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1st July 2019

Current Issue

Words from the President

Council of SLAGM - 2019

Educational Activities

Annual Academic Sessions-

2018

SLAGM articles

-Ageing Phenotypes and

Geriatric Syndromes

-Care of Older People - Is

it different?

SLAGM Publications 2018-2019

Training Programmes

Forthcoming Events

New Members

Other news

SLAGM NEWS Official Newsletter of Sri Lanka Association of Geriatric Medicine

Volume 1, July 2019 ISSN: 2682-714X

Words from the President

Dear Colleagues and Friends………..Read more

Annual Academic Sessions 2018

Compiled and edited by Dr. Achala Balasuriya Dr. Hamsananthy Jeevatharan Mr. Harshitha Galhenage

Office: Wijerama House,

No 6, Wijerama MW,

Colombo 7.

E- mail : slagm2014@gmail.com

(Administrative Secretary)

TP -94 (0) 11-2693025

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SLAGM Council 2019 Founder Dr. Lalith Wijeratne

Patron Dr. Selvie Perera

President Dr. Padma S Gunaratne

Vice Presidents Dr. Ruvan Ekanayake Dr. Priyankara Jayawardhena

Secretary Dr. Chamila Dalpathadu

Assistant Secretary Dr. Thusha Nawasiwatte

Treasurer Dr. Sajeewana Amarasinghe

Assistant Treasurer Dr. V. L. Dassanayake

Immediate Past President Dr. Dilhar Samaraweera

Council Members Dr. W.D. Thilakaratne Dr. Senaka Bandusena Dr. Lasantha Ganewatte Dr. Anoja Rajapakse Dr. Pradeepa Gajendran Dr. C.N. Wijeratne Dr. Achala Balasuriya Dr. K.V.C. Janaka Dr. Upul Dissanayake Prof. Antoinette Perera Dr. Nirmala Wijekoon Dr. G.K.K. Sewwandi Dr. Chandana Kanakaratne Dr. K.P. Karunathillake Dr. Dilanka De Silva Dr. Barana Millewithana Dr. M.N. J. Gunathilake Dr. J.B. Jayawardena

President’s Message Dear Colleagues and Friends,

Greetings from the SLAGM!

I am pleased to announce the launching of the very first Newsletter of Sri Lanka

Association of Geriatric Medicine at the Annual General Meeting in July 2019.

I believe, the Newsletter is a much needed addition to the SLAGM at this time

when our membership numbers are increasing, and we are strengthening our

links with Regional and International Geriatric Associations. We plan to publish

our SLAGM Newsletter every 3 months in the form of an E- Newsletter.

Sri Lanka Association of Geriatric Medicine was established in 2014 with the

objective of ensuring geriatric education among the medical fraternity and the

public with the common goal of promoting good health and well-being among

the senior citizens in Sri Lanka. Since inception, the SLAGM thrived under the

guidance of the eminent inaugural President, Dr. Dilhar Samaraweera.

I was fortunate to be able to serve as the President of this distinguished

Association. I am pleased that I am writing this message at a time that the

energetic Council of the SLAGM is very much contented with our activities over

the last year.

Annual Scientific Conference 2018, was the leading event organized with the

participation of more than 200 attendees under the theme “Adding quality to

added years” at the Galle Face Hotel, Colombo. There was a neuro-

rehabilitation workshop for the therapists in the pre-congress session. Seven

invited overseas speakers addressed wide range of geriatric topics in the main

academic programme.

In addition to organizing the vibrant Annual Scientific Conference, SLAGM was

able to carry out many outstation academic programmes and workshops

during this period. The Council aligned the main academic programs spanned

throughout the year in keeping with the conference theme “Adding quality to

added years” focusing on the need to establish multi- disciplinary team care

for older adults in Sri Lanka.

