How to remain healthy at 70? Don’t treat your stomach like a dustbin, not everything has to be palatable
AIIMS geriatrician Dr Prasun Chatterjee on the most common complaints of those above 70 and the screening tests they should take.
With Prime Minister Narendra Modi recently expanding the scope of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) for people over the age of 70 years, it is likely to help them access healthcare and hospitalisation.
Yet much of the disease burden is avoidable, if we are mindful about our lifestyle, says Dr Prasun Chatterjee, geriatrician from the All-India Institute of Medical Sciences (AIIMS). Excerpts:
What are the most common health complaints among the elderly?
For those between the ages of 65 and 75 years, the complaints are similar to those you would see in people in their 40s — diabetes, hypertension, coronary artery disease and stroke. Infection is also very common among the elderly, mostly pneumonia and urinary tract infections. This is because the immune system is weakened with age — we call it immune senescence. Knee and joint pains are common in this age group.
Among 75-year-olds, we see multi-morbidities or multiple health issues. There is some forgetfulness or dementia, some gait and balance problems and Parkinson’s, a brain disorder that causes a gradual decline in movement, balance and coordination. The risk of falls and fall-related injury also goes up in this age group. Cardiovascular problems get exacerbated, heart failure being very common.
There is a high prevalence of various cancers in this age group — bone, lung, stomach, or colon cancers are among the common ones.
One thing we often do not talk about is depression and social isolation that is also commonly experienced by people over the age of 75 years.
When it comes to the very old — people over the age of 80 or 85 years — sarcopenia or weakness of muscles happens in addition to other health issues. Nutritional problems are also common. We see something called anorexia of ageing, when a decreased appetite results in malnutrition. We also see anaemia because of poor food intake.
Being a tertiary care hospital, we do not see healthy people often. But there has definitely been a paradigm shift among the ageing population as we see more and more people living longer and healthier. We see 90-year-olds, who have been able to prevent forgetfulness and dementia by increasing their cognitive reserve, which is the ability of the brain to withstand age-related damage and ageing because of sharpening thinking abilities and resilience throughout their lives.
They have been able to retain their muscles with regular exercise and a high protein diet. An active body has meant that they have been able to maintain social connections and are less likely to have depression.
How can one age healthily?
Ageing actually starts from the womb of the mother, meaning healthy ageing should be practised throughout the life.
Exercise is the most important aspect — children should play regularly and not spend a lot of their time sitting in front of televisions, computers or phones. Adults also need to follow an exercise regimen at all ages. If you do not exercise in youth, your life later is likely to be more painful.
Your eating behaviour also has an impact. You cannot treat your stomach like a dustbin and not everything has to be palatable. You should eat home-cooked, simple meals as much as you can. If you see older people right now, you will see they have not developed the taste for fast food simply because they didn’t grow up with it. But children these days are very fond of processed foods. We must restrict sweet and processed foods in their diet.
Having a purpose in life is equally important. Someone with a purpose is likely to be happy and likely to live longer.
What are the types of screening that one should undergo?
People over the age of 60 years — those who have just retired — should go to their doctor at least once to get their overall physical and mental health check-up. There are quick screening methods. We do a comprehensive geriatric screening, which is a head-to-foot assessment where we check everything from hearing, vision, lower limb gait and speed, heart and lungs.
They should also screen for some cancers such as prostate cancer, which is very common in this age group. Colon cancer is something that people should keep an eye out for — a stool test can be indicative. Women should be screened for many gynaecological cancers, such as those of ovaries, cervix and breast.
Another important test is the one for haemoglobin. Silent blood loss from the food pipe is something that is common in this age group.
For bone health, I recommend the Dexa scan from the age of 60. Women must take this test at 55 because they start experiencing bone loss soon after menopause. If everything is normal, then the scan may be repeated after five years. Apart from physical tests, do not forget tests for mental health.