aging gracefully - pmpspmps.org.my/11asean/11thasean-slides/ageing_gracefully.pdf · aging...
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Aging Gracefully
Dr Cheah Wee Kooi
Physician and GeriatricianHead of Medical Department and Clinical Research Centre
Hospital Taiping
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Her tips
• She married her double second cousin at 21, who started courting her when she was 15
• Employed servants and never had to work
• Pursuing hobbies such as fencing, cycling, tennis, swimming, rollerskating, playing the piano and making music with friends
• She gave birth to her only child at 23, and their only son on the same year.
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• World War II: “German soldiers slept in my rooms but ‘did not take anything away’“; so that she bore no grudge against them.
• Aged 90 and with no heirs left, selling the property in exchange for a right of occupancy and a monthly revenue of 2,500 francs (€380) until her death
• 30 years later, lawyer died, family continue to pay
• moved into a nursing home, having lived on her own until age 110
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Content
• Gerontology vs Geriatric
• Situation in Malaysia
• Frail vs. Robust
• Mind, Meals and Movements
• Environment
• Conclusion
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Geriatric vs Gerontology
• GERON = the elderly
• Iatric = medicine
• Logy= science
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Malaysia will be an aged nation by 2030 with people enjoying longer life
2,249
2,903(9.2%)
3,749(11.1%)
5,819(15.3%)
6,957 (17.4%)
8,231(19.8%)
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
2010 2015 2020 2030 2035 2040
Nu
mb
er
(To
tal)
Nu
mb
er
(Mal
e &
Fem
ale)
Male Female Total
11
• 2010 Data: Malaysian Population and Housing Census 2010
• 2015 – 2014 Data : Forecasted
Source: Department of Statistics Malaysia
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Distribution of Elderly Population by State 2016
12
0.00
2.00
4.00
6.00
8.00
10.00
12.00
14.00
16.00Percentage Of Elderly Population By State
Department of Statistic Malaysia
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The distribution of the elderly
2030
2020
2010
Year
Elderly age 60 years old and above
Malaysian less than 60 years old
1980
1 dalam 7
1 dalam 9
1 dalam 13
1 dalam 19
Number of the elderly
4,656,000
3,318,900
2,066,967
759,494
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19912016e
(estimate)
M F M F
69.2 73.4 72.6 77.2
Life expectancy
Healthy Life Expectancy
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Successful aging
• Biologically
– Personal level
• Sociologically
– Environmental and community level
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Successful agingBiologically
• Reasonably ‘not so bad’ gene
• Cancer screening
• Cardiovascular risk reduction
• 3 Ms
– Movement
– Meals
– MindPreventing disease vsPromoting Health
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MOVEMENT AND MEALS
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Chronological vsPhysiological
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FRAILTY
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SARCOPENIASkeletal muscle lossPoor muscle quality
PHYSICAL FUNCTIONSIMPARIMENTWeak muscle strengthSlow gait speedPoor balance
FRAILTYDeficits accumulationFatigueSedentary behaviourWeight lossCognitive impairmentSocial isolation
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EFFECTS OF AGING AND ILLNESS
23Argilés JM et al. J Am Med Dir Assoc. 2016;17(9):789-796
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Myth buster
• Loss of muscle mass occurs with aging.Between 40 and 70 years, muscle mass decreases by about 8% per decade; beyond 70 years, the rate of loss increases to about 15% per decade.
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40-year-old control
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CALORIES:20 CAL/KG PER DAY
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EXPERT RECOMMENDATIONS ELDERLY
27Deutz et al. Clinical Nutrition. 2014;33:929-936
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Protein misdistribution
28
Paddon-Jones & Rasumussen. Curr Opin Clin Nutr Metab Care.
2009;12(1):86–90.
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How do we measure?
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Hand grip testDynamometers
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Monitoring
• Weight
• Serum albumin
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PREVENTION
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An Active lifestyle
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Successful agingBiologically
• Reasonably ‘not so bad’ gene
• Cancer screening
• Cardiovascular risk reduction
• 3 Ms
– Movement
– Meals
– Mind
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MIND
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Look to the east!Okinawa
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Ikigaithe reason to jump out of bed every
morning
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Successful aging
• Biologically
– Personal level
• Sociologically
– Environmental and community level
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WHO Global Age-friendly Cities:The Perak Initiative
27 June 2019
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Age-friendly city topic areas
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Conclusion
• Growing older is a continuous process, but getting old is a choice
• Aging gracefully – Individually and Socially
• Mind, muscle and meal
• Age-friendly city
• From worrying about challenges to celebrating longevity
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Thank you