muscle loss and weakness, which heightens fatigue. “It becomes a vicious cycle that contributes to things like depression, which can make you more fatigued,” according to Dr. Jean Kutner, a professor of medicine and chief medical officer at the University of Colorado Hospital.
To stop that from happening, Johnson came up with a plan after learning her lung cancer had returned. Every morning, she set small goals for herself. One day, she’d get up and wash her face. The next, she’d take a shower. Another day, she’d go to the grocery store. After each activity, she’d rest.
In the three years since her cancer came back, Johnson’s fatigue has been constant. But “I’m functioning better,” she shares. She’s learned how to pace herself and find things that motivate her, like teaching a virtual class to students training to be teachers and getting exercise under the supervision of a personal trainer.
When should older adults be concerned about fatigue?
“If someone has been doing OK but is now feeling fatigued all the time, it’s important to get an evaluation,” says Dr. Holly Yang, a physician at Scripps Mercy Hospital in San Diego and incoming board president of the American Academy of Hospice and Palliative Medicine.
“Fatigue is an alarm signal that something is wrong with the body but it’s rarely one thing. Usually, several things need to be addressed,” according to Dr. Ardeshir Hashmi, section chief of the Center for Geriatric Medicine at the Cleveland Clinic.
Among the items physicians should check:
- Are your thyroid levels normal?
- Are you having trouble with sleep?
- If you have underlying medical conditions, are they well controlled?
- Do you have an underlying infection?
- Are you chronically dehydrated?
- Do you have anemia (a deficiency of red blood cells or hemoglobin), an electrolyte imbalance, or low levels of testosterone?
- Are you eating enough protein?
- Have you been feeling more anxious or depressed recently?
- And might medications you’re taking be contributing to fatigue?
“The medications and doses may be the same, but your body’s ability to metabolize those medications and clear them from your system may have changed,” Hashmi shares, noting that such changes in the body’s metabolic activity are common as people become older.
Many potential contributors to fatigue can be addressed. But much of the time, reasons for fatigue can’t be explained by an underlying medical condition.
That happened to Teresa Goodell, 64, a retired nurse who lives just outside Portland, Oregon. During a December visit to Arizona, she suddenly found herself exhausted and short of breath while on a hike, even though she was in good physical condition. At an urgent care facility, she was diagnosed with an asthma exacerbation and given steroids, but they didn’t help.
Soon, Goodell was spending hours each day in bed, overcome by profound tiredness and weakness. Even small activities