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Showing posts with label Senior Health. Show all posts
Showing posts with label Senior Health. Show all posts

Tuesday, September 9, 2025

Take a seat and exercise

For those with limited mobility, chair exercises are a good way to work out. — The Straits Times/ANN

As individuals age, it becomes increasingly important to maintain physical activity for overall health and well-being.

Regular exercise aids seniors in managing weight, elevating mood, improving balance and lowering the risk of chronic illnesses.

However, many older adults encounter obstacles that complicate traditional forms of exercise like walking or jogging.

Mobility limitations, joint discomfort and various health issues can hinder participation in more intensive workouts, resulting in a sedentary lifestyle that may adversely affect health. 

For those who find walking challenging, chair exercises offer an excellent alternative.

These low-impact movements can be performed while seated, making them both accessible and safe for seniors across all fitness levels.

Chair exercises not only encourage physical activity, but also provide numerous advantages, including enhanced cardiovascular health and improved muscle strength.

By integrating these exercises into their daily routines, seniors can improve their quality of life and maintain their independence.

Exercises for heart health

As people age, it is essential to prioritise heart health.

Below are a few effective chair exercises designed to enhance cardiovascular fitness:

Seated marching

Sit upright in a sturdy chair with your feet flat on the floor.

Raise one knee towards your chest as high as you can, then lower it and repeat with the other leg.

Alternate your legs for one to three minutes while maintaining proper posture.

This exercise stimulates the heart and improves coordination.

Arm circles

While seated, extend your arms to the sides at shoulder height.

Move your arms in small circles, gradually increasing the circle size over 30 seconds, then reverse direction for another 30 seconds.

This movement enhances shoulder mobility and promotes blood circulation.

For added intensity, consider holding light weights.

Leg lifts

Extend one leg straight out, keeping it parallel to the ground for a few seconds before lowering it.

Repeat 10-15 times before doing the same with your other leg.

To raise your heart rate, combine leg lifts with seated marching or perform the lifts more quickly.

This exercise benefits heart health while also strengthening your legs and improving overall mobility.

Each exercise is designed to be low-impact, yet effective, making them accessible for seniors at all fitness levels.

Exercises for muscle strength

You don't necessarily have to lift heavy weights to build muscle strength if you are not strong enough; start light – even a filled water bottle will do. — dpaYou don't necessarily have to lift heavy weights to build muscle strength if you are not strong enough; start light – even a filled water bottle will do. — dpa

As individuals age, preserving muscle strength becomes increasingly vital for overall health and mobility.

Chair exercises provide a safe and effective means for seniors to build and maintain muscle strength without requiring extensive equipment or risking falls.

Below are some beneficial chair exercises specifically designed to enhance muscle strength in various body areas:

Seated leg extensions

Sit upright in a sturdy chair with your feet flat on the ground.

Slowly extend one leg straight out in front of you, keeping your knee straight and your foot flexed (i.e. in its normal bent position).

Hold the extended position for a count of three before gently lowering your leg back to the starting position.

Repeat this movement 10-15 times before switching to your other leg.

This exercise is an excellent way to strengthen the quadriceps, which are the large muscles located at the front of the thighs.

It also enhances knee stability, which is essential for maintaining mobility.

Seated bicep curls with weights

Sit comfortably in a chair with a weight (such as a dumbbell or a filled water bottle) in each hand, arms resting at your sides.

Keeping your elbows close to your body, lift the weights up towards your shoulders while exhaling.

Pause briefly at the peak of the movement, then slowly lower the weights back to the starting position while inhaling.

Aim for 10-15 repetitions, ensuring proper posture throughout the exercise.

This straightforward, yet effective exercise not only strengthens the arms, especially the biceps, but also enhances grip strength, which can assist in daily activities.

Chair squats for lower body strength

Begin by sitting on the edge of the chair with your feet flat on the floor, hip-width apart.

Slightly lean forward and engage your core.

