Yesterday was World Elders Day
Wishing you a 100 healthy years
Dr M.L. Kataria

MORE than 2500 years ago a young prince was overwhelmed with suffering in life, at birth, in old age, disease and death. He renounced his princely pleasures to discover a panacea for human suffering. For 12 long years he visited all holy places and holy men. He roamed in hills, dales and jungles of India, till emaciated down to his bones, under a Banyan tree at Gaya. While in meditation, he was enlightened. He became the Buddha. He gave humanity an eight-fold path to peace and happiness in life. But, alas, he discovered no panacea for disease and old age, except fateful self-surrender! At 80, he died of food poisoning, with no cure at that time.

It was for science during the past millennium to discover the cause and treat disease. Since times immemorial old age has also been regarded as a conglomerate of all diseases. The myth of geriatric helplessness has been exploded. Old age is no longer a burden upon one-self or on the family. Fifty years ago our life-span was 33 years. It is now 66 years. Fifty years hence it will be 100 healthy years. Thanks to the marvels of bio-medical sciences.

Think of any incapacitating ailment peculiar to old age. On timely and frequent monitoring it is either preventable, or easily curable, with scientific knowledge and multi-pronged tools of technology now available. Cataract, glaucoma (chitta and kala motia) and senile retinal/ macular degeneration, for long incapacitating old age scourges, with present-day sophisticated techniques of phaco-emulsification, intra-ocular lens implantation and laser therapy, in competent hands, are no longer dreaded ailments. One can have one’s vision restored to normal standards without using ugly and thick glasses.

Hypertension, angina, ischaemic heart and coronary artery disease, strokes, hemiplegias and myocardial infarctions are no longer old age fatal problems. Monitored well in time and with proper life style, these are preventable, and can be efficiently managed.

Cancers of prostrate, breast and cervix can now be detected well in time. Their early detection can ensure their total elimination by surgical, radiotherapeutic and chemotherapeutic techniques, and a full life-span expected.

In a recent issue of the journal of the National Academy of Sciences, USA, Ikuo Nishimoto of Keio University, Tokyo, has claimed to have identified a substance called “humanin”, a protein comprising 24 amino-acids, which prevents degeneration of brain cells, and has a promising future to control Alzheimer’s disease.

Lately, the role of embryonic stem cells to cure the neuro-psychiatric disorders and also several other genetic ailments, including diabetes, during the coming decades is yet another ray of hope for a Nobel laureate.

Pre-and-post-menopausal disorders, weight gain and many irksome problems due to hormonal imbalances can be skilfully managed by hormonal replacement therapy, counselling, diet control, yoga, exercise, etc, in women on the threshold of old age and well into old age.

We are running three Geriatric Health Care Centres, exclusively for senior citizens at Chandigarh, Mohali and Panchkula. In these centres it is not uncommon to encounter senior citizens, over 70 and even over 80, asking for aphrodisiacs for both spouses, of course in confidence. For this ever increasing tribe, old age is certainly no longer a burden! They quote Sherali Farzali Muslimov of Azerbaijan, who dies at 142 and married for the umpteenth time at 137. May you live at least a 100 healthy years. Amen!

The writer is a retired Brigadier, who runs health care centres for Ex-Servicemen.

Nutritional requirements of senior citizens
Dr U.S. Bansal

SENIOR citizens have been traditionally defined as a section of the population above 65 years of age. It is a well-known fact that good nutritional habits clearly influence the quality of life a person may expect in later years.

Malnutrition costs senior citizens by exacerbating disease, by increasing disability, by decreasing their resistance to infection and by extending their hospital stays. It costs caretakers by increasing worry and care-giving demands.

Aging is associated with changes in the senses of taste, smell, sight, hearing, touch and diminished food intake at individualised rates. Good nutrition is one of the cornerstones of the management of senior citizens and plays a crucial role in helping them to remain healthy and functioning.

The recommended dietary requirement calls for an average caloric intake of 2400 Kcal/day for men and 2000 Kcal/day for women. Health problems arise when the intake is less than 1600 Kcal/day. Out of the total daily caloric intake, about 60 per cent should come from the carbohydrates, 25 per cent from the fats and 15 per cent from the proteins. One gram of carbohydrates gives about 4 calories and so is the case with proteins, while 1 gram of fat gives about 9 calories.

