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The Elderly
Their Future Impact
Prof Faisal Abdul Latif AlNasir FPC,MICGP,FRCGP,PhD
Family Medicine
Vice President
Arabian Gulf University, Bahrain
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• Poor raw material
• Prevailing poverty
• Lack of national strategies
• Fast ageing in parallel with rapid social changes
– urban vs. rural ageing
– changes in family structure
The reality in the developing world
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Ageism
Definition: even among good social classes
Internal changes in the body of all living kinds.
The process which changes a healthy individual
into a fragile one.
Continuous changes in different organs’ functions.
Coni et al.
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Ageing is a complex biological process
leading to;
- decrease cell abilities for auto repair.
- continuous cell death.
- decrease body immunity.
- disturbance in homeostasis.
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How does it happens
Biological clock
No way for measuring ageing
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Facts
Fact (1)
Physiological changes due ageing are common
among mammals (e.g. hair whitening, decrease
immunity) but severity differs from one mammal
to other
e.g.;
-Rodents Renal failure
-Humans CNS atrophy “Alzheimer”
Coni, N. et al
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Fact (2)
- Ageing is controlled by genetic factors no way
of measuring it.
- But MLP (Maximum life Span) can help.
e.g.;
- 3 to 5 yeas in rodents
- 115 years in human
Social trends, 1982
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Facts (3)
Decreases calorie intake helps in
delaying ageism.
Christianser and Grzgowski, 1993
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NOBODY CAN PREVENT A PERSON FROM
GETTING OLD.
BUT IT IS POSSIBLE THAT DISABILITIES
COULD BE DETECTED MUCH EARLIER AND
ATTENTION IS GIVEN TO IT MAKING
SURE THAT IT DOES NOT PROGRESS.
Can we prevent ageing?
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Level of activity declines with increase age and
the prevalence of disability increases with age.
Mastin GM, et al 1996
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Elderly relate most of their problems to ageing
process so do not complain. Therefore there is
an accumulative process of complication
happening leading to worsening of disabilities.
Williamson, 1996
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Studies have shown that the risk of
death after the age of 30 years
doubles every 8 years
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Common problems among the
elderly:
1- Mobility.
2- Changes in body physiology (drugs, illness).
3- Decrease in mental abilities.
4- Incontinence.
5- Risk of storks.
6- Psychological problems.
Barber, JH 1984
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الرحيم الرحمن هللا بسم
"وهللاالذيخلقكممنضعفثمجعلمنبعدقوة
ضعفاوشيبايخلقمايشاءوهوالعليمالقدير"
موالرةرسو
“God Created you from weakness and
made you
again weak and aged after strength”
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Physical Changes
As age increases, changes occur in the
behaviors, appearance, physical and
mental abilities.
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BIOLOGICAL CHANGES IN THE ELDERLY
Fibroblast
Collagen
Elastic Fibers -- Stiffness
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BIOLOGICAL CHANGES IN THE ELDERLY
Fibroblast
Collagen
Elastic Fibers -- Stiffness
Differentiate between mutton and beef!
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1- Eye
2- Ear
3-Taste
4-BMR (Internal metabolism)
5-Cardiovascular system
“Reubin A, etal 1985”
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6- Respiratory system “Kitzman Dw, etal 1988”
7- Renal System (Kidney function less by 50%
at 80 years) “Campbell, lefrak,1987”
8- Nervous system (Brain Smaller by 10% at
80 years)
9- Body temperature (Temp centres, Sweat
glands)
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10- Sleeping: up to 45%.
30% of causes of Insomnia are due
to depression but cold, uncomfortable
bed, pain, diseases, noise, stimulant
drinks (coffee,tea) play a role.
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11- Sign and symptoms of illnesses
Although pain may be a major complaint
of old people, pain sensation is altered
e.g. in fracture pelvis what patient complains of
is inability to move.
Pathy, 1967
12- Cancer
13- Brain function; Acute Or Chronic
(Dementia 5-10% over 65 years of age).
14- Mobility
15- Immunity
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16-Disabilities.
Difficulty in moving around leads to difficulty
in becoming independent.
Each elderly has 3.4 disabilities of which 50%
were not known to their GP (which were
amenable to some sortie of action).
Isac, 1971
30% of women are prone to fall at 65-69 years
This increases to 50% after 80 years of age.
All could lead to disabilities.
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The process of optimizing opportunities
for health, participation and security in
order to enhance quality of life as
people age.
WHO in 1990
Active Ageing
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SERVICES
1- HOME VISIT: CLEANING, WASHING,
PERSONAL TOILET, CARE OF
MEDICATION
2- MEAL ON WHEELS
3- VISITING SERVICES
4- SOCIAL AIDS
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5-LAUNDRY
6-NIGHT WATCH SERVICES
7-DAY CENTRE & CLUB
8-DOMICILIARY VISITS
9-BENEFITS: PERSONAL ALLOWANCES
HOT FOOD,CLOTHING,TICKETS
SERVICES
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10-HOBBIES & CRAFTS CENTERS
11-CHIROPODY SERVICES
12-HOSPICE
13-CLINICS
14-PRE-RETIREMENT TRAINING COURSES
15-RETIRED EMPLOYEE’S ASSOCIATION
16-REMPLOYMENT BUREAUS: VOLUNTARY
SERVICES
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It is to spend long days
And not once feel that we were ever
young.
It is to add, immured
In the hot prison of the present, month
To month with weary pain.
It is to suffer this,
And feel but half, and feebly, what we
feel:
Deep in our hidden heart
Festers the dull remembrance of a
change,
But no emotion none.
It is last stage of all
When we are frozen up within, and quite
The phantom of ourselves,
To hear the world applaud the hollow
ghost
Which blamed the living man.
Growing Old
Matthew Arnold
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Growing Old
Matthew Arnold
What is it to grow old?
Is it to lose the glory of the form,
The luster of the eye?
Is it for beauty to forego her wreath?
Yes, but not for this alone.
Is it to feel our strength
Not our bloom only, but our strength decay?
Is it to feel each limb
Grow stiffer, every function less exact,
Each nerve more weakly strung?
Yes, this, and more! but not,
Ah, 'tis not what in youth we dreamed 'would be!
'Tis not to have our life
Mellowed and softened as with sunset-glow,
A golden day's decline!
'Tis not to see the world
As from a height, with rapt prophetic eyes,
And heart profoundly stirred;
And weep, and feel the fullness of the past,
The years that are no more!
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It is to suffer this,
And feel but half, and feebly, what we feel:
Deep in our hidden heart
Festers the dull remembrance of a change,
But no emotion none.
It is last stage of all
When we are frozen up within, and quite
The phantom of ourselves,
To hear the world applaud the hollow ghost
Which blamed the living man.
Growing Old
Matthew Arnold
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Ageism
Definition: even among good social classes
Internal changes in the body of all living kinds.
The process which changes a healthy individual
into a fragile one.
Continuous changes in different organs’ functions.
Coni et al.