feeding children

Mama, give me the right food

Your Health
DR GITA MATHAI

“My child does not eat at all. Could you prescribe a tonic?” This is a concern expressed by most parents during their visit to the paediatrician for a routine checkup. Yet, rarely do these children appear malnourished. They do not have sunken cheeks nor are the ribs plainly visible. They seem healthy and their weight is appropriate. The complaints arise probably because the amount of food they eat falls short of the parents’ expectations.

The weight of a child in the first year is determined by the birth weight. For example, a child who is 3kg at birth should be 9kg on his or her first birthday (three times the birth weight). After the first year, the growth rate slows down. The weight after the age of two can be calculated using the formula: (age +3) x 5 = weight in pounds. Divide it by 2.2 to get the value in kilograms. The BMI is calculated as weight in kilograms divided by height in metre cubed. For children up to 10 years, this should be 23.

If a child is underweight, or the weight curve has plateaued or is dropping, investigations have to be done. The problem may be treatable and correctable. Children often get worm infestation. This may cause weight loss and a perverted desire to eat chalk, toothpaste, uncooked rice or lick paint. Usually a single dose of albendazole is all that is required. It can be prescribed by the paediatrician. But if the physical examination and tests are normal, the problem may lie with faulty feeding practices.

Correct food habits have to be started at birth and continued through life. Breast milk is best for a newborn baby even if it is pre-term. The World Health Organisation has recommended that it should be the only food (exclusive) the baby receives for the first 120 days. Breast milk has a high concentration of antibodies and immunoglobulins which protect against viral and bacterial diarrhoea, cold, cough, measles, chicken pox, mumps and a variety of other infections between six and nine months. Despite extensive research and claims of superiority, baby food manufacturers have not managed to duplicate breast milk.

Weaning foods can be introduced after 120 days. Breast milk tastes bland, so unless the initial weaning food tastes similar, the baby may reject it. Natural foods like rice, wheat or ragi are best. Precooked, ready-to-eat packaged cereals have no advantage. They may (despite claims to the contrary) contain preservatives or high concentrations of electrolytes which the baby’s immature organs cannot handle.

New foods should be introduced only every two weeks. Mashed banana, stewed apple and freshly prepared juices are easily digested. Homemade string hoppers or idlies can be served with milk and sugar. A mixture of rice, pulses, potato, carrot and other vegetables can be cooked with salt, mashed properly and given to the baby.

After the age of 10 months, undiluted cow milk may be given. The total quantity a day should not exceed 400ml. But if it is given first thing in the morning, it suppresses the appetite. Milk should be served after breakfast. It contains only 60 calories per 100ml. This means that consuming large volumes will fill the stomach but not provide as much energy as the same volume of calorie-dense food. Additives and “health drinks” do not really provide nutrition. They contribute very little to the health or weight of a child unless taken in large unrealistic portions.

A sedentary child who sits in front of the television will not have a good appetite. Physical activity is essential. This has to be provided and supervised by parents as most schools today concentrate on academics. At least one hour of activity — such as running, jumping and cycling — is essential for a good appetite and good health.

Milk biscuits, cream biscuits, packaged snacks and aerated, carbonated cool drinks provide empty calories. A child who is not particular about meals but prefers to eat snacks and watch television all day will be unhealthy, develop a paunch and have a poor appetite. This may also lead to obesity. An occasional snack is a reward, not a substitute for proper meals.

Many “health tonics”, often touted as natural, are available in the market. Non- allopathic (homeopathic or aryuvedic) products may have tongue-twisting names and contain many ingredients. Their side effects are not known, nor whether they have reactions with any allopathic medication that a child is taking. Tonics containing cyproheptadine do increase the appetite. This drug is actually a potent antihistamine with many dangerous side effects, one of which is an increased appetite.

It must also be kept in mind that the apple does not fall far from the tree. If both parents are thin, it is likely that the child will also be so. This may be genetic or the result of food and exercise habits inculcated over several generations.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in.

Feeding children

Mama, give me the right food

	Your Health   DR GITA MATHAI

"My child does not eat at all. Could you prescribe a tonic?" This is a concern expressed by most parents during their visit to the paediatrician for a routine checkup. Yet, rarely do these children appear malnourished. They do not have sunken cheeks nor are the ribs plainly visible. They seem healthy and their weight is appropriate. The complaints arise probably because the amount of food they eat falls short of the parents' expectations.

The weight of a child in the first year is determined by the birth weight. For example, a child who is 3kg at birth should be 9kg on his or her first birthday (three times the birth weight). After the first year, the growth rate slows down. The weight after the age of two can be calculated using the formula: (age +3) x 5 = weight in pounds. Divide it by 2.2 to get the value in kilograms. The BMI is calculated as weight in kilograms divided by height in metre cubed. For children up to 10 years, this should be 23.

If a child is underweight, or the weight curve has plateaued or is dropping, investigations have to be done. The problem may be treatable and correctable. Children often get worm infestation. This may cause weight loss and a perverted desire to eat chalk, toothpaste, uncooked rice or lick paint. Usually a single dose of albendazole is all that is required. It can be prescribed by the paediatrician. But if the physical examination and tests are normal, the problem may lie with faulty feeding practices.

Correct food habits have to be started at birth and continued through life. Breast milk is best for a newborn baby even if it is pre-term. The World Health Organisation has recommended that it should be the only food (exclusive) the baby receives for the first 120 days. Breast milk has a high concentration of antibodies and immunoglobulins which protect against viral and bacterial diarrhoea, cold, cough, measles, chicken pox, mumps and a variety of other infections between six and nine months. Despite extensive research and claims of superiority, baby food manufacturers have not managed to duplicate breast milk.

Weaning foods can be introduced after 120 days. Breast milk tastes bland, so unless the initial weaning food tastes similar, the baby may reject it. Natural foods like rice, wheat or ragi are best. Precooked, ready-to-eat packaged cereals have no advantage. They may (despite claims to the contrary) contain preservatives or high concentrations of electrolytes which the baby's immature organs cannot handle.

New foods should be introduced only every two weeks. Mashed banana, stewed apple and freshly prepared juices are easily digested. Homemade string hoppers or idlies can be served with milk and sugar. A mixture of rice, pulses, potato, carrot and other vegetables can be cooked with salt, mashed properly and given to the baby.

After the age of 10 months, undiluted cow milk may be given. The total quantity a day should not exceed 400ml. But if it is given first thing in the morning, it suppresses the appetite. Milk should be served after breakfast. It contains only 60 calories per 100ml. This means that consuming large volumes will fill the stomach but not provide as much energy as the same volume of calorie-dense food. Additives and "health drinks" do not really provide nutrition. They contribute very little to the health or weight of a child unless taken in large unrealistic portions.

A sedentary child who sits in front of the television will not have a good appetite. Physical activity is essential. This has to be provided and supervised by parents as most schools today concentrate on academics. At least one hour of activity — such as running, jumping and cycling — is essential for a good appetite and good health.

Milk biscuits, cream biscuits, packaged snacks and aerated, carbonated cool drinks provide empty calories. A child who is not particular about meals but prefers to eat snacks and watch television all day will be unhealthy, develop a paunch and have a poor appetite. This may also lead to obesity. An occasional snack is a reward, not a substitute for proper meals.