Gradually rise from the chair by pushing through your heels and standing up, keeping your back straight.

Once fully standing, gently lower yourself back down to the chair, controlling your descent to avoid plopping down.

Repeat this movement eight to 12 times.

Chair squats not only build lower body strength, targeting the glutes, hamstrings and quadriceps, but also improve balance and stability, facilitating everyday activities.

Safety tips

Participating in chair exercises can be an excellent way for seniors to maintain their physical health and well-being, but safety should always be a priority.

Here are some essential safety tips to ensure a safe and effective workout:

Choose the right chair and environment

Select a sturdy, armless chair with a stable base.

Ensure that the seat height allows your feet to rest flat on the floor.

Keep the area free of obstacles and exercise in a well-lit environment.

Warm-up and cool-down activities

Begin with gentle neck rolls, shoulder shrugs and wrist circles as warm-up exercises to prevent injury.

Cool down with seated stretches for your arms, legs and back to maintain flexibility and reduce soreness.

Listen to your body and avoid strain

Pay attention to any discomfort during exercises.

If something feels wrong, stop immediately.

If you feel better, then restart gradually.

You can increase the intensity of the exercises as you build strength.

By adhering to these safety tips, seniors can safely enjoy chair exercises while minimising the risk of injury, fostering a sustainable fitness routine and promoting overall health.

Be consistent

As discussed throughout this column, chair exercises offer a valuable opportunity for seniors to maintain their health and well-being, particularly for those who may encounter mobility challenges.

These simple, yet effective routines allow for physical activity without the necessity for extensive walking or standing.

Consistency is key, and even a few minutes each day can lead to significant health improvements.

The benefits of chair exercises also extend beyond the physical realm, contributing to emotional and mental well-being.

We encourage seniors and their caregivers to incorporate these exercises into their regular routines.

By making these movements a part of daily life, seniors can continue to lead active lifestyles, fostering independence and enhancing their quality of life.

By Datuk Dr Nor Ashikin Mokhtar - is a consultant obstetrician and gynaecologist, and a functional medicine practitioner. For further information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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Thursday, August 21, 2025

Juggling multiple medications

 

Taking many drugs at one go may be necessary, especially for less healthy older adults, but we must be aware of the potential dangers.


There are times when it is necessary for a patient to take multiple drugs daily as they suffer from a few chronic medical conditions, but their regime should be regularly reviewed to ensure all the drugs they are on are still necessary. — Pexels

The Malaysian population is rapidly ageing, with over 11% currently aged 60 and above.

This figure is projected to rise to 17.3% by 2040.

The demographic shift has led to increasing healthcare demands, particularly in managing chronic diseases such as diabetes, hypertension (high blood pressure) and heart disease.

These conditions require long-term medicine use.

Alarmingly, studies indicate that nearly half of older Malaysians experience polypharmacy.

Many are also prescribed potentially inappropriate medications or fail to adhere to their treatment regimens.

This issue calls for coordinated care, increased awareness and targeted interventions.

Understanding polypharmacy

Polypharmacy is generally defined as the use of five or more medicines at the same time.

However, the number of medicines alone does not determine the impact.

The necessity and appropriateness of these medicines are equally important.

Polypharmacy can be both beneficial and harmful.

Appropriate polypharmacy occurs when multiple medicines are clinically necessary, carefully monitored and effectively managed.

For example, a person with high blood pressure, diabetes and heart disease may require several medicines to maintain stable health.

Problematic polypharmacy occurs when medicines are prescribed to treat the side effects of other medicines (a situation known as a prescribing cascade), or when the medicines themselves are potentially harmful.

Polypharmacy is common among older adults for several reasons.

Understanding these contributing factors is essential in order to design effective strategies to minimise medicines-related harm and improve overall patient care.

