PDF - Tan Tock Seng Hospital

6
THE STRAITS TIMES
MARCH 15 2012
In the third of a
four-part series,
Lea Wee finds out the
differences between
normal ageing and
age-related diseases
Growing old
healthily
G
reying hair, lines on the
face and aches in the
bones – these are
familiar signs of ageing.
What may be less
well known is that
growing old is not synonymous with
being ill, said Dr Tan Thai Lian, head
of the department of geriatric
medicine at Tan Tock Seng Hospital.
Physical ageing does not take
away a person’s ability to function in
daily life, the way that diseases do.
Unfortunately, certain conditions
are often accepted as part of
physical ageing and left untreated,
said Dr Tan. These include the four
“I”s of geriatric medicine –
incontinence (involuntary leakage of
urine), instability (which may lead to
falls), immobility (which can cause a
person to be bed-bound) and
impaired cognition (a decline in
mental abilities).
However, physical ageing does
weaken a person’s immune system
so that he is more vulnerable to
infections and other diseases.
To counter that vulnerability, the
ageing person must have adequate
and balanced nutrition, practise
proper hygiene and seek treatment
for infections promptly, said Dr Tan.
Physical ageing also occurs at
different rates among people.
Hence, one 70-year-old may be
physiologically younger than another
70-year-old and, therefore, able to do
more physically.
Even within the same person, body
systems “grow old” at different rates.
For instance, in a person with
dementia, the brain may age faster
than the lungs or heart.
The varying “ages” are due to a
combination of genetics and
environmental factors, said Dr Tan.
He said: “Someone who has a
healthy diet and exercises regularly is
more likely to be physiologically
younger than someone who doesn’t.”
Physical ageing is but one
dimension of ageing. Other
dimensions include psychological
ageing (the perception of how old
people feel) and social ageing
(cultural expectation of how people
should act as they grow older).
In other words, age is not just a
number. Dr Tan said: “It is multidimensional and highly individualised.”
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THE DIGESTIVE TRACT
Normal changes
Older adults may eat less
because they feel full more
easily. However, eating can
continue to be a pleasurable
experience.
THE BRAIN
Normal changes
The brain shrinks with age. Older people may take longer to recall recent
events, respond to certain stimuli and learn new things.
These aside, they have no problems with functioning in daily life.
Some cognitive abilities, such as wisdom and life experience, are
stable or may even improve with age.
PHOTOS: ST FILE, TNP FILE
THE SKIN
Normal changes
The skin becomes thinner, less elastic, drier and cracks more easily.
Diseases and prevention
Ageing skin breaks down more easily and is more prone to infection.
Skin infections such as those caused by common bacteria like
streptococcus and staphylococcus are not a normal part of ageing.
Keep the skin clean by bathing every day. Those who cannot reach all
parts may find it easier to do so in a shower seat. Apply moisturiser
frequently and put on sunscreen when you go out. Chronic sun exposure
is a major cause of skin changes over time.
THE HEART AND BLOOD
CIRCULATION
Normal changes
Blood vessels become thicker
and stiffer. The heart needs to
pump harder to send blood to
other parts of the body.
These changes may cause a
small spike in blood pressure –
the pressure against the walls
of the arteries as blood flows
through. Blood circulation may
not be as good as before.
Blood may take a longer time
to return to the head when a
person changes his position, for
instance, from sitting to
standing. This may cause him
to feel light-headed in a
condition called postural
hypotension.
Diseases and prevention
High blood pressure does not
have to happen in older people,
especially if they have lived a
healthy lifestyle since young.
Avoid eating excessive salt,
which raises the risk of
developing high blood pressure.
Change positions gradually
to avoid postural hypotension.
THE BREATHING TRACT
Normal changes
The cough reflex, which helps
expel food or other foreign
particles from the respiratory
tract, is weaker, especially if a
person is lying on a bed.
Choking or a blockage of the
windpipe is more common in
old age.
The mucociliary mechanism,
which involves fine hairs on the
surface of the upper airway
binding food and other foreign
substances with mucus and
sweeping them out, also
becomes less effective.
Diseases and prevention
It is easier for food or liquid to
enter the lungs and cause
infection or pneumonia.
To prevent this, avoid talking
or other distractions while
eating. Avoid cough
suppressants, unless advised
by your doctor, as they may
further weaken the cough reflex.
Smokers should quit
smoking, which has been
shown to damage the
mucociliary mechanism.
THE MUSCLES AND BONES
Normal changes
The muscles and bones
become weaker and smaller but
these changes need not affect
the older person’s ability to
continue with his daily life. They
need not, for instance, cause
him to fall more often.
Diseases and prevention
The changes also do not
inevitably progress into
osteoporosis, or brittle bone
disease, with age.
The condition is sometimes
described as “a paediatric
disease with geriatric
consequences”. Prevention
must start early, with children
getting proper nutrition and
enough calcium. Bone mass is
laid down only in one’s youth
and, like a bank deposit,
greater reserves last longer.
Once a person reaches his
peak bone mass by the age of
30, he can only maintain it, but
not build it up anymore.
It is also important to keep
active as immobility can speed
up muscle and bone loss.
Diseases and prevention
Dementia, which is the loss of thinking, memory and behavioural skills
that interfere with life, is not part of ageing. Cognitive training, combined
with regular aerobic exercise, can buffer a person against it.
Diseases and prevention
Malnutrition can occur, not so
much due to feeling full more
easily, but because of a
physical condition or disease,
such as the loss of teeth; or
social factors, such as the lack
of an eating companion.
Having no teeth, or being
“edentulous”, is usually the
effect of poor gum care in
youth.
Constipation may also occur.
This is not because food
moves more slowly through the
colon in older people, but
because of inactivity and
inadequate fluid
intake.
Older adults tend to feel
less thirsty than younger
people.
THE BLADDER
Normal changes
The bladder capacity of a
person becomes smaller as he
ages and he may find he needs
to empty his bladder more
often.
His pelvic floor muscles may
become less toned, making it
difficult for him to control the
bladder sometimes.
But these changes are
usually not serious enough to
affect his sleep or his daily life.
Diseases and prevention
Urinary incontinence, or the
involuntary leakage of urine, is
often the effect of medication,
stroke and other diseases,
rather than straightforward
ageing.
Doing regular pelvic floor
exercises may help a person
with urinary incontinence regain
control over his bladder.
Source: Dr Tan Thai Lian, head
and senior consultant at the
department of geriatric medicine
at Tan Tock Seng Hospital