Health con­cerns

Not all symp­toms can be at­trib­uted to old age and do­ing so can de­prive loved ones of proper treat­ment.

The Star Malaysia - Star2 - - LIFESTYLE -

THE world ob­served In­ter­na­tional Day for Older Per­sons last Fri­day. The United Na­tions-spon­sored an­nual event is de­signed to bring at­ten­tion to a global pop­u­la­tion of el­derly per­sons who are rapidly in­creas­ing.

Ac­cord­ing to the UN, one-third of the world’s pop­u­la­tion will soon be over the age of 60. The ma­jor­ity of older per­sons live in de­vel­op­ing coun­tries. Their pop­u­la­tion is ex­pected to ex­ceed 70% by the year 2030.

Against this back­ground, Wheel Power spoke to con­sul­tant neu­rol­o­gist Dr Lim Shen-Yang of Uni­ver­sity Malaya Med­i­cal Cen­tre, Kuala Lumpur, for his views on the type of neu­ro­log­i­cal ail­ments that could af­fect the el­derly in Malaysia.

“In­ter­na­tional Day for Older Per­sons of­fers us a chance to cel­e­brate the fact that over the last half­cen­tury, the av­er­age life­span of Malaysians has in­creased by about 20 years to 74 years of age,” pointed out Dr Lim.

“This is due to a mul­ti­tude of fac­tors: bet­ter san­i­ta­tion, health­ier life­styles, and ad­vances in (and im­proved ac­cess to) med­i­cal care,” he said, adding that peo­ple are liv­ing longer and lead­ing pro­duc­tive and ful­fill­ing lives.

“We are for­tu­nate that def­er­ence for el­ders still re­mains a cor­ner­stone of our cul­ture. While age­ing grace­fully is a pos­i­tive thing, one can­not get away from the fact that older peo­ple are at in­creased risk of de­vel­op­ing health prob­lems,” cau­tioned Dr Lim.

“Many of the phys­i­cal and mental changes that oc­cur with age are ac­cepted as part of the process of ‘wear and tear’. How­ever, it is a com­mon mis­take to at­tribute all symp­toms oc­cur­ring in older per­sons to old age. In so do­ing, we may be de­priv­ing our­selves or our loved ones of proper treat­ment.”

Dr Lim has au­thored nu­mer­ous pub­li­ca­tions in med­i­cal jour­nals and books, and is an as­so­ci­ate edi­tor of Neu­rol­ogy Asia. He cited an ex­am­ple where pro­fes­sional in­ter­ven­tion is nec­es­sary. A care­ful eval­u­a­tion of an older per­son with walk­ing dif­fi­cul­ties – and falls – may point to a neu­ro­log­i­cal dis­or­der.

These could in­clude nor­mal-pres­sure hy­dro­cephalus (in which ex­ces­sive fluid ac­cu­mu­lates in the brain), cer­vi­cal or lum­bar spondy­lo­sis (where arthritic changes in the spine cause nerve im­pinge­ment) and Parkin­son’s dis­ease (a move­ment dis­or­der that fre­quently causes slow­ing of gait to the point of “freez­ing” or be­ing “glued” to the floor).

Stroke, a con­di­tion where blood ves­sels in the brain be­come blocked, lead­ing to the de­struc­tion of brain cells that are de­prived of oxy­gen, can also be the prob­lem.

“These con­di­tions which be­come in­creas­ingly com­mon with age, have spe­cific treat­ments that can re­sult in marked im­prove­ment,” said Dr Lim. “If left un­treated, pro­gres­sive or per­ma­nent dis­abil­ity may re­sult.”

Dr Lim who is also a Parkin­son’s dis­ease and move­ment dis­or­ders spe­cial­ist, was quick to point out that some of the neu­ro­log­i­cal con­di­tions can be suc­cess­fully treated with med­i­ca­tion to re­store func­tion.

“Walk­ing dif­fi­cul­ties should not be au­to­mat­i­cally viewed as an in­evitable part of age­ing,” he said. “Some­times, there may be a treat­able un­der­ly­ing dis­ease.”

Other neu­ro­log­i­cal con­di­tions that be­come more fre­quent with in­creas­ing age in­clude Alzheimer’s Dis­ease, Lewy Body Dementia, neu­ro­pathic (nerve) pain, and mo­tor neu­ron dis­ease.

Al­though cures for these con­di­tions are not yet in sight, cer­tain symp­toms, such as hal­lu­ci­na­tions or para­noid delu­sions (that com­monly, for ex­am­ple, cause pa­tients to con­stantly ac­cuse other mem­bers of the house­hold of steal­ing from them) can be ef­fec­tively treated.

Dr Lim stressed that the im­por­tant thing is not to ig­nore these prob­lems as they cause dis­tress to both the pa­tient and care­giver.

“New cog­ni­tive en­hancers can some­times re­duce be­havioural dis­tur­bances, and im­prove me­mory and mo­ti­va­tion,” he said.

“How­ever, it should be noted that older pa­tients can be more prone to ex­pe­ri­enc­ing ad­verse ef­fects from med­i­cal in­ter­ven­tions, so the pros and cons of ini­ti­at­ing treat­ment need to be con­sid­ered care­fully, tak­ing into ac­count an in­di­vid­ual’s over­all sit­u­a­tion.

“For ex­am­ple, whilst treat­ment of high blood pres­sure has been a ma­jor pub­lic health suc­cess in re­duc­ing strokes and heart attacks, over-ag­gres­sive treat­ment can some­times lead to light-head­ed­ness and falls, a point of spe­cial rel­e­vance in some older pa­tients who may al­ready be frail to be­gin with.

“The of­ten-com­plex na­ture of med­i­cal care of older pa­tients un­der­scores the im­por­tance of hav­ing a doc­tor who is knowl­edge­able and skil­ful, and will­ing to take the time to sort through the is­sues,” con­cluded Dr Lim.

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