On 29 Mar, 2025, Seniors Today hosted their weekly Health Live Webinar with a senior internal medicine expert, Dr Rajiva Gupta who spoke on and answered questions about Fatigue in Seniors: Causes, Solutions and the path to Vitality
About Dr Rajiva Gupta:
Dr Rajiva Gupta is a Senior Consultant in Internal Medicine and Diabetes with an experience spanning over 40 years. He did his MBBS from Maulana Azad Medical College, New Delhi and MD from Dr. Ram Manohar Lohia Hospital, New Delhi (now called PGIMER – Post Graduate Institute of Medical Education & Research, University of Delhi). He has also done a Postgraduate Programme in Diabetology from the Johns Hopkins University School of Medicine, USA and a Specialist Certificate Course from the International School of Diabetes (IDF).
Dr Gupta currently has a consultation practice at his personal clinic Upchaar Wellness in Gurugram as well as affiliated with C K Birla Hospitals at Gurugram and Punjabi Bagh, Delhi.
He has been practising earlier at his clinic in Ashok Vihar Delhi and has been affiliated with major hospitals like Fortis Hospital, Shalimar Bagh, Max Super Speciality Hospital Shalimar Bagh, Delhi Heart and Lung Institute New Delhi etc.
Dr Gupta has conducted CME (continuing medical education) programmes in the fields of internal medicine with special focus on diabetes, clinical cardiology, and geriatrics and given lectures and conducted certified courses on various topics in diabetology, cardiology, critical care , geriatrics and Covid-19.
He has attended several national and international symposia, conferences and workshops under the auspices of leading organisations and institutions like Harvard University, American College of Cardiology, Cleveland Clinic, European Society of Hypertension , Indian Thyroid Society, American Diabetes Association, American Society of Hypertension etc.
Dr Rajiva Gupta has been an active researcher having participated in several national and global clinical trials in the fields of diabetes and cardiology. He is a member of several prestigious professional organisations like the Endocrine Society, American Diabetes Association, American Association of Clinical Endocrinologists, American College of Physicians, American College of Cardiology, Research Society for the Study of Diabetes in India , Geriatric Society of India etc. He has contributed articles in the fields of Vitamin D , Insulin therapy, Geriatrics in reputed journals.
Dr Rajiva Gupta has written a book “Stress & Diabetes: The Underappreciated Connection” published by the Pendown Press, New Delhi which was released at the New Delhi World Book Fair in 2023. He is also author of the recently released book, Stress and Fatigue | The Unnoticed Connection.
There are many patients who present to the clinic with the question, “Doctor, I’m tired all the time. Is this just a normal part of the process of ageing?”
The good news is, fatigue isn’t inevitable.
Health is not merely an absence of disease, it is a complete presence of individuals well being, in terms of physical health, mental, emotional and spiritual health.
As we age, the process of recovery slows down, sleep becomes lighter and endurance declines.
Many of us assume fatigue is an unavoidable part of ageing, this is a myth. More often, fatigue stems from factors like:
- Stress
- Poor sleep
- Nutritional deficiencies
- Chronic diseases such as diabetes, thyroid disorders, hypertension, heart disease, etc.
- Emotional strain such as anxiety can further deplete
Fatigue can affect our memory, mobility and overall wellbeing making it essential to distinguish between normal ageing and excessive tiredness.
We can regain our energy and vitality by:
- Identifying the root causes
- Staying active
- Balancing rest with movement
Age is just a number but wellbeing’s is a choice
All lifestyle adjustments can make a big difference, helping us be more energetic and improving our quality of life, at any stage of life.
Fatigue is a persistent state of exhaustion that affects the body, mind and emotions leading to reduced energy, motivation and concentration.
Types of fatigue:
- Physical fatigue associated with physical weakness, sluggishness and reduced stamina
- Mental fatigue associated with difficulty in concentration, forgetfulness and mental fog, cognitive impairment
- Emotional fatigue is when we start to feel sad and irritable, demotivated and emotionally drained
Fatigue is a widespread issue in seniors is common but is often overlooked because it is considered as a normal part of ageing.
Statistics show that almost 40-60% of elderly experience fatigue. Fatigue increases with age, estimated to be around 29% at the age of 70 years, increasing to 68%ile by the age of 85 years
Most common causes for fatigue globally include:
- Chronic diseases such as diabetes, thyroid disorders, hypertension, heart disease, etc.
- Poor sleep
- Inactivity
- Psychosocial issues
Common causes for fatigue in India include:
- Malnutrition
- Anemia
- Neglect of the elderly
- Poor access to quality healthcare
Developed nations benefit from better healthcare and early diagnosis while in India, fatigue is more prevalent due to undiagnosed conditions because of restricted access to healthcare, malnutrition and limited geriatric care.
Socioeconomic disparities and unaddressed mental health issues further contribute to the burden.
Common causes of fatigue in seniors is usually multifactorial, resulting from a combination of medical conditions, lifestyle factors and psychological issues.
- Medical issues, chronic illnesses and physiological changes that come with ageing
- Anemia with low red blood cell count reduces the oxygen supply to tissues leading to weakness
- Chronic diseases such as diabetes, heart diseases, kidney disease, lung diseases and cancer; cause fatigue and tiredness through different mechanisms
- Underactive thyroid slows down the metabolism leading to tiredness
- Hyperthyroidism accelerates the metabolism to an unduly high rate, therefore causing fatigue
- Nutritional deficiencies such as low levels of Vitamin B12, iron and Vit D
- Sleep disorders such as insomnia, inability to sleep, sleep apnoea
- Restless leg syndrome
- Chronic pain related conditions which are common in the senior population such as osteoarthritis of the knees/ hip, fibromyalgia, disc disease
- Chronic infections such as tuberculosis
- Medications
- Lifestyle factors
- Inactivity- lack of regular physical activity leads to muscular deconditioning making even simple tasks exhausting
- Poor diet- taking infrequent meals, skipping meals, consuming excessive sugar
- Dehydration
- Excessive caffeine, alcohol
- Psychological causes. Emotional well being plays a key role. Depression often goes undiagnosed in seniors, which can lead to persistent tiredness. Chronic stress and anxiety, loneliness and social isolation
- Dementia and cognitive fatigue
- Chronic fatigue syndrome- fatigue lasting for longer than 6 months. It os often accompanied by sleep disturbances, memory issues and body pain
By understanding the common causes, the seniors can take the appropriate, proactive steps, thereby enhancing their quality of life and ensuring long term well being.
Fatigue impacts our daily life in the following ways:
- Decreases our mobility
- Decreases physical strength and stamina
- Makes daily tasks difficult
- Increases the dependence of the elderly on family members and caregivers
- Increased risk of falls, serious injuries, eating to hospitalisation
- Weakened immunity
- Chronic exhaustion leading to increased risk of infections
- Memory decline, cognitive loss, affects motivation and decision making ability
One should seek medical attention when:
- One tends to experience persistent fatigue that does not improve with rest
- Unexplained weight changes (loss/ gain)
- Shortness of breath, chest discomfort
- Frequent dizziness, fainting spells
- Chronic pain which affects our daily life
- Sleep disturbances which affect our energy levels
- Memory issues
- Depression, anxiety
Management and prevention of fatigue:
- Medical management
- Identifying and correcting the underlying health issues
- Nutrition and hydration
- Physical activity
- Sleep improvement
- Maintaining mental and emotional well being