Carbohydrates: The richest source is plant starch present in wheat and rice, as also in corn and potatoes.

Proteins: There are two sources in our diet. One is animal protein (its sources are meat, egg, milk, paneer, etc) and the other is plant protein. (sources: pulses, soyabean peas, mushrooms, etc) Adequate dietary protein intake is crucial for senior citizens. Four eggs a week is recommended by the Egg Corporation of India.

Fats: Again, there are two types of fats in our daily diet. One type is saturated fats — the sources are cream, butter, ghee, meat, yolk of egg, milk, coconut oil, etc. The second type is unsaturated fats which are mono-unsaturated and polyunsaturated fats. The sources of mono-unsaturated fats are mustard oil, olive oil, til oil, etc, while the sources of poly-unsaturated fats are refined oils, especially Saphola and Ricela (rice bran). Emphasis should be on reducing the intake of saturated fat and choosing unsaturated fat.

Fibre or roughage is a very valuable ingredient in the food of the elderly as it helps the digestive system work properly by making it exercise and clear out the bowel. Its sources are leafy vegetables, fruits, carbohydrates, etc. The role of fibres in lowering blood cholesterol (fat circulating in blood) levels as a risk factor for coronary artery disease is well known.

Though water has no caloric value, it should be taken in sufficient quantity along with food or otherwise.

Minerals and vitamins: An adequate intake is equally essential as agents that enhance the health of the elderly. The important minerals are calcium, zinc, iron, copper, sodium, potassium, etc. Their sources are green leafy vegetables, fruits, carbohydrates, milk, etc. Important vitamins are Vitamin-E, Vitamin-C, Vitamin-A, Vitamin-D, Riboflavin, Vitamin B12. The sources are green leafy vegetables, yellow fruits, cod liver oil, fish oil, carrots, sprouted grams/dals, milk, butter, citrous fruits, amla, chillies, etc. Seasonal cheap and easily affordable fruits and vegetables are rich in minerals, vitamins and fibres.

The writer is a former CMO, Health Department, Chandigarh Administration.

‘Doctor, I don’t want to use spectacles’
Dr R. Kumar

AS soon as a girl or a boy suffering from weak eye-sight is advised to wear spectacles, a lot of hue and cry is raised by the parents. There is also plenty of tear shedding by the beneficiary. Looking in anguish and almost totally disappointed by the doctor’s misadventure, the parents would say, “doctor, advise us some medicine, miracle food or eye-exercises. We can spend any amount on these things, but we will not allow our daughter to use spectacles, at all. We have already consulted the optical shop in the market. The “optometrist” has advised several foods and vitamins, besides giving spectacles…. But we are paying you this fee so that…”

“Why did you consult a non-doctor in the first instance?, the doctor interrupts in amusement.

The fact is that 25 to 30 per cent of our youngsters have a weak vision, naturally. The key to success in studies and sports lies in good vision. The easy and almost sure solution lies in the correction of vision through the use of lenses in appropriate frames or the use of contact lenses. There is no dearth of the choice of lenses —simple white glasses, photo-chromatic glasses, anti-glare glasses, ultraviolet protective glasses, plastic lenses, etc. This arrangement is fine for most people. Medicines, food, exercises, etc, are hardly helpful as a cure. Spectacles for better vision are user-friendly. So, don’t hate them.

Most people want to avoid the use of spectacles for cosmetic/appearance reasons, though their merit is well established. Often they expect permanent vision correction without the use of any aid like contact lenses or spectacles. This has been tried by changing the shape of healthy cornea through the cut of knife (radial keratotomy-RK) or the use of laser (photo refractive keratotomy-PRK or Lasik). Remember, this surgery is not a medical necessity at all; it is only to avoid spectacles.

In the past most surgeons were apprehensive about cutting a healthy cornea with a knife or burning it with laser for fear of irreversible damage to this transparent window of the eye. The fears were not wholly unfounded. Damage to the eyes of a large number of such young patients did occur through the use of RK procedure. This procedure is now almost abandoned due to the notoriety earned.

