Aging without disease

January 26, 2012

The gift of long life is more precious when those extra years are lived in good health. But many still spend their golden years confronting one health problem after another. For expert insight on healthier aging, Better Health turned to Dr. Lily Chaisompong, a Bumrungrad specialist in geriatric health with many years of experience helping patients enjoy healthier, higher quality senior years.

Aging without disease

Healthier senior years depend on preventing age-associated diseases.

The world keeps getting older. Demographics and longevity gains have expanded the size of the  senior population in most parts of the world, including Thailand. Thailand’s senior population, those aged 60 or older, has surpassed 8 million – about 11 percent of the total population – an increase of almost one million since 1997.     

The population has been “graying” in large part because people are living longer; a study by the Institute for Population and Social Research at Thailand’s Ma-hidol University reported the average life expectancy for Thai children born in 2010 is 73 years – 13 years longer compared to children born in 1975. And it’s expected to increase further to nearly 80 years within another decade. 
The gift of long life is more precious when those extra years are lived in good health. But many still spend their golden years confronting one health problem after another. For expert insight on healthier aging, Better Health turned to Dr. Lily Chaisompong, a Bumrungrad specialist in geriatric health with many years of experience helping patients enjoy healthier, higher quality senior years.


Beyond the numbers    

In chronological terms, 60 is the commonly accepted age when an adult becomes a senior. But from a medical perspective, chronological age doesn’t tell the full story of an individual’s overall health or level of physical fitness. “Each person ages at his or her own pace, so chronological age alone doesn’t reveal a lot,” says Dr. Lily. “The body begins its decline around the age of 40. While many factors affect the aging process, it’s clear that taking better care of one’s health slows the rate of decline.”      

Some of the most serious health problems pose greater threats as we age. These health problems related to age fall into one of two categories. Age-associated conditions, such as cardiovascular disease, increase in frequency with age. The other category, age-specific diseases, includes conditions such as osteoporosis and Alzheimer's disease that affect only older age groups.

Vascular threats    

Vascular-related disorders such as diabetes, high blood pressure and stroke are not directly associated with aging. They typically affect people whose prolonged, unhealthy habits – especially poor diets and lack of exercise – lead to high blood sugar and high cholesterol, key risk factors for vascular diseases. Reducing these risks can usually be accomplished through lifestyle modification, i.e. adopting healthier diet and exercise habits. Dr. Lily cautions seniors to avoid extreme changes, such as totally cutting out dietary fat or meat from one’s diet. Our bodies need fat; foods including meat are important sources of energy, protein and nutrients that help repair damage caused by the aging process. “Many seniors make the mistake of avoiding high-protein foods as they assume their bodies are too old to chew and digest meat,” Dr. Lily explains. “In actual fact, protein is important to counter loss of muscle mass and brain shrinkage. Without enough protein, they’re at  greater risk of seeing their health deteriorate more quickly.”     

For seniors already diagnosed with a vascular disease, fish and nuts are healthier protein sources than beef, pork or chicken. Fiber from nuts promotes the removal of bodily waste through the excretory system. It also facilitates the release of cholesterol and helps control blood sugar. Fish containing omega-3 fatty acids are one of the best sources of the so-called “good fats” believed to help lower blood cholesterol. 

Osteoporosis dangers    

The impact of the aging process is marked by a decline in bone density, greater risk of bone fractures, and eventually having to deal with osteoporosis. Dr. Lily cautions women to be especially watchful for potential bone threats as their risk for osteoporosis is significantly higher than men. “Women naturally have thinner bones than men,” notes Dr. Lily. “At the onset of menopause, a woman’s body abruptly stops producing the sex hormones which were helping maintain stronger bones; the abrupt end to hormone production accelerates the decline in bone density. For men, osteoporosis poses less of a threat because the decline in male sex hormones happens gradually – and somemen actually don’t suffer any decline.” 