Widening the scope of membership by accommodating all health care

professionals on a single platform with the intention of promoting “Holistic

Approach for Elders”, is a primary target of SLAGM and we are working

towards realizing this goal. The SLAGM was the key figure to unveil the multi-

disciplinary approach in the minds of nurses and allied health professionals by

publishing the bulletin “Health Care for Older People – Holistic Approach” with

contributions from all the members of the team. This valuable bi-annual

publication is now available in all libraries related to health professional

education.

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Specialty Day in Geriatrics 2019

Programme

Care for The Elderly: What is Distinct? Dr. Chandana Kanakaratne Consultant Geriatrician End Stage Kidney Disease in Older Adults: Practical Considerations in Management Dr. S.Mathu Consultant Nephrologist Cognitive Impairment in Older Adults: Evaluation & Management Prof. Shehan Williams Professor in Psychiatry Hyponatraemia in Older Adults: Diagnosis and Therapeutic Considerations Dr. Manilka Sumanathilake Consultant Endocrinologist COPD Exacerbations in Older Adults: How to Prevent, Detect and Treat Dr. Amitha Fernando Consultant Respiratory Physician Frailty: Prevention Detection and Management Dr. Dilhar Samaraweera Consultant Physician Management of Urinary Incontinence in Older Adults Prof. Ajith Malalasekara Consultant Genito- Urinary Surgeon Arrhythmias in Older Adults : Detection and Management Dr. Asunga Dunuwila Consultant Cardiac Electro Physiologist

During the course of the year, the SLAGM was invited to represent the

interests of the Association at many national level activities including the

National Steering Committee on Elderly Health Care organized by the Youth,

Elderly and Disabled Unit of the MoH. Thereby, we are contributing to the

national grid on elderly health care.

As a grieving nation following the series of Easter bomb blasts, the multi –

disciplinary health care professionals that consists of all categories of staff

is the strength of the SLAGM. As we work united in the SLAGM, our

multidisciplinary team members which involve all categories of health care

workers irrespective of their level of education, religion, race or cast is the

pride of our Association.

I look forward to continuing with more educational programmes for

professionals and health care team members with a wide range of

community-based programmes for the public, as we join hands with the

New Council to be appointed following the Annual General Meeting in July

2019.

Dr. Padma Gunaratne

President

SLAGM.

Educational Activities Sri Lanka Association of Geriatric Medicine held many academic programs

for both medical doctors, nurses and allied health professionals over the

past one year. These programs focused on educating the health care

providers about the special needs of the older patient, the distinctive

aspects of providing care for the elderly, common age related morbidities

like dementia, frailty and falls. These educational programs also introduced

the need for multidisciplinary care approach to manage the ageing patient

for a holistic service provision. The resource persons for these activities

were members of the SLAGM Council, Consultants in Internal Medicine,

Neurology, Psychiatry, Rheumatology and Community Medicine.

Number of educational programs were done at National Hospital of Sri

Lanka. In 2018 June, the first Specialty Day in Geriatric Medicine was held at

ClinMARC, NHSL with the participation of postgraduate trainees,

consultants, medical officers of various grades, nurses and allied health

professionals.

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On the first of October 2018, as the world

celebrated the “World Elders Day” SLAGM

held a public educating media interview with

the participation of Dr.Padma Gunaratne

(President), Dr. Priyankara Jayawardena (Vice

President) and Dr. Dilhar Samaraweera at the

Health Promotion Bureau on the MoH.

Kandy Foundation Sessions 2018 was held in

August in collaboration with SLAGM.

During the course of 2018, SLAGM held a

special General Meeting and a new

constitution allowing membership to nurses

and other allied health professionals such as

physio and occupational therapists was

sanctioned.

In 2019, SLAGM carried out several

educational sessions in and out of Colombo to

link the health care personnel in many parts of

the island towards providing holistic care for

the older patient.

“Holistic Care for Elderly” training course for

doctors, nurses and allied Health professionals

was held on 4th January 2019 at the National

Hospital, Colombo and, also at Awissawella

BOI conference Hall ,on 8th February 2019.

