How Elderly can stay Healthy and enjoy the Golden years?

Dr Dipankar Debnath

MBBS. FCGP. PGDGM. DNB(T)

Consultant Geriatrician and Family Physician

9830303450

Ageing is an inevitable, progressive and generalized impairment of functions, resulting in diminution or loss of many body functions and increases the risk of age related diseases. An elderly is portrayed as a feeble old person with disability and diseases. There are many diseases which are common in elderly but there are many ways an elderly can live a healthy, independent, disease free life. Today our average life expectancy is 65 years, which was around 42 years in 1947 and is increasing. There is a growing need of geriatrics in our country.

Geriatric Medicine deals with aging process, disease prevention, diagnosis and treatment of health problems of elderly. It is at a very incipient stage in our country and most people are not aware of it.

Most common diseases of elderly are – Constipation, Hypertension, Ischaemic Heart disease (IHD), Heart failure, Vertigo, Osteoporosis, Osteoarthritis, Falls and Cancer.

Ageing is the most potent risk factor for hypertension, ischaemic heart disease (IHD), heart failure and stroke. Hypertension is caused by stiffening of the arteries. IHD is due reduced blood flow to heart muscles and this causes chest pain mostly during exertion. High cholesterol and atherosclerosis causes narrowing of arteries leading to IHD. Heart failure is a condition where heart cannot pump blood adequately to maintain required blood pressure. They should exercise regularly to increase physical fitness and adaptation to stress, have low salt diet and regularly keep a record of blood pressure. They should take medicines regularly along with periodic medical checkup. Hypertensives should not stop medicines on their own as it can raise blood pressure dangerously and can cause stroke.

Dizziness occurs in up to 30% of elderly. True vertigo causes an illusion of spinning movement of self or the surrounding. Dizziness is multifactorial, with dysfunction in several systems. Thus precise diagnosis is difficult and treatment is more complex. Making small improvements to each contributing problem can add up to a big overall improvement.

Osteoporosis means porous bones characterized by low bone mass and reduced bone strength. The bones become more fragile and increase the risk of fractures. Postmenopausal women are more affected than men. Osteoarthritis is the wear and tear of the joints due to excessive use and to old injuries in the affected joints. It is the most common joint problem and affects mostly the hip and the knees. It causes cracking, creaking and painful joints, with movement restriction in later phase. These can be prevented easily by taking adequate calcium and vitamin D in diet or as supplement, reduce excess body weight, regular weight bearing exercise and use of proper walking aid.

Falls are a major cause of fracture and disability. Risk factors are increase age, improper gait and balance, poor vision and hearing, osteoporosis, arthritis, medications, physical fitness and home environment. Fall prevention measures should be a priority with promotion of elderly friendly home environment.

Increased age is a risk factor for cancer. Presentation of cancer may be typical in the form of breast lump, anaemia, rapid weight loss, loss of appetite, altered bowel habit or pain. Immediate measures should be taken for proper check up and cancer detection. Most common are the cancers of breast, cervix, prostrate, lung, gastric, gallbladder, pancreas and colon. Treatment depends on stage of detection, age, the co-morbidities and tolerance to treatment. Therefore regular health check up with periodic investigation is a must for early detection and prevention of metastasis. Here the aim is adequate treatment where possible but care and comfort for the terminally ill who do not have much treatment option.

Proper nutrition is a must in elderly. They should have a low salt, low fat, low spice, high fiber diet of small frequent meals and plenty of water, at least 3 litres per day. Maintain a healthy lifestyle with regular physical activity of brisk walking of 30 minutes for at least 5 days a week. Regular physical exercise maintains a healthy mind and body and controls hypertension, diabetes and obesity. It helps to relax better, have a good sleep and have better bowel movement. Regular bowel habit is a must to avoid constipation. Body weight should be kept at optimum and smoking and excess alcohol should be avoided.