Many "health tonics", often touted as natural, are available in the market. Non- allopathic (homeopathic or aryuvedic) products may have tongue-twisting names and contain many ingredients. Their side effects are not known, nor whether they have reactions with any allopathic medication that a child is taking. Tonics containing cyproheptadine do increase the appetite. This drug is actually a potent antihistamine with many dangerous side effects, one of which is an increased appetite.

It must also be kept in mind that the apple does not fall far from the tree. If both parents are thin, it is likely that the child will also be so. This may be genetic or the result of food and exercise habits inculcated over several generations.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in.

preparation for pregnancy

Preparing for your baby

Your Health
DR GITA MATHAI

A painting by Dipti Chakrabarti
“My baby is small because I had typhoid / jaundice during pregnancy.” “This is my third pregnancy; I lost one child and the other was born very small.”

“I needed interventions to get pregnant. This baby cost more than a lakh.”

Common but preventable events. India has a high maternal mortality rate of 450 per 1,00,000 live births. The figure, of course, does not account for women who have a lifetime of ill health after childbirth. Our country has a high infant mortality rate as well. There are 21.76 births per 1,000 every year. Out of this 1 lakh newborns die in the first 24 hours of their life and an unknown percentage has lifelong “special needs”.

Today many women are educated, employed and self sufficient. They no longer consider home making and child bearing their primary function in life. Despite this, it is a function many eventually have to perform. Human beings, after all, live to procreate, produce children and ensure the survival of family genes. Reproduction is the prerogative of women. They must try to remain physically fit to undertake this venture. The ability to conceive, carry a healthy child to term and then deliver normally must not be taken for granted. Thought, effort and preparation has to go into this “natural” function.

All parents need to focus on the prevention of diseases that can affect the lives of their little ones. Some infectious diseases, such as German measles, can have a devastating effect on the child if acquired by the mother during pregnancy. It causes heart defects, deafness, cataract, a small head and mental retardation. Mumps, on the other hand, can cause an abortion. Chicken pox may lead to abnormal arms and legs, and eye and brain damage. All this means a lifetime of misery for the mother, who bears the brunt of caring for a child with special needs.

These common infectious diseases can be prevented by timely immunisation. The MMR (measles, mumps, rubella or German measles) vaccine should be given at the age of 15 months with a booster at 9-10 years. Chicken pox can be prevented by a single dose of Varicella vaccine administered soon after the first birthday. These vaccinations are not yet part of the National Immunisation Programme (NIP) and therefore not provided free of cost by the government.

Hepatitis B is a type of jaundice that is dangerous, can be fatal and is passed on to the baby by the mother. Hepatitis A causes jaundice that is usually mild and self limiting. During pregnancy, however, it can devastate a woman’s health as it aggravates nausea and vomiting. It affects the liver, which is more sensitive to damage during pregnancy.

Both types of jaundice are preventable with immunisation. Hepatitis B immunisation has recently been made part of the NIP. It is available free and given at birth and then along with triple antigen (DPT). Older children have not had the benefit of this programme and need to be immunised separately. Hepatitis A immunisation is not free. It is advised after the age of two years.

Typhoid is a very common infection, especially in the monsoon. Again, women who develop it can become very ill. Many medicines used to treat this infection are contraindicated during pregnancy. Striking a balance between the health of the mother and that of the unborn child becomes a tricky balancing act. Again, preventive immunisation is available and consists of a single injection every three years.

The Human Papillovirus (HPV) causes wart-like growths in the genital area, which requires delivery by caesarian section. The infection can later progress to cervical cancer. It is preventable with three doses of vaccine between the ages of 9-11 years.

Women tend to be anaemic with haemoglobin values less than the recommended 12gm/dl. Anaemic women produce low birth weight babies who have insufficient iron at birth. This can be prevented with iron supplements. It is usually available as a combination tablet with folic acid — a vitamin that prevents defects in the baby’s brain and spinal cord. This can be started (after consulting your doctor) following menarche (onset of menstruation).

Regular exercise is essential for girls. It should be started at the primary school level, with jogging, cycling or swimming for 30-40 minutes a day. Stretching and yoga help the flexibility of the joints that need to "give" during labour. Hormonal imbalances, polycystic ovarian disease and many fertility problems correct themselves if ideal body weight is maintained. This endurance training is helpful during the long exhausting hours of labour.

When your precious daughter is about to get married, make sure her immunisations are complete. And perhaps present her a treadmill or any other exercise machine in lieu of some jewels.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in

Preparation for pregnancy

Preparing for your baby

Your Health   DR GITA MATHAI

A painting by Dipti Chakrabarti "My baby is small because I had typhoid / jaundice during pregnancy." "This is my third pregnancy; I lost one child and the other was born very small." "I needed interventions to get pregnant. This baby cost more than a lakh." Common but preventable events. India has a high maternal mortality rate of 450 per 1,00,000 live births. The figure, of course, does not account for women who have a lifetime of ill health after childbirth. Our country has a high infant mortality rate as well. There are 21.76 births per 1,000 every year. Out of this 1 lakh newborns die in the first 24 hours of their life and an unknown percentage has lifelong "special needs". Today many women are educated, employed and self sufficient. They no longer consider home making and child bearing their primary function in life. Despite this, it is a function many eventually have to perform. Human beings, after all, live to procreate, produce children and ensure the survival of family genes. Reproduction is the prerogative of women. They must try to remain physically fit to undertake this venture. The ability to conceive, carry a healthy child to term and then deliver normally must not be taken for granted. Thought, effort and preparation has to go into this "natural" function. All parents need to focus on the prevention of diseases that can affect the lives of their little ones. Some infectious diseases, such as German measles, can have a devastating effect on the child if acquired by the mother during pregnancy. It causes heart defects, deafness, cataract, a small head and mental retardation. Mumps, on the other hand, can cause an abortion. Chicken pox may lead to abnormal arms and legs, and eye and brain damage. All this means a lifetime of misery for the mother, who bears the brunt of caring for a child with special needs. These common infectious diseases can be prevented by timely immunisation. The MMR (measles, mumps, rubella or German measles) vaccine should be given at the age of 15 months with a booster at 9-10 years. Chicken pox can be prevented by a single dose of Varicella vaccine administered soon after the first birthday. These vaccinations are not yet part of the National Immunisation Programme (NIP) and therefore not provided free of cost by the government. Hepatitis B is a type of jaundice that is dangerous, can be fatal and is passed on to the baby by the mother. Hepatitis A causes jaundice that is usually mild and self limiting. During pregnancy, however, it can devastate a woman's health as it aggravates nausea and vomiting. It affects the liver, which is more sensitive to damage during pregnancy. Both types of jaundice are preventable with immunisation. Hepatitis B immunisation has recently been made part of the NIP. It is available free and given at birth and then along with triple antigen (DPT). Older children have not had the benefit of this programme and need to be immunised separately. Hepatitis A immunisation is not free. It is advised after the age of two years. Typhoid is a very common infection, especially in the monsoon. Again, women who develop it can become very ill. Many medicines used to treat this infection are contraindicated during pregnancy. Striking a balance between the health of the mother and that of the unborn child becomes a tricky balancing act. Again, preventive immunisation is available and consists of a single injection every three years. The Human Papillovirus (HPV) causes wart-like growths in the genital area, which requires delivery by caesarian section. The infection can later progress to cervical cancer. It is preventable with three doses of vaccine between the ages of 9-11 years. Women tend to be anaemic with haemoglobin values less than the recommended 12gm/dl. Anaemic women produce low birth weight babies who have insufficient iron at birth. This can be prevented with iron supplements. It is usually available as a combination tablet with folic acid — a vitamin that prevents defects in the baby's brain and spinal cord. This can be started (after consulting your doctor) following menarche (onset of menstruation). Regular exercise is essential for girls. It should be started at the primary school level, with jogging, cycling or swimming for 30-40 minutes a day. Stretching and yoga help the flexibility of the joints that need to "give" during labour. Hormonal imbalances, polycystic ovarian disease and many fertility problems correct themselves if ideal body weight is maintained. This endurance training is helpful during the long exhausting hours of labour. When your precious daughter is about to get married, make sure her immunisations are complete. And perhaps present her a treadmill or any other exercise machine in lieu of some jewels. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in

Preparation for pregnancy

Preparing for your baby

    

Your Health

DR GITA MATHAI

 

A painting by Dipti Chakrabarti

"My baby is small because I had typhoid / jaundice during pregnancy." "This is my third pregnancy; I lost one child and the other was born very small."

