Last week, we talked about the global statistics of HIV/AIDS and learned that 15% of all newly diagnosed HIV/AIDS cases are in those 50 and older.  We also learned that the virus that causes HIV can cause dementia and the virus and/or drugs used to treat it can cause osteoporosis and osteonecrosis as well as peripheral neuropathy.  These conditions can all impact someone’s ability to age within their home.   This week however, we’ll be talking more about why the numbers for those 50 and older are being diagnosed with HIV.   I think there’s a belief/feeling out there that older people can’t get HIV/AIDS, but clearly, the numbers show differently.  So, why are people aged 50 and older accounting for 15% of newly diagnosed HIV/AIDS cases?

1.  Not practicing safe sex

•  With the use of medications for erectile dysfunction, more older men may be engaging in unsafe sexual activity

•  Older women don’t risk getting pregnant and so are not asking their partners to use condoms

•  Also, with age, women experience vaginal thinning and dryness, which can cause vaginal tears

2.  Injecting drugs or smoking crack

•  HIV through injection drug use accounts for more than 16% of AIDS cases in adults 50 and older

3.  Lack of knowledge about the disease:

•  A lot of older adults may falsely believe this is a disease of youth and not a disease that can impact them

•  Don’t use condoms

•  Don’t get tested

4.  Healthcare workers may underestimate the risk for their patient’s disease and not discuss HIV/AIDS with their older clients

5.  Symptoms may be misdiagnosed

•  Physicians may miss a diagnosis of AIDS including symptoms such as fatigue, weight loss, and mental confusion because they think it is part of the normal aging process,

So, what to do next?

If you think you may be at risk for HIV/AIDS, get tested.  While the stigma for HIV/AIDS may be greater for older adults, knowing your status is crucial.  The CDC recommends routine testing for people up to age 64.  They also suggest HIV testing for those 64 and older if they have risk factors for HIV/Infection.  Additionally, the CDC recommends prevention strategies such as education for older adults.

In keeping with National Diabetes month, The Aging Suite will be discussing diabetic neuropathy this week.  Diabetic Neuropathy can occur in all of the body’s organs, impacting the way in which individuals function safely in their homes. This impact can be due to issues such as sensation and vision loss as well as muscle weakness.  By educating our readers about diabetes’ effects on the body, we hope to continue in our efforts to help the elderly population successfully age in place.

It’s estimated that 60 to 70 percent of people with diabetes have diabetic neuropathy.  Diabetic neuropathy, nerve damage caused by diabetes, can occur in all of the body’s organ systems.  The cause of the nerve damage can be due to several factors such as:

• High blood glucose levels
• Abnormal blood fat levels
• Nerve inflammation
• Low insulin levels
• Smoking or alcohol use

Risk Factors for Diabetic Neuropathy include:

• Being overweight
• Being a diabetic for a long time period
• Diabetics who have a difficult time controlling their blood sugar
• Diabetics who have high levels of blood fat
• Diabetics with high blood pressure

There are 4 classifications of Diabetic Neuropathies; they are, peripheral, autonomic, proximal, and focal.

Peripheral Neuropathies
This is the most common type of diabetic neuropathy and is nerve damage in the arms, hands, legs, and feet.  Symptoms include:

• Numbness or tingling
• Pain and cramps
• Loss of balance
• Muscle weakness

Autonomic Neuropathies affect the eyes, heart, lungs, kidneys, sex organs, as well as the urinary, respiratory, and digestive systems.  Symptoms include:

• Hypotension
• Being unaware when your blood sugar levels drop
• Constipation
• Nausea and vomiting
• Diarrhea
• Urinary tract infections
• Urinary incontinence
• Erectile dysfunction

Proximal Neuropathies are more common among older diabetics and individuals with type II diabetes.  This type of neuropathy initially starts off as pain in the legs, thighs, buttocks, or hips.  Proximal neuropathies cause leg weakness, resulting in mobility issues.

Focal Neuropathies are unpredictable and can cause severe pain.  It often impacts nerves in the legs, head, and trunk.  This type of neuropathy occurs more often in older adults and can cause:

• Double vision
• Pain in the lower back and pelvis area
• Thigh pain
• Chest or abdominal pain
• Bell’s palsy

Diabetic Neuropathies can be prevented by managing your blood sugar levels and keeping them to a normal or as close to normal as possible range.   Diabetic foot care is also essential.  Sores and ulcers can lead to infection.  Diabetic neuropathies that cause pain may be treated with pain medications.  For those who experience urinary tract infections, they may be treated with antibiotics.  Your physician may prescribe occupational and physical therapy to address muscle weakness.  Check out this week’s technology in the Suite to learn more about diabetic foot care.

Source:   National Institutes of Health