Little-Known Winter Dangers for Elders

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Falls and hypothermia are likely to top the list of caregiver concerns during the icy winter months, but seniors are also at risk for some lesser-known health hazards like seasonal affective disorder and vitamin D deficiency. The good news is that both of these conditions are easily treatable.

Winter SADness

Feeling a bit glum may seem like an ordinary reaction to the fading glow of the holidays and the darker winter months, but, when that feeling of sadness persists for more than a week or two, it’s a red flag.

Seasonal affective disorder (SAD) is a form of depression that cycles with the seasons. It can occur during any time of the year, but it typically affects people during the winter months.

As the weather gradually gets colder and the days get shorter, people affected by winter-induced SAD will generally begin to feel the symptoms of depression. Signs of SAD include a loss of energy, changes in appetite and sleeping habits, irritability, and loss of interest in socializing and other activities.

According to the National Institutes of Health, SAD is more prevalent in women and people who live further from the equator, where the sun is not as strong or constant.

The main difference between SAD and general depression is that SAD only strikes during certain times of the year. A decline in the amount of daylight during fall and winter affects circadian rhythms and causes hormonal changes that lead to depressive symptoms in people with SAD. These effects can be compounded if a person cannot or does not want to regularly spend time outdoors, which is particularly impactful to those who are housebound or live in areas prone to ice and snow.

Treatments for SAD

Like other forms of depression, SAD can be treated with antidepressant medications. These prescriptions take a few weeks to achieve their full effect. If a loved one is prone to SAD, it is best to begin this form of treatment prior to the onset of symptoms each year.

A non-pharmaceutical option for alleviating the symptoms of SAD is light therapy. Light therapy utilizes a piece of equipment called a “light box,” which is essentially a fluorescent lamp that emits a spectrum of light intended to simulate natural sunlight. A good quality light box will come with a filter that blocks harmful UV rays so that the light does not damage a person’s eyes or skin.

Research has shown that, when used properly, a light box can help decrease the amount of melatonin (a hormone that is typically produced at night and causes drowsiness and lethargy) circulating in a person’s body and regulate the neurotransmitters serotonin and epinephrine. Having an imbalance of these chemicals can heighten symptoms of depression.

If your loved one is diagnosed with SAD, their doctor may instruct them to sit in front of a light box for 30 to 45 minutes a day, usually in the morning, in order to make up for the lack of sunlight many people experience during winter. Although it is not always the go-to treatment for SAD, some studies have shown that light therapy has the potential to be as effective as antidepressant medication when it comes to treating the disorder.

Of course, a more natural alternative to light therapy is daily exposure to sunlight. If time, physical health, and weather conditions permit, it would be beneficial for a person with SAD to go outside for a few minutes each day to soak up some sun. Every little bit helps.

Vitamin D Deficiency

Research shows that vitamin D plays an increasingly important role in physical and mental health. This vital nutrient has been linked to bone and heart health, cancer and diabetes prevention, and increased immune function.

Vitamin D deficiency is bad for a person’s health at any age, but it can be particularly dangerous for older individuals. Symptoms of vitamin D deficiency are very subtle and can include muscle and bone pain, excessive fatigue, and depressed mood. Seniors who don’t get enough vitamin D are at an increased risk of developing osteoporosis—a dangerous decrease in bone density that can contribute to broken bones.

The National Institutes for Health has identified elderly people as an at-risk group for vitamin D deficiency. Not only do changes in diet often eliminate foods rich in vitamin D from a senior’s meal choices, but aging bodies have more difficulty converting and absorbing vitamin D from foods. Additionally, older bodies are less efficient at using sunlight to produce vitamin D, and seniors are more likely to have mobility limitations that prevent them from getting outside to get enough sun exposure. Furthermore, certain medications, such as the anti-inflammatory prednisone, can inhibit the ability to produce and metabolize vitamin D.

A Fortified Diet is the Best Defense

A simple blood test is used to diagnose vitamin D deficiency, but it can be tricky to treat this condition. Doctors are loath to prescribe extra time in the sun to a group of people prone to developing skin cancer, and it can be difficult to determine proper dosages for supplementation.

The safest way to treat or prevent deficiency is to ensure a senior eats food fortified with vitamin D. A person can obtain vitamin D naturally by eating beef liver, egg yolks, cheeses, and fatty fish like salmon. Certain varieties of milk, yogurt, cereals and juice are fortified to contain extra doses of the vitamin, but not so much as to pose a hazard to a person’s health.

If you believe an aging loved one may be experiencing something more serious than the winter blues, encourage them to meet with their doctor to determine if SAD or vitamin D deficiency may be to blame. The physician will work with you both to devise an appropriate course of treatment to help your loved one feel like themselves again.

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9 Comments

Keeping warm with light weight, comfy coverings, comfortable seating, and plenty of warm light helps us all through winter blues. Background music can add to the warm feelings. Eradicate drafts!
Hannalee, I immediately looked up where you live when I read your advice about wheeling your loved one out into the sun for breakfast. Yup. Arizona! Good for you. That is not much of an option for Minnesotans, for much of the year. :-) Definitely, though, if your climate allows it, that is a great route to take.

In this northern climate, many people need to take vitamin D supplements. It would be hard to guess at dosage, but it can be tested when other lab work is done or by itself. After you've been on a supplement a while, it can be tested again, and the dosage adjusted.
Hi Jeanne--I think you are right, vit. D can work great with monitoring. I forgot to mention fish oil, we both take it. We live in Flagstaff, where it gets pretty cold too! But probably not quite as cold as Minnesota. Another thing to try I was going to mention: a dawn simulator. Supposedly if you have any kind of bipolar disorder a light box could cause mania. But a dawn simulator seems to be safer. It just slowly turns lights on (they have to be incandescent), and for some people this helps reset hormones, avoiding the effects of "bad" hormones that are stimulated when the usual sleep and wake processes aren't working right.