 

"I needed interventions to get pregnant. This baby cost more than a lakh."

 

Common but preventable events. India has a high maternal mortality rate of 450 per 1,00,000 live births. The figure, of course, does not account for women who have a lifetime of ill health after childbirth. Our country has a high infant mortality rate as well. There are 21.76 births per 1,000 every year. Out of this 1 lakh newborns die in the first 24 hours of their life and an unknown percentage has lifelong "special needs".

 

Today many women are educated, employed and self sufficient. They no longer consider home making and child bearing their primary function in life. Despite this, it is a function many eventually have to perform. Human beings, after all, live to procreate, produce children and ensure the survival of family genes. Reproduction is the prerogative of women. They must try to remain physically fit to undertake this venture. The ability to conceive, carry a healthy child to term and then deliver normally must not be taken for granted. Thought, effort and preparation has to go into this "natural" function.

 

All parents need to focus on the prevention of diseases that can affect the lives of their little ones. Some infectious diseases, such as German measles, can have a devastating effect on the child if acquired by the mother during pregnancy. It causes heart defects, deafness, cataract, a small head and mental retardation. Mumps, on the other hand, can cause an abortion. Chicken pox may lead to abnormal arms and legs, and eye and brain damage. All this means a lifetime of misery for the mother, who bears the brunt of caring for a child with special needs.

 

These common infectious diseases can be prevented by timely immunisation. The MMR (measles, mumps, rubella or German measles) vaccine should be given at the age of 15 months with a booster at 9-10 years. Chicken pox can be prevented by a single dose of Varicella vaccine administered soon after the first birthday. These vaccinations are not yet part of the National Immunisation Programme (NIP) and therefore not provided free of cost by the government.

 

Hepatitis B is a type of jaundice that is dangerous, can be fatal and is passed on to the baby by the mother. Hepatitis A causes jaundice that is usually mild and self limiting. During pregnancy, however, it can devastate a woman's health as it aggravates nausea and vomiting. It affects the liver, which is more sensitive to damage during pregnancy.

 

Both types of jaundice are preventable with immunisation. Hepatitis B immunisation has recently been made part of the NIP. It is available free and given at birth and then along with triple antigen (DPT). Older children have not had the benefit of this programme and need to be immunised separately. Hepatitis A immunisation is not free. It is advised after the age of two years.

 

Typhoid is a very common infection, especially in the monsoon. Again, women who develop it can become very ill. Many medicines used to treat this infection are contraindicated during pregnancy. Striking a balance between the health of the mother and that of the unborn child becomes a tricky balancing act. Again, preventive immunisation is available and consists of a single injection every three years.

 

The Human Papillovirus (HPV) causes wart-like growths in the genital area, which requires delivery by caesarian section. The infection can later progress to cervical cancer. It is preventable with three doses of vaccine between the ages of 9-11 years.

 

Women tend to be anaemic with haemoglobin values less than the recommended 12gm/dl. Anaemic women produce low birth weight babies who have insufficient iron at birth. This can be prevented with iron supplements. It is usually available as a combination tablet with folic acid — a vitamin that prevents defects in the baby's brain and spinal cord. This can be started (after consulting your doctor) following menarche (onset of menstruation).

 

Regular exercise is essential for girls. It should be started at the primary school level, with jogging, cycling or swimming for 30-40 minutes a day. Stretching and yoga help the flexibility of the joints that need to "give" during labour. Hormonal imbalances, polycystic ovarian disease and many fertility problems correct themselves if ideal body weight is maintained. This endurance training is helpful during the long exhausting hours of labour.

 

When your precious daughter is about to get married, make sure her immunisations are complete. And perhaps present her a treadmill or any other exercise machine in lieu of some jewels.

 

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in

Preparation for pregnancy

Preparing for your baby

    

Your Health

DR GITA MATHAI

 

A painting by Dipti Chakrabarti

"My baby is small because I had typhoid / jaundice during pregnancy." "This is my third pregnancy; I lost one child and the other was born very small."

 

"I needed interventions to get pregnant. This baby cost more than a lakh."

 

Common but preventable events. India has a high maternal mortality rate of 450 per 1,00,000 live births. The figure, of course, does not account for women who have a lifetime of ill health after childbirth. Our country has a high infant mortality rate as well. There are 21.76 births per 1,000 every year. Out of this 1 lakh newborns die in the first 24 hours of their life and an unknown percentage has lifelong "special needs".

 

Today many women are educated, employed and self sufficient. They no longer consider home making and child bearing their primary function in life. Despite this, it is a function many eventually have to perform. Human beings, after all, live to procreate, produce children and ensure the survival of family genes. Reproduction is the prerogative of women. They must try to remain physically fit to undertake this venture. The ability to conceive, carry a healthy child to term and then deliver normally must not be taken for granted. Thought, effort and preparation has to go into this "natural" function.

 

All parents need to focus on the prevention of diseases that can affect the lives of their little ones. Some infectious diseases, such as German measles, can have a devastating effect on the child if acquired by the mother during pregnancy. It causes heart defects, deafness, cataract, a small head and mental retardation. Mumps, on the other hand, can cause an abortion. Chicken pox may lead to abnormal arms and legs, and eye and brain damage. All this means a lifetime of misery for the mother, who bears the brunt of caring for a child with special needs.

 

These common infectious diseases can be prevented by timely immunisation. The MMR (measles, mumps, rubella or German measles) vaccine should be given at the age of 15 months with a booster at 9-10 years. Chicken pox can be prevented by a single dose of Varicella vaccine administered soon after the first birthday. These vaccinations are not yet part of the National Immunisation Programme (NIP) and therefore not provided free of cost by the government.

 

Hepatitis B is a type of jaundice that is dangerous, can be fatal and is passed on to the baby by the mother. Hepatitis A causes jaundice that is usually mild and self limiting. During pregnancy, however, it can devastate a woman's health as it aggravates nausea and vomiting. It affects the liver, which is more sensitive to damage during pregnancy.

 

Both types of jaundice are preventable with immunisation. Hepatitis B immunisation has recently been made part of the NIP. It is available free and given at birth and then along with triple antigen (DPT). Older children have not had the benefit of this programme and need to be immunised separately. Hepatitis A immunisation is not free. It is advised after the age of two years.

 

Typhoid is a very common infection, especially in the monsoon. Again, women who develop it can become very ill. Many medicines used to treat this infection are contraindicated during pregnancy. Striking a balance between the health of the mother and that of the unborn child becomes a tricky balancing act. Again, preventive immunisation is available and consists of a single injection every three years.

