Ageing and Health

Common health concerns for older adults

Many older people have a “don’t ask, don’t tell” relationship with their healthcare providers. This isn’t an advisable action as learning about your health and ways to improve your overall well-being can benefit your quality of life. Hence, it is crucial to ask a health expert any questions you might have despite how embarrassing you might think it is. Plus, knowing information about your health can clear your doubts and give you a peace of mind.

If you are still in denial to seek answers to some health-related questions, fret not as we have compiled a few common doubts and questions that can assist you in taking the next course of action to enhance your standard of living. With that in mind, Associate Professor Dr. Mogana Rajagopal , RPh MMPS PhD (Pharmacy), PGDTT, BPharm (Hons), Dean Faculty of Pharmaceutical Sciences UCSI University and Tan Lee Fang (Pharmacist) BPharm (Hons) shared some interesting tips on healthy ageing.

Dr. Mogana Rajagopal
Tan Lee Fang

1Twenty80: How do you stay healthy as you get older?
Mogana Rajagopal and Tan Lee Fang: A healthy lifestyle is needed to stay healthy as we get older. Healthy lifestyle includes adequate and balanced nutrition, physical activities, establishing social relations and getting a good night’s sleep.

Unhealthy lifestyle such as smoking, alcohol consumption and sedentary living should be avoided as these may contribute to the development of chronic illnesses1.

For healthy ageing, dietary patterns emphasizing plant-based foods should be adopted by consuming more fruits, vegetables, and whole grains, while having a moderate amount of dairy products, fish, and poultry. Apart from that, it is crucial to consume low amounts of sugars, saturated fat, and processed foods.

Dietary antioxidants such as flavonoids, carotenoids, vitamins and minerals help fight oxidative stress and provide protection against diseases like Alzheimer’s disease and cataract. Dietary supplements like multivitamin, protein and mineral may be helpful for those elderly who fail to meet their nutritional requirement through diet3.

1Twenty80: What type of exercises are good for older adults?

Mogana and Lee Fang: The recommended exercise suitable for older adults includes:

  • Aerobic and endurance activities (require at least 150 minutes of moderate intensity weekly).
  • Muscle-strengthening activities (Moderate to vigorous intensity of muscle-strengthening activities should be done at least twice a week).
  • Flexibility and balance activities are recommended for maintaining a normal range of motion for daily activities and is usually combined with warm-up or cool-down activities.
  • On the other hand, older adults at risk of falls should perform balance training such as backward, sideways, heel and toe walking as well as standing from a sitting position, together with standardized exercises from a program to prevent falls4.

1Twenty80: Can I still exercise at the age of 50 and above?
Mogana and Lee Fang: Yes, physical activity plays an important role in healthy ageing, and it should be part of every older adult’s plan of care except in circumstances where it is contraindicated.

Exercise or physical activities can help in many ways, for instance,

  • Improves mobility, cognition and independent functioning
  • Prevents Sarcopenia, Osteoporosis, falls and numerous health conditions

The level of physical activities done should be tailored according to the level of fitness and ability of older adults to prevent injuries4,6

1Twenty80: I can’t sit through a movie without going to the bathroom. Is that something I should be worried about?
Mogana and Lee Fang:
Overactive bladder (OAB) is a syndrome characterized by urinary urgency, typically accompanied by frequent urination and nocturia, with or without urgency urinary incontinence, in the absence of urinary tract infection or other obvious pathology9. It is a bothersome condition with increased prevalence with age for both males and females, with females develop incontinence at a much earlier age. It has remarkable effects on the quality of life as it affects the physical and social functioning, vitality, and emotion of an individual10. The symptoms of OAB are due to abnormal bladder to abnormal bladder contraction and may be representing the clinical endpoint of various initiating causes. Visit a health care provider if you think you have OAB. OAB is a symptomatic diagnosis, and a basic assessment is required to confirm the diagnosis and to exclude any other underlying causes prior to initiating the management9.

1Twenty80: How can you tell the difference between forgetfulness and Alzheimer’s disease?
Mogana and Lee Fang:
Alzheimer’s disease is the most common form of dementia in people above 65 years old with major symptoms of progressive forgetfulness and is usually accompanied by symptoms suggestive of social withdrawal11,12. There are several differences between forgetfulness as a result of normal ageing and that of Alzheimer’s disease, which may be demonstrated in the abilities of short-term memory and learning new information, planning, problem-solving and decision-making, language, orientation, visual perceptual skills as well as mood and behaviour13. For instance, forgetting about which day it is and remembering it at a later time is considered to be part of normal ageing while losing track of the date or time of year may indicate Alzheimer’s disease. Forgetting words to use occasionally and losing things once in a while are considered normal ageing, whereas trouble having a conversation and frequently misplacing things and unable to locate them can be due to Alzheimer’s disease12.

