HEALTHY AGING

Dr. VINOD KUMAREmeritus Prof., St Stephens Hospital, Delhi

Formerly, Prof. of Medicine & Chief, Geriatric Services, AIIMS, New Delhi &

WHO Advisory Panel on Aging and Health

HEALTHY AGINGDEFINITION AND GOALS

Healthy and active aging is a process to achievephysical, mental and social well being throughoutone’s life particularly in the later years

WHAT IS THE GOAL ?Disease & disability free life with high physical &cognitive function and active engagement with lifein old age

HEALTHY AGING IS A REALITY AND NOT A DREAM

• Functional capacity like ventilator capacity, muscle strength & cardiovascular output increases in childhood & peaks in early adulthood, eventually followed by a decline resulting in disease & disability in old age.

• Rate of decline however gets accelerated by negative adult life style factors like smoking, alcohol, lack of exercise, improper diet as well as by environmental & external factors; Hence this decline can be slowed down or even reversed at any age through the individual himself or the policy makers.

DETERMINANTS OF ACTIVE AGING

• Behavioural: smoking, alcohol, exercise, diet, drugs

• Environmental: pollution, home safety, rural/urban

• Socioeconomic: family,community ,income, literacy

• Personal: biology, genetics, coping mechanisms

• Services: primary care, health prom. disease preven

IS PRESENT MINDSET CHANGING ?

• Traditionally, elderly in India have come to accept failing health & dependency as a part of their old age, disengage from material life, practice spirituality and live in joint family.

• With increasing life span, greater social & household involvement of elderly is happening but it is a challenge for Indian geriatricians to change their mindset so that they begin adopting healthy lifestyles & environment to eliminate risk factors and remain fit and independent.

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HEALTHY AGING DETERMINANTSWith Impact on Life Long

Development and QOLNEGATIVE

• Poverty & Abuse

• Illiteracy

• Double Burden

• Insanitation

• Inaccessible Care

POSITIVEPOSITIVE

Joint FamilyJoint Family

Active InvolvementActive Involvement

Physical ActivityPhysical Activity

VegetarianismVegetarianism

Spirituality & ReSpirituality & Relaxlax

MODIFIABLE DISEASE RISK FACTORSCardiovascular: sedentary, obesity, lipids, BP, salt, diet, smok, pollutPulmonary: smoking, environmental pollutionNeurological: BP, smoking, alcohol, diet, depress,mental inactivityDiabetes: diet,sedentary, obesityMusculoskeletal: sedentary, obesity, hormone deficiency Gastrointestinal: low fibre, alcohol, poor oral hygieneUrogenital: BP, hormone deficiency Infections: under nutrition, poor skin care and no vaccinationCancers: diet, smoking, chewing tobaccoSpl senses: sunlight, noise, diabetes, water fluoride, drugsAccidents : unsafe homes

K S Sunil. Primer on Geriatric Care. Pp 12-18, 2002

SUMMARY OF LIFE STYLE GOALS

• Physical activity• Healthy diet• Avoid smoking• Judicious medication • Good oral hygiene• Health screening

• Social involvement• Mental activity• Immunizations• Hormones – HRT• Clean environment• Home safety

PHYSICAL ACTIVITY• Benefits: Physiological, psychological and social. if physical exercise could be dispensed as a pill, it

could be the most valuable prescription to prevent diseases (Edward Staneley)

• Varieties: Aerobic, resistance and balance exercises. yogic, spiritual & exercise related to work,

recreation, household and social interaction• Duration: Brisk walk for 20-60 mts for 3-5 d/week morning walk better as he is fresh, walks with his

whole body; in evening he walks only with his legs 1.WHO. The Heidelberg Guidelines. JAPA 5: 2-8, 1997; 2.Vinod Kumar. JAPA 6: 205-6, 1998

HEALTHY DIET

• Low fat, low salt, adequate liquids, proteins, vitamins, calcium, micronutrients and high fibre, fruits and vegetables

• Make them relish their food with good flavour, smell, colour, utencils and environment

• Frequent small meals, no overeating food left on the table does more good than what has

been taken

SMOKING AND EXCESS ALCOHOL

• It is never too late to quit smoking

• Consuming alcohol in excess is different from taking in moderation

• Scientific methods are in place to give up these addictions and to deal with problems of withdrawl

JUDICIOUS MEDICATIONS

• Properly understand directions of their use• Take with or after food unless told otherwise• Get ingredients checked to avoid duplication• Consult doctor to avoid unnecessary medicines• Never hoard medicines you no longer require• Do not share medicines with anyone

MISCELLANEOUS

• Personal cleanliness and oral hygiene• Bowel movements and sound sleep• Avoid dust and pollution• Home and road safety• Specific tasks e.g.Screening, HRT, immunization• Engagement with life is a must: A perpetual holiday

is a good working definition of hell-Bernard Shaw• Have a positive attitude: To me old age is always 15

years older than I am