 

The Human Papillovirus (HPV) causes wart-like growths in the genital area, which requires delivery by caesarian section. The infection can later progress to cervical cancer. It is preventable with three doses of vaccine between the ages of 9-11 years.

 

Women tend to be anaemic with haemoglobin values less than the recommended 12gm/dl. Anaemic women produce low birth weight babies who have insufficient iron at birth. This can be prevented with iron supplements. It is usually available as a combination tablet with folic acid — a vitamin that prevents defects in the baby's brain and spinal cord. This can be started (after consulting your doctor) following menarche (onset of menstruation).

 

Regular exercise is essential for girls. It should be started at the primary school level, with jogging, cycling or swimming for 30-40 minutes a day. Stretching and yoga help the flexibility of the joints that need to "give" during labour. Hormonal imbalances, polycystic ovarian disease and many fertility problems correct themselves if ideal body weight is maintained. This endurance training is helpful during the long exhausting hours of labour.

 

When your precious daughter is about to get married, make sure her immunisations are complete. And perhaps present her a treadmill or any other exercise machine in lieu of some jewels.

 

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in

Preparation for pregnancy

Preparing for your baby

Your Health   DR GITA MATHAI

A painting by Dipti Chakrabarti "My baby is small because I had typhoid / jaundice during pregnancy." "This is my third pregnancy; I lost one child and the other was born very small." "I needed interventions to get pregnant. This baby cost more than a lakh." Common but preventable events. India has a high maternal mortality rate of 450 per 1,00,000 live births. The figure, of course, does not account for women who have a lifetime of ill health after childbirth. Our country has a high infant mortality rate as well. There are 21.76 births per 1,000 every year. Out of this 1 lakh newborns die in the first 24 hours of their life and an unknown percentage has lifelong "special needs". Today many women are educated, employed and self sufficient. They no longer consider home making and child bearing their primary function in life. Despite this, it is a function many eventually have to perform. Human beings, after all, live to procreate, produce children and ensure the survival of family genes. Reproduction is the prerogative of women. They must try to remain physically fit to undertake this venture. The ability to conceive, carry a healthy child to term and then deliver normally must not be taken for granted. Thought, effort and preparation has to go into this "natural" function. All parents need to focus on the prevention of diseases that can affect the lives of their little ones. Some infectious diseases, such as German measles, can have a devastating effect on the child if acquired by the mother during pregnancy. It causes heart defects, deafness, cataract, a small head and mental retardation. Mumps, on the other hand, can cause an abortion. Chicken pox may lead to abnormal arms and legs, and eye and brain damage. All this means a lifetime of misery for the mother, who bears the brunt of caring for a child with special needs. These common infectious diseases can be prevented by timely immunisation. The MMR (measles, mumps, rubella or German measles) vaccine should be given at the age of 15 months with a booster at 9-10 years. Chicken pox can be prevented by a single dose of Varicella vaccine administered soon after the first birthday. These vaccinations are not yet part of the National Immunisation Programme (NIP) and therefore not provided free of cost by the government. Hepatitis B is a type of jaundice that is dangerous, can be fatal and is passed on to the baby by the mother. Hepatitis A causes jaundice that is usually mild and self limiting. During pregnancy, however, it can devastate a woman's health as it aggravates nausea and vomiting. It affects the liver, which is more sensitive to damage during pregnancy. Both types of jaundice are preventable with immunisation. Hepatitis B immunisation has recently been made part of the NIP. It is available free and given at birth and then along with triple antigen (DPT). Older children have not had the benefit of this programme and need to be immunised separately. Hepatitis A immunisation is not free. It is advised after the age of two years. Typhoid is a very common infection, especially in the monsoon. Again, women who develop it can become very ill. Many medicines used to treat this infection are contraindicated during pregnancy. Striking a balance between the health of the mother and that of the unborn child becomes a tricky balancing act. Again, preventive immunisation is available and consists of a single injection every three years. The Human Papillovirus (HPV) causes wart-like growths in the genital area, which requires delivery by caesarian section. The infection can later progress to cervical cancer. It is preventable with three doses of vaccine between the ages of 9-11 years. Women tend to be anaemic with haemoglobin values less than the recommended 12gm/dl. Anaemic women produce low birth weight babies who have insufficient iron at birth. This can be prevented with iron supplements. It is usually available as a combination tablet with folic acid — a vitamin that prevents defects in the baby's brain and spinal cord. This can be started (after consulting your doctor) following menarche (onset of menstruation). Regular exercise is essential for girls. It should be started at the primary school level, with jogging, cycling or swimming for 30-40 minutes a day. Stretching and yoga help the flexibility of the joints that need to "give" during labour. Hormonal imbalances, polycystic ovarian disease and many fertility problems correct themselves if ideal body weight is maintained. This endurance training is helpful during the long exhausting hours of labour. When your precious daughter is about to get married, make sure her immunisations are complete. And perhaps present her a treadmill or any other exercise machine in lieu of some jewels. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in

dementia

The recent elections threw up a spate of experienced “senior citizen” politicians, astute, informed and ready with verbal repartee. They are part of the 4.5 per cent of our population over the age of 65 years. They present a stark contrast to many other senior citizens who cannot remember what was said to them a few minutes ago, though the past is still very vivid and easily recollected. Questions get repeated over and over and answers are irrelevant. Words seem lost, forgotten or are inappropriate. These individuals no longer seem to follow a logical train of thought. Their personalities change for the worse and they become short-tempered and difficult to deal with.

Such people may struggle with 21st century gadgets such as microwaves, mobile phones and remote controls, which seem to make their life more complicated. Keeping track of medication becomes a logistic nightmare. Falls with injury and fractures occur as balance and co-ordination become faulty.

People fitting this description are loosely classified as suffering from dementia, a Latin word that means “deprived of mind”. Dementia may be due to many causes. Alzheimer’s disease is the commonest type of dementia and is the diagnosis in 50 per cent of the cases.

Dementia occurs in the elderly as brain cells deteriorate with age. Chemical messengers in the brain, essential for its proper functioning, become depleted and chromosomes shorten. Many of these changes are inevitable and irreversible.

Young people may develop symptoms similar to dementia, but in their case it usually occurs as a sequel to a brain infection (encephalitis or meningitis), brain trauma owing to an accident or a sport like boxing, bleeding in the brain (subdural haematoma), poisoning with lead or other heavy metals, or lack of sufficient thyroid hormone (hypothyroidism). The dementia is often cured if the underlying condition is treated successfully.

Recently, some types of dementia have been found to have a genetic basis. Many members of an affected family carry certain gene mutations that are passed on through the generations. Scientists are now beginning to identify these defects.

The risk of developing dementia increases if the lifestyle involves excessive alcohol consumption, smoking, a sustained elevated abnormal lipid profile, uncontrolled hypertension or diabetes. Heart or lung diseases, which compromise blood supply to the brain, also accelerate dementia.

The diagnosis of dementia is based on medical history and an evaluation of orientation, general intellectual, academic and language skills, memory, reasoning and judgment. Scans (computed tomography or CT and magnetic resonance imaging or MRI) and electroencephalograms (EEGs) help to evaluate changes in the brain and clinch the diagnosis.

