Staying healthy in old age
Your Health
DR GITA MATHAI
India is a young country. Thirty per cent of its population is below the age of 30 and seven per cent over the age of 60. In this scenario, writing about old age may seem inappropriate as it apparently affects only a minority!
This, however, is a fallacy, as the burden of caring for the seven per cent — financially, physically and emotionally — falls on the rest of the population.
Parents grow old, children often live far away and the elders refuse to move in with the next generation as they wish to retain their independence. Responsibility can no longer be relegated to relatives or neighbours. Visits to your parents are a good time to check if they are being able to cope.
Physical appearance provides invaluable clues. Parents should appear clean and well groomed. Failure to bathe, brush teeth or wear clean clothes indicates an inability to keep up with daily routine. This may be due to physical weakness, dementia or just depression.
Adults usually have a fixed routine. If you carefully watch the way parents do things around the house, you might find inexplicable illogical changes in the routine. The house may be dirty and housework neglected. Also, they may be absent-minded, like leaving things on the stove and forgetting about them. These are danger signals indicating that care is required.
Make sure the lighting in the house is bright, especially in hallways and bathrooms. Narrow staircases and slippery front steps are also difficult to navigate. Banisters are essential. Supporting bars need to be embedded near the toilet and bathing areas. Otherwise the chances of accidental falls and fractures are greater.
Good nutrition is essential for immunity (to prevent diseases) and muscle mass (for strength to prevent falls). To monitor nutrition, keep an eye on the weight, the quality of skin, hair and nails. Older adults may suffer from malnutrition even when they can financially afford an adequate diet. They may be unable to shop for the materials required. Cooking may be troublesome, time consuming or they may be physically unable to do it. Medications, illness or a recent hospitalisation may dull taste and reduce the appetite. Diet restrictions (on salt, sugar, oil, fluid and spice) owing to diseases may make the food unappetising and inadvertently limit intake. Social isolation and depression can also lead to people eating less.
If necessary, meals (at least once a day) can be delivered from outside.
We all have memory lapses and these are greater and more frequent with increasing age. Glasses and keys may be constantly misplaced. Memory loss is abnormal if it extends to names of close relatives (children, grandchildren, nieces and nephews), the way to the neighbourhood shop or dosages of regular medications. At that point, medical evaluation is required.
Lifestyle and chronic diseases occur with ageing. It is important that all medical details and prescriptions be neatly filed chronologically. This should then be placed in an accessible place. Medical check ups and visits to the doctor should be scheduled regularly. Medical containers should be neatly labelled. If tablets are in strips, the person should be able to distinguish one medicine from another. Some look very alike (calcium tablets and metformin) and it is possible to make disastrous, life-threatening mistakes.
Hearing and eyesight should be checked regularly and timely corrective measures taken. Hearing loss and partial loss of eyesight leads to dependency and feelings of social isolation. Cataract surgery and hearing aids (if required) often are lifesavers.
Sleep disturbances are common in older adults. In some it may be because of Alzheimer’s, when the sleep-wake cycle is disturbed , leading to daytime drowsiness and night-time restlessness. In many it may be because of medications, snoring (obstructive sleep apnea) or restless legs or just depression.
Good sleep can be promoted with
Exposure to a few hours of bright sunlight in the morning
Not taking caffeine (tea or coffee) after 1pm.
Adjusting medication with the help of the doctor so that any tablets with a stimulatory effect are taken in the morning.
Avoid sleeping tablets as they are habit forming and cause confusion.
Daytime sleep should be avoided at all costs. No one can sleep for more than 6-7 hours a day. If this quota is used up during the day, night sleep will be affected.
Medically treat any diseases that might interfere with restful sleep.
At the age of 60, elders need a dose of pneumococcal vaccine to prevent the development of silent and often fatal pneumococcal pneumonia.
Physical activity for at least an hour a day should be encouraged. Walking will help with appetite, lifestyle diseases, balance co-ordination, depression, dementia and sleep disturbances. It will also entail some social activity as they will meet other walkers.
A little extra effort will pay off in the long run to make old age hassle free for everyone, both the elderly and the young adult.
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
Showing posts with label old age. Show all posts
Showing posts with label old age. Show all posts
Wednesday, January 25, 2012
Friday, November 6, 2009
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
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
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