The Secrets to Active Aging

Annabelle C. Fuentes, MD, FPAFP

Training Officer, Department of Family and Community Medicine
Medical Specialist 3
Wellness and Occupational Health Coordinator
Vicente Sotto Memorial Medical Center
“ There is nothing
we can do to stop
Ageing,
…but we can make
the rest of our life,
the best of our
life.”
Population ageing is first and foremost a
success story for public health policies as
well as social and economic development...

G. H. Brundtland, Dir Gen, WHO 1999

 In the Philippines

They made up 6.8 percent of the 92.1 million

household population in 2010, higher than the 6.0
percent recorded in 2000.

YEAR % of Senior Citizen in

General Population
1980 5.3
2000 6.0
2011 6.9
2040 13.8
Seniors/ Older Persons

Young Old - 60-69

Middle Old – 70-79
Old Old – 80 and Above
 Normal Effects of Aging on the Body

Copyright © 2010 Pearson Education, Inc.

GERIATRIC
SYNDROMES
 GERIATRIC SYNDROMES
• Complex, multifactorial conditions in which large
number of underlying risk factors involving
different organ systems interact in influencing
ultimate clinical presentation, course and
outcome
• Highly prevalent in frail elderly and can exert a
substantial impact on quality of life and
disability.
 Major chronic conditions affecting
older people worldwide

• Cardiovascular diseases (such as coronary heart disease)

• Hypertension
• Stroke
• Diabetes
• Cancer
• Chronic obstructive pulmonary disease
• Musculoskeletal conditions (such as arthritis and osteoporosis)
• Mental health conditions (mostly dementia and depression)
• Blindness and visual impairment
 DEMENTIA

DEMENTIA is an acquired, persistent

disease of the brain manifested by multiple
areas of intellectual (cognitive) impairments
sufficient to disturb functional abilities.
 DEPRESSION
• Prevalence is high in elderly 15-40%
produced by illness, disability, retirement,
loss of loved one, social isolation, financial
loss, etc.
• Loss of appetite, sleep problems, feeling
sad, loss of energy, loss of interest in
activities previously enjoyed, loss of interest
in sex, avoids social activities, suicide
tendency
OSTEOPOROSIS
• Primary type due to menopause and age-
related changes
 FALLS
• Each year 30% to 50% of community-
dwelling persons aged > 65
• In long-term care, about 50% of residents fall
annually
• Complications of falls are the leading cause
of death from injury in persons aged > 65
• Fractures: 90% result from falls
• M – medications, malignancy
• E – emotions
• A –anorexia of aging
• L – late-life paranoia
• S – swallowing difficulties
• O – oral health
• N – no money
• W – wandering
• H – hyper/hypothyroidism, hypermetabolism
• E – enteric problems
• E – eating problems
• L – low salt, low cholesterol diets
• S – shopping and food preparation problem
 MALNUTRITION
Cellular imbalance between the supply of
nutrients and energy and the body’s demand
for them to ensure growth, maintenance and
function
- WHO
SLEEP DISORDERS
- Disturbed sleep
- Decrease continuity
- Daytime sleepiness are common complaints
of elderly
 VIOLENCE and ABUSE
Older people who are frail or live alone may
feel particularly vulnerable to crimes such as
theft and assault. A common form of violence
against older people (especially against older
women) is “elder abuse” committed by family
members and institutional caregivers who
are well known to the victims. Elder abuse occurs
in families at all economic levels
POLYPHARMACY
- Average elderly has 4 prescription medications,
- “Beer’s Criteria” – listing of inappropriately
used drugs
• Medications with no apparent use
• Duplicate medications
• Interacting medications
• Contraindicated medications
• Inappropriate dose
• Medications to treat adverse reactions
SENSORY IMPAIRMENT
1. Vision
Snellen Chart
Complete eye check-up yearly
2. Hearing
to check for Presbycussis
“Poor Vision & Hearing loss often leads to
injury, depression, dissatisfaction with life,
& withdrawal from social activities.”
• Three retirees, each with a
hearing! loss, were playing
golf one fine March day.
One remarked to the other,
"Windy, isn't it?"

• "No," the second man

replied, "it's Thursday."

• And the third man chimed in,

"So am I. Let's have a beer."

•
Staying Active Is a Key to Good
Health in Old Age
Department of Family and Community
Medicine
 Active Ageing:
The Concept and Rationale
 Active ageing is the process of
optimizing opportunities for health,
participation and security in order
to enhance quality of life as people
age.
The term “active ageing”
was adopted by the
World Health Organization
in the late 1990s.

