Glowing Old

Of all the people who have ever lived to age 65, more than half are now alive and show the phenomenon of ageing. In nature, ageing is most notable for its absence; nearly all the animals die of predation, disease or environmental hazards rather than ageing.

The branch of medicine, which studies the phenomena and problems of senescence is called Geriatrics. In Western word it is much studied. In spite of many studies scientist are at a loss to explain the cause of ageing - is it a genetically programmed mechanism or is it due to progressive random damage.

The process of ageing is a decline in various organ systems of the body. This starts getting evident by the third decade of life. It is gradual and progressive although the rate and extent of decline vary. Diet, environment and personal habits besides genetic factors influence it. If there is no disease process, ageing does not impose any restrictions on activities of daily living, regardless of age.

There are certain changes in the body, which are age related and should not be taken as pathological. They are increase in body fat, decrease in body water, presbyopia (vision problem), hearing loss for high frequency and decrease in lung elasticity with stiffness in chest wall. Gastrointestinal, liver, renal, musculoskeletal and nervous system all exhibit slowing. Due to these physiological changes some features become obvious like forgetfulness, bony fragility, stiffer gait, increase in body sway, early awakening from sleep or insomnia and susceptibility to glaring lights creating difficulty in driving, especially at night.

The general tendency is to take all the problems as a part and parcel of old age. This is not so. Problems like intellectual impairment and depression should be carefully evaluated and if required appropriate treatment must be provided.

One major problem faced by the elderly specially women is urinary incontinence.

If we think about the process of urinary control it won't take us long to realise that it is a complicated process involving adequate mobility, mental acuity, motivation and manual dexterity. A flaw in any one of these would lead to urinary incontinence. Problems like delirium, depression, urinary tract infection, diabetes mellitus and lack of oestrogen hormone in women are highly likely to cause incontinence though it is usually transient. Sometimes urinary bladder or its musculature has such problems that on coughing, laughing or even without such stress urine leaks. This can be helped by voiding urine every one or two hour without feeling the urge or by doing pelvic muscle exercise. Sometimes drugs or surgery may be required.

With loss and slowing of various acuity, it is invariable that falls may result and consequent injuries may force a person to bed rest. A man's house is his castle is an age-old saying but the flaws of castle, which could be easily overcome in younger age, become a pitfall in elderly. Inadequate lighting in stairs or kitchen, cracks in the flooring and slippery bathrooms may create an unforeseeable emergency. The medical advice of bed rest should always be discussed in detail with the doctor because a prolonged bed rest may create bedsores or blood clots in veins.

A long list of problems could be drawn but as Alexis Carrol said "what matters is not to add years to your life but to add life to your years". So a good family physician with whom you could talk in detail, who knows you well enough to sort out genuine problems requiring treatment must be kept in touch with. Light exercise like walking or yoga is very important. It improves mood and social interaction, reduces insomnia and constipation and improves posture.

The biggest asset for a glowing old age is a high self-esteem. Reasonable financial independence and self-dependence go a long way towards bringing it about. A realisation is also required about the fact that development of mankind has taken place only because the younger generations have been facing forward. This is the law of nature and has to be honoured. Rather than brooding and getting upset about what our children are doing or not doing about us.

The trouble with future is that it arrives before we are ready for it and that is the difference between growing old and glowing old.