Nurses Program at NHSL

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Regional Meeting at BOI Conference

Hall Awissawella

SLAGM members with Team Awissawella

On 26th of March 2019, SLAGM Regional

Meeting Galle, was held in collaboration with

the Galle Medical Association (GMA).

Postgraduate trainees of Geriatric Medicine,

consultants from Internal Medicine,

Neurology, Geriatric Medicine, Psychiatry and

Rheumatology participated at this event. Prof.

Ashish Goel from University College of Medical

Sciences, Guru Teg Bahadur Hospital New

Delhi also participated at this event.

Dr. Padama Gunaratne

Prof. Shehan Williams

Prof. Ashish Goel

SLAGM and GMA Teams at Galle

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The audience

Dr. Sithira and Dr. Suamya in” role play”

SLAGM and KCS teams

Regional Meeting Kegalle

SLAGM Regional Meeting in collaboration with

the Kegalle Clinical Society was held at the

District General Hospital Kegalle on the 14th of

June 2019. SLAGM program under the theme

“Holistic Care for the Elders” was attended by a

large number of participants involving

consultants. grade medical officers, nurses and

allied health care professionals. Highlights of

the program are shown below.

Dr. P. Gunaratne (President) addressing the

gathering

Dr. Dilhar Samaraweera (Founder President),

lighting the lamp

Dr. Chandana Kanakaratne

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Fourth Annual Academic Sessions of

the SLAGM 2018

Geriatric Medicine and Neuro-Rehabilitation

Conference of the SLAGM was held between 25th

and 27th October 2018 in collaboration with

Association of Sri Lankan of Neurologists (ASN) at

the Gall Face Hotel Colombo. The theme for the

conference was “Adding Quality to Added Years”.

The vibrant clinical program was attended by a

large number of delegates both local and

international. The Guests of Honour for the

inauguration were the President of the British

Geriatric Society, Dr. Eileen Burns and Dr. Nirmal

Surya, Honorary Associate Professor of Neurology

at the Bombay Hospital and Research Centre. The

Minister of Health, Dr. Rajitha Senaratne graced

the occasion as the Chief Guest.

There were Pre-congress workshops on

Management of Spasticity for doctors and,

rehabilitation of Stroke and Parkinson’s disease

for physio and occupational therapists conducted

by international resource persons from India and

Australia. The international faculty members

were, Professor Susan Kurrle from Hornsby

Kuringal Hospital Sydney, Australia, Prof. Ian

Cameron, Professor of Rehabilitation Medicine,

University of Sydney, Dr. Veena Raykar Consultant

specialist in Rehabilitation from Concord Hospital

Sydney, Dr.Abhishek Srivastava, Consultant in

Rehabilitation Medicine and Director of

Neurological Rehabilitation and physical Medicine

at Kokilaben Hospital Mumbai, India, Ms. Reenai

Pillay Senior Rehabilitation and Occupational

Therapist, Concord Hospital Sydney Australia and

Ms. Clarie Gill a Senior Physiotherapist from St

George Hospital Sydney Australia.

Local faculty members included Dr. Padma

Gunaratne, President SLAGM and Consultant

Neurologist, Dr. Sudath Gunasekara, Consultant

Clinical Neurophysiologist, Dr.Senaka Bandusena

Consultant Neurologist, Dr. Champika

Gunawardena, Consultant Neurologist, Dr. Dilhar

Samaraweera, Consultant Physician, Dr. Kapila

Ranasingha, Consultant Psychiatrist and Dr.

Shiromi Maduwage Consultant Community

Physician.

Dr. Chandana Kanakaratne, Consultant Physician

(Consultant Geriatrician UK), Dr.Chandana

Karunathilake, Consultant Orthopaedic Surgeon,

Dr.Manilka Sumanathilake, Consultant

Endocrinologist, Dr. Arosha Dissanayake,

Consultant Physician, Mr. Yasantha Kodagoda,

Additional Solicitor General and President’s

Counsel, Dr. Noel Somasundaram Consultant

Endocrinologist, Dr.Panduka Karunanayake

Consultant Physician and Prof. Godwin

Constantine, Consultant Cardiologist.