Some of the factors that can be attributed to the high frequency of polypharmacy among older adults are:

  • The presence of multiple chronic medical conditions, for which the long-term use of medicines is necessary,
  • Prescription of medicines on multiple different occasions by different healthcare practitioners, which increases the risk of duplication or drug interaction.
  • Prescribing cascades, where medicines are prescribed to treat the side effects caused by other medicines.
  • The absence of regular medicine reviews, which may allow unnecessary or outdated prescriptions to continue without reassessment.
  • Poor communication between patients and healthcare providers, which can result in confusion or misuse of medicines.
  • Widespread and accessible pharmaceutical promotions, which encourage patients to use traditional or over-the-counter medicines alongside prescribed medicines without medical advice.

Potential dangers

Polypharmacy carries genuine and significant risks, especially for older adults.Community pharmacists are one resource patients can easily access to ensure that their medicine regime is up-to-date and not causing any unnecessary side effects. — FilepicCommunity pharmacists are one resource patients can easily access to ensure that their medicine regime is up-to-date and not causing any unnecessary side effects. — Filepic

Due to slower metabolisms and potentially impaired kidney function, the elderly are more vulnerable to the negative effects of multiple medicines.

Some of the most concerning consequences include emergency hospitalisations due to medicine-related complications, drug interactions that lead to undesirable side effects or reduced effectiveness, and adverse side effects such as dizziness, confusion or gastrointestinal issues.

In addition, when medicines impair alertness or physical coordination, they may contribute to falls, fractures and cognitive decline.

Several studies conducted in Malaysia also show that the majority of older adults do not take their medicines as prescribed.

Polypharmacy has a direct impact on medication adherence, which refers to how well patients follow their prescribed treatment plans.

As the number of prescribed medicines increases, the elderly often struggle with complex dosing schedules, leading to missed or incorrect doses.

This not only compromises treatment outcomes, but also increases the risk of hospitalisations and complications.

To address these, it is essential to provide patient education, simplify medicine regimens, and offer support through technology and caregiver involvement.

Reducing the risks

Healthcare systems around the world are adopting more proactive strategies to ensure the safe and effective use of medicines, especially in light of growing concerns about polypharmacy.

One important strategy is regular medicine reviews.

Patients are encouraged to inform their doctors and pharmacists about all the medicines they are taking, including prescriptions, over-the-counter products and supplements.

This open communication allows more regular medicine reviews, which helps healthcare providers identify medicines that may no longer be necessary or could be potentially harmful.

Another key practice is deprescribing, which involves gradually reducing or stopping medicines that are no longer beneficial.

Medicine reconciliation is also essential.

This process ensures that any changes to a patient’s medicine list, such as during hospital admission, discharge or transfer to a nursing home, are accurate and appropriate.

Technology also plays a helpful role.

Electronic health records can alert healthcare providers to potential interactions or duplicate medicines.

Most importantly, a patient-centred approach is needed.

When patients are involved in decisions about their treatment, it builds trust, improves adherence to medicines and leads to better health outcomes.

The most effective strategies to manage polypharmacy involve active participation from both patients and their caregivers.

Several steps are encouraged to support safe medication use:

  • Maintain an updated medicines list, including over-the-counter products, supplements and herbal remedies.

    Bring this list to every medical appointment.

  • Ask your doctor or pharmacist about the purpose, benefits and possible side effects of each medicine.
  • Inform your doctor or pharmacist when you experience side effects, especially if they are suspected to be caused by a medicine.
  • Get help from pharmacists for medicine reviews, especially after hospital stays or when there is a change in the medicine regimen.
  • Use adherence devices or tools to help take medicines correctly, such as pill boxes, mobile apps or mobile alarms.

The role of pharmacists

As the number of elderly individuals taking multiple medications daily continues to rise, the role of pharmacists has become increasingly vital.

While doctors are responsible for diagnosing conditions and prescribing treatments, pharmacists ensure that medications are used safely, correctly and effectively.

With specialised knowledge in pharmacology and drug interactions, pharmacists are often able to detect issues that may be overlooked by others.

These include overlapping therapies, potentially harmful drug combinations, and unnecessary or duplicate prescriptions.