Laser correction in its original form (PRK) or modified form (Lasik), where laser is applied under a flap, is in use at present and most of the patients get good to excellent results with this procedure. Though the Lasik procedure is reasonably safe and effective, it is neither absolutely safe nor a precise correction is fully guaranteed. The results are not 100 per cent predictable; there can be under-correction, over-correction.

If you are over 40 years of age you will require reading glasses, anyway, even after full correction. There is no Lasik correction for age-related failure of reading vision. Also in some cases after Lasik correction, there may be a return of near-sightedness after a variable period.

Laser correction is recommended after the vision and the power of glasses has got stabilised, i.e. around 20 years of age. Your eye-specialist, after a thorough examination, can advise about your suitability or otherwise for Lasik surgery.

Keep in mind that no surgical procedure is totally risk-free. It can lead to serious complications like infection and loss of vision, though not commonly noticed. Several other problems may be occasionally experienced — fluctuating vision, decreased vision, light sensitivity, halos of light around the images, glare, weakened cornea, pain in the eye, corneal haze, etc. What will be the fate of this sculpted cornea in the long run or what will be the effects of ageing, surgery, accident, etc, on it is yet to be established.

As long as you are happy with them, your old friend, the spectacles, are still the best option.

The writer, a senior eye consultant, was earlier associated with the PGI, Chandigarh.

INFO CAPSULE
Depression and memory loss

WASHINGTON: Researchers who analysed data from a long-term Cardiovascular Health Study have found that symptoms of depression, irritability, and apathy often accompany mild memory loss, known to doctors as “mild cognitive impairment” which should be immediately treated.

The researchers from five medical centres, including Wake Forest University Baptist Medical Center, reported in the current Journal of the American Medical Association that their study, based on participants followed for more than 10 years, was the first to show that the appearance of psychiatric symptoms correlates with the development of mild cognitive impairment.

While psychiatric symptoms occur in the majority of persons with outright dementia, “these are the first population-based estimates for neuropsychiatric symptoms in mild cognitive impairment,” the group reported. “These symptoms have serious adverse consequences and should be inquired about and treated as necessary.” ANI

Calculator for skin cancer treatment

Washington: US researchers have developed a new, user-friendly calculator that will help doctors better understand complex skin cancer data and help patients make more informed decisions about treatment.

The brainchild of three researchers from the Mayo Clinic, namely Dr Charles Loprinzi, Dr Stephen Thome and Mike Heldebrant, a Ph.D. candidate, the calculator, details of which have been published in the current issue of Mayo Clinic Proceedings, helps determine the baseline prognosis for patients newly-diagnosed with melanoma, an often fatal cancer of the skin, and the potential benefits for such patients of receiving interferon therapy after surgery.

Two years ago, these very investigators had also created a similar calculator to help doctors provide breast cancer patients with survival estimates for each treatment option after surgery. ANI

Restoring heart’s normal rhythm

WASHINGTON: A common treatment for atrial fibrillation, a medical condition characterised by an irregular and rapid beating of the heart’s atrial chambers that results when the normal electrical conduction system of the atria is not functioning properly, can sometimes result in stroke. Now, US researchers say that this risk can be minimised if patients take anticoagulation medication prior to the procedure.

The procedure, called elective direct current (DC) cardioversion of atrial fibrillation, is the electronic restoration of the heart’s normal rhythm.

Researchers from the Mayo Clinic found that the rate of stroke or other embolic happenings — clots or blockages of the blood vessels — occurring in a patient after cardioversion was less than 1 per cent. ANI

Low BP lessens stiffness of arteries

TOKYO: A new Japanese study has revealed that when it comes to reducing blood pressure, lower BP reading is better as it lessens stiffness of the arteries.

The findings, presented at the American Heart Association’s 56th Annual High Blood Pressure Research Conference in Orlando, have revealed that in people taking a variety of medications to lower their blood pressure, those whose blood pressure was reduced to lower than the standard goal also had reduced stiffness in their arteries.

People treated to the standard goal didn’t experience the same improvement in their artery stiffness, the study says.

“Artery stiffness is associated with heart disease and death in people with high blood pressure,” says study senior researcher Dr Atsuhiro Ichihara of the Keio University School of Medicine, Tokyo. ANI