Highlights from the Pre- Congress

Session

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Annual Academic Sessions 2018

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Annual Dinner 2018

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SLAGM articles

Ageing Phenotypes and Geriatric Syndromes Dr. Saumya Darshani, Registrar in Geriatric Medicine, National Hospital, Colombo

The hallmark of ageing is decrease in functional properties of cells, tissue and organ systems. This loss of

functional properties results in a loss of homeostasis leading to decreased adaptability to stressors causing

adverse health outcomes such as morbidity or mortality. This phenomenon is now believed to be of

random occurrence and accumulation of functional loss due to multiple factors rather than a programmed

genetically determined process, therefore we witness the individual variations in aging. This explains why

merely the chronological age does not precisely predict the phonotypical age.

Figure: Ageing phenotypes and genesis of geriatric syndromes.

(Source-Oxford Textbook of Geriatric Medicine)

Ageing Phenotypes

There are four ageing phenotypes described in the literature which are results of multisystem effects of

ageing. These can be taken as parameters that measures rate of ageing.

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1. Change in body composition

There is a progressive decline in lean body mass comprising muscle and visceral organs after 30 years

which is accelerated after 60 years. There is an increase in fat mass during middle age, then decline in

latter ages. It is mostly the visceral and inter-muscular fat that increases while there is decline in

subcutaneous fat. However until around 70 years body weight is usually stable or slightly increases while

there is parallel decrease in both fat-free mass and fat after 70 years. Furthermore, there is development

of poor quality muscles due to increased fat infiltration within the muscle with ageing. These major

changes in body composition negatively affect functional status and contribute to impaired mobility and

disability in older adults.

2. Imbalance in energy availability and demand

The degenerative process that characterizes ageing occurs when the individual’s ability to balance energy

production and expenditure declines.

Resting metabolic rate (RMR) is the energy required to maintain structural and functional homeostasis at

physical rest, in fasting and neutral conditions. RMR that is higher than expected for a certain age, sex and

body composition has been found to be an independent risk factor for mortality and predicts future

greater burden of chronic diseases. Consequently, it should be considered a marker of health

deterioration in older adults.

It is observed in studies that the peak oxygen consumption (VO2 max),which estimates the maximum

energy that can be produced by an organism over extended time periods declines with age around 10%

per decade starting from 30s. This decline is more accelerated in chronic disease and those with sedentary

life. VO2 max is a reflection of cardiovascular and respiratory adaption to transport oxygen and

adaptations within muscle to use oxygen to meet the energy demands of physical activity and thereby

represents the maximal ability to use oxygen to meet the energy demands of physical activity (maximal

aerobic capacity), physical function and mobility in older adults.

3. Homeostatic dysregulation

With ageing, there is impairment in acute inflammatory responses resulting in increased susceptibility to

infections. However on the other hand, there is mild persistent chronic inflammation in the body causing

tissue damage and degeneration. This is revealed by detection of elevated levels of serum C-reactive

protein and interleukin-6 (IL-6) which is shown to be associated with age related chronic diseases,

hospitalizations, disability and mortality.

Homeostatic dysreguations also can be seen in hormonal regulations where there is decline in anabolic

hormones such as GH, IGF-1, vitamin D, DHEAS, testosterone, estrogens and relative preservation of

catabolic hormones such as thyroid hormones and cortisol. This dysregulation can result in physical

disability and cognitive impairment and also predicts cardiovascular and all-cause mortality in older

adults.

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4. Neuronal functions and neuroplasticity

It is commonly observed that the memory, processing speed, executive function, and reasoning are

commonly reduced with ageing. Contrary, other mental functions like verbal abilities, numerical abilities

and general knowledge tend to be spared. There are both structural and functional changes in brain with

ageing which are responsible for decline in brain functions. These changes are modified by genetic and

environmental factors. It is evident that cardiovascular and metabolic risk factors, inflammation, stress,

and deposition of iron and beta-amyloid accelerate brain ageing, while leading an intellectually

challenging, physically active, and socially engaged life mitigate cognitive decline and play a protective

role enhancing neuroplasticity, and perhaps also facilitate novel neurogenesis in specific parts of the brain.

