as likely to remain free of a disability involving activities of daily living than a person with a low level of social activity, and about 1.5 times as likely to remain free of disability involving instrumental activities of daily living or mobility.


Your father could be suffering from depression since the passing of your mom. Why not encourage him to visit his doctor to make sure his health checks are up-to-date. Then suggest that he reconnect with his friends or make new ones at a senior center or faith-based organization.


Perhaps he could use a little help as well. A CAREGiver from Home Instead Senior Care® could help on two fronts: first, a CAREGiver could provide companionship and someone to accompany him to events or activities. A CAREGiver also could assist your father in reconnecting with old friends or help facilitate his social schedule.

Diabetes and Depression: Double the Trouble

Q. My 85-year-old mother has been depressed since my father died. She’s also diabetic. What problems should I be looking out for and how can I help her?


Here’s an interesting fact from a recent study: About 20 to 25 percent of patients with diabetes also have depression – nearly twice as many as those without diabetes.

What’s more, older women suffering with diabetes and depression have a significantly increased risk of death from heart disease, as well as an increased death risk from all causes, over a six-year period, according to a report in a recent issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

A study of 78,282 older women in the Nurses Health Study – aged 54 to 79 – was conducted in 2000 by An Pan, Ph.D., of the Harvard School of Public Health, Boston, and her colleagues.


The women were classified as having depression if they reported being diagnosed with the condition, were treated with antidepressant medications or scored high on an index measuring depressive symptoms. Reports of type 2 diabetes were confirmed using a supplementary questionnaire.


During six years of follow-up, 4,654 of the women died, including 979 who died from cardiovascular disease.


Compared with women who did not have either condition, the results were:


● Those with depression had a 44 percent increased risk of death,


● Those with diabetes had a 35 percent increased risk of death and


● Those with both conditions had approximately twice the risk of death.


When considering only deaths from cardiovascular disease:


● Women with diabetes had a 67 percent increased risk,


● Women with depression had a 37 percent increased risk and


● Women with both had a 2.7-fold increased risk.

Be sure your mother is under a doctor’s care. If she lives alone and you can’t be with her all the time, consider hiring a caregiver companion to assist her. A companion could remind her to take her medications, help her around the house and generally brighten her day.

Age-Related Macular Degeneration Drops by a Third

Q. My husband has been suffering from macular degeneration for the past five years. Is there any positive news on the horizon about this disease? What are ways that he can cope with this dreaded condition?

There is some good news just out. The percentage of people with age-related macular degeneration has dropped by a third in the past 15 years, possibly because of a decrease in smoking – a known cause of the disease.

The overall prevalence of AMD among adults age 40 and older was an estimated 6.5 percent, which represented a decrease from the 9.4 percent reported in a 1988 to 1994 survey. The estimated prevalence of late (more advanced) AMD was 0.8 percent.

Macular degeneration, or age-related macular degeneration (AMD), is a leading cause of vision loss in Americans 60 and older. It is a disease that destroys sharp, central vision, which is needed to see objects clearly and to complete such important tasks as reading and driving.

“Despite new medical and surgical interventions, age-related macular degeneration (AMD) remains an important cause of vision loss in the United States,” the authors write as background information in the article.

“The decreasing prevalence of AMD may reflect recent change in the frequency of smoking and other exposures such as diet, physical activity and blood pressure associated with AMD,” according to the study.

While this news may not be of direct benefit to your husband, it does bode well for future seniors who can alter their lifestyle in an effort to help prevent this disease.

Heart Association Lowers Sodium Intake Guidelines

Q. My 82-year-old mother’s doctor is constantly harping on her to lower her salt intake. I’m never sure of how much is too much sodium and salt.


The American Heart Association (AHA) has recently weighed in on this important matter, issuing a call to action for the public, health professionals, the food industry and the government to intensify efforts to reduce the amount of sodium (salt) Americans consume daily to 1,500 milligrams.

This was already the level recommended by most health groups for senior citizens – those most in danger of high blood pressure.
The AHA noted that elevated blood pressure (hypertension) is a major public health problem – approximately 90 percent of all Americans will develop hypertension over their lifetime.

