- By Linda Melone
How many times have you ignored achy joints or feelings of fatigue, assuming it's all part of getting older? If you're like most people in midlife, probably too often. But sometimes symptoms we pass off as age-related may actually be signs of something more, something that could be addressed with treatment.
Here's how you can tell what's normal and what might need a doctor's evaluation:
1. Crankiness Grumpiness and aging do not have to go hand in hand, despite the stereotypes of the grouchy old guy chasing kids off his lawn.
"Everyone feels cranky once in a while," says psychiatrist Gayani DeSilva of St. Joseph Hospital in Orange, Calif. "However, when crankiness persists and interferes with personal relationships, goals and everyday life, it may be a sign of something more serious," such as depression, sleep deprivation or even a mood or psychotic disorder. If a sour mood continues without an identifiable cause, see a doctor.
2. Inability to stay awake in the evening If you avoid nighttime parties or have to cut off dinners with friends and family early because you just can't stay awake, the cause may be Advanced Phase Sleep Disorder. This is an unusual condition in which people become sleepy early in the evening, sometimes three or four hours before most people, and wake earlier in the morning, because their circadian rhythms are off.
"It's only a disorder if it interferes with your desires to participate and engage in activities," says neurologist Allen Towfigh, a board-certified sleep medicine doctor affiliated with New York-Presbyterian/Weill Cornell Medical Center. But this is not a typical sign of aging and it can be treated with bright light therapy (exposure to artificial light that mimics outdoor light) or by taking melatonin.
3. Weight loss for no reason Most of us can only wish for effortless weight loss. But when it occurs out of the blue with no conscious effort on your part, that's not age-related shrinkage but a sign of something potentially serious.
If you have unexplained weight loss in which you lose 10 percent of your body weight in six months, see your doctor. It could be a symptom of various conditions, including hyperthyroidism (overactive thyroid), diabetes, non-Hodgkin's lymphoma, depression, liver disease or disorders that interfere with nutrient absorption.
4. Slower walking Some gradual slowing down is a natural part of the normal aging process, says Dr. Paul Bendheim, clinical professor of neurology at the University of Arizona College of Medicine. But if you've recently slowed down precipitously and can't explain why, see a doctor.
"Pronounced walking slowness, usually seen in conjunction with other abnormalities of gait in an older person, can result from a number of factors," Bendheim says, including arthritic conditions, stroke, peripheral nerve disease, Parkinson's disease or even a pronounced, unacknowledged fear of falling. "Recent evidence shows that some gait changes, including slowing, may be a sign of memory impairment and Alzheimer's disease," he adds.
5. Painful joints We know that many people experience joint pain as they age. But if you're having pain that is persistent or excessive, don't just grin and bear it; find out the cause.
"It may be arthritis, or something more extensive," says rheumatologist Gilbert Gelfand of CareMore Medical Group in La Mirada, Calif. If you have osteoarthritis you'll feel achier as the day goes on, Gelfand says, but if you're stiff in the morning, it's more likely a sign of rheumatoid (inflammatory) arthritis. Unlike osteoarthritis, rheumatoid arthritis involves swelling and warmth in the joints, he says. A skin rash with dry mouth and eyes accompanying the joint aches may indicate lupus. See a doctor immediately if you suspect any of these conditions.
6. Shakiness Occasional tremors and shaky hands can occur at any age. While they are more likely the older you get, you should neither expect these symptoms nor ignore them.
"Tremors are most often noticed in the hands, but may affect the legs, head and even the voice," Bendheim says. These are often symptoms of a condition known as essential tremor. More common than Parkinson's disease but less disabling, essential tremor often runs in families and can be most clearly observed during reaching or writing. It's worsened by fatigue, caffeine and stress and your doctor may advise diet or lifestyle modifications to limit symptoms. Sometimes doctors prescribe a beta blocker as well.
But shakiness or tremors that occur suddenly, progressively worsen or are accompanied by other neurological symptoms may be a sign of a degenerative condition such as Parkinson's, stroke or multiple sclerosis and should be evaluated immediately.