ageing successfully · 2019-08-20 · ageing successfully susan kurrle geriatrician, hornsby...
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AGEING SUCCESSFULLY
Susan Kurrle
Geriatrician, Hornsby Ku-ring-gai and Eurobodalla Health Services Clinical Director, NSLHD Aged Care and Rehabilitation Network
Curran Professor in Health Care of Older People Faculty of Medicine, University of Sydney
Director, NHMRC Cognitive Decline Partnership Centre
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AGEING SUCCESSFULLY IN THE ABSENCE OF THE FOUNTAIN OF YOUTH
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EXAMPLES OF SUCCESSFUL AGEING
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WHAT DO THESE PEOPLE HAVE IN COMMON?
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WHAT DO THESE PEOPLE HAVE IN COMMON?
• They are all over 85 years of age
• They have all exceeded their life expectancy
• They are all outside and being active and engaged in activities outside “normal” daily activities
• They have not let age get in the way of doing what they want to do
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LIFE EXPECTANCY IN AUSTRALIA: MEN 81 YEARS WOMEN 85 YEARS
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SO HOW DO WE STAY FIT AND WELL INTO OUR 80S AND 90S?
HOW DO WE LIVE WELL UNTIL WE DIE?
AND HOW DO WE AVOID THE UNPLEASANT CONDITIONS OF OLDER AGE SUCH AS DEMENTIA, SARCOPENIA, AND FRAILTY?
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MADAME JEANNE CALMENT
• Took up fencing , aged 85
• Rode bicycle till 100
• Lived alone till 110
• Port wine, 2 cigs/ day, 1kg dark chocolate every week
• Gave up smoking at 120
• Poured olive oil on food and rubbed onto her skin
• Outlived husband, child and grandchildren
Died 122, slightly frail but without dementia
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SUCCESSFUL AGEING
• Have the right genes: health and longevity are hereditary
• Have the right personality: be a “glass half full” person
• Be physically active
• Be mentally and socially active
• Eat and drink well
• Maintain independence
• Avoid disease
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SARCOPENIA
• We lose approximately 1% of muscle mass every year from age 30, more after age 75
• Lose gluteal muscle mass more than any other muscle groups in both men and women
• May be unrecognised because muscle is replaced by fat or connective tissue
• Loss of muscle with age is probably inevitable – even life long athletes have less muscle mass as they age
• Muscle mass is not the same as muscle strength as quality of muscle is also important
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SARCOPENIA IN THE THIGH
(ICD 10 CM CODE: M 62.84 FROM JULY 1ST)
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WHAT ARE THE CONSEQUENCES OF SARCOPENIA?
• Low muscle strength • Slow gait speed • Increased risk of falls • Decreased function in ADLs
• Increased chance of hospitalisation
• Increased chance of institutionalisation
• Poor post operative recovery
• Higher drug toxicity
• Development of frailty
• Increased risk of death
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TREATMENT OF SARCOPENIA
• Progressive resistance training 3 sessions/week of main muscle groups
• Appropriate nutrition: • protein 1.5gm/kg/day in divided doses (whey protein enriched
with leucine) • Omega 3 FAs 4gms/day • Vit D if deficient
Cruz-Jentoft 2014
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PHYSICAL ACTIVITY
30 minutes of brisk walking, jogging, cycling, swimming, dancing 5 times a week
Resistance training • gym program • home program of sit to stand and hand weights
Balance training • Stand on one leg • Tandem stance and walk
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BE MENTALLY AND SOCIALLY ACTIVE
• Develop mental activities and social networks • Learn a new language, play a musical instrument • Join: Mens’ sheds, “Stitch and bitch”, U3A, Probus • Become a volunteer • Go to concerts, theatre, galleries • Get married - men live longer if living with a wife
rather than alone (and the risk of Alzheimer’s disease is decreased)
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EAT AND DRINK WELL
• Consider the Mediterranean diet: • High intake of vegetables, nuts, and legumes (peas, beans, lentils)
• Use of “good” oils (olive oil) and fish • Less dairy and meat
• Reduce intake of saturated fats, processed foods, fast foods, packaged foods
• Low to moderate use of alcohol (2 drinks a day and 1 alcohol free day a week)
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BARRIERS TO SUCCESSFUL AGEING
• Significant chronic disease in mid life • Diabetes • Respiratory disease • Renal disease • Cardiac disease
• Cancer
• Poverty
• Smoking
• Prison
• Homelessness
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IT IS NEVER TOO LATE TO START!
Ruth Frith:
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WHY IS IT IMPORTANT FOR THE YOUNGER GENERATIONS THAT WE AGE
SUCCESSFULLY?
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GRANDPARENTS
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GRANDPARENTS
• Annually almost 1 million children in Australia received some care from grandparents
Careforkids.com.au
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GRANDPARENTS
• Grandparenting is good for cognitive function in older women – minding grandchildren predicted significantly higher cognitive function compared to those not minding grandchildren (Australian Womens Healthy Ageing Project)
Burns & Szoeke 2015
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AGEING SUCCESSFULLY WITH SOME HELP
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OLD PEOPLES’ HOME FOR 4 YEAR OLDS
COMING SOON ON ABC TV
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QUESTIONS?