In the advisory, published in Circulation: Journal of the American Heart Association, the association sets out the science behind the American Heart Association’s recommendation for the general population, which is to consume no more than 1,500 milligrams (mg) of sodium a day because of the harmful effects of sodium – elevated blood pressure and increased risk of stroke, heart attacks and kidney disease.

Sodium consumption is currently more than two times higher than the recommended upper limit of 1,500 mg daily, with 77 percent of that consumption coming from packaged, processed and restaurant foods.

“Even a modest decline in intake – say 400 mg per day – would produce benefits that are substantial and warrant implementation,” say the advisory authors.


According to the advisory:


• As sodium intake rises, so does blood pressure and the risk of negative health outcomes.


• Independent of its effects on blood pressure, excess sodium intake adversely affects the heart, kidneys and blood vessels.


• The potential public health benefits of sodium reduction are enormous and extend to all Americans.


• Scientific evidence on the adverse effects of excess sodium is strong and compelling.


It’s important to check the sodium level in packaging, particularly of processed foods, to ensure that you are staying within the recommended daily allowance. Consult with your doctor or a nutritionist if your mother has questions.

Positive Attitude Often Leads to Better Health

A recent question from a client:

Q.    I like to think that I am a senior with a sunny outlook on life. Does this matter when it comes to overall health? 

Existing research does indicate a direct correlation between attitude and feeling good. Positive emotions do, in fact, influence healthy outcomes for older people.


“We all age. It is how we age, however, that determines the quality of our lives,” said Anthony Ong of Cornell University, author of the review article in Current Directions in Psychological Science. The data he reviews suggest that positive emotions may be a powerful antidote to stress, pain and illness.

There are several pathways through which a positive attitude can protect against poor health later in life. For example, happier people might take a proactive approach to aging by regularly exercising and budgeting time for a good night’s sleep.

On the other hand, these people may avoid unhealthy behaviors, such as smoking and risky sex. The benefits of these healthy lifestyle choices may become more important in older adults, as their bodies become more susceptible to disease.

An optimistic outlook also has been shown to combat stress, a known risk factor for a lot of disease. Studies have found that people with stronger positive emotions have lower levels of chemicals associated with inflammation related to stress. Also, by adopting a positive attitude people may even be able to undo some of the physical damage caused by stress.

Research has uncovered an interesting paradox: Despite the notable loss of physical function throughout the body, a person’s emotional capacity seemed to stay consistent with age.

So staying upbeat definitely can make a difference in your life, as can making important contributions to society. Many older adults volunteer or even continue working. One profession that attracts seniors is caregiving. That’s because older adults can often relate the best to other seniors. The local Home Instead Senior Care® office hires senior CAREGivers to assist other older adults in their homes with such tasks as companionship, meal preparation, light housekeeping and shopping.

When The Sun Goes Down, Seniors' Fears Often Take Center Stage

During the day, dementia regularly sends the 86-year-old woman into states of confusion.  But at night, her situation worsens considerably.  In the dark, she is terrified and often doesn’t know where she is or whom she’s with.  And across the city, another woman about the same age also fears nights.  It’s then that she wonders who might know she’s alone and if they’ll break into her house and rob her.

Whether the causes are physical or psychological, or related to diseases such as Alzheimer’s disease or other dementias, nighttime can be a frightening time for seniors – especially those who are living alone.  Many problems that occur with seniors at night are rooted in the physical changes that take place as the result of aging.  And those issues are often connected to sleep disorders.

In a 2005 Gallup poll of 1,000 adults over the age of 50, only 32 percent reported getting a good night’s sleep all seven days of the week.  And yet respondents ranked good sleep as being more important even than interpersonal relationships.

According to Dr. Harrison Bloom of New York City’s International Longevity Center – USA, this Gallup study revealed a number of factors to explain sleep problems – including worry.  Bloom, a geriatrician, is interested in efforts to help seniors and healthcare providers identify solutions to sleep-related disorders in older adults.

Seniors’ sleep problems may be rooted in many sources.  “There are physiological changes occurring with age, such as a decreased amount of time spent in some stages of sleep,” says Bloom.  In addition, he lists several other barriers that can limit quality sleep for seniors:

• Congestive heart failure, which prevents people from resting in a flat position;
• Arthritis pain, which can keep sufferers awake;
• Bladder or prostate problems that prompt people to get up for repeated bathroom breaks; and,
• Even medications for certain diseases can impact sleep.