The above four ageing phenotypes explain how ageing results in physical and cognitive frailty and multi-

morbidity. The rising susceptibility for disease occurrence by ageing process creates multi-morbidity

which defined as the co-existence of at least two diseases. Therefore ageing has become the major risk

factor for multi-morbidity. The frailty, multi-morbidity and disability are inter-connected. However, the

causal relationship between frailty and multi-morbidity is yet to be proven.

The multisystem effects of ageing lead to well recognized geriatric syndromes including falls, urinary

incontinence, dementia, delirium, pressure ulcers etc. Most geriatric syndromes are results of specific

combinations of over expressed ageing phenotypes. Those syndromes are multi factorial health

conditions that have emerged when the accumulated effects of impairments in multiple systems render

an older person vulnerable to situational challenges. Therefore its pathophysiology is different from the

pathophysiology of most non-geriatric conditions (one alteration leading to one disease involving one

system). For example, urinary incontinence in older individuals is usually due to a combination of changes

in body composition with consequent reduced muscle mass and strength of the bladder and pelvic floor

muscles, altered neurological reflexes related to neuro-degeneration (both central and peripheral nervous

systems) and recurrent urinary tract infections due to poor immunity. Therefore, the treatment of urinary

incontinence in an elderly female who presented with concomitant urinary tract infection is not really

achieved only by mere treatment of infection. One must address the problems such as pelvic muscle

weakness, constipation, mobility issue, depression and much more to overcome the syndrome.

Therefore, knowing the phenotypical changes that occur with ageing is essential not only for advancing

research, but also for the clinical diagnosis, etiological identification and treatment of geriatric syndromes

and may improve the healthcare of older adults.

References

1. Fabbri E, Zoli M, Ferrucci L (2017).The emergence of ageing phenotypes and multisystem decline. In: Michel JP,

Beattie BL, Martin FC, Walston JD. Oxford Textbook of Geriatric Medicine. 3rd ed.: Oxford University Press;. pp. 311-

316.

2. Fedarko NS. The Biology of Aging and Frailty.Clin Geriatr Med. 2011 Feb; 27(1): 27–37.

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3. Vetrano DL, Palmer K, Marengoni A, et al.(2018) Frailty and multi-morbidity: a systematic review and meta-

analysis.J Gerontol A Biol Sci Med Sci. May 3. Doi:10.1093/gerontogly110.

4. Inouye SK, Studenski S, Tinetti ME, Kuchel GA (2007). Geriatric syndromes: clinical, research, and policy

implications of a core geriatric concept. J Am Geriatr Soc; 55: 780–91.

Care of Older People - Is it different? Dr. Chandana Kanakaratne, Consultant Physician & Geriatrician

Over the last many decades we witnessed the expansion of the population in Sri Lanka beyond 21 million.

Education, skills and experiences of the population, as a whole, have improved vastly with many

advantages. People live much longer now than it was many decades ago. We have become one of the

longest living populations in the south Asian region with an average life expectancy over 75. Improved

medical services and social circumstances, good nutrition, better education, easy access to global

advancements in technology are among many other factors that would have contributed to the improved

life expectancy.

Everyone has a right to life irrespective of the age. As clinicians our duty is to ensure productive life for

everyone. Promoting an active ageing process is useful in this regard. World Health Organization proposed

three pillars to active ageing.

‘Active ageing’ for better life

Active ageing principles are meant to focus us on the right direction to achieve the best quality of life

though achievement of best outcomes with ageing. It consists of three important components.

Firstly, it’s important that we feel well and happy with ourselves (positive wellbeing). Secondly, we should

work towards the best possible physical and mental health, best social well-being, and the best physical

function. Thirdly, we should remain involved with the families, peers, and the rest of the community

throughout life and the ageing process. Maintaining healthy interactions with others seem to improve not

only the psychological health but also the physical health.

