Wednesday, April 22, 2009

STI: Old and behold

April 23, 2009

Old and behold

There's no escaping ageing but eating right and exercise can keep mind and body healthy. JUNE CHEONG reports


We are born to age.


'From the day we're born, our body cells are programmed to age but we won't see much of these changes until we hit 30 and beyond,' said Dr Wong Wei Mon, a doctor in anti-ageing and aesthetics medicine at Raffles Hospital.


While growing older is inevitable, the rate at which you age varies. Genes play a part but lifestyle, environment and diet are also important influences.


Of course, new technologies and therapies like the polypill, a combination of five drugs including aspirin, can help to stave off disease and degeneration.


But why wait till you are ailing before you lament your long-lost youthful body?


Dr Roger Tian, from Changi Sports Medicine Centre at Changi General Hospital, said: 'We cannot prevent ageing but we can reduce its impact on our life with a healthy diet, regular exercise, sufficient sleep and rest, reducing stress (stress hormones accelerate the ageing process) and alcohol intake and stopping smoking.'


Dr Wong concluded: 'The thing to be feared about ageing is disease. If we can do something to preserve our health in our late 20s or teens, most people won't be worried about ageing.'




When ageing starts: 30 and above.


What happens: As one gets older, bone creation slows. When bones become thin, they lose strength and break more easily - a condition known as osteoporosis.


Women lose 3 to 5 per cent of bone mass every year after menopause due to the drop in oestrogen levels, which are necessary for bone health.


Treatment: Medication can slow bone loss.


Prevention: Exercise regularly (at least three times a week for 30 to 40 minutes each time) and take adequate calcium and vitamin D. Avoid smoking. Build up a high bone mass before you hit 30.


Information provided by Dr Lim Yeow Wai, an orthopaedic surgeon at Raffles Hospital; Dr Roger Tian from Changi Sports Medicine Centre, Changi General Hospital




When ageing starts: Medical experts disagree on when the brain ages. A study published in the journal Neurobiology Of Ageing found that the brain begins to decline at age 27.


Dr Prem Pillay, a consultant neurosurgeon at Singapore Brain-Spine-Nerves Centre at Mount Elizabeth Medical Centre, said: 'With good genes and plenty of stimulating activities, you can keep your brain in top form into your 60s and even 70s.'


What happens: The brain loses neurons and the connections between the neurons as it ages.


Treatment: A variety of therapies, including drugs and brain exercises, can help to slow the brain's decline.


Prevention: Use it or lose it is the adage that your brain lives by. Challenging yourself at work and at play, exercising regularly and eating right will help your brain stay active and healthy longer.




When ageing starts: From 20 but most people do not notice the effect on their hearing until they are 50.


What happens: The inner ear contains hair cells that enable you to hear. As you age, hair cells degenerate and auditory nerve fibres, which send sound information to the brain, are reduced, leading to hearing loss.


Treatment: Hearing aids which amplify sounds and implantable hearing devices like a cochlear implant can help.


Prevention: Dr Stephen Lee, a specialist in ear, nose and throat (ENT) surgery at Raffles Hospital, said you can protect your ears by avoiding prolonged or frequent exposure to loud sounds.


Additional information provided by Dr Raymond Ngo, a consultant at the department of otolaryngology at National University Hospital; Dr Eng Soh Ping, a consultant otolaryngologist at the ENT department at Changi General Hospital




When ageing starts: 40 and above.


What happens: Dr Clement Tan, a consultant at the department of ophthalmology at National University Hospital, said that the lens hardens through life, eventually becoming a cataract. The eye's ability to focus on near objects deteriorates. Most people will start experiencing symptoms in their 50s.


Other common eye conditions are age-related macular degeneration (ARMD), diabetic retinopathy and glaucoma. In ARMD, abnormal, new blood vessels may develop, causing haemorrhage or swelling in the eye, or there may be deposits in the retina.


In diabetic retinopathy, the blood vessels in the retina leak