Dr. Sonia Ancoli-Israel, professor of psychiatry at the University of California at San Diego and a sleep disorders expert, agrees it’s not necessarily the aging process that disturbs sleep, but rather those changes that accompany getting older.  She explains, “In addition to those medical illnesses and medications common in older adults, there can be psychiatric problems and changes in circadian rhythms.”

Circadian rhythms are those body rhythms that help determine when we sleep – and they change as we age.  Ancoli-Israel conducted a study five years ago that exposed nursing home patients with dementia to either morning or evening bright light in an effort to adjust their bodies’ circadian rhythms.  Both techniques improved their nighttime sleep.

Nonetheless, even though research is helping to identify solutions, statistics indicate that more seniors than ever are searching for medical remedies to sleep problems.  For example, between 2000 and 2004, use of prescription insomnia drugs climbed by 16 percent among people 65 years and older, according to an analysis by the prescription-management firm Medco Health Solutions of Franklin Lakes, NJ.

However, while many such aids are on the market, sleep medications might not be the best answer for all older adults, as some may make seniors confused and disoriented.  These are symptoms that, in particular, should not be exaggerated in those seniors who already are confused due to Alzheimer’s disease or other dementias.

In fact, those symptoms can wreak nighttime havoc in the lives of seniors and family caregivers, according to Dr. Sharon Brangman, professor of medicine at SUNY Upstate Medical University in Syracuse, N.Y.  Brangman explained that one of her patients is an 80-year-old woman with Alzheimer’s who suffers from anxiety during the day, and then takes a nap in front of the television in the evening.  Consequently, she has no desire to sleep at night.

Brangman said of this patient, “Her husband is her primary caregiver, and he’s exhausted at the end of the day.  But he’s afraid to sleep at night because she might wander.  When she goes to sleep, he often lets her sleep until noon.  We’ve tried to encourage him not to let her sleep during the day, and suggested activities for her and respite breaks for him.”

While the issues pertaining to older adults with dementia-related illnesses are different from those affecting seniors with sleep disorders and physical ailments, all of these factors can contribute to the psychological anxiety that seniors may experience when darkness falls.  Ancoli-Israel says, “Many seniors undoubtedly are anxious because they know it’s harder to reach help at night.  And there’s more time to think about the things that might be going wrong.”

The good news is that frightened older adults typically benefit tremendously from nighttime companionship.  In fact, the seniors served by our franchise often face challenges at night that can disturb their sleep as well as their peace of mind.  That’s why our Home Instead CAREGivers are regularly called upon to provide evening or overnight care for seniors – including those with Alzheimer’s and other dementias – and to assist them in dealing with the anxiety that can accompany the onset of darkness.  These CAREGivers help with various non-medical tasks and are available daily to provide care for just a few hours or around the clock. 

This seems like a pretty simple response to a very complicated problem, so you might ask, “Does it work?”  Well, the 86-year-old woman with dementia who awoke at night was very effectively reassured by a regular overnight CAREGiver.  And for the woman who was afraid of being robbed, along with providing her with overnight companionship, efforts were made to secure her home – including lighting the exterior of her house.  It’s those kinds of extras that can make the difference between seniors having peace of mind or being afraid in their own homes.

ten ways to help seniors avoid night fright

These tips from Home Instead Senior Care and senior care professionals can help older adults feel more secure at night:

• Encourage seniors to obtain a lifeline, which is a button they can push to summon medical help if they need it.
• At night play soft music which has a calming effect.
• Install night lights to make it easier for seniors to see when they get up at night.
• Light the outside of the house and set timers to activate some indoor lights. Older adults feel more secure knowing their house is illuminated.
• Let your older loved ones know they can call you. Put your number or that of another family member or friend on speed dial.
• Reassure them the house is secure and rehearse them on the process to make sure their doors and windows are locked.
• Make sure the interior of the house is safe by installing grab bars and getting rid of throw rugs.
• Consider climate control but make sure the house isn’t too hot or too cold.
• Encourage a set routine which helps a senior feel less anxious.
• Hire a caregiver who can provide assistance from a few hours a day to 24 hours, seven days a week.

Information gathered and provided by: Home Instead Senior Care, Inc.