Do take it to heart

State spending on health can’t keep pace with cardiac diseases. Making the right lifestyle choices is the best preventive and a cost-effective solution

Non-infectious diseases such as heart disease and cancers kill more people in India than all other causes of death put together, with heart disease taking the lead with 2.5 million deaths annually. It shows no bias and is the leading cause of death across age, gender, incomes, regions, and urban and rural India. No matter how old you are, how rich you are or where you live, heart disease — which causes heart attacks and strokes — is more likely to kill you than any other disease.

There are subtle variations, though. It is more likely to kill men than women: 20.3% of all male deaths are caused by heart disease and stroke as compared to 16.9% deaths in women, shows data from the Registrar General of India’s study of One Million Deaths in India, which uses country-wide Sample Registration System and verbal autopsy — asking the family about the sickness, symptoms and treatment, especially if the death took place at home — to identify the cause of death. Then there are regional variations, with deaths being the highest in the more affluent states of Goa, Tamil Nadu, Andhra Pradesh and Punjab, compared to Uttar Pradesh, Madhya Pradesh, Bihar and Rajasthan.

The projected cumulative loss of national income due to loss in productivity because of early death from noncommunicable diseases for 2006-2015 is $237 billion. By 2030, this productivity loss is projected to double. This is far greater than the corresponding loss in the US, which has a population a fourth the size of India’s. Add to this India’s expenditure on healthcare — around 4.1% of its GDP, only 26% of which was government funding — and you have millions of people pushed to poverty just to pay healthcare bills.

The sliver of hope in this litany of bad news is that over 90% of heart disease depends on how we live our lives, our stresses, what we eat and how active we are. Of course, genes have some role to play, but nine in 10 heart attacks can be prevented by controlling blood pressure, cholesterol and diabetes; eating high fibre-low fat food; staying fit; not smoking; and managing psychosocial factors such as stress. Early detection and treatment of hypertension (chronic high blood pressure), for example, reduces death from heart attacks by 35-60%.

And it’s never too late to start. Even adopting four healthy

Don’t miss a beat behaviors — eating at least five fruits and vegetables daily, exercising for at least 2.5 hours a week, maintaining a healthy weight, and not smoking — after 45 years reduces the risk of heart disease by over one-third, reports a study in The American Journal of Medicine. The study found that these changes lowered heart attack risk by 35% and death from heart attacks by 40% in people between 45 and 64 years. The benefits were there even for those who lived a decadent life till they decided to turn over a new leaf and tread the path to health.

The heart-protective benefits begin the moment you make healthy choices. The nutritional plan for a healthy heart is eating less of saturated fats like butter and more of oils such as olive and mustard oils, eating five or more servings of fruits and vegetables a day; six or more servings of whole grains such as wheat and brown rice; low-fat milk products; legumes and beans; and fish and lean meats.

But making diet changes alone are not enough to keep the heart healthy and people need to have high activity levels, keep weight in check and not smoke. Smoking is the biggest cause of heart attack in young people with no other risk factors because it increases the risk of clot formation in the blood, which can block arteries and cause a heart attack even in healthy people. A review of heart disease incidence in 21 countries reported in the journal Tobacco Control showed that smokers had a five times greater risk of heart attack than non-smokers.

Obesity also perpetuates a chain of risk factors such as diabetes, high blood pressure and high cholesterol, each of which individually boosts the risk of heart disease. Keeping the body mass index (BMI) between 22 and 23 — a little lower than the internationally recommended cut off of 25 — lowers a person’s heart risk substantially. BMI is calculated by dividing a person’s weight in kilograms by the height in meters squared.

The reason why Indians need to keep their weight lower than Caucasians is our warped fat distribution. A Canadian study of four ethnic groups — South Asians, Chinese, aboriginal populations and Caucasians — showed that for the same level of body mass (weight), South Asians had more body fat. All South Asians also accumulate fat around their abdomen, which is the worst possible place to put on weight. A waist size larger than 38 for men and 35 for women may be a sign of the metabolic syndrome, which is characterized by a group of risk factors such as diabetes, high blood pressure, elevated trigycerides, low good cholesterol (HDL) and high bad cholesterol (LDL), and a pro-inflammatory state (elevated levels of C-reactive protein in the blood), showed study on ‘Waist circumference cutoff points and action levels for Asian Indians’ in the International Journal of Obesity.

