The Older Diver – Problem?
To my knowledge there is no specified age limit to sport diving.

Diving Concerns:

• Condition Related

Most elderly divers are not capable of sustaining the work load required by all but the least physically demanding dives. The majority of elderly divers do not exercise regularly or adequately.

• Treatment Related

Physical training can definitely minimize the decline in physical capacity in older divers.

• Diver Related

Chronological age and physiological age can differ markedly; and each individual ticks to his own genetic clock.

Risk Assessment

• Risk from the Condition

General health, agility and stregth decrease with age. Maximum heart rate, oxygen uptake and lung compliance decrease with age. [Parker, ‘The Sport Diving Medical’]
Good screening is necessary. Older divers have a higher incidence of chronic diseases; i.e., cardiovascular disease and chronic lung disease. Appropriate screening evaluations of the heart and coronary arteries with exercise testing is useful in older divers before instituting a diving program.
Osteoporosis (men and women) increases with age and increased incidence of fractures becomes a factor.

• Risks from treatment

The older diver is more prone to be taking multiple drugs and medicines, some of which have effects that are adverse to diving. These should be listed and evaluated prior to allowing diving. See web page at http://scuba-doc.com/drugsdiv.htm .

• Risks to the Diver

–Atherosclerosis affects the blood flow to the brain, heart, kidneys and limb muscles and therefore the function of these organs.
–Inability to self rescue due to decreased strength from muscle atrophy would be an important consideration.
–The older diver is more prone to hypothermia due to decreased tissue perfusion, decreased fat stores and decreased metabolism.
–Decompression sickness increases with age. [Edmonds] This may be due to decreased tissue perfusion and arthritic changes in the joints.

• Advising the Diver

Most very old divers arrange for a personal dive guide to assist them in suiting up, donning gear, managing their entrances and exits from the water and accompanying them during the dive. The problem comes in getting the elderly to recognize when the time comes to ask for help! It’s hard to get an old diver out of the water!

• Potential for injury from future diving

Myocardial infarction, heart failure account for a high percentage of deaths while diving. [Caruso]
Increased risk of pulmonary edema [additive effects of pulmonary edema of diving with borderline heart failure from intrinsic heart disease.
Increased risk of fractures [hip]
Increased risk of decompression sickness
Inability to self rescue or manage unexpected water movements [current, surges, wave action].

• Modifiers

Regular Checkups.
Good physical conditioning
Absence of cardiovascular-pulmonary disease
Mentally alert
Diving Experience
Alteration of diving profiles with shallower, shorter diving, longer and deeper safety stops and longer surface intervals

• Dive or not dive

If an older diver is in good physical condition and is mentally alert enough to do adequate problem solving at depth, then I would personally have no qualms in certifying him to dive. The older diver is more likely to take fewer chances and to obey the rules. There are few 70 year-old ‘Buccaneers’!

• Genetic clocks

To my knowledge there is no specified age limit to sport diving. Chronological age and physiological age can differ markedly; and each individual ticks to his own genetic clock. This having been said, most elderly divers are not capable of sustaining the work load required by all but the least physically demanding dives. The majority of elderly divers do not exercise regularly or adequately. Physical training can definitely minimize the decline in physical capacity in older divers.

• Good screening necessary

Older divers have a higher incidence of chronic diseases; i.e., cardiovascular disease and chronic lung disease. Atherosclerosis affects the blood flow to the brain, heart, kidneys and limb muscles and therefore the function of these organs. Appropriate screening evaluations of the heart and coronary arteries with exercise testing is useful in older divers before instituting a diving program.

• “I’m gonna live (dive) forever!”

If a 90 year old is in good physical condition, able to perform self and buddy rescue and is mentally alert enough to do adequate problem solving at depth, then I would personally have no qualms in certifying him to dive.

• Ask for Help

Most very old divers arrange for a personal dive guide to assist them in suiting up, donning gear, managing their entrances and exits from the water and accompanying them during the dive. The problem comes in getting us old GCFD’s (“geezer-codger-fogy- duffers”) to recognize when the time comes to ask for help! It’s darned hard to get an old surgeon out of the O.R. – but doubly hard to get an old diver out of the water!

• Older-Safer!

The obverse may also be operative; the older diver is more likely to take fewer chances and to obey the rules. There are few 70 year-old ‘Buccaneers’!