Wed, 15 May 2002

Growing old is not a gray issue

Stevie Emilia, The Jakarta Post, Singapore

Aging has a different effect on people. While some women will rush to the beauty clinic to get rid of wrinkles with Botox, men might find themselves giving Viagra a try.

Aging, however, is a natural process that happens to us all. There is no way of stopping it, and the bad news is, women will experience it sooner than men.

According to Dr. Chan Kin Ming, a consultant geriatrician at Gleneagles Hospital Singapore, women age first, while men catch up with them about five years later.

"We can see this from the aging of bones. Women, for instance, enjoy the peak of bones at the age of 30 and then after that, their bones start ageing. They might experience osteoporosis and other bone problems. Men experience it five years later than women," he said. He was one of the speakers at a two-day seminar on positive aging, gracious living, organized by Gleneagles Hospital Singapore early this month.

He realized that there is a misperception about aging and negative thinking toward the issue.

"Aging is irreversible, it is dependent on changes that occur in biological systems once the peak of vitality has been reached.

"Growing old will not necessarily mean suffering from negative health problems. The elderly can also enjoy a positive life ... so don't follow anything blindly just to stop ageing."

Many factors, he said, accelerate aging, like diseases, a decrease in hormones or menopause. "Aging is a complex issue, it might be affected by many things, like genetic factors, the environment, hormones or diet," Chan said.

Some health problems experienced by the elderly include:

* Memory disorders

* Eye problems, like cataracts, glaucoma, age-related maculopathy

* Cardiovascular diseases like coronary artery disease, hypertension, congestive heart failure, atrial fibrillation, sick sinus syndrome, conduction defects and stroke.

* Rheumatic disease, like osteoarthritis and osteoporosis

* Sex problems, like erectile dysfunction in men and urogenital atrophy, which occurs in post-menopausal females due to low levels of estrogen and may cause vaginal dryness, dysparenia and recurrent vaginal infection.

* Digestive disorders, which include reflux oesophagitis, flatulence, colorectal cancer, fecal incontinence and fecal impaction.

Should one fear aging?

"I don't think so, we will still age anyway. We can't ignore the fact that as we grow older we develop many diseases. The important thing is how to think positively about ageing," Chan said, insisting that the elderly maintain good health, watch their diet, exercise and have hobbies and friends to keep their mind active.

Advancements in medicine and technology have lowered the mortality rate and increased life spans. The global phenomenon of a graying population has sparked many concerns among developed and developing countries.

By 2020, it is estimated that the world will have more than 1 billion people aged 60 and over. In Singapore, about 7 percent of the current population is aged 65 years and above, and by the year 2030, that figure will have increased to about 19 percent.

"Before, only a lucky few could reach the age of 60, but now, surviving to the age of 100 is no longer an anomaly. We see patients over the age of 100 attending medical clinics and hospitals," said Dr. Edward Leung, a consultant geriatrician and president of the Hong Kong Association of Gerontology.

The increase in life expectancy, he said, brings with it new challenges, both economic and humanistic aspects, which had not been faced before the 20th century.

On the macroeconomic level, for instance, the increase in the number of elderly people beyond the statutory retirement age means an increasing dependency of the elderly on society's economic support -- no matter what type of retirement protection is offered -- while some will depend on the government's support.

"To tackle this problem, society needs to examine ways to promote economic independence of the elderly through job opportunities," Edward said.

With an escalating number of aging people, he said he also saw a demand for the care of the elderly as they are prone to chronic diseases, which would incur recurrent costs on specialist care and hospitalization.

Moreover, functional disabilities secondary to chronic and degenerative conditions, like stroke and dementia, have resulted in a heavy demand for personal nursing care for the elderly, he added.

"In this century, we will need to examine ways to promote healthier aging societies, reduce dependency through preventive measures and provide support to families caring for elderly members," Edward said.

The medical community could contribute to dealing with aging problems by, among other things, searching for primary and secondary preventive strategies to reduce the advent and degenerative conditions in the elderly and providing training and education to healthcare professionals on the needs of an aging population.

But again, physical well-being may not be everything.

"With the presence of medical advancements, there are many physically healthy old people around. Unfortunately, there's a lack of psychological support for the elderly. In the end, they may be physically healthy, but lonely."