Aging Gracefully

Dr Cheah Wee Kooi

Physician and GeriatricianHead of Medical Department and Clinical Research Centre

Hospital Taiping

Her tips

• She married her double second cousin at 21, who started courting her when she was 15

• Employed servants and never had to work

• Pursuing hobbies such as fencing, cycling, tennis, swimming, rollerskating, playing the piano and making music with friends

• She gave birth to her only child at 23, and their only son on the same year.

• World War II: “German soldiers slept in my rooms but ‘did not take anything away’“; so that she bore no grudge against them.

• Aged 90 and with no heirs left, selling the property in exchange for a right of occupancy and a monthly revenue of 2,500 francs (€380) until her death

• 30 years later, lawyer died, family continue to pay

• moved into a nursing home, having lived on her own until age 110

Content

• Gerontology vs Geriatric

• Situation in Malaysia

• Frail vs. Robust

• Mind, Meals and Movements

• Environment

• Conclusion

Geriatric vs Gerontology

• GERON = the elderly

• Iatric = medicine

• Logy= science

Malaysia will be an aged nation by 2030 with people enjoying longer life

2,249

2,903(9.2%)

3,749(11.1%)

5,819(15.3%)

6,957 (17.4%)

8,231(19.8%)

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

2010 2015 2020 2030 2035 2040

Nu

mb

er

(To

tal)

Nu

mb

er

(Mal

e &

Fem

ale)

Male Female Total

11

• 2010 Data: Malaysian Population and Housing Census 2010

• 2015 – 2014 Data : Forecasted

Source: Department of Statistics Malaysia

Distribution of Elderly Population by State 2016

12

0.00

2.00

4.00

6.00

8.00

10.00

12.00

14.00

16.00Percentage Of Elderly Population By State

Department of Statistic Malaysia

The distribution of the elderly

2030

2020

2010

Year

Elderly age 60 years old and above

Malaysian less than 60 years old

1980

1 dalam 7

1 dalam 9

1 dalam 13

1 dalam 19

Number of the elderly

4,656,000

3,318,900

2,066,967

759,494

19912016e

(estimate)

M F M F

69.2 73.4 72.6 77.2

Life expectancy

Healthy Life Expectancy

Successful aging

• Biologically

– Personal level

• Sociologically

– Environmental and community level

Successful agingBiologically

• Reasonably ‘not so bad’ gene

• Cancer screening

• Cardiovascular risk reduction

• 3 Ms

– Movement

– Meals

– MindPreventing disease vsPromoting Health

MOVEMENT AND MEALS

Chronological vsPhysiological

FRAILTY

SARCOPENIASkeletal muscle lossPoor muscle quality

PHYSICAL FUNCTIONSIMPARIMENTWeak muscle strengthSlow gait speedPoor balance

FRAILTYDeficits accumulationFatigueSedentary behaviourWeight lossCognitive impairmentSocial isolation

EFFECTS OF AGING AND ILLNESS

23Argilés JM et al. J Am Med Dir Assoc. 2016;17(9):789-796

Myth buster

• Loss of muscle mass occurs with aging.Between 40 and 70 years, muscle mass decreases by about 8% per decade; beyond 70 years, the rate of loss increases to about 15% per decade.

40-year-old control

CALORIES:20 CAL/KG PER DAY

EXPERT RECOMMENDATIONS ELDERLY

27Deutz et al. Clinical Nutrition. 2014;33:929-936

Protein misdistribution

28

Paddon-Jones & Rasumussen. Curr Opin Clin Nutr Metab Care.

2009;12(1):86–90.

How do we measure?

Hand grip testDynamometers

Monitoring

• Weight

• Serum albumin

PREVENTION

An Active lifestyle

Successful agingBiologically

• Reasonably ‘not so bad’ gene

• Cancer screening

• Cardiovascular risk reduction

• 3 Ms

– Movement

– Meals

– Mind

MIND

Look to the east!Okinawa

Ikigaithe reason to jump out of bed every

morning

Successful aging

• Biologically

– Personal level

• Sociologically

– Environmental and community level

WHO Global Age-friendly Cities:The Perak Initiative

27 June 2019

Age-friendly city topic areas

Conclusion

• Growing older is a continuous process, but getting old is a choice

• Aging gracefully – Individually and Socially

• Mind, muscle and meal

• Age-friendly city

• From worrying about challenges to celebrating longevity

Thank you