Osteoporosis is a disease which gradually worsens over the course of many years. It progresses quietly; symptoms usually don’t appear until years later. Osteoporosis tends to be diagnosed after significant decline in a patient’s bone density or, in some cases, after a serious fracture-causing fall. Adopting preventive measures earlier in life is one of the best ways to reduce your risk of a future osteoporosis diagnosis and for limiting the condition’s severity.      

Calcium plays a critical role in keeping bones healthy and strong. Adults should take in about 1,000 mg of calcium a day. In Thailand, most people don’t get enough calcium from their diet, even when including calcium-rich foods like fish, nuts, tofu and leafy green vegetables. That’s because most Thais, especially seniors, don’t consume enough milk and other dairy products that are rich in calcium.

Calcium supplements can offset some of the shortfall. But they can be difficult for the body to absorb, especially calcium carbonate; its absorption rate can be as low as 40 percent. One way to compensate is by dividing the supplement into smaller doses of 500-600 mg, and take with meals for better absorption. 

Drug interaction dangers

As many seniors know from personal experience, dealing with age-related health problems usually means taking more medications. Prescriptions can come from multiple sources, with different doctors treating different health problems, additional advice from caring friends and relatives on top of one's own research and knowledge. Besides medicines prescribed by doctors, many seniors also take various vitamins, supplements and/or traditional Thai and Chinese remedies.      

Unfortunately, many don’t fully understand the potential dangers of drug interactions occurring when certain medications are taken together. Dr. Lily notes that, in theory, medication should be taken only when necessary, and all things being equal, as seldom as possible. “Seniors should consult a specialist, either a doctor or pharmacist, for advice on a medication’s necessity and potential drug interactions,” she explains. “And at every consultation, inform your doctor or pharmacist of any medications you’re currently taking, to avoid possible duplication.” 

NSAIDs caution

Seniors need to be cautious with certain drugs such as non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs including aspirin and ibuprofen can cause serious side effects, especially perforation of the stomach lining, kidney problems and high blood pressure. These drugs should only be taken when necessary under a doctor’s direction, and prolonged use should be avoided.     

Caution should also be taken with cold medicines, antihistamines and certain types of sleep aids. These medicines affect the central nervous system and, especially if taken in too large a dose, can cause blurred vision and drowsiness, potentially leading to an accident or dangerous fall. Strong sleeping medications such as diazepam interact with chemicals in the brain and are known to cause depression when taken for an extended period of time.      

Managing and treating age-associated diseases depends largely on patients taking an active role in managing their health. That includes making healthier lifestyle choices when it comes to nutrition and exercise. Good mental and emotional health is also important in dealing with symptoms and managing chronic illnesses. And a strong support system can make a significant difference. As Dr. Lily says, “the caring and support of the family’s younger generations and close friends truly helps seniors live happier, healthier lives.”


Bladder control ailments differ by gender 

Health issues affecting bladder control are more prevalent in older adults.  But the chief complaints depend on gender; the problems of senior men tend to be the opposite of senior women.

Prostate problems

Men are most likely to experience difficulty passing urine, with prostate enlargement the most common cause of the problem. When the prostate gland becomes enlarged, it presses against the urethra, making it more difficult – or, in severe cases, impossible – for urine to pass through the urethra.     

For men with milder cases, doctors typically prescribe anti-spastic medication which reduces the size of the prostate to the point where symptoms dissipate and normal bladder function is restored. In more serious cases, surgery to remove a portion of the prostate may be recommended.    

Female incontinence    

Incontinence is the most pre-valent bladder-related health problem for senior women. It’s typically caused by pelvic organ prolapse, a condition that makes it difficult to prevent urine from  leaking through the urethra.     

Exercising the pelvic muscles can help relieve the problem; contracting the pelvic floor muscles 100 times a day will tighten pelvic muscles and reduce incontinence. In more serious cases, your doctor may recommend surgical treatment to correct the problem.
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