With diseases outpacing government spending on health by giant leaps, prevention is the only practical way to save the country from an avalanche of medical bills.

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Ensure a life of dignity for the aged: Pranab

President Pranab Mukherjee on Monday called for measures to enable the elderly to lead a life of “dignity.”

Speaking at a function organised by HelpAge India to mark the International Day of Older Persons, Mr. Mukherjee expressed concern over the growing neglect and abuse of seniors in the country.

Mr. Mukherjee said: “I have to confess my deep alarm and dismay in this context over the findings of the 20 city survey conducted by HelpAge which reveals that one out of three elders have faced abuse. It is even more shocking to learn that those surveyed describe their sons and daughters-in-law as the primary abusers. Many report such abuse as having continued for more than five years and most do not complain to anyone in order to uphold family honour.”

The President pointed to the withering away of family values and expressed hope that the shocking revelations about elderly abuse would serve as a warning.

“We must do everything possible to ensure that our elders can live a life of dignity, enjoying the best of medical attention, economic security as well as emotional stability. Our culture, history, traditions, religion and philosophy all enjoin us to respect our elders and to fill their lives with abundant love and affection.”

To the nation, with a very large young population, the President’s message included a reminder, “…India is what it is today because of the contributions made by our elders in their youth. If those hands steadied you when you learned to walk, then you need to support them when they need help and hope there will be others who will do the same for you when you grow old.”

“It’s just another phase”

“Society and the government should be sensitised to the fact that old age is just another phase of life with its special needs and characteristics just like childhood and youth,” the President said, adding that efforts should be made to provide health care and economic security to the aged.

“The real challenges that lie in the field of health security are accessibility and affordability of medical health facilities. The elderly require special geriatric care… their medical expenses increases with age whereas their income decreases or remains static. Private hospitals are reluctant to provide concessions to the elderly and insurance companies unwilling to insure the elderly,” he said.

“Proud to be an elder”

Earlier, the President made a reference to his own age and urged the elderly to refrain from thinking of old age as an inhibitor.

“I turn 77 a few months from now. Our honourable Prime Minister has just celebrated his 80th birthday. Ms. Lata Mangeshkar celebrated her 83rd birthday a few days back. Justice V.R. Krishna Iyer is going strong at the age of 97, intellectually vibrant and deeply concerned about the welfare and progress of our nation. Many more illustrious persons can be added to this list, but I stop here… There is in this audience and all around us a large number of elders who are making extremely valuable contributions to our country and to our society. I salute them and am proud to be one of them, an ‘elder’ leading a productive and fruitful life.”

The President said with advancement of medical science and technology, age is by no means a disabling factor. Quoting W. Somerset Maugham and Henry Wadsworth Longfellow, the President encouraged the elderly “to get out of a ‘retirement mentality’ and think about old age as a second innings.”

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Elderly to constitute 20 per cent of India's population by 2050: Report

India's population is likely to increase by 60 per cent between 2000 and 2050 but the number of elders, who have attained 60 years of age, will shoot up by 360 per cent and the government should start framing policies now else its consequences are likely to take it by surprise, a UN report said.

"India has around 100 million elderly at present and the number is expected to increase to 323 million, constituting 20 per cent of the total population, by 2050," the report jointly brought out by United Nations Population Fund (UNFPA) and Help Age International said.

With an emphasis on addressing urgent concerns of elderly person worldwide like investment in pension and quality health care, the report said if these are not addressed promptly, the consequences of these issues are likely to take unprepared countries by surprise.

"In order to realize their right to enjoy the highest attainable standard of physical and mental health, elder persons must have access to age-friendly and affordable information and services that meet their demands," the report added.