Community pharmacists, in particular, are in a unique position to support patients directly.

As the most accessible healthcare professionals, they can offer personalised counselling, conduct routine medication reviews and help patients understand the purpose and proper use of each medicine.

They can also identify early signs of adverse effects or non-adherence, and refer patients for further medical attention when necessary.

Addressing polypharmacy requires a coordinated approach that centres on the patient.

As the population grows older, providing safe, effective and individualised treatment is crucial.

Balancing illness management with quality of life is key to delivering better and safer care to older adults.

For any inquiries regarding medicines, please call the National Pharmacy Call Centre (NPCC) at the toll-free number 1-800-88-6722 during weekdays from 8am to 5pm, except on public holidays.

By PAYAL CHOUDHURY

Payal Choudhury is a pharmacist at Hospital Tengku Ampuan Najihah in Kuala Pilah, Negri Sembilan. This article is courtesy of the Health Ministry’s Pharmacy Practice and Development Division.

For more information, email starhealth@thestar.com.my.

The information provided is for educational and communication purposes only, and should not be considered as medical advice.

The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The

Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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Juggling Multiple Meds: Doctors and the Ninth Prescription

https://www.linkedin.com/pulse/pills-should-more-than-color-day-alan-pitt-m-d-/

Several years ago, when prescribed a single medication to be taken daily for several months, I found it very difficult to remember to take it every day. I knew it was important and I knew why I was taking it, but even then I forgot. That experience got me thinking about the many people who are asked to take six, seven, ten drugs a day…forever. I have no idea how they remember to take all of these drugs correctly, and the fact is, most people don’t. This was made clear to me as early as my residency, when it was not uncommon for people to bring in garbage bags full of medicines. When asked how they determined which ones to take and when, these patients often seemed to go by the pill color of the day rather than any set schedule or plan. 

In fact, the data on this issue—known as medical compliance—reveal an abysmal record of patients’ taking medications “as prescribed.” Reportedly less than one third of diabetic patients take metformin correctly. And only half the patients with high blood pressure take even 80% of their medications as prescribed. The end result is a multi-billion-dollar expense with unpredictable and often dangerous outcomes. How does this happen? 

Unfortunately, when it comes to prescriptions, providers are required to be compulsive. We are trained not only to address every problem with a solution, but also to do so on an individual basis. If you have asthma, there's a treatment for that. If it’s heart disease, here’s another pill. Diabetes? Take three more. The list grows quickly, adding expense and, more alarmingly, often resulting in untoward drug-drug interactions. It’s gotten so bad you’d be justified in thinking certain providers delusional for even believing the patient could take the list of medications “as prescribed.” Yet, when you talk to physicians about this issue, many simply shrug their shoulders. They’ll tell you they have little choice. The current medical legal climate requires a response to each identified problem.

One solution to this quagmire is personalized medicine, a topic I’ve discussed in prior posts. I should note that personalized medicine means different things to different people, but for many, America's love affair with technology often translates personalized medicine into genomic medicine. Eric Topol wrote extensively about this in his book  Creative Destruction of Medicine, explaining how, through sequencing the genome, doctors will be able to predict how each individual will respond to a particular drug. Equipped with such powerful tools, it’s not hard to imagine a future pharmaceutical industry that could customize medications, rather than simply produce mass quantities that work "well" for the average person. 

Until that particular biotech future arrives, I think there is a far simpler and immediate opportunity open to personalized medicine: by identifying a patient's ability to participate in her own care and then matching the medication regimen not only to her needs and preferences, but to subjective criteria such as mental clarity, alertness, daily routines, family support, etc. Two people with exactly the same list of problems may have very different abilities and willingness to take a complex regimen of medications. A 50-year-old executive may have the same problem list as an 80-year-old nursing home patient, but will clearly have different organizational skills, financial resources as well as an understanding of why the regimen matters. For physicians to write prescriptions they know deep down their patients cannot take borders on the absurd and certainly does not constitute good care. 

