‘I get tired easily!”

I hear this a lot from my patients — most of them are in their 70s and 80s — to which I respond, “Explain what you mean by that phrase.”

Some say they used to be able to walk a block or two before becoming short of breath. Some feel tired upon waking up in the morning. And some just don’t have the energy to do the things they used to do.

Why we get tired

As we get older, a lot of changes happen to our bodies. It’s hard to associate the symptoms immediately to one system.

For example, the heart is responsible for sending oxygen to all parts of the body so organs can function properly.

As we age, the heart becomes bigger in size and pumps a little bit slower than before. The blood vessels become stiffer, making the heart work harder to push the blood out to other areas of the body.

All this extra effort by your heart can cause you to feel tired easily, even when you keep your activity level the same.

Another organ — the thyroid gland — can produce less of the hormone that aids metabolism, causing symptoms such as fatigue, delayed problem-solving and low energy.

Other reasons for feeling fatigued could be related to the medications that you take. More often than not, medications to control blood pressure can affect your circulation, making you feel tired due to a lowered blood pressure and heart rate.

Some pain medicine can cause significant sedation that can mimic symptoms of fatigue.

Antidepressants and anti-anxiety pills can have these side effects, too.

Other medical conditions can present as fatigue.

People with a diagnosis of dementia can have decreased physical activity, further making them feel more tired. This is similar to people who are wheelchair- or bed-bound — the less energy they expend, the less food they consume, resulting in less energy available for the body to use.

Depression is also one of the most common culprits to cause these symptoms.

A lot of older patients do not complain of being sad or depressed compared to their young counterparts.

However, they usually present with anhedonia — a lack of interest in activities they used to enjoy. They might also have complicated grief due to loss of loved ones and friends.

Anemia and malignancy can also present with feeling unusually tired.

What can I do?

In order to determine which is which, I would recommend seeing your primary care physician so you can be evaluated.

Your PCP will review the medications you take and do a thorough physical exam to understand why you’re feeling the way that you do.

Your PCP might order some tests to help determine what is causing your tiredness.

Other preventive measures you can take to feel less tired include:

>> Incorporating physical activity into your daily routine.

>> Eating a healthful diet.

>> Quitting smoking.

>> Getting enough sleep.

>> Managing stress.

Dr. Eugene Lao is a family medicine physician at Kauai Medical Clinic who specializes in outpatient medicine and geriatrics. He is certified by the American Academy of Family Physicians and is member of the American Geriatrics Society, the American Medical Association and the Philippine Medical Association.