Health in Older Adults: Symptoms That Deserve Attention
This article is written for people caring for an elderly parent or grandparent. When someone is 75 or 80, it's easy to dismiss a worrying symptom as "just age." But some changes are not normal. They need medical assessment, and the sooner the better. Here is a practical guide: what to notice, when to be concerned, and how to help a loved one get the care they need.
Symptoms that get put down to age (and shouldn't be)
Illnesses in older adults often present atypically — without the usual symptoms, or with symptoms that seem like a normal part of ageing. This is called atypical presentation.
- General weakness and reduced activity. "Tired" and "doesn't want to walk" can signal heart failure, anaemia, infection, depression, or early dementia. If an older person has suddenly become less active, that's a symptom, not just age.
- Loss of appetite and weight. A mild decline in appetite over time is normal. But if an older person has noticeably lost weight over a few months, this needs investigation.
- Urinary problems. Incontinence is often assumed to be inevitable, but in many cases it's treatable. Painful or frequent urination is a sign of infection.
- Chronic pain. Older people often don't mention pain, believing "that's just how it is." But pain that limits movement or disrupts sleep deserves medical evaluation.
- Hearing and vision loss. Progressive decline in hearing or vision that isn't being corrected increases the risk of isolation, depression, and falls. This is a medical problem.
Confusion: when it's serious
If an older person has suddenly become confused, disoriented, or "not themselves" — this is a medical situation. Especially if the change happened quickly — over hours or days.
Delirium is acute confusion. The person may be agitated or, conversely, unusually drowsy. Delirium in older adults can be caused by:
- infection (especially a urinary tract infection — in older people, UTIs often present as confusion);
- electrolyte imbalance or dehydration;
- medication side effects;
- a stroke or heart attack;
- pain that the person cannot express.
Delirium is not dementia, although it can look similar. Its cause is treatable, and with proper care it resolves. But it requires rapid medical assessment. Don't wait — call a doctor.
Falls: why they matter as a symptom, not just an accident
Falls are one of the leading causes of loss of independence and mortality in older adults. But "fell" is a symptom, not just an event. Every fall warrants medical evaluation to identify the underlying cause:
- balance problems from a neurological issue;
- a drop in blood pressure on standing (orthostatic hypotension);
- medication side effects (especially sleep aids, blood pressure drugs, diuretics);
- muscle weakness from vitamin D and calcium deficiency;
- vision impairment.
After a fall: assess the situation (is there pain in the hip, back, or leg — signs of a fracture). If a fracture is suspected, don't move the person yourself — call an ambulance. Even if "nothing is broken," see a doctor. The cause of the fall needs to be found.
Early signs of dementia
Dementia develops gradually. Early signs are easy to attribute to tiredness or stress. What to watch for:
- Repeated questions or stories — asking the same question several times within an hour, not remembering having asked.
- Difficulty with familiar tasks — paying bills, driving a familiar route, making a complex recipe become sources of struggle.
- Disorientation in time and place — not remembering the day of the week or year, getting confused in familiar locations.
- Mood and personality changes — irritability, suspicion, social withdrawal in someone who was previously open and engaged.
- Language problems — struggling to find a word, losing the thread of a conversation.
These signs are not a diagnosis — they're a reason to see a neurologist or geriatrician. Some causes of memory decline in older adults are reversible: B12 deficiency, hypothyroidism, depression, sleep disorders. Proper diagnosis is the first step.
How to help an older person prepare for a doctor's visit
Older people often find it difficult to describe symptoms — due to cognitive changes, reluctance to complain, or fear. Here's how to help:
- Keep a symptom diary. Record: when the symptom appeared, how often, what precedes it, what eases it. This is invaluable information for the doctor.
- Compile the medication list. Older adults often take 5–10 or more medications. Bring ALL pills or a complete list with dosages.
- Attend the appointment together — if the person is comfortable with that. You'll retain information that they may miss.
- Write down questions in advance. What is most concerning? What has changed over the past few months?
If you're unsure how urgent a symptom is, describe the situation to the assistant. It will help assess whether urgent care is needed.
Frequently asked questions
How do I know when to call an ambulance for an older person?
Call immediately for: sudden confusion or loss of consciousness; signs of stroke (FAST: facial asymmetry, arm weakness, speech problems); chest pain or breathing difficulty; a fall with suspected hip fracture (person cannot get up); a rapid deterioration in condition over a few hours; fever above 38.5°C with confusion.
Is it normal for an older person to sleep a lot?
Sleep needs change with age, but a sudden significant increase in sleep is not normal. It can indicate depression, heart failure, infection, medication side effects, or early dementia. If someone has started sleeping noticeably more, it's worth seeing a doctor.
How do you tell dementia from depression in an older person?
This is difficult even for doctors. Both conditions produce reduced activity, memory problems, and social withdrawal. Key differences: with depression, the person usually complains about their memory themselves; with dementia, they typically don't. Depression tends to develop more quickly; dementia progresses gradually. Diagnosis is made by a neurologist or psychiatrist.
What can I do if an older relative refuses to see a doctor?
Don't push or dismiss their concerns. Try naming a specific symptom that worries you rather than "you look unwell." Offer to go together. Sometimes it helps to start with a phone consultation or telemedicine — this feels less daunting than a hospital visit.
How many medications is "too many" for an older person?
Taking 5 or more medications at once is called polypharmacy and warrants attention. The risk of interactions and side effects rises significantly. Ask the treating doctor to review the full medication list once a year: some drugs are prescribed for a limited time but continue to be taken for years.
How do I talk to an elderly relative about health concerns?
Speak with respect — not like you're talking to a child. Choose a calm moment, not during an illness or stressful time. Use "I" statements: "I've noticed you've been having trouble hearing. I'm worried. Could we go and get it checked together?" Avoid demanding or threatening — it shuts the conversation down.
Symptomatica is an informational reference service. Not a medical service; does not diagnose or prescribe treatment. For any symptoms, please consult a doctor.