Throughout life the body is constantly dissolving older bone cells and replacing them with new, stronger cells. However, as age increases, the body becomes less efficient at this process and calcium from the old cells is not reused nor is new calcium properly used to replace what has been lost. There are many reasons why this can occur, but the most common are a decrease in the production of estrogen (in women) and a decrease in the amount of calcium available in the diet (affecting both men and women). In both conditions, increasing the geriatric patient’s calcium intake has been shown effective in the prevention of new fractures.

The most widely used form of calcium as a dietary is a compound known as calcium carbonate, which is usually provided as a pill or capsule. Although the amount of calcium per capsule or pill will vary by manufacturer, a total dosage of 500 mg per day is a recommended starting dosage.

The body is incapable of using calcium directly to make new bone cells. In order to produce new cells, vitamin D must also be present.

Vitamin D is also known as the “sunshine vitamin” because the body can can manufacture it from simpler substances when the skin It has been repeatedly noted that geriatric patients, because they spend relatively more time indoors, tend to have lower vitamin D levels than those who spend more time outdoors. Vitamin D is also felt to be important to the normal function of the body’s immune system as well.

For most geriatric patients, an adequate supply of vitamin D is provided by foods such as milk and dairy products to which vitamin D has been added. The packaging of such vitamin D-supplemented food is usually labeled as “vitamin D fortified” or some similar term.

The suggested daily allowance of vitamin D is 400 IU (International Units) per day, which is the same as 10 micrograms. Vitamin D supplements are also available at pharmacies and health food stores.

While no one set of instructions will be appropriate for all geriatric patients, daily nutritional supplements containing calcium and vitamin D can be important in both the prevention of osteoporosis and in maintaining a healthy immune system.

Early symptoms of dementia often consist in changes in personality, or in behavior. Often dementia can be first evident during an episode of delirium. There is a higher prevalence of eventually developing dementia in individuals who experience an acute episode of confusion while hospitalized.

Dementia can affect language, comprehension, motor skills, short-term memory, ability to identify commonly used items, reaction time, personality traits, and executive functioning. Even without signs of general intellectual decline, delusions are common in dementia (15-56% incidence rate in Alzheimer’s type, and 27-60% incidence rate in multi-infarct dementia). Often these delusions take the form of monothematic delusions, like mirrored self-misidentification.

Elderly people can also react with dementia-like symptoms to surgery, infections, sleep deprivation, irregular food intake, dehydration, loneliness, change in domicile or personal crises. This is called delirium, and many if not most dementia patients also have a delirium on top of the physiologial dementia, adding to the symptoms.

The delirium can go away or greatly improve when treated with tender care, improved food and sleeping habits, but this does not affect the alterations in the brain. Affected persons may also show signs of psychosis or depression. It is important to be able to differentiate between delirium and dementia.

Proper differential diagnosis between the types of dementia will require, at the least, referral to a specialist, e.g. a geriatric internist, geriatric psychiatrist or neurologist. However, there are some brief 5-15 minute tests that have good reliability and can be used in the office or other setting to evaluate cognitive status.

Except for the treatable types listed above, there is no cure to this illness, although scientists are progressing in making a type of medication that will slow down the process.

Exercise has even been demonstrated to be a significant factor in avoiding the onset Alzheimer’s Disease. Older adults who exercise at least three times a week are almost 40% less likely to be diagnosed with the disease than those who don’t exercise.

Another exciting finding is that there doesn’t seem to be any “cutoff” age for experiencing the benefits of regular exercise. Study participants from age 40 to 90 all showed measurable and even startling improvements in health, strength, and mental clarity as a result of exercise.

Even the most apparently age-related problems of all, menopause and andropause (or “male menopause”), respond favorably to a regular exercise program. Middle aged female study participants who exercised at least three times a week reported a marked reduction in the uncomfortable symptoms of menopause, and recent research by the New England Research Institutes in Massachusetts suggest that lack of exercise and the resulting weight gain can significantly increase the amount of testosterone men lose during middle age. By exercising regularly and maintaining fitness over 50, it’s possible that midlife men could improve mental clarity, increase energy, and enhance sexual function.

The best news of all is that realizing the dramatic benefits of over 50 fitness doesn’t require an intensive or rigorous regimen. Moderate exercise done regularly at least three times a week is enough to get the anti-aging process going.