THE world observed International Day for Older Persons last Friday.
The occasion is a United Nations-sponsored annual event that is designed to bring attention to a global population of elderly persons who UN experts are saying are rapidly increasing without proper notice by governments, societies and other bodies around the world.
The world, according to the UN, will soon have a third of the population who will be over the age of 60.
The majority of older persons live in developing countries. Their proportion is expected to exceed 70 percent by the year 2030.
Against this background, Wheel Power recently spoke to consultant neurologist Dr Lim Shen-Yang at University Malaya Medical Centre in Kuala Lumpur for his views on the elderly in Malaysia.
I asked the senior lecturer, in particular, about what kinds of neurological ailments that could challenge an older generation of Malaysians.
“International Older Persons Day on October 1 offers us all a chance to celebrate the fact that over the last half-century, 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 added.
Dr Lim went on to point out that not only are people living longer; they are also leading productive and fulfilling lives.
“We are also fortunate that deference for elders in our society 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 a process of ‘wear and tear’.
“However, it is a common mistake to simply attribute all symptoms occurring in older persons to ‘old age’. In so doing, we may be depriving ourselves or our loved ones of proper treatments.”
Dr Lim who has authored numerous publications in medical journals and books and currently serves as associate editor of Neurology Asia, 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 an excessive amount of 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 destruction of brain cells that are deprived of oxygen can also be the problem.
“All of these conditions,” Dr Lim pointed out, “which become increasingly common with ageing - have specific treatments that in some cases may result in marked improvement.
“If left untreated, however, 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, and in some cases, even back to normal.
“Thus, walking difficulties should not be automatically viewed as an ‘inevitable’ part of aging,” 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 frightening 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 major distress to both the patient and caregiver.
“New ‘cognitive enhancers’ can sometimes reduce behavioural disturbances, and also improve memory and motivation,” said Dr Lim.
“However, it should be noted that older patients can be more prone to experiencing adverse effects from medical interventions, and therefore the pros and cons of initiating any 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 the number of cardiovascular events such as 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 (whether this is a general practitioner, neurologist, geriatrician, etc.) who is knowledgeable and skilful, and willing to take the time to sort through the issues,” concluded Dr Lim.
The End
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