Ask the Doctor: Dry Eye Syndrome Tips; Muscle Strength and Protein; Holiday Blues

By Bruce A. Ferrell, MD
Professor of Medicine and Geriatrics, UCLA
Editor-in-Chief, UCLA Medical Center Healthy Years

Q: My eyes have developed a kind of sticky, scratchy feeling that is really getting uncomfortable. Is this what dry eye feels like?

A: The symptoms you describe are common to dry eye syndrome, also known as keratoconjunctivitis sicca. Other symptoms are itchy, stinging, or burning sensations.

As our tear ducts grow less productive with age, dry eye is a common condition for those age 65 and older. Some medications, such as those for controlling blood pressure or treating depression, can also inhibit tear production. Diabetes and arthritis can cause dry eyes, as can long-term use of contact lenses. Keeping the eyes moist is essential to eye health and good vision. When you blink, your eyelid spreads fluid from your tear glands over the eye, then drains it away through the tear ducts. This balance of moisture keeps the outer layer of the eye free of debris and the cornea clear for optimum vision.

Tears also help protect the eyes from infection. Ultimately, untreated chronic dry eye can damage the eye’s surface and impair vision.

p>Most cases of dry eye are treatable with artificial tears, which are available in over-the-counter preparations or prescription drops that increase tear production. Talk with your ophthalmologist about treatment options.

Q: Now that I am older and losing some muscle strength, should I be eating more protein?

A: Yes! Increasing protein intake as we age is important for a number of reasons.

First, we must compensate for the fact that our bodies no longer process protein as well as they once did. Slowed metabolism prevents full absorption of nutrients, so more protein is required just to “break even” and keep the body’s systems running properly. Adequate muscle strength is essential for an independent lifestyle, so seniors must consume extra protein just to maintain their lean muscle and body mass. If you have an active lifestyle, you will need to take in even more.

Additional protein can also help fortify your system against the chronic inflammation that accompanies common age-related health problems. Research by the National Institute of Health recommends for those age 65 and older 1 to 1.2 grams of protein per kilogram (about 2.2 pounds) of body weight per day. This works out to 73 to 87 grams of protein daily for someone who weighs 160 pounds.

For those with chronic or acute disease, the recommendation increases to 1.2 to 1.5 grams per kilogram of body weight, or 87 to 109 grams. Also, plant sources of protein are healthier than animal sources (beans versus steak). Note: the exception to this advice would be for those suffering from kidney disease, which may require a reduction in protein intake.

Q: I always feel low during the holidays. Other than antidepressants, is there anything I can do to avoid these feelings?

A: The declining daylight hours, combined with emotional and financial stresses that often accompany the holidays, make depression a problem for many people. However, depression is NOT a normal part of aging, as research indicates 58 percent of seniors believe it to be.

There are steps you can take, other than medication, to feel better at this time of year. First, do not fall victim to the common holiday excesses of food and alcohol, as this will only exacerbate your symptoms. Keep to a healthy routine with your meals and self-care. As many people are sensitive to seasonal light changes, you may benefit from increasing your daily exposure to bright light.

Fatigue is a common symptom of depression, so engage in daily exercise to increase your energy levels. Daily walks are optimal, but if the weather or your mobility don’t allow it, develop a chair exercise routine that utilizes light hand weights, partial leg lifts, and gentle spinal twists. No matter what, talk with your doctor about your symptoms. Depression is highly treatable, and by seeking assistance you may find the means to enjoy the holiday season once again.

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