Sensory pathology

Sensory deficits in geriatric patients, such as those affecting vision and hearing, are very common and their prevalence increases with increasing age of the patient. Its alterations have an important impact on the relationship between the patient and his environment.

Often this impact on the quality of life of the elderly person is not valued in its proper measure, either by the patient's relatives or by some health professionals. These deficits are, on many occasions, erroneously considered as physiological processes that occur in the normal environment of the aging process, so they are sometimes not given the importance they deserve. It must be considered that the decrease in visual function or hearing function are not intrinsic processes of aging, and they deserve to be prevented and treated in the same way as many other pathologies in the elderly.

The complications of sensory deficits are:

• Social isolation
• depression
• falls, with its procession of complications: fractures, dependency, isolation, etc.

For all these reasons, the detection, treatment and prevention of sensory deficits is essential for the maintenance of the quality of life of the elderly.

In addition to the physiological loss due to age, there are pathologies that contribute greatly to sensory dysfunctions; Problems such as diabetes mellitus, high blood pressure or diseases of the sense organs (glaucoma, macular degeneration, etc.) will decisively affect the functioning of these systems.

Therefore, it is deduced that the prevention of sensory deficits in the elderly is essential to maintain as much as possible a better quality of life for individuals of this age group.

The view

The guidelines for health recommendations in the elderly advise that at least once a year the elderly person undergo an eye examination to detect the most frequent causes and with specific treatment of blindness. The most common vision problems in older people are:

• Presbyopia: Commonly known as "eyestrain", it is a consequence of the aging of the eye and the loss of elasticity of the lens. It is almost inevitable, it begins to manifest itself between the ages of 40 and 45 and, although it can be corrected, there is no cure. But its effect can be mitigated by using the corresponding glasses with convergent lenses graduated according to the vision deficit.
• Cataracts: They are caused by the progressive loss of transparency of the lens and lead to an increasing decrease in visual acuity. In their initial state, they can be manifested by a sensation of dazzling, decreased sensitivity to contrasts and difficulties in perceiving relief and colors. The chances of getting cataracts increase with advanced age, diabetes, certain eye infections or trauma, and genetic tendencies. Fortunately, with a correct diagnosis, cataracts have good treatment, which is mainly surgical.
• Glaucoma: It is an increase in intraocular pressure, due to lack of drainage of the aqueous humor, which causes damage to the optic nerve with vision problems and, if not corrected in time, blindness. Increased intraocular pressure occurs when aqueous humor does not flow properly into and out of the eye. This obstruction produces an increase in this fluid inside the eye with increased intraocular pressure and on the optic nerve. It presents as vision of floaters or flashing flies, loss of side or peripheral vision, pain in the eyes, headache, blurred vision, vision of rainbow-like halos, nausea and vomiting, and even blindness. It is advisable to check the eye pressure every 1 or 2 years in those over 50 years because it can reach the point where it is irreversible. Medical treatment is very effective and for difficult cases it is possible to intervene surgically.
• Macular degeneration: It is a progressive and irreversible deterioration of the retina, especially the area of ​​the macula, the most important area for retinal function. Its cause is not known for certain; there is talk of genetic influences, but also of chronic deficiencies of vitamins A and of group B, as well as excessive exposure to UVA-UVB rays. There are no clear preventive measures, but early detection is possible through periodic reviews and as soon as alterations such as black spots in the visual field or deformities in the image are detected.
• Diabetic retinopathy: It is one of the main causes of blindness in the western world. It is about the affectation of the retinal function due to the alteration of the microcirculation in a diabetic patient. The best prevention of diabetic retinopathy is, first, prevention of the onset of diabetes, and second, maintaining good metabolic control after diabetes has already developed.

The ear

About a quarter of people aged 65 to 74 years and up to half of those over 75 years of age suffer from presbycusis, a hearing loss significant enough to interfere with their social activity due to the aging process itself characterized by otosclerosis. If it is not remedied quickly, deafness ends up becoming an obstacle that isolates socially, promotes depression and behavioral disorders and worsens dependency.

It is of essential importance that in the event of any hearing problem, the specialist doctor, the otolaryngologist, is consulted for a study and an assessment of the causes that motivate the hearing loss. Depending on the cause, this will be the treatment, but it should never be that of resignation and the mistaken belief that it is something "natural" with age. In addition, current technology offers us the best advances in hearing aids, hearing aids that go completely unnoticed and that adapt to the hearing level of each person.