Sensory changes in older age - Ajit Patel Wellness, Ajit Patel UK

Quoted by BBC News: "Our senses are vital in keeping us upright, balanced, active and able to interact with the world around us, detecting the things we need and avoiding hazards. As sight and hearing become less sharp, we are increasingly at risk of falls and other accidents. They also bring a lot of the pleasures of life, from the enjoyment of music, TV, books or a good conversation, to the satisfaction of a tasty meal. Without them, people can become isolated, and every basic activity of daily living becomes more difficult.

Whatever the cause of sensory loss, there’s quite a lot you can do to prevent their decline or help combat it once it happens.

Sight changes as you age

Most people find that as they reach their 40s they start to develop changes in their vision, even if their sight was previously good. Typically it becomes more difficult to read text and do close work, especially if lighting is poor. This is called presbyopia and occurs because of changes in the tissues of the eye, especially in the lens which becomes larger and less flexible, affecting its ability to focus. It becomes necessary to wear glasses just for reading and those who already wear glasses or contact lenses may need to wear bifocal or varifocal lenses. After a decade or two presbyopia stabilises and there’s no further deterioration in close vision.

Glare may also become a problem as changes within the lens causes light entering the eye to be scattered rather than focused precisely. People particularly notice this glare from car headlights or streetlights when driving at night.

Some people find their colour perception dims and it becomes harder to distinguish different shades. Another important change is that the eyes become dryer, as less tears are produced and the constituents change so they’re less efficient at forming a protective lubricating film across the eye.

At the same time a variety of eye diseases and other conditions start to become more common and may also cause problems with vision, including:

    Glaucoma.
    Cataracts.
    Age-related macular degeneration (AMD) which causes loss of central vision.
    Diabetes.
    High blood pressure.

To tackle age-related eye changes, make sure you:

•     Get your eyes tested at least every two years and make sure your glasses are in good condition.
•     Get your doctor to check for problems such as high blood pressure or diabetes and take medication as recommended to prevent damage to the eye.
•     Use reading glasses or bifocal/varifocals.
•     Make sure lighting is good (clip lights which attach to books can help).
•     Use eye drops or artificial tears to keep the eyes lubricated and comfortable.
•     Electronic readers can magnify text to much larger fonts and some even provide backlighting.

Hearing changes with age

Hearing also tends to deteriorate with age. Up to a third of people between 65 and 75, and half of the over 75s have problems with deafness, usually in both ears. In fact our hearing changes from early adulthood onwards – teenagers can hear very high pitched sounds which are already lost by the third decade.

The age-related decline in hearing is called presbyacusis and it’s usually due to degeneration of the hearing nerves and organs of the inner ear. There’s a gradual loss of the tiny hair-like cells in the inner ear which act as sensors to detect sound waves. This is compounded by damage to the blood vessels especially when someone has conditions such as atherosclerosis or high blood pressure. Occasionally sounds waves can’t be conducted so easily through the hearing system, perhaps because of damage to the tiny bones in the middle ear.

Hearing loss often first become noticeable when the sounds of speech (especially higher pitched consonants) can no longer be detected or are distorted. Voices sound mumbled and slurred (especially women and children, who use higher pitches). People also often find loud noise becomes irritating or uncomfortable, and it becomes increasingly difficult to hear what someone is saying if there’s more than one speaker, or in a noisy environment.

Some people are more genetically predisposed to presbyacusis, while exposure to loud noise earlier in life also does a lot of damage. Other factors include:

    Chronic infections of the middle ear.
    Drug treatments.
    Osteoporosis.

Like presbyopia, presbyacusis also plateaus and deterioration tends to stop around the age of 70.

To tackle age-related ear changes, make sure you:

•     Get your hearing checked if you’re having problems. Modern digital hearing aids are very effective and very discrete.
•     Find out about other hearing support services and devices such as telephone amplifiers.
•     Ask your doctor to check for conditions such as wax blocking the ears, which might be aggravating the problem.
•     Protect your ears, avoid loud noises and use headphones with care.

Keeping your balance as you age

A decline in our ability to balance means that one in three people over 65 fall each year, accounting for nearly 90 per cent of broken bones and many serious injuries and deaths.

The brain combines information from several senses to help us balance:

    Vision (try closing your eyes while standing on one leg to appreciate this).
    The balance organs of the inner ear (the vestibular system).
    Something called proprioception which is a position sense which sends information from the soft tissues such as muscles and joints and tells the brain about our location, movement and posture.

As we grow older, there’s loss of vibration sensations and joint position sense which is greatest in the lower limbs. To some extent vision compensates for this but in poor light, or when there are visual problems such as a cataract, this compensation may be limited.

Posture becomes increasingly unsteady as the muscles grow weaker and the body sways more. When balance is challenged, it’s harder to regain control and a stable balanced position.

To tackle age-related balance changes, make sure you:   

• Take physical activity to strengthen muscles and balance which can be very effective. For example, regular Tai Chi has been shown to half the number of falls among people in their 70s.
• Get advice from your gym, or a physiotherapist about the right sort of balance training exercises.
• Try to play some low impact sports such as yoga and pilates, which can help balance while more active sports such as swimming, bowling or walking can help to strengthen muscles.

Taste and smell changes as we age

Our sense of taste and smell are closely linked and both may fade with age. Diseases such as Parkinson’s disease, Alzheimer’s, polyps in the nose, or head injury can play a part, while many drugs and medicines can interfere with taste and smell.

We need smell to detect hazards such as smoke, but also for the pleasure of eating – many older people lose interest in food partly because they lose this pleasure.

To tackle age-related changes in taste and smell, make sure you:

•     See your doctor to rule out reversible causes.
•     Regularly brush and floss your teeth and get your dentist to check your oral health as a dry mouth or gum disease can interfere with taste.
•     If you smoke, try to quit as this can have a big impact, you’ll notice an improvement in the taste and smell of your food.
•     Change the sort of food you eat – try out different herbs and spices. People with taste loss often enjoy citrus and other sharp foods.

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