Although I'd like to think physicians would read this and suddenly change the way they write prescriptions, I am not that naïve. Without a significant change in how we're trained as well as appropriate protections from medical legal risk, it's unlikely doctors will suddenly change the way they practice. However, you as the patient have an opportunity to ask the questions. Are all of these medicines necessary? And if I only take a portion of the drugs, what is the overall increased risk to my health?  If you find yourself simply unable to follow the regimen, have an honest conversation about alternatives. Remind your doctor that you are not a “problem list” but an individual with specific medical requirements and concerns.

Ultimately, treating problem lists instead of people may be “right" but it's not reasonable. 

Friday, June 6, 2025

Breaking the sound barrier: How to stay sociable despite hearing loss

 


The vestibular system, located in the inner ear, is responsible for maintaining balance, stability and spatial orentatation - dpa

So you find it increasingly difficult to follow conversations amid the clattering dishes and loud voices in a restaurant, and then afterwards you feel exhausted? If this sounds familiar, hearing loss could be on the horizon. Christin Klose/dpa© DPA International

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To be a good listener, you've got to be interested in what the speaker is saying. And you need to hear well. If your sense of hearing is weakening, you're likely to first notice it during conversations. Why?

"Because sometimes the speaker will use slight nuances of speech, their tone of voice, or minimally raise or lower their voice, to give what they're saying a particular meaning," says audiologist Eberhard Schmidt.

If you don't pick up these nuances and overtones, you won't know, for example, whether the speaker expects an immediate reaction from you or wants to complete their train of thought first.

Having to concentrate hard when you're listening to someone may be a sign of hearing loss. In some cases, listening can become so strenuous that it tires you out as the day goes on, doctors say. Another possible sign is waning attentiveness during conversations.

Listening is even more strenuous in a noisy environment: music playing, dishes clattering, other conversations nearby. This requires the ability to selectively focus on the conversation you're having, known as the "cocktail party effect." To have it, you need good hearing in both ears.

Your ears work closely together with your brain to filter the voice of your interlocutor out of multiple other sources of sound. "The sound waves that enter both ears are 'translated' into information and classified," Schmidt says.

If you're hard of hearing, your selective attention is impaired. The words of your interlocutor are then largely drowned out by background noise, sentences getting through only in fragments or muffled, explains Schmidt.

There are other signs of possible hearing loss, including constant ringing or buzzing in the ears - known as tinnitus - dizziness, impaired balance and headaches. Another is often being asked to turn down the volume of the TV or radio.

While no one likes to admit trouble hearing - for many a source of embarrassment or shame - a gradual decline in the functioning of the tiny hairs in the inner ear that turn sound waves into electrical signals, and the auditory nerve that transmits them to the brain, is a normal part of ageing.

Reluctant though you may be, you should get a hearing test from an ENT specialist or audiologist if you have hearing problems. Left untreated, hearing loss can lead to social withdrawal and is also linked to increased risk of falling - the vestibular system, responsible for balance, is located in the inner ear.

For mild hearing loss, a hearing aid is often unnecessary. Minor lifestyle adjustments can help to manage it, a very common one being to sit in a front row at speaking events (but not at loud events such as rock concerts!).

"If you sit way in back at church, for instance, you'll experience the reverberations especially strongly, which makes listening and understanding much more difficult," remarks Schmidt, also president of Germany's Federal Guild of Hearing Aid Professionals (biha).

In cases of moderate to severe hearing loss, however, a hearing aid is advisable. "It will detect and suppress disruptive sounds during conversations, enabling you to understand them," Schmidt says. "When it recognizes speech, it automatically turns down background noise."

New hearing aid wearers shouldn't expect things to sound as before though, since your auditory system and brain have to get used to the device. So experts will generally recommend wearing it in fairly quiet environments first, and only later where there's more background noise - say, from a TV or radio - and when you're on the phone.- dpa