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  • October 30, 2014

Diminishing Senses - Ladue News: Special Features

Diminishing Senses

Part of Aging

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Posted: Thursday, October 14, 2010 12:00 am

Let’s face it: As we get older, our eyes, ears and bodies don’t work as well as they used to. Luckily, it’s happening to all of us, so medical science has developed ways we can work with our changing senses.

Our Eyes

Ophthalmologist Dr. Sean Breit of Eye Care Associates of St. Louis, says cataracts become most frequent in the 60s and 70s, but not all people will have them bad enough to require surgery. Diet plays a role in cataract formation, as does smoking, diabetes and sun exposure without sunglasses. Lens replacements are successful in over 95 percent of cases and recovery is quick.

The two age-related eye changes that can result in vision loss are glaucoma and macular degeneration. Glaucoma, which causes increased pressure inside the eye, is a silent disease but easily detectable during eye exams. Breit recommends that after age 50, everyone have an eye exam with a glaucoma test yearly. “We test for pressure and look inside the dilated eye for any damage,” Breit says. “Usually managed by eye drops and other topical applications, glaucoma may require a laser treatment to open the drainage outlets that keep fluid from building up.”

Age-related macular degeneration (ARMD), a condition causing loss of central vision, has hereditary components and is also affected by sun exposure and smoking. “Particularly in people with a family history, I tell them to eat a balanced diet high in fruits and vegetables and take a daily multivitamin,” Breit explains. “Eye-specific vitamins, such as PreserVision or ICaps, can slow down the progression in people with ARMD, but have no effect on prevention.”

Another age-related condition, Breit says, is posterior vitreous separation, in which the vitreous gel of the eye starts to liquefy and pull away from the retina. Although quite common, particularly in very nearsighted people, it can sometimes cause tears in the retina, so people with this condition should see an eye doctor promptly. Symptoms include sudden appearance of long, stringy floaters across the vision or light flashes in dark rooms. Those will disappear over time, as long as there is no retina damage.

The most frequent change Breit sees in older adults is dry eye, which can cause a scratchy feeling, sudden blurriness or excessive tearing. That should be reported to the physician because certain medications may make it worse and might need to be adjusted. Treatment is simple in most cases: artificial tears or prescription eye drops help boost tear production. The main thing is to have regular vision exams to catch changes early.

Hearing

Amy Krueger is an audiologist with Hear USA. She says signs of hearing loss include: straining to hear normal conversation, difficulty understanding or misunderstanding words, thinking other people are mumbling, increasing the volume of the TV, and as it progresses, avoiding social situations and feeling frustrated communicating. “Age is the No. 1 factor in hearing loss, but there may be some hereditary issues, vascular problems, medications, viruses or prolonged exposure to noise,” she says. “Hearing loss from noise exposure starts with the higher frequencies, which include the consonant sounds in speech that typically begin or end words, leading to misunderstanding.”

Krueger says 31 million Americans have hearing loss, and that people wait an average of seven years before getting help. That’s not good because psychological and emotional effects escalate when it goes untreated. “There still seems to be a stigma associated with using hearing aids, even though the technology is vastly improved and aids are smaller than ever,” she says. “The longer people wait to get them, the harder it is to adjust. Long-term auditory deprivation reduces the brain’s ability to understand speech. It’s much better for quality of life to get them when you notice it interfering with your life.”

One other age-related hearing problem, tinnitus, is noise in the ears ranging from ringing to roaring, and often accompanies hearing loss and inner ear damage. It also can be caused by medications or high blood pressure, Krueger explains, so you should check it out. People who get hearing aids report that the tinnitus becomes less noticeable.

Other Sensory Decline

Dr. David Carr of Washington University School of Medicine says several areas of sensory loss can affect older people. “Balance is complicated, and subtle impairments in that area can lead to falls and decreased activity,” he says. “The problem is that it may have multiple causes. Diffuse atherosclerosis affecting the central nervous system can affect balance. Also, the more sedentary you become, the more muscle weakness is a factor. Medications can also impact it, as can neuropathy, or loss of sensation in the feet.” Vision is a cue for balance and can compensate for lack of feeling from diabetic neuropathy. He says impairments in depth perception can affect balance, as well as dizziness caused by problems with the vestibular system in the inner ear. “I’m convinced that a lot of balance impairment can be managed by regular walking, Tai chi or yoga—really any kind of regular activity, even ballroom or square dancing.”

Taste and smell also can change as we age. Tongue diseases and vitamin deficiencies can contribute to that loss. Carr recommends a multivitamin with good B-complex neurologic vitamins. To compensate for decreased taste and smell, he recommends using more spices to stimulate the taste buds, and making sure hot food is served steaming hot, so the nose is stimulated by heightened aroma. When sensory problems cause poor food intake, there are prescription drugs that can be used for short periods to jumpstart the appetite.

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