The UNFPA in its study in India, which was conducted in seven states, found that around one-fifth of the elderly live alone or with spouses only in both rural and urban areas.

70 per cent of the elderly population is illiterate and their earning capacity in the past (during their adult years) was limited and they depended upon some productive labour work outside home for their survival.

The number of people aged 80 and above, which presently is 9,249 will increase to 44,218 by 2050 while China will have 98,339. The ratio of men per 100 at the age of 60 and 80 years will be 92 and 82 which will mean women have more life expectancy.

Of the total number of elderly, about 83 per cent men were married and only 40 per cent women, while China has 79 per cent married men and 61 per cent married women.

According to the report, by 2050, India and China will have about 80 per cent of the world's elderly living there, and India is likely to pip China in the number of centenarians.

In China, there are currently 14,300 centenarians, whose number is likely to increase to 262,500, in Japan, which already has 49,500 centenarians it is expected to increase to 617,000.

In India, the total numbers of centenarians are likely to be between 151,000 and 620,000, the report said.

The report, which was released in Tokyo on the International Day of Older Persons, says that of the seven billion people who live on the planet, 893 million or 12.8 per cent are elderly.

The elderly population is likely to swell by 200 million taking it well beyond one billion people, and this would put great strain on welfare and medical systems.

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Every third senior citizen in India abused, mainly by son: Study

  

Indian sons, and their wives, aren't treating their aged parents well. A study on abuse of India's elderly, conducted across 20 cities and involving over 5,500 older people, has found that almost 1 in 3 (32%) have faced abuse. The son has been found to be the primary abuser in 56% of cases, followed by the daughter-in-law in 23% cases.

The study, to be presented to President Pranab Mukherjee on October 1, celebrated globally as the International Day of Older Persons, said more than 50% of those abused had faced it for more than five years. More than half (55%) of those who were abused did not report it to anyone. Around 80% of them did not report the matter to uphold family honour.

Delhi actually witnessed an exponential increase in abuse of the elderly. In 2011, Delhi's abuse of the elderly rate stood at 12%. In comparison, 29.82% elderly people in Delhi said they faced abuse in 2012.

The study, conducted by Help Age India, found that abuse was highest in Madhya Pradesh (77.12%) while people in Rajasthan (1.67%) were most well behaved with the elderly in their family. Nearly 30% or 1 in 3 elderly persons reported abuse in Maharashtra while the abuse rate was just above 1 in 4 (27.56%) in Tamil Nadu. It was 60% in Assam, 52% in UP, 43% in Gujarat, 42.86% in Andhra Pradesh and 40.93% in West Bengal.

The study also brought out some shameful figures for Delhi. While nearly 30% of Delhi's senior citizens had faced abuse, the primary perpetrator of abuse was the son in 60% cases, followed by the daughter-in-law in 24% cases. In Delhi, 76% of those abused did not report it, while of those who felt abused, 69% had felt disrespected with 35% facing it daily.

Around 86% of elderly felt that the most effective measure to control elder abuse was through sensitizing children and strengthening inter-generation bonding and 14% felt increased economic Independence was the solution.

The study said that in India, the family has been the mainstay of social support. "Even in this age and time, 58% of older persons in India are living with the family. The findings of this report also affirm confidence in the ability of the family to care for its older members," the report said.

The National Policy on Older Persons has also recognized the importance of family for the wellbeing of older persons and has decided to have programmes to promote family values, sensitize the young on the necessity and desirability of inter-generational bonding and continuity and the desirability of meeting filial obligations.

"State policies will encourage children to co-reside with their parents by providing tax relief, allowing rebates for medical expenses and giving preference in the allotment of houses. The policy also says that short-term staying facilities for older persons will be supported so that families can get some relief when they go out," the study said.

The report made an interesting recommendation. In order to prevent elder abuse, it said there should be nationwide programmes in schools and colleges for sensitizing children and young adults towards the ageing and the aged, sensitization of healthcare workers to recognize and develop a protocol for treatment, develop a robust social security system that not only ensures income security to the older persons but also gives them opportunities for income generation.