Dementia can be treated with medications like donepezil, rivastigmine, galantamine hydrobromide and memantine. Specific symptoms and behavioural problems can be treated with sedatives and antidepressants. It is important to take the medicines exactly as prescribed in the correct dosage, which is often individualised. Many people take alternative medications such as vitamin E, omega 3 fatty acids, Coenzyme Q or extracts of ginkgo biloba (a Chinese herb). The dosage schedules are not established. There may be unwanted reactions with the regular medication.

For a long time Indian physicians thought that dementia was a “Western” disease. They felt it did not occur in India as we had longer hours of sunlight exposure. And also because our diet contained turmeric which has the protective anti aging antioxidant curcumin.

Actually earlier, life expectancy in India was only 45 years. This made cases appear few and far between. Now it has increased to 64. Still, only 4.8 per cent of our population is over the age of 65 years. This is in contrast to Western countries where 12 per cent of the population falls in this group.

Today, realisation has dawned that across the globe 0.3-0.4 per cent of the elderly suffers from dementia. We in India are not equipped to deal with it. Caretakers are expensive and family members are left with the difficult responsibility. Geriatrics is an emerging speciality and still not very popular. Old age homes are a recent phenomenon. Insurance is often not available to cover the medical care of the elderly.

Dementia occurs in a genetically predisposed individual living in a conducive environment. Age and genes cannot be changed but blood sugars, lipid levels and hypertension can be controlled. Stimulating the brain by doing puzzles, painting or learning a new skill compensates for some of the changes associated with dementia. The more frequent the activity, the more beneficial the effects. Physical activity such as walking an hour a day also helps delay dementia.

Many young adults do not exercise regularly. Old age seems far away and they feel “this cannot happen to me”. Nothing could be further from the truth.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in

Dementia

Old and forgetful

Your Health   DR GITA MATHAI

The recent elections threw up a spate of experienced "senior citizen" politicians, astute, informed and ready with verbal repartee. They are part of the 4.5 per cent of our population over the age of 65 years. They present a stark contrast to many other senior citizens who cannot remember what was said to them a few minutes ago, though the past is still very vivid and easily recollected. Questions get repeated over and over and answers are irrelevant. Words seem lost, forgotten or are inappropriate. These individuals no longer seem to follow a logical train of thought. Their personalities change for the worse and they become short-tempered and difficult to deal with. Such people may struggle with 21st century gadgets such as microwaves, mobile phones and remote controls, which seem to make their life more complicated. Keeping track of medication becomes a logistic nightmare. Falls with injury and fractures occur as balance and co-ordination become faulty. People fitting this description are loosely classified as suffering from dementia, a Latin word that means "deprived of mind". Dementia may be due to many causes. Alzheimer's disease is the commonest type of dementia and is the diagnosis in 50 per cent of the cases. Dementia occurs in the elderly as brain cells deteriorate with age. Chemical messengers in the brain, essential for its proper functioning, become depleted and chromosomes shorten. Many of these changes are inevitable and irreversible. Young people may develop symptoms similar to dementia, but in their case it usually occurs as a sequel to a brain infection (encephalitis or meningitis), brain trauma owing to an accident or a sport like boxing, bleeding in the brain (subdural haematoma), poisoning with lead or other heavy metals, or lack of sufficient thyroid hormone (hypothyroidism). The dementia is often cured if the underlying condition is treated successfully. Recently, some types of dementia have been found to have a genetic basis. Many members of an affected family carry certain gene mutations that are passed on through the generations. Scientists are now beginning to identify these defects. The risk of developing dementia increases if the lifestyle involves excessive alcohol consumption, smoking, a sustained elevated abnormal lipid profile, uncontrolled hypertension or diabetes. Heart or lung diseases, which compromise blood supply to the brain, also accelerate dementia. The diagnosis of dementia is based on medical history and an evaluation of orientation, general intellectual, academic and language skills, memory, reasoning and judgment. Scans (computed tomography or CT and magnetic resonance imaging or MRI) and electroencephalograms (EEGs) help to evaluate changes in the brain and clinch the diagnosis. Dementia can be treated with medications like donepezil, rivastigmine, galantamine hydrobromide and memantine. Specific symptoms and behavioural problems can be treated with sedatives and antidepressants. It is important to take the medicines exactly as prescribed in the correct dosage, which is often individualised. Many people take alternative medications such as vitamin E, omega 3 fatty acids, Coenzyme Q or extracts of ginkgo biloba (a Chinese herb). The dosage schedules are not established. There may be unwanted reactions with the regular medication. For a long time Indian physicians thought that dementia was a "Western" disease. They felt it did not occur in India as we had longer hours of sunlight exposure. And also because our diet contained turmeric which has the protective anti aging antioxidant curcumin. Actually earlier, life expectancy in India was only 45 years. This made cases appear few and far between. Now it has increased to 64. Still, only 4.8 per cent of our population is over the age of 65 years. This is in contrast to Western countries where 12 per cent of the population falls in this group. Today, realisation has dawned that across the globe 0.3-0.4 per cent of the elderly suffers from dementia. We in India are not equipped to deal with it. Caretakers are expensive and family members are left with the difficult responsibility. Geriatrics is an emerging speciality and still not very popular. Old age homes are a recent phenomenon. Insurance is often not available to cover the medical care of the elderly. Dementia occurs in a genetically predisposed individual living in a conducive environment. Age and genes cannot be changed but blood sugars, lipid levels and hypertension can be controlled. Stimulating the brain by doing puzzles, painting or learning a new skill compensates for some of the changes associated with dementia. The more frequent the activity, the more beneficial the effects. Physical activity such as walking an hour a day also helps delay dementia. Many young adults do not exercise regularly. Old age seems far away and they feel "this cannot happen to me". Nothing could be further from the truth. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in

