The Most Common 3 Lettered Disease

By Mark Ackerman, PA

I am sure you have all noticed that many medical conditions and diseases are abbreviated with 3 letters. Some of these are conditions are, for example, HTN which stands for Hypertension, CRF which stands for Chronic Renal failure and OSA which stands for Obstructive Sleep Apnea. Well, the other week I had a patient in his late 80’s who came in complaining that he had OLD, which of course stands for “old”. He told me he had a lot of problems that he thinks are simply related to old age. Of course, we had a good laugh about that comment but then, getting down to business, we had to look at his list of problems and see which ones were potentially age related and which were not related to age.
It is true that many of the older patients I see simply blame their problems on their age and not some other condition. But we need to be clear about this; there are a lot of conditions that people get in their old age that age is not a direct cause of. True age-related conditions, are conditions that everyone tends to get simply because of their age.
In other words, there are some medical conditions that we get due to our lifestyle, our genetics or our occupations. Many of these problems we get when we become old but not because we are old. These conditions tend to be expressed in our older years but can clearly be found even in younger ages. We can see, for example, hypertension and high cholesterol in teenagers who are just born with the genetics that lead to these conditions in their young age. I like to tell these people that the only mistake they have made in life is that they did a bad job of picking their parents.
Other things of course come about due to our lifestyles. If you smoke for several years, you dramatically increase the chances of getting the effects of that in the form of high blood pressure, vascular disease (with heart attacks and strokes) lung disease (like emphysema) and a whole host of different cancers. In addition, we tend to get these things at a younger age than we would have normally.
So, what are the medical conditions that we get in old age that everyone gets simply because they get old? Well, here is where it can get a little of confusing. These conditions tend to be the usual conditions (e.g. HTN, HLP, OSA etc.) but they are mediated by aging changes and not genetics or lifestyle. What they are mediated by is something called entropy.
Entropy is a concept of physics which basically says that as time goes on, things tend to fall out of order. As a way of a simple example, think about your house. Things tend to fall out of order. The dishes can get stacked up in the sink, the carpet tends to get dirty, the paint tends to fade in the sunlight and the grass just keeps on growing with the spring rains. Suffice it to say, as we get older, our tissues and metabolic processes get weaker, and that weakness leads to most of these problems.
For example, our heart tends to weaken so that we have decreased output of blood from the heart. Our blood vessels get stiffer and less compliant leading to elevated blood pressure. Our lungs get weaker, so we have decreased lung volumes and some shortness of breath. Our muscles and even our bones get weaker from lack of movement, so we develop arthritis. Our kidneys lose nephrons so don’t filter our blood as well as they could.
But the good news is that entropy can be managed. You can do the dishes, vacuum the rug, paint the house and mow the yard to make things better. The even better news is that entropy in regard to our physical health can also be managed. Believe it or not, while there is no fountain of youth, there is a way to be youthful in your old age. I am not just talking about your attitude here but by doing the things that make you younger.
The primary activity to manage entropy in health is of course exercise. The more engaged you become with activity and exercise, the better you get. Exercise can actually make your heart and lungs work better. Your mentation and mental health can improve along with your bowel and bladder habits. Exercise in the form of mobility can make your arthritis better.
The key of course is to get motivated and get started. I am reminded about the power of discipline in this situation. When we are young, the more discipline we have, the more options we get later in life. This is not just true in our youth but in our older ages; the more you focus on getting younger through increased activity, the more options you get to live a healthier life.
The bottom line here is that you may come down with that dreaded medical condition OLD but that of course is better than dying young and, there is something you can do about it.