| Nafisa Ali Sodhi, an epitome of graceful ageing
Indians havent reached the stage of Methuselah (who, the Bible says, lived for 969 years), but our life expectancy has increased from 32 years in 1940 to 65 years in 2000. Seven per cent of the 1.1 billion Indian population is today over the age of 60. We now have better access to health care but can we look forward to fun, health, dignity, economic independence and a peaceful death?
Today children work far away from home, the joint family system is breaking down, and women (traditional care-givers) have joined the work force. The old have to fend for themselves.
They cannot afford to be ill as sickness is expensive. Preventive medicine and maintenance of health is, therefore, a priority.
Good vision and hearing prevent accidents, but unfortunately they are the first senses that fail. After the age of 60, 30 per cent of the people are unable to hear a conversation. Leaning slightly forward and turning to the right side does help initially, but eventually hearing aids may be needed. Eyes too should be checked regularly and defects corrected promptly.
The skin loses its elasticity with age, becoming dry and wrinkled. Itching and scratching cause mechanical injury and secondary bacterial infection. Apply a small quantity of a mixture of 500ml of coconut oil, 500ml of sesame oil and 100ml of olive oil half an hour before bath. Add a teaspoon of coconut oil to the bath water. Use a moisturising soap. Apply body lotion or baby oil after bath.
Despite good care, regular brushing and flossing, the teeth may become discoloured, brittle, and may decay and recede. Visit the dentist at least once a year.
Sleep becomes less relaxing with early waking up and relative insomnia. Extrinsic factors like a snoring spouse or frequent essential trips to the toilet may compound the problem. Intrinsic factors like reduction in the restful delta rhythm, depression, pain, anxiety and stress can be tackled with exercise, meditation, yoga and prayer instead of getting addicted to sleeping pills.
With age the heart and blood vessels become less efficient even in the absence of obvious diseases. The heart tends to get enlarged and the pumping action decreases. The blood vessels become less pliable and elastic. This can result in the swelling of feet, high blood pressure and heart failure. Restricting salt consumption to 5gm (one teaspoon in 24 hours) and avoiding salty fried food, pickles and chutneys will help alleviate this problem.
The digestive tract also slows down. When this is compounded with a decrease in fibre content of the food and insufficient fluid intake, constipation becomes a problem. The oesophageal sphincter becomes inefficient, allowing acid to regurgitate from the stomach, causing burning and chest pain. Digestive problems are aggravated by smoking, drinking, untimely meals or lying down immediately after food.
Bones weaken with age, arthritis sets in, flexibility is lost and muscle strength reduces. These can lead to pain, falls and fractures. Supplements of calcium (1.2gms/day), walking for 40 minutes a day, and strengthening and flexibility exercises will help.
If you have a chronic disease like diabetes or high blood pressure, regular health checkups are a must.
Men need an annual digital exam of the prostate and a PSA (prostate specific antigen) test to rule out cancer of the prostrate.
Women need a pelvic examination and a PAP smear starting at 35-40 years, repeated every three years.
A breast self examination should be done every month. A screening mammogram at 40 years, and then every two years after that, is needed to detect breast cancer early enough.
Annual haemoglobin, blood sugar, lipid profile, urea, creatinine and thyroid function tests are also needed.
A baseline chest X-ray will help detect tuberculosis, emphysema and cancer.
A baseline ECG should be done around the age of 50 years and then repeated every 2-3 years.
An annual faecal occult blood test helps detect colorectal cancer.
Flexible sigmoidoscopy/colonoscopy at 50 and every 4 years thence is advisable.
Bone densitometry evaluates the risk of osteoporosis. It should be done every 1-2 years after menopause.
Immunisation does not stop in childhood. After the age of 65 years, pneumococcal vaccine will help prevent pneumonia, and flu vaccine influenza. Both are debilitating and can be fatal in the elderly.
To age healthily, control your weight, blood pressure and diabetes, eat four to six portions of fruit or vegetables daily, do not smoke, avoid salt, drink alcohol in moderation, walk daily, maintain muscle strength and flexibility with exercise and sleep for six or seven hours a night.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at firstname.lastname@example.org