Dementia

Old and forgetful

Your Health   DR GITA MATHAI

The recent elections threw up a spate of experienced "senior citizen" politicians, astute, informed and ready with verbal repartee. They are part of the 4.5 per cent of our population over the age of 65 years. They present a stark contrast to many other senior citizens who cannot remember what was said to them a few minutes ago, though the past is still very vivid and easily recollected. Questions get repeated over and over and answers are irrelevant. Words seem lost, forgotten or are inappropriate. These individuals no longer seem to follow a logical train of thought. Their personalities change for the worse and they become short-tempered and difficult to deal with. Such people may struggle with 21st century gadgets such as microwaves, mobile phones and remote controls, which seem to make their life more complicated. Keeping track of medication becomes a logistic nightmare. Falls with injury and fractures occur as balance and co-ordination become faulty. People fitting this description are loosely classified as suffering from dementia, a Latin word that means "deprived of mind". Dementia may be due to many causes. Alzheimer's disease is the commonest type of dementia and is the diagnosis in 50 per cent of the cases. Dementia occurs in the elderly as brain cells deteriorate with age. Chemical messengers in the brain, essential for its proper functioning, become depleted and chromosomes shorten. Many of these changes are inevitable and irreversible. Young people may develop symptoms similar to dementia, but in their case it usually occurs as a sequel to a brain infection (encephalitis or meningitis), brain trauma owing to an accident or a sport like boxing, bleeding in the brain (subdural haematoma), poisoning with lead or other heavy metals, or lack of sufficient thyroid hormone (hypothyroidism). The dementia is often cured if the underlying condition is treated successfully. Recently, some types of dementia have been found to have a genetic basis. Many members of an affected family carry certain gene mutations that are passed on through the generations. Scientists are now beginning to identify these defects. The risk of developing dementia increases if the lifestyle involves excessive alcohol consumption, smoking, a sustained elevated abnormal lipid profile, uncontrolled hypertension or diabetes. Heart or lung diseases, which compromise blood supply to the brain, also accelerate dementia. The diagnosis of dementia is based on medical history and an evaluation of orientation, general intellectual, academic and language skills, memory, reasoning and judgment. Scans (computed tomography or CT and magnetic resonance imaging or MRI) and electroencephalograms (EEGs) help to evaluate changes in the brain and clinch the diagnosis. Dementia can be treated with medications like donepezil, rivastigmine, galantamine hydrobromide and memantine. Specific symptoms and behavioural problems can be treated with sedatives and antidepressants. It is important to take the medicines exactly as prescribed in the correct dosage, which is often individualised. Many people take alternative medications such as vitamin E, omega 3 fatty acids, Coenzyme Q or extracts of ginkgo biloba (a Chinese herb). The dosage schedules are not established. There may be unwanted reactions with the regular medication. For a long time Indian physicians thought that dementia was a "Western" disease. They felt it did not occur in India as we had longer hours of sunlight exposure. And also because our diet contained turmeric which has the protective anti aging antioxidant curcumin. Actually earlier, life expectancy in India was only 45 years. This made cases appear few and far between. Now it has increased to 64. Still, only 4.8 per cent of our population is over the age of 65 years. This is in contrast to Western countries where 12 per cent of the population falls in this group. Today, realisation has dawned that across the globe 0.3-0.4 per cent of the elderly suffers from dementia. We in India are not equipped to deal with it. Caretakers are expensive and family members are left with the difficult responsibility. Geriatrics is an emerging speciality and still not very popular. Old age homes are a recent phenomenon. Insurance is often not available to cover the medical care of the elderly. Dementia occurs in a genetically predisposed individual living in a conducive environment. Age and genes cannot be changed but blood sugars, lipid levels and hypertension can be controlled. Stimulating the brain by doing puzzles, painting or learning a new skill compensates for some of the changes associated with dementia. The more frequent the activity, the more beneficial the effects. Physical activity such as walking an hour a day also helps delay dementia. Many young adults do not exercise regularly. Old age seems far away and they feel "this cannot happen to me". Nothing could be further from the truth. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in

Dementia

Old and forgetful

Your Health   DR GITA MATHAI

The recent elections threw up a spate of experienced "senior citizen" politicians, astute, informed and ready with verbal repartee. They are part of the 4.5 per cent of our population over the age of 65 years. They present a stark contrast to many other senior citizens who cannot remember what was said to them a few minutes ago, though the past is still very vivid and easily recollected. Questions get repeated over and over and answers are irrelevant. Words seem lost, forgotten or are inappropriate. These individuals no longer seem to follow a logical train of thought. Their personalities change for the worse and they become short-tempered and difficult to deal with. Such people may struggle with 21st century gadgets such as microwaves, mobile phones and remote controls, which seem to make their life more complicated. Keeping track of medication becomes a logistic nightmare. Falls with injury and fractures occur as balance and co-ordination become faulty. People fitting this description are loosely classified as suffering from dementia, a Latin word that means "deprived of mind". Dementia may be due to many causes. Alzheimer's disease is the commonest type of dementia and is the diagnosis in 50 per cent of the cases. Dementia occurs in the elderly as brain cells deteriorate with age. Chemical messengers in the brain, essential for its proper functioning, become depleted and chromosomes shorten. Many of these changes are inevitable and irreversible. Young people may develop symptoms similar to dementia, but in their case it usually occurs as a sequel to a brain infection (encephalitis or meningitis), brain trauma owing to an accident or a sport like boxing, bleeding in the brain (subdural haematoma), poisoning with lead or other heavy metals, or lack of sufficient thyroid hormone (hypothyroidism). The dementia is often cured if the underlying condition is treated successfully. Recently, some types of dementia have been found to have a genetic basis. Many members of an affected family carry certain gene mutations that are passed on through the generations. Scientists are now beginning to identify these defects. The risk of developing dementia increases if the lifestyle involves excessive alcohol consumption, smoking, a sustained elevated abnormal lipid profile, uncontrolled hypertension or diabetes. Heart or lung diseases, which compromise blood supply to the brain, also accelerate dementia. The diagnosis of dementia is based on medical history and an evaluation of orientation, general intellectual, academic and language skills, memory, reasoning and judgment. Scans (computed tomography or CT and magnetic resonance imaging or MRI) and electroencephalograms (EEGs) help to evaluate changes in the brain and clinch the diagnosis. Dementia can be treated with medications like donepezil, rivastigmine, galantamine hydrobromide and memantine. Specific symptoms and behavioural problems can be treated with sedatives and antidepressants. It is important to take the medicines exactly as prescribed in the correct dosage, which is often individualised. Many people take alternative medications such as vitamin E, omega 3 fatty acids, Coenzyme Q or extracts of ginkgo biloba (a Chinese herb). The dosage schedules are not established. There may be unwanted reactions with the regular medication. For a long time Indian physicians thought that dementia was a "Western" disease. They felt it did not occur in India as we had longer hours of sunlight exposure. And also because our diet contained turmeric which has the protective anti aging antioxidant curcumin. Actually earlier, life expectancy in India was only 45 years. This made cases appear few and far between. Now it has increased to 64. Still, only 4.8 per cent of our population is over the age of 65 years. This is in contrast to Western countries where 12 per cent of the population falls in this group. Today, realisation has dawned that across the globe 0.3-0.4 per cent of the elderly suffers from dementia. We in India are not equipped to deal with it. Caretakers are expensive and family members are left with the difficult responsibility. Geriatrics is an emerging speciality and still not very popular. Old age homes are a recent phenomenon. Insurance is often not available to cover the medical care of the elderly. Dementia occurs in a genetically predisposed individual living in a conducive environment. Age and genes cannot be changed but blood sugars, lipid levels and hypertension can be controlled. Stimulating the brain by doing puzzles, painting or learning a new skill compensates for some of the changes associated with dementia. The more frequent the activity, the more beneficial the effects. Physical activity such as walking an hour a day also helps delay dementia. Many young adults do not exercise regularly. Old age seems far away and they feel "this cannot happen to me". Nothing could be further from the truth. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in