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Strengths and challenges of ageing

Ageing is an inevitable process we all face. It starts rather early in life around 25 to 30 years of age, and

continue to express its effects on the body and the mind for the rest of our lives. As the time goes by

people may develop more and more wisdom through the ongoing education and life experiences enabling

them to deal with many different events in life effectively and satisfactorily, and also to guide, inspire and

mentor the younger generations. But the toll of ageing on the mind and the body is undeniable.

Up to the age of mid-twenties the body organ systems such as cardiovascular, respiratory and central

nervous systems continue to grow. After that age their capacities and degree of functioning start declining

gradually and, the process of ageing sets in. Though we may feel strong and healthy for many years and

decades to come the ageing process advances day by day bringing on the inevitable changes. We become

more vulnerable to chronic non communicable diseases (NCDs) such as diabetes, high blood pressure,

heart disease and stroke. Declining immune systems make one vulnerable for acute and chronic

infections. Cancers become common. Many people harbour multiple NCDs, hence, they end up having to

see many specialists. They are also subjected to poly-pharmacy, which can be very confusing and

impossible to cope with. Lack of coordination of care by one clinician is a disturbing reality for many.

Are there any specific changes associated with ageing?

Ageing also brings about many ageing related difficulties. Walking and balance issues are not uncommon.

These with many other reasons such as multiple diseases and drugs make one vulnerable for falls and an

increased falls risk. Those who fall may encounter very unpleasant outcomes such as fractures, head

injuries and other injuries, loss of confidence and independence, and ‘fear of falls’ restricting one’s

confidence to walk again. Incontinence of urine and, sometimes faeces, and constipation are common

with ageing. Mental health issues such as dementias, depression, anxiety and delirium are very common

with ageing though they are very often missed and unattended.

Frailty is another major area of concern increasingly recognized with ageing and in older people. It still

has not got adequate recognition and attention as a significant risk factor for poor quality of life and a

definite threat to the independence of life. Frailty is given so much attention in some parts of the world

that they have developed special services with purpose-built frailty units staffed by trained staff.

Does everyone go through the ageing process at the same rate?

Ageing process does not continue at the same rate in all. Although the one’s genetic composition is the

major contributor for the ageing process it also depends on the integrity of an individual based on one’s

activities, habits and experiences in life. Unhealthy diet, lack of exercises, diseases, malignancies and

disabilities, poor habits such as abuse of alcohol, drugs and smoking, exposure to toxins, stress and other

psychological issues and many other factors may hasten the ageing process. Therefore, there is no one

pattern to the ageing process in everyone. That’s why it is important to take each person as a unique

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individual and assess their problems and difficulties on individual basis, in a person centered way. So it is

very obvious that the discussions on healthy ageing process should not be restricted to those who are

already in the ageing process but also offered to the younger populations as well.

How do the diseases behave with ageing? Can we approach the diseases

occurring later in life the same way we approach them when we are younger?

When one develops an acute disease such as an infection the usual approach is to recognize the nature

of the illness and, then offer a targeted treatment appropriate to the illness. For instance, if someone

develops an infection antibiotics are given for certain period of time and it is expected that person will be

better. It works well and truly with younger people.

When it comes to older individual the acute illness can lead to many other complications. They may be

confused and become restless and agitated or stop eating and drinking. They may lose balance and the

ability to walk independently resulting in falls. They may struggle to get on with the day to day work and

some may even become chair bound or bed bound. Some become incontinent. Treating just the acute

illness is not going to make the patient better. While acute illness is treated as for the younger people

attention should be given to other difficulties. Patient may not volunteer with such information, hence,

the medical team should positively look for them. Input from the therapists like physiotherapists,

dieticians, occupational therapists, swallowing specialists may be needed. Sometimes the services of the

mental health teams or other specialists may be necessary. Care from different specialists should be

coordinated and delivered to suit the patient’s needs.

