Due to age-related consequences alone, older adults have the greatest risk of suffering from diseases and illnesses. The number one cause of death in the United States is coronary artery disease, which is a consequence of hypertension. This disease occurs when the arteries that provide blood to the heart muscle become stiff and narrowed. This results from the gradual accumulation of cholesterol and plaque along the artery’s inner walls. The plaque buildup is known as atherosclerosis. As the plaque within the artery grows, blood flow decreases to the heart and the heart is not able to get enough oxygen. This is why coronary artery disease is also called ischemic heart disease, due to the lack of oxygen to the heart. The result is chest pain, known as angina, and gradual death of the heart muscle’s cells, called myocardial infarcation.
There are several ways coronary artery disease is different in elderly people from younger adults. The disease has an atypical presentation with increasing age. This means that the real cause of symptoms is not easy to identify in older adults. With chest pain (angina), an older adult can experience shortness of breath (dyspnea), nausea, and pulmonary edema. Dypnea and confusion can result from myocardial infarcation. Lethargy and confusion can follow heart failure.
In regards to the prevalence of coronary heart disease, there is a greater prevalence in older than in younger men and women. Men and women ages 75 and older have the greatest prevalence rate, although studies have shown that women have a slightly lower prevalence compared to men starting at age 55.
There are a variety of risk factors that contribute to coronary artery disease. The non-modifiable risk factors are age, gender, and heredity—specifically, race and genetics. Modifiable risk factors are obesity, hypertension, diabetes mellitus, high lipids (particularly cholesterol), and physical inactivity. Additional modifiable risk factors include:
-Socio-economic status: Factors such as education, poverty, and housing are risk factors.
-Mood: People who have depressed mood are more likely to have coronary artery disease
-Social support: People with more social interactions are less likely to have the disease.
-Physical function
-Sexual function: The more sexually active a person is, the lower their risk of the disease.
It is important to note that one of the biggest risk factors for coronary artery disease is metabolic syndrome, which is a collection of multiple conditions: hypertension, hyperlipidemia (high triglyceride and low HDL cholesterol), type II diabetes mellitus, and abdominal obesity.
There are three types of preventions that are related to coronary artery disease. Primary prevention stops a disease from occurring. Secondary prevention inhibits a condition or symptoms from progressing into disease. Tertiary prevention is treatment of a disease. The primary prevention for coronary artery disease is vaccination. Secondary prevention is the treatment of hypertension, and tertiary prevention is medication for a patient with the disease.
Many older adults in nursing homes and assisted living facilities are either at risk or already have coronary artery disease. It is crucial that staff in these facilities provide the best type of care for these patients to either prevent or treat their diseases. If you or a love one has experienced suffering due to deficient care provided by nursing home or assisted living facility staff, contact us today for a free consultation. At the Yeroushalmi Law, we believe that all older adults under the care of a long-term care facility are entitled to quality treatment.