dementia

Old and forgetful

Your Health   DR GITA MATHAI

The recent elections threw up a spate of experienced "senior citizen" politicians, astute, informed and ready with verbal repartee. They are part of the 4.5 per cent of our population over the age of 65 years. They present a stark contrast to many other senior citizens who cannot remember what was said to them a few minutes ago, though the past is still very vivid and easily recollected. Questions get repeated over and over and answers are irrelevant. Words seem lost, forgotten or are inappropriate. These individuals no longer seem to follow a logical train of thought. Their personalities change for the worse and they become short-tempered and difficult to deal with. Such people may struggle with 21st century gadgets such as microwaves, mobile phones and remote controls, which seem to make their life more complicated. Keeping track of medication becomes a logistic nightmare. Falls with injury and fractures occur as balance and co-ordination become faulty. People fitting this description are loosely classified as suffering from dementia, a Latin word that means "deprived of mind". Dementia may be due to many causes. Alzheimer's disease is the commonest type of dementia and is the diagnosis in 50 per cent of the cases. Dementia occurs in the elderly as brain cells deteriorate with age. Chemical messengers in the brain, essential for its proper functioning, become depleted and chromosomes shorten. Many of these changes are inevitable and irreversible. Young people may develop symptoms similar to dementia, but in their case it usually occurs as a sequel to a brain infection (encephalitis or meningitis), brain trauma owing to an accident or a sport like boxing, bleeding in the brain (subdural haematoma), poisoning with lead or other heavy metals, or lack of sufficient thyroid hormone (hypothyroidism). The dementia is often cured if the underlying condition is treated successfully. Recently, some types of dementia have been found to have a genetic basis. Many members of an affected family carry certain gene mutations that are passed on through the generations. Scientists are now beginning to identify these defects. The risk of developing dementia increases if the lifestyle involves excessive alcohol consumption, smoking, a sustained elevated abnormal lipid profile, uncontrolled hypertension or diabetes. Heart or lung diseases, which compromise blood supply to the brain, also accelerate dementia. The diagnosis of dementia is based on medical history and an evaluation of orientation, general intellectual, academic and language skills, memory, reasoning and judgment. Scans (computed tomography or CT and magnetic resonance imaging or MRI) and electroencephalograms (EEGs) help to evaluate changes in the brain and clinch the diagnosis. Dementia can be treated with medications like donepezil, rivastigmine, galantamine hydrobromide and memantine. Specific symptoms and behavioural problems can be treated with sedatives and antidepressants. It is important to take the medicines exactly as prescribed in the correct dosage, which is often individualised. Many people take alternative medications such as vitamin E, omega 3 fatty acids, Coenzyme Q or extracts of ginkgo biloba (a Chinese herb). The dosage schedules are not established. There may be unwanted reactions with the regular medication. For a long time Indian physicians thought that dementia was a "Western" disease. They felt it did not occur in India as we had longer hours of sunlight exposure. And also because our diet contained turmeric which has the protective anti aging antioxidant curcumin. Actually earlier, life expectancy in India was only 45 years. This made cases appear few and far between. Now it has increased to 64. Still, only 4.8 per cent of our population is over the age of 65 years. This is in contrast to Western countries where 12 per cent of the population falls in this group. Today, realisation has dawned that across the globe 0.3-0.4 per cent of the elderly suffers from dementia. We in India are not equipped to deal with it. Caretakers are expensive and family members are left with the difficult responsibility. Geriatrics is an emerging speciality and still not very popular. Old age homes are a recent phenomenon. Insurance is often not available to cover the medical care of the elderly. Dementia occurs in a genetically predisposed individual living in a conducive environment. Age and genes cannot be changed but blood sugars, lipid levels and hypertension can be controlled. Stimulating the brain by doing puzzles, painting or learning a new skill compensates for some of the changes associated with dementia. The more frequent the activity, the more beneficial the effects. Physical activity such as walking an hour a day also helps delay dementia. Many young adults do not exercise regularly. Old age seems far away and they feel "this cannot happen to me". Nothing could be further from the truth. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in

Old age

Old and forgetful

Your Health   DR GITA MATHAI

The recent elections threw up a spate of experienced "senior citizen" politicians, astute, informed and ready with verbal repartee. They are part of the 4.5 per cent of our population over the age of 65 years. They present a stark contrast to many other senior citizens who cannot remember what was said to them a few minutes ago, though the past is still very vivid and easily recollected. Questions get repeated over and over and answers are irrelevant. Words seem lost, forgotten or are inappropriate. These individuals no longer seem to follow a logical train of thought. Their personalities change for the worse and they become short-tempered and difficult to deal with. Such people may struggle with 21st century gadgets such as microwaves, mobile phones and remote controls, which seem to make their life more complicated. Keeping track of medication becomes a logistic nightmare. Falls with injury and fractures occur as balance and co-ordination become faulty. People fitting this description are loosely classified as suffering from dementia, a Latin word that means "deprived of mind". Dementia may be due to many causes. Alzheimer's disease is the commonest type of dementia and is the diagnosis in 50 per cent of the cases. Dementia occurs in the elderly as brain cells deteriorate with age. Chemical messengers in the brain, essential for its proper functioning, become depleted and chromosomes shorten. Many of these changes are inevitable and irreversible. Young people may develop symptoms similar to dementia, but in their case it usually occurs as a sequel to a brain infection (encephalitis or meningitis), brain trauma owing to an accident or a sport like boxing, bleeding in the brain (subdural haematoma), poisoning with lead or other heavy metals, or lack of sufficient thyroid hormone (hypothyroidism). The dementia is often cured if the underlying condition is treated successfully. Recently, some types of dementia have been found to have a genetic basis. Many members of an affected family carry certain gene mutations that are passed on through the generations. Scientists are now beginning to identify these defects. The risk of developing dementia increases if the lifestyle involves excessive alcohol consumption, smoking, a sustained elevated abnormal lipid profile, uncontrolled hypertension or diabetes. Heart or lung diseases, which compromise blood supply to the brain, also accelerate dementia. The diagnosis of dementia is based on medical history and an evaluation of orientation, general intellectual, academic and language skills, memory, reasoning and judgment. Scans (computed tomography or CT and magnetic resonance imaging or MRI) and electroencephalograms (EEGs) help to evaluate changes in the brain and clinch the diagnosis. Dementia can be treated with medications like donepezil, rivastigmine, galantamine hydrobromide and memantine. Specific symptoms and behavioural problems can be treated with sedatives and antidepressants. It is important to take the medicines exactly as prescribed in the correct dosage, which is often individualised. Many people take alternative medications such as vitamin E, omega 3 fatty acids, Coenzyme Q or extracts of ginkgo biloba (a Chinese herb). The dosage schedules are not established. There may be unwanted reactions with the regular medication. For a long time Indian physicians thought that dementia was a "Western" disease. They felt it did not occur in India as we had longer hours of sunlight exposure. And also because our diet contained turmeric which has the protective anti aging antioxidant curcumin. Actually earlier, life expectancy in India was only 45 years. This made cases appear few and far between. Now it has increased to 64. Still, only 4.8 per cent of our population is over the age of 65 years. This is in contrast to Western countries where 12 per cent of the population falls in this group. Today, realisation has dawned that across the globe 0.3-0.4 per cent of the elderly suffers from dementia. We in India are not equipped to deal with it. Caretakers are expensive and family members are left with the difficult responsibility. Geriatrics is an emerging speciality and still not very popular. Old age homes are a recent phenomenon. Insurance is often not available to cover the medical care of the elderly. Dementia occurs in a genetically predisposed individual living in a conducive environment. Age and genes cannot be changed but blood sugars, lipid levels and hypertension can be controlled. Stimulating the brain by doing puzzles, painting or learning a new skill compensates for some of the changes associated with dementia. The more frequent the activity, the more beneficial the effects. Physical activity such as walking an hour a day also helps delay dementia. Many young adults do not exercise regularly. Old age seems far away and they feel "this cannot happen to me". Nothing could be further from the truth. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in