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How to Stay Socially Engaged as You Age

As you get older, normal changes in your brain can make it more difficult for you to learn new information or remember things. In people who have dementia, this intellectual impairment becomes so severe that it interferes with their lives. Sometimes cognitive decline cannot be avoided, but in other cases, keeping your mind stimulated or interacting with your peers may help ward off dementia and depression, another common senior health concern.

One recent study from the Rush Alzheimer’s Disease Center in Chicago found that highly social seniors had a 70 percent lower rate of cognitive decline than their less social peers. Another study, by researchers at the University of Alabama in Birmingham, discovered that Internet use was associated with a 30 percent decrease in depressive symptoms.

Tips for Staying Socially Engaged as You Age

There are plenty of ways to stay socially connected and intellectually stimulated:

Nurture your social network. Make an effort to maintain your close personal relationships with family members, friends, church members, neighbors, and other important people in your life. Even if they’re not close by, you can still keep in touch by e-mail or Facebook. According to data from the Pew Research Center’s Internet & American Life Project, the 74-plus demographic is the fastest-growing group across Web-based social networks. Use of sites like Facebook and Twitter among Internet users 65 and older grew 100 percent between 2009 and 2010, from 13 percent to 26 percent. Many assisted living centers have even begun offering technology classes to get seniors online and in the social-networking loop.

Play "mind" games. Regularly doing crossword puzzles and playing chess and other intellectually stimulating games keeps your mind active and, if you play with others, helps you stay socially connected to your peers. Scientists believe that both your body and your mind follow the principle "use it or lose it." So think of these games as fun ways to exercise your brain.

Join a club. Contact your local senior center and ask around to see if there are any clubs in your area you would be interested in becoming a part of. Attending regular book club, garden club, or art club meetings is a great way to meet new people and establish rewarding relationships with people who have similar interests.

Go back to work. Many people experience stress after they retire, feeling they have lost part of their identity. If you are longing to work again, consider taking a part-time job, which can help keep your mind stimulated and give you a sense of greater contribution. Civic Ventures and the Work Search program offer assistance to older people who want to get back into the workforce.

Volunteer in your community. If you want to have a feeling of purpose or contribute to a greater cause, find a way to volunteer in your community. You can find out more about volunteer opportunities through organizations like Senior Corps, a government-run organization that connects seniors with local and national organizations in need of volunteers. Recent studies show that older individuals who volunteer have a reduced risk of death compared to their counterparts who do not.

Offer family assistance. If you have grandchildren or other young family members you would like to see more of, offer to babysit regularly. Chasing around after children is a great way to keep you physically active and improve your sense of well-being.

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Cut down old age odds

Old age brings in a lot of worries, but the two most dreaded by all is the reducing health levels and marked changes in the facial features.  Though some segments are controlled by nature and not much can be done but for sure their effect can be minimized and subdued. Well-nourished living habits, thorough maintenance and a stress free lifestyle can sure make it a win situation. The following are a few simple measures which when religiously adopted can keep odds at bay and make one feel and appear younger:

Do hydrate yourself enough on daily basis. A water intake of about 2 to 3 liters is integral. The water supply to the body keeps the levels up to the mark and moisturizes internally

Never let your face is left on without any moisture. Even after washing the face pat it dry and then apply a good moistening agent to keep the skin at bliss. A cleansed, washed skin type would guarantee a flawless complexion in long run. It should be a habit as only long term measures can help

Avoid excess of tea and coffee though two cups a day are fine but any more can be troublesome.

Always opt for options that are rich in anti-oxidants. Anti-oxidants rich foods curtail the ageing factors making one look much younger. Fruits, green leafy vegetables, fresh salads, green tea and herbal methods should be a must. Experts suggest having at least two fruits on daily basis or two bowls of salads full of lettuce, broccoli, bell peppers, and tomatoes.

