Swelling of the Legs in the Elderly, Reasons and Causes

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Leg swelling is not an uncommon occurrence in life,

particularly in adults. In many instances it is temporary and passes without treatment. Leg
swelling may arise with walking or standing for long periods beyond what a person is
accustomed to, and also occurs more frequently in a person who is overweight or leads a
sedentary lifestyle. This may also apply to the elderly who are frail and immobilized. Although it
is is often not caused by any diseases in these situations and passes shortly thereafter, there are
times when leg swelling needs to be taken as a very serious sign. Leg swelling that is persistent
or recurrent for no apparent reason, or swelling of the legs in the elderly may be a sign of an
underlying disorder. Some of these conditions, particularly in the elderly, are very serious and
potentially fatal.

Meaning of Leg Swelling

There are several reasons for swelling of the legs but in most instances it is due to fluid
accumulation within the legs. Sometimes excess fluid pools within the tissue spaces (edema)
while at other times it may be accumulated within the blood vessels. Fluid normally flows in and
out of the tissue spaces and blood vessels in order for nutrients, oxygen, carbon dioxide or
wastes. The body has several efficient mechanisms to ensure that fluid does not accumulate in
any part of the body.

The legs are the most prone to swelling because the return of fluid to the heart is against gravity.
Therefore any problem in terms of excess fluid within the body, reduced heart function,
problems with the blood vessels and related dysfunction will lead to fluid accumulating in the
legs first before arising in other parts of the body. Leg swelling is therefore a sign of an
underlying problem in one or more of these systems.

Causes of Swollen Legs

Swollen legs may occur for a myriad of reasons. The more important causes in the elderly
includes :

Venous insufficiency where the leg veins are compromised and the blood from the legs
cannot return to the heart efficiently. It is due to conditions like varicose veins where the
 valves in the veins are inadequate and the veins bulge. Deep vein thrombosis (DVT) is
one of the serious conditions that can arise in the elderly if the clot in the leg dislodges,
it can block the artery in the lungs which can be fatal.
Heart failure where the heart cannot pump blood effectively which also compromises
the return of blood to the heart.
Kidney problems where the kidneys ability to regulate the water levels in the body are
affected thereby causing the retention of fluid in the body.
Fractures of the leg bone which is more commonly in the elderly with age-related
decrease in bone density and diseases that causes brittle bones like osteoporosis.
Sometimes if there is damage of the nerves in the leg like with long term diabetes
mellitus and there may be no severe pain despite a fracture.
Joint swelling particularly in the toe, ankle or knee joints due to conditions such as
rheumatoid arthritis, gout and osteoarthritis which are also more frequently seen in the
elderly.
Medication for conditions such as high blood pressure (hypertension) and diabetes
mellitus. These conditions are also more common in the elderly and require lifelong
medication. Swelling may arise as a side effect.

Although these are not the only conditions that cause leg swelling, it is among the more common
and important causes of a swollen leg in an elderly person. Further diagnostic investigation is
necessary to conclusively identify the cause. Leg swelling should be assessed by a medical
professional and treated accordingly. Measures such as elevating the legs and resting can reduce
swelling to some extent but medical treatment is necessary.

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