Delivering best health care for elders

Patient-centered care is achieved by multi-disciplinary assessment and input through a team of different

specialists such as doctors, nurses and therapists working together to achieve common goals appropriate

to a particular patient.

Comprehensive Geriatric Assessment is a tool used in Geriatric Medicine to assess the needy as well as

vulnerable and frail elders to prevent them from reaching adverse outcomes and improve their medical

and social well-being.

Long term care plans are laid down for very frail patients and, this process is known as “advanced care

planning”.

Future

Sri Lankan population is ageing fast. Providing better care for elders through any specialty will also depend

on the ability to deal with ageing related issues interacting with the primary issues. Familiarizing the

medical trainees and the doctors, especially the younger generation, with the principles of Geriatric

Medicine will help the medical profession and the ageing population.

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SLAGM Publications (2018-2019)

SLAGM published 2 issues of SLAGM bulletin, Health Care for Older People – Holistic Approach on

Dementia and Parkinson’s disease. This bulletin with contributions from all members of the MDT will be

published biannually and the topics relevant to care of the older persons will be addressed. This

publication endeavors to educate the health care team managing the older people in the context of the

multidisciplinary approach and will be made available in all libraries relevant to medical profession.

SLAGM, as a medical professional body committed for elderly medicine, concentrate more on training

health care professionals. The first volume was launched at the Annual Academic Sessions 2018 at the

Galle Face Hotel Colombo. This publication can be accessed through SLAGM web: https://www.slagm.lk

free of charge.

Community Education from SLAGM

SLAGM is also in the process of implementing a coordinated Trainer Training Program on Healthy

Ageing named ”Wedihiti Diviyata Athwelak” ( An aid for healthy ageing) for community education.

“Wadihiti Deviyata Athwelak” is a WHO funded TOT for medical practitioners on prevention and

early detection of conditions commonly seen among older people. The programme addresses topics

such as NCD, falls, respiratory disorders, hearing and vision impairment, nutrition, psychiatry

disorders, medical check-ups and activities for daily living in relation to ageing. Resource persons have

been nominated by the respective professional colleges. Trained medical professionals will be

awarded with certificates, manual and the CDs of presentations. Trained medical professionals are

encouraged to address Elder Societies in villages, country wide.

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New members 2018

Dr. Niluka Gunathilaka, Dr. Nirmala Wijekoon, Dr. N. Shanthakunahara , Dr. Prashanthika Nawasiwatte,

Dr. Senaka Bandusena, Dr. Sajeewana Amarasinghe, Dr. Keerthi Gunesekara, Dr. Inuka Kishara

Goonerathne, Dr. Varithamby Thambipillai Rajendran, Dr. Rajawasam Wellala Hettige Janaka Prasan

Waidyasekara, Dr. Atapattu Egodage Sunethra Senanayake, Dr. Gamini Pathirana , Dr. Ruvan Ekanayaka,

Dr. T. Thivakaran, Dr. Udaya Kumara Ranawaka , Dr. M.T.M Riffsy, Dr. Darshana Dias Wijegunasinghe,

Dr. H. Pathirage Manjula, Dr. G. N .N Fernando, Dr. A. M .J. Abeynayake, Dr. Hamsananthy Jeevatharan

and Dr. F. H.D.S Silva.

New members 2019

Dr. K. G. N. Umayangani Jayasinghe, Dr. N. A. M. Sohan Cooray, Dr. K. D. Duminda, Dr. A. G. Saumya

Darshani, Dr. S. A. A. Senevirathne and Dr. N. D. Jayaweerabandara.

Acknowledgement

Sri Lanka Association of Geriatric Medicine is thankful to all our resource persons and sponsors for their

contributions to make all activities of SLAGM 2018/2019 a great success.

Forthcoming Events

Annual Academic Sessions 2019 will be held from 30th November to 1st December at Galle

Face Hotel Colombo. More Information is available at our web site : https://www.slagm.lk. Please

keep the dates free for an enriching academic experience!