Vitamin rich fruits and vegetables. These small but very important percentages of diet are quite apt to turn things your way. So never to neglect them and intricate wise in the diet form. Also many think supplements can satisfy the needful but taking a natural form is much more beneficial.

Lycopene in tomatoes is wonderful for skin repairs and promote a healthy skin type. A raw tomato a day would be fine to meet up the demand.

Mineral rich foods like oil seeds, legumes, nuts all are a must. Often females give up on the nut section thinking them a high calorie version but the nourishment they aid is miraculous and necessary. Obviously moderation is needed but abstinence is not advisable.

The green color of the plants derived from chlorophyll is essential to keep your skin fresh. Green leafy vegetables stuffed with chlorophyll cleanse and keep the tone on.

Anti-ageing juices are a prevalent variety these days prepared with tomatoes, cucumber, aloe Vera, mint, and wheat grass form a perfect blend and an anti-ageing tool. The juice would be only beneficial if prepared fresh without any preservatives and consumed on daily basis.

As mentioned above as well never to give up on oils they are very much needed by the body for complete functioning

Always keep yourself into some physical activity. It is necessary to keep things going your way.

Yoga and meditation with some breathing exercises will help you keep young and also stress free.   

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Suggestions to Remain Healthy

 To remain healthy in old age, control your weight, blood pressure and diabetes, eat four to six portions of fruit or vegetables daily, do not smoke, avoid salt, drink alcohol in moderation, walk daily, maintain muscle strength and flexibility with exercise and sleep for six or seven hours a night .

  Adopting healthful habits can significantly alter the course of aging and prevent common diseases.   Here are some suggestions to remain healthy in old age:

 * Drink enough water:  It cleanses your body machinery and helps your heart in functioning well. Drinking of enough water will keep away chances of kidney stone and urine problem. It will also keep you looking young and active along with natural glow on your face.

 * Exercise regularly:  Vigorous physical activity may stop you from looking and feeling old, it may even help you live longer. Whether you're 30, 60 or 90, endurance enables you to do what you want to do. A study by McMaster University researchers has shown that there is no substitute for exercise when it comes to keeping old age at bay. Research from Tel Aviv University has found that endurance exercises like a jog or spinning class can make us look younger. Exercise unlocks the stem cells of our muscles. These exercises increase the number of muscle stem cells and enhance their ability to rejuvenate old muscles. Endurance exercises also improve the levels of 'spontaneous locomotion' — the feeling that tells our bodies to just get up and dance. Ageing is typically associated with a reduced level of spontaneous locomotion.

 * Well balanced diet: Well-balanced diet plays a very important part in keeping you healthy in old  age. Avoid taking rich food like sweets, high stuffed and fried.  You should add calcium rich diet as it will strengthen your bones. Add fruits, vegetables and greens in your daily diet to maintain your health in old age. 

 * Be happy and engage in recreational activities:  During old age, Factors like social isolation, low income and depression affect health in old age. Loneliness is a common problem in old age and leads to related problems. During this time, it becomes all the more important for seniors to take on some activity which occupy their time.

  * Exercise your brain by participating in mentally stimulating activities such as reading, writing, doing puzzles and play to learn the Chess Game.

 * Keep your eyes and ears fit by regular checkup.  Vision and hearing tests by specialists should be a regular part of your anti-aging plan. Sight-threatening diseases that are more common with age, including cataracts, glaucoma and macular degeneration can be controlled or halted if caught early. Hearing loss, the third most common chronic condition can contribute to cognitive decline, depression and social isolation,    To reduce your risk of eye disease, avoid tobacco smoke, wear sunglasses, maintain a healthy weight and control high blood pressure and blood sugar levels. To reduce the risk of hearing loss, consider using earplugs in noisy places.

 * Check your BP: Always contact with your doctor to keep blood pressure, blood sugar and cholesterol levels under control even as you get into your 70s and beyond.

 * Control your overweight. You should be especially vigilant against creeping weight gain. Obesity is the gateway to many ailments, such as heart diseases, diabetes and arthritis.