1Twenty80: How do I know if I have osteoporosis?

Mogana and Lee Fang: Majority of the patients having osteoporosis are asymptomatic with diagnosis only made after a fracture. Diagnosis of Osteoporosis is based on the measurement of Bone Mineral Density (BMD) using dual energy x-ray absorptiometry (DXA) along with clinical evaluation which includes history, physical examination and laboratory investigations. Bone density test results can help to determine if someone has Osteopenia (bone loss that has not yet reached the stage of Osteoporosis) or Osteoporosis, and how susceptible the bones are to fracture.

1Twenty80: What can be done to prevent hair loss?

Mogana and Lee Fang: Each human was born with roughly five million hair follicles, which will not be added throughout life. The lifespan of our hair ranges from about two to seven years.

However, there are certain factors that can impact the growth of hair and result in a shorter lifespan. For example:

  • Smoking.
  • Excessive exposure to chemicals.
  • The use of bleach, hair dyes and the misuse of hair products can damage the hair, resulting in hair loss.
  • Deficiency of certain micronutrients.
  • Avoid treating the hair with high heat tools or hair dryers too often as it dehydrates the hair follicle and is vulnerable to damage.

1Twenty80: Why does my skin have pigmentation and what can I do to prevent it as I age?
Mogana and Lee Fang:
Melanin is the brown pigment that contributes to the colour of the skin. Melanin pigments are mainly produced during exposure to the sun to protect against the damaging effect of UV radiation25. Ageing is associated with approximately eight percent reduction of melanocytes (cells involved in producing melanin) every 10 years. However, with the long term exposure to sun, it irreversibly increases the number of melanin-producing melanocytes, resulting in uneven pigmentation and mottled pigmentation with ageing26.

Hence, in an attempt to reduce pigmentation, a broad-spectrum sunscreen that is able to protect the skin against UVA (Ultraviolet A-Rays) and UVB (Ultraviolet B-Rays) is important.

Sunscreen should be applied 15 to 30 minutes prior to sunlight exposure, and reapply at least every two hours during any conditions that may remove sunscreen from your body such as sweating and swimming.

Apart from that, avoid performing activities when the sun rays are strongest, such as between 10 am to 3 pm. It if is unavoidable, protect the skin using sun protection such as umbrella or sun protection clothing27.

1Twenty80: I have wrinkles and sagging skin. Is it possible to reduce or prevent it from occurring?
Mogana and Lee Fang:
Ageing results in apparent changes to the skin that occurs via a complex biological process and the most obvious ones being the increasing amount of fine lines and wrinkled skin.

To prevent wrinkles, regular use of sunscreen is an important strategy to reduce photo-ageing. In addition, using moisturiser can help hydrate the skin which is important to counteract dehydrated skin.

Adding ingredients such as retinol, ascorbic acid and vitamin E into the daily skin care routine is also beneficial as they are able to exert antioxidant activity while promoting collagen production27,29. Facial movements such as frowning, wrinkling of nose and grimacing are also associated with wrinkles formation26.

1Twenty80: Is losing sex drive natural with ageing?
Mogana and Lee Fang:
Study revealed that sex drive, activity and function were reduced above 60 years old, with women being more affected. However, the decrease in sex drive is not totally biological with psychology playing a role in it as well. Hormonal changes occurs during perimenopause and menopause, with a decline in oestrogen level. The decreased level of oestrogen causes the vaginal to become thin, pale and dry with a loss of elasticity and lubrication. With this, sexual activity becomes painful and uncomfortable, resulting in a decreased interest and avoidance of intercourse36.

In addition, a women’s perception of their body image will also affect their sexual function37. Therefore, women who perceive ageing as unattractive could result in a decrease of having intimate connection with their partner. Furthermore, the presence of certain chronic disease such as cardiovascular disease could leads to decreased sexual function via a reduced blood flow to the sex organs such as vagina, causing a reduced arousal.

1Twenty80: I often get infections around my genital area. What is a common cause of genital infection?
Mogana and Lee Fang:
Bacterial vaginosis (BV) and complicated vulvovaginal candidiasis (VVC) are among the common postmenopausal vaginal infections. Prior to menopause, the high estrogenic state promotes the homeostasis of the vaginal microenvironment via regulating the proliferation of vaginal epithelium and the collection of glycogen. The glycogen-rich environment supports the growth of Lactobacilli via supplying a low pH environment and lactic acid, thus protecting against vaginal infections37. On the other hand, with a decreased oestrogen production with age, and particularly in postmenopausal women, results in an increased intravaginal pH, thus increases the chance for harmful micro-organisms colonization, hence, vaginal infection38.

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