Health Concerns for Divers Over 50

Getting older doesn’t have to mean give up on diving, but divers over 50 should be aware of common medical issues that may interfere with safe diving. Heart disease, respiratory disease and musculoskeletal disorders can increase the odds for a serious diving injury. Learn more about the three main health concerns that come with ageing.

1. Heart Disease

Heart disease is a leading cause of death worldwide, and a common factor in diving fatalities. While the overall fatality rate in scuba diving is relatively low, Divers Alert Network® (DAN®) researchers have found the risk of death while diving increases with age, mostly due to cardiac health related issues. Specifically: the risk of cardiac-related death while diving is 10 times higher in divers over age 50 than in those younger than 50.

With ageing, arteries and especially coronary arteries that supply blood to heart, are increasingly affected by atherosclerosis (hardening of the arteries). This increases the diver’s risk of sudden cardiac death due to acute blockage of circulation to heart muscles (myocardial infarction) or failure of heart electric system (arrhythmia). Both conditions are commonly known as “heart attacks” and can be fatal if they occur while diving. (Learn more about The Effects of Ageing on Your Cardiovascular System.)

For divers with pre-existing coronary heart disease, exertion such as swimming against a current, in heavy waves or wearing too much weight may produce circumstances that can provoke heart attack. Immersion alone may provoke acute arrhythmias (disturbances of the heart’s rhythm) in divers with heart conditions, that can likewise result in sudden death.

Heart disease can progress silently, and many divers may not be aware they have an issue. That said, the probability of heart disease increases for divers who smoke, are obese, do not participate in regular physical activity. Other risk factors, like hypertension, diabetes, and high cholesterol can be detected by medical examination and testing.

The good news is: proper control mitigates risk and slows down the progression of atherosclerosis. A diver at risk should quit smoking, manage their weight, eat healthy and make other lifestyle adjustments. Those diagnosed with hypertension, diabetes and high cholesterol should seek proper treatment and adhere to their physician’s recommendations.

2. Cardiovascular Drugs

Divers should be familiar with the side effects of any drugs they take and be sure their physician knows about their diving activities. Learn more about diving and cardiovascular drugs, including antiplatelets and anticoagulants, statins, antihypertensives and antiarrhythmics, and consult your doctor.

The bad news: the diver must be pro-active and seek regular medical evaluations. Divers over 45 years of age should get a medical examination once a year — at a minimum. Those with a family history of heart disease or premature death should start annual examinations at earlier age.

3. Musculoskeletal Disorders

As divers age, they may experience some form of arthritis, or undergo a joint replacement. Generally speaking, neither of these issues will prevent someone from diving provided they follow their physician’s recommendations and keep in mind the following:

• Diving with symptoms or old injuries may result in a more severe injury.
• Decreased activity and immobilisation increases the likelihood musculoskeletal problems will heal.
• Diving is not recommended during a prescribed period of decreased activity or immobilisation.
• Injuries that impair blood flow pose a theoretical risk of causing decompression sickness (DCS).

Rheumatoid Arthritis

Divers with rheumatoid arthritis (RA) should avoid diving during periods of inflammation, especially those with pulmonary complications due to an increased risk for arterial gas embolism. The altered blood flow caused by RA can affect normal inert gas exchange, and potentially make the diver more susceptible to decompression illness (DCI). Additionally, joint pain due to lifting and carrying of dive equipment (for example), can be difficult to differentiate from DCI.

Divers who experience “flare-ups” should wait until their symptoms have resolved before scuba diving. But an active, healthy person with RA can scuba dive – if cleared by a physician.

Osteoarthritis

Osteoarthritis (OA) is a disease of the bone and cartilage. It often manifests as joint pain, and can result in a significant decrease in the range of motion. By age 60-70, many individuals have symptoms of osteoarthritis.

Divers with OA may find opening or closing their tank valve difficult, or they may struggle to grip a zipper. If cleared by a physician for diving, the diver might consider gear modifications such as bigger knobs or zipper tabs to overcome these difficulties. The diver should also ensure their buddy is aware of their condition and prepared to assist.

Scuba diving can be beneficial for persons with OA. Neutral buoyancy underwater reduces the weight on affected joints and can provide relief from pain. Swimming can strengthen the diver’s muscles and supporting structures for joints and the spine while simultaneously releasing endogenous painkillers (endorphins) which provide pain relief.

That said, OA can cause a diagnostic dilemma. It may be difficult for a doctor to discern the difference between arthritis pain and joint pain caused by decompression sickness. Divers should take care to dive conservatively.

Joint Replacement

After a hip or knee replacement, it’s critical for the body to completely heal before returning to physical activity. If a doctor has given their approval to resume exercise and weight-bearing activities, an individual may resume diving. If there is pain, swelling or stiffness, diving is not advised. Additionally, divers should no longer be reliant on medication for pain relief.

Scuba is a low-impact activity that offers may offer health benefits for individuals who want to stay active. Studies suggest diving improves circulation and reduces blood pressure, and there are social benefits as well. By maintaining a healthy lifestyle and communicating with your doctor and dive shop, divers can enjoy scuba diving for decades.