Aging is increasingly coming to the fore in Singapore – by 2030, almost a third of our population will be aged 60 and above. But while growing older is inevitable, how well you age is not a matter to be taken for granted.
Dr. Vina Doshi, a specialist in geriatric medicine, explains how associated physiological changes affect the condition of our bodies, dietary patterns, and mobility.
To start, physiological changes are to be expected as part of aging. Dr. Doshi highlights that some of these issues are similar to those that you would see among young children, such as “problems with gait and falling.”
“Life’s a cycle, so a lot of the issues that you see in children [and] toddlers actually resurface as one ages,” she says.
Consequently, just like how people are cautious about how they care for children, considered care is required for the elderly.
Physiological changes take place because aging affects every organ in the body. For one, skin, which as an organ protects the body from overheating by allowing it to sweat, starts to decrease in its ability to sweat. This leads to a lower tolerance for heat.
The thinning of skin together with the reduced sweating also lowers its integrity, causing the risk of wounds to be higher, even from minor injuries.
Other physiological changes include the thinning of bones and wearing out of joints, which can lead to osteoporosis and arthritis respectively. Arthritis in the knees and hips can cause pain, changing the way an elderly person walks and hence affecting his stability and resulting in an increased risk of falls. This is compounded by the increased risk of fractures from thinning bones.
In addition, aging affects the functioning of organs such as the heart, lungs, kidneys, and liver.
Pathological changes can also occur; these are “not natural” and cause the development of chronic diseases such as hypertension and diabetes. Chronic diseases can affect the whole body in different ways.
“[Physiological and pathological developments] change the condition of our bodies compared to when we were younger,” says Dr. Doshi.
When these take place at the same time, along with the occurrence of other aging-specific issues including dementia, these can form a complex confluence of influences on the aging process.
In light of all these changes, it is important to not just focus on prolonging lifespan, but to also ensure quality of life.
“We want people who are older and all that, but who are happy and healthy right?” says Dr. Doshi.
Apart from genetics, other factors affecting the aging process are “potentially changeable” and can be managed.
First of all, ensuring good spiritual and mental health through taking steps such as spending time with ourselves and nature, can boost physical health.
“At the end of the day, what is our attitude to life?” asks Dr. Doshi.
“It’s our own attitude to life that is going to determine how long we live and whether we live healthily or not,” she adds.
Carrying out regular physical activity continually strengthens the body and trains balance and gait. Physical activity can begin from simple exercises including tai chi – these have the added benefit of being gentle on the joints and hence suitable for those with arthritis. Even those who have chronic diseases and are on medication, can continue to engage in physical activity. Nonetheless, if you have not been exercising, it is advisable to consult your doctor before starting.
Physical activities that are conducted in groups also provide opportunities for social interaction, which can help to stave off loneliness and depression.
Physical activities do not necessarily need to be exercise; activities such as gardening count as well, and can be very satisfying emotionally and spiritually. Continuing to get around on your own, whether through taking public transport or using mobility aids, is also a way to remain active.
A crucial, but often forgotten contributory factor in sustaining physical activity is the condition of our feet. The neglect of your feet, especially with conditions including diabetes, can result in wounds and hamper physical activity.
Dr. Doshi recommends moisturizing the top parts of the feet, which helps the skin to remain as intact as possible and safeguards against breakage. Footwear should also be non-slip, with good heels for protection and be secure, through good Velcro straps for example.
Maintaining your eyesight and teeth are also important. Seeing clearly can help you to carry on doing things for yourself and perceive others around you for better social bonding. Even if you are less mobile, getting a simple cataract procedure done can help you see better and hence enjoy life more.
Where teeth are concerned, making sure that you are able to chew will help you fulfil your dietary requirements. Hence, regular visits to the dentist are vital in maintaining good oral health.
“If you don’t eat well, and you don’t eat the right foods or enough, how do we expect you to remain physically active and build those muscles?” emphasizes Dr Doshi.
While staying physically active is important, certain dangerous and risky activities should be avoided. For example – do not climb up on a chair to reach for items. Whatever that is needed on a day-to-day basis should be at a level which you can reach easily.
Rugs should be made non-slip – these can be secured with Velcro onto the floor – and clutter should be minimized to lower the related high risk of tripping.
There should be measures put in place to provide help when needed. Grab bars, non-slip flooring and railings on both sides of staircases are some examples Dr. Doshi gives. Night lights or sensor lights and a suitable height for your bed – where your hips and knees are at 90 degrees when seated – can also help prevent falls when you get up to use the toilet at night.
While staying physically active is important, certain dangerous and risky activities should be avoided. For example – do not climb up on a chair to reach for items. Whatever that is needed on a day-to-day basis should be at a level which you can reach easily.
Rugs should be made non-slip – these can be secured with Velcro onto the floor – and clutter should be minimized to lower the related high risk of tripping.
There should be measures put in place to provide help when needed. Grab bars, non-slip flooring and railings on both sides of staircases are some examples Dr. Doshi gives. Night lights or sensor lights and a suitable height for your bed – where your hips and knees are at 90 degrees when seated – can also help prevent falls when you get up to use the toilet at night.
In order to keep enjoying life, it is also advisable to plan ahead for your finances to ensure that you have enough for your needs. Dr. Doshi highlights the multiple financial assistance schemes available, such as the foreign domestic worker levy concession, the Home Caregiving Grant, and the Enhancement for Active Seniors scheme where elder-friendly features can be introduced for flats. The Agency for Integrated Care administers many of these grants and levies and more information is available on its website.
Aging gracefully involves all aspects of your life. In addition, any medical condition should be addressed and managed alongside.
“Rather than be in denial, let us face this head-on and get it sorted out because that is going to affect how we age,” says Dr. Doshi.
Most crucially, an open and positive attitude to life goes a long way.
Dr. Doshi advises, “If we start off with the right attitude, our bodies will respond positively as well.”