It is meant to convey a
more inclusive
message
than “healthy ageing.
 Mission
 To address the special needs of elderly
patients.
 To provide prompt and quality service to all
elderly patients.
 To provide equitable and sustainable
services to elderly patients.
 To ensure that the Rights of the Elderly are
protected and implemented.
Comprehensive Geriatric Assessment
Comprehensive Geriatric Assessment

Functional ability
Comprehensive Geriatric Assessment
Screening for Disease
Comprehensive Geriatric Assessment
 Injury Prevention
 Medications

 Osteoporosis
Comprehensive Geriatric Assessment

Health and Social Services

 MOBILITY AND DEXTERITY
 Functional Reach Test

• The Functional Reach

Test is a single item test
developed as a quick
screen for balance
problems in older adults.
• Interpretation:
A score of 6 or less
indicates a significant
increased risk for falls.
A score between 6-10
inches indicates a
moderate risk for falls.
Comprehensive Geriatric Assessment

Health and Social Services

 Sensory Perception

 VISION
Comprehensive Geriatric Assessment

 Sensory Perception
 VISION
Comprehensive Geriatric Assessment

 Sensory Perception
 HEARING
Comprehensive Geriatric Assessment
Nutritional Health Screen
Comprehensive Geriatric Assessment
 Immunizations
VACCINATION*
• Influenza (Flu) - yearly
• Tetanus- evry 10 years
• Pneumococcal – for those
above 65 yo then after 5
years
• Zoster (Shingles) – for
adultd 60 y.o and older
• Hepatitis B – esp wd
people having diabetes
*CDC
Comprehensive Geriatric Assessment
 Sexuality
 Sex, Health, And Years Of Sexually
Active Life Gained Due To Good Health
Sexual activity,
particularly for men and
for women in the later life
cohort, was also
positively associated with
health. Among sexually
active respondents, good
health was significantly
associated with frequent
sex (once or more
weekly) in men (adjusted
odds ratio 1.6 to 2.1) and
with a good quality sex
life among men and
women in the midlife
cohort (1.7).
Comprehensive Geriatric Assessment

Continence
Comprehensive Geriatric Assessment
Mental Status
Comprehensive Geriatric Assessment
Mental Status
Retirement Boosts Your Risk of
Depression by 40 Percent
According to a new report released by the
Institute of Economic Affairs (IEA),1following an
initial boost in health, retirement increases your
risk of clinical depression by 40 percent while
raising your chances of being diagnosed with a
physical condition by 60 percent. It also:
Reduces your likelihood of being in self-reported
excellent or very good health by 40 percent
Raises your risk of taking medication for a
diagnosed physical condition by 60 percent
MOVE IT OR LOSE IT
Regular exercise is even
more important for
seniors than other age
groups …
But, as we all know, the
hardest part is getting
started…
• Get your parent involved • Encourage your parent to
in some type of social exercise
interaction
• Many senior community
• Senior centers programs offer Over 65
Exercise Programs
• Card clubs
• Join your parent for a short
• Volunteering walk outside or at the mall
• Talking with others every day
• Encourage your parent to
keep moving, at least 30
minutes a day
 Nutrition
• Are you physically healthy??
Nutritional Screening
Body Mass Index
BMI= Actual Body Weight in kg
(height in meter)2
 Body Mass Index

WHO ASIA PACIFIC

• <18.5 – underweight • <18.5 – underweight
• 18.5- 24.9 – normal • 18.5 – 22.9 – normal
• 25- 29.9 – overweight • 23 – 24.9 – overweight
• 30 – 34.9 – obese I • 25 – 29.9 – obese I
• 35- 40 – obese II • >30 – obese II
• >40 – obese III
 Total energy requirement (TER) =
bodyweight x factor
Activity Example of activities Factor
Sedentary Secretary, clerk, typist administrator, cashier, bank 30
teller

Light Teacher, nurse, physician, student, laboratory 35

technician, housewife with maids

Moderate Housewife without maid, vendor, mechanic, 40

jeepney driver

Heavy Farmer, laborer, miner, fisherman, heavy 45

equipment operator

Kung ikaw ay 70 kg:

70 kg x 30 (sedentary) = 2100 kcal
Modified Food Pyramid for 70+
 Say “no” to eating alone

• Make a date to share lunch or dinners with

children, grandchildren, nieces, nephews,
friends, and neighbors on a rotating basis.
• Join in by taking a class, volunteering, or going
on an outing, all of which can lead to new
friendships and dining buddies.
Elderly Fashion
Elderly Fashion
• Style is one of those
things that gets better
with age, right?
Well if that's true, then
you have no better place
to look to for inspiration
than your elders!
• "The real secret is being
in love with life and
realizing what you
have.”
• “Don’t be afraid to look
different.”
- Ari Seth Cohen, Advanced Style
You are never to old to set another goal or to dream a
new dream
C.S Lewis
All of us have parents
In the long run we will be like them too,
In the end what matters is that ...
Have we valued them as we should do.
How To Beat The Retirement Blues
“Parting is such sweet
sorrow that I shall say
goodnight till it be morrow.”

― William Shakespeare, Romeo and Juliet

Develop a rhythm!
For the elderly, there’re
jobs at SM malls!!!
Under the SM Cares for
Senior Citizens Program,
the elderly from 60 to 70
years old are afforded
the opportunity to work at
SM either as greeters or
ushers at the entrances,
food courts and cinemas
of the SM malls.
So don’t feel
pressured by the myth
of the golden years.
Like any other stage of
life, there are
wonderful things and
there are challenges. ..
• What’s the key to
a smooth
retirement? Tend
to your
psychological
portfolio as much
as your financial
one, researchers
say.
Never Lose Your Sense of Humor
“ He who LAUGHS,
LASTS!”…

Despite its seemingly

lightweight nature, humor
is actually a sophisticated
tension-defusing
mechanism.
• THE SENILITY PRAYER:
Grant me the
senility to forget
the people I never
liked anyway, the
good fortune to
run into the ones I
do, and the
eyesight to tell the
difference.