Old age

Old and forgetful

Your Health   DR GITA MATHAI

The recent elections threw up a spate of experienced "senior citizen" politicians, astute, informed and ready with verbal repartee. They are part of the 4.5 per cent of our population over the age of 65 years. They present a stark contrast to many other senior citizens who cannot remember what was said to them a few minutes ago, though the past is still very vivid and easily recollected. Questions get repeated over and over and answers are irrelevant. Words seem lost, forgotten or are inappropriate. These individuals no longer seem to follow a logical train of thought. Their personalities change for the worse and they become short-tempered and difficult to deal with. Such people may struggle with 21st century gadgets such as microwaves, mobile phones and remote controls, which seem to make their life more complicated. Keeping track of medication becomes a logistic nightmare. Falls with injury and fractures occur as balance and co-ordination become faulty. People fitting this description are loosely classified as suffering from dementia, a Latin word that means "deprived of mind". Dementia may be due to many causes. Alzheimer's disease is the commonest type of dementia and is the diagnosis in 50 per cent of the cases. Dementia occurs in the elderly as brain cells deteriorate with age. Chemical messengers in the brain, essential for its proper functioning, become depleted and chromosomes shorten. Many of these changes are inevitable and irreversible. Young people may develop symptoms similar to dementia, but in their case it usually occurs as a sequel to a brain infection (encephalitis or meningitis), brain trauma owing to an accident or a sport like boxing, bleeding in the brain (subdural haematoma), poisoning with lead or other heavy metals, or lack of sufficient thyroid hormone (hypothyroidism). The dementia is often cured if the underlying condition is treated successfully. Recently, some types of dementia have been found to have a genetic basis. Many members of an affected family carry certain gene mutations that are passed on through the generations. Scientists are now beginning to identify these defects. The risk of developing dementia increases if the lifestyle involves excessive alcohol consumption, smoking, a sustained elevated abnormal lipid profile, uncontrolled hypertension or diabetes. Heart or lung diseases, which compromise blood supply to the brain, also accelerate dementia. The diagnosis of dementia is based on medical history and an evaluation of orientation, general intellectual, academic and language skills, memory, reasoning and judgment. Scans (computed tomography or CT and magnetic resonance imaging or MRI) and electroencephalograms (EEGs) help to evaluate changes in the brain and clinch the diagnosis. Dementia can be treated with medications like donepezil, rivastigmine, galantamine hydrobromide and memantine. Specific symptoms and behavioural problems can be treated with sedatives and antidepressants. It is important to take the medicines exactly as prescribed in the correct dosage, which is often individualised. Many people take alternative medications such as vitamin E, omega 3 fatty acids, Coenzyme Q or extracts of ginkgo biloba (a Chinese herb). The dosage schedules are not established. There may be unwanted reactions with the regular medication. For a long time Indian physicians thought that dementia was a "Western" disease. They felt it did not occur in India as we had longer hours of sunlight exposure. And also because our diet contained turmeric which has the protective anti aging antioxidant curcumin. Actually earlier, life expectancy in India was only 45 years. This made cases appear few and far between. Now it has increased to 64. Still, only 4.8 per cent of our population is over the age of 65 years. This is in contrast to Western countries where 12 per cent of the population falls in this group. Today, realisation has dawned that across the globe 0.3-0.4 per cent of the elderly suffers from dementia. We in India are not equipped to deal with it. Caretakers are expensive and family members are left with the difficult responsibility. Geriatrics is an emerging speciality and still not very popular. Old age homes are a recent phenomenon. Insurance is often not available to cover the medical care of the elderly. Dementia occurs in a genetically predisposed individual living in a conducive environment. Age and genes cannot be changed but blood sugars, lipid levels and hypertension can be controlled. Stimulating the brain by doing puzzles, painting or learning a new skill compensates for some of the changes associated with dementia. The more frequent the activity, the more beneficial the effects. Physical activity such as walking an hour a day also helps delay dementia. Many young adults do not exercise regularly. Old age seems far away and they feel "this cannot happen to me". Nothing could be further from the truth. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in

dementia

Old and forgetful

Your Health   DR GITA MATHAI

The recent elections threw up a spate of experienced "senior citizen" politicians, astute, informed and ready with verbal repartee. They are part of the 4.5 per cent of our population over the age of 65 years. They present a stark contrast to many other senior citizens who cannot remember what was said to them a few minutes ago, though the past is still very vivid and easily recollected. Questions get repeated over and over and answers are irrelevant. Words seem lost, forgotten or are inappropriate. These individuals no longer seem to follow a logical train of thought. Their personalities change for the worse and they become short-tempered and difficult to deal with. Such people may struggle with 21st century gadgets such as microwaves, mobile phones and remote controls, which seem to make their life more complicated. Keeping track of medication becomes a logistic nightmare. Falls with injury and fractures occur as balance and co-ordination become faulty. People fitting this description are loosely classified as suffering from dementia, a Latin word that means "deprived of mind". Dementia may be due to many causes. Alzheimer's disease is the commonest type of dementia and is the diagnosis in 50 per cent of the cases. Dementia occurs in the elderly as brain cells deteriorate with age. Chemical messengers in the brain, essential for its proper functioning, become depleted and chromosomes shorten. Many of these changes are inevitable and irreversible. Young people may develop symptoms similar to dementia, but in their case it usually occurs as a sequel to a brain infection (encephalitis or meningitis), brain trauma owing to an accident or a sport like boxing, bleeding in the brain (subdural haematoma), poisoning with lead or other heavy metals, or lack of sufficient thyroid hormone (hypothyroidism). The dementia is often cured if the underlying condition is treated successfully. Recently, some types of dementia have been found to have a genetic basis. Many members of an affected family carry certain gene mutations that are passed on through the generations. Scientists are now beginning to identify these defects. The risk of developing dementia increases if the lifestyle involves excessive alcohol consumption, smoking, a sustained elevated abnormal lipid profile, uncontrolled hypertension or diabetes. Heart or lung diseases, which compromise blood supply to the brain, also accelerate dementia. The diagnosis of dementia is based on medical history and an evaluation of orientation, general intellectual, academic and language skills, memory, reasoning and judgment. Scans (computed tomography or CT and magnetic resonance imaging or MRI) and electroencephalograms (EEGs) help to evaluate changes in the brain and clinch the diagnosis. Dementia can be treated with medications like donepezil, rivastigmine, galantamine hydrobromide and memantine. Specific symptoms and behavioural problems can be treated with sedatives and antidepressants. It is important to take the medicines exactly as prescribed in the correct dosage, which is often individualised. Many people take alternative medications such as vitamin E, omega 3 fatty acids, Coenzyme Q or extracts of ginkgo biloba (a Chinese herb). The dosage schedules are not established. There may be unwanted reactions with the regular medication. For a long time Indian physicians thought that dementia was a "Western" disease. They felt it did not occur in India as we had longer hours of sunlight exposure. And also because our diet contained turmeric which has the protective anti aging antioxidant curcumin. Actually earlier, life expectancy in India was only 45 years. This made cases appear few and far between. Now it has increased to 64. Still, only 4.8 per cent of our population is over the age of 65 years. This is in contrast to Western countries where 12 per cent of the population falls in this group. Today, realisation has dawned that across the globe 0.3-0.4 per cent of the elderly suffers from dementia. We in India are not equipped to deal with it. Caretakers are expensive and family members are left with the difficult responsibility. Geriatrics is an emerging speciality and still not very popular. Old age homes are a recent phenomenon. Insurance is often not available to cover the medical care of the elderly. Dementia occurs in a genetically predisposed individual living in a conducive environment. Age and genes cannot be changed but blood sugars, lipid levels and hypertension can be controlled. Stimulating the brain by doing puzzles, painting or learning a new skill compensates for some of the changes associated with dementia. The more frequent the activity, the more beneficial the effects. Physical activity such as walking an hour a day also helps delay dementia. Many young adults do not exercise regularly. Old age seems far away and they feel "this cannot happen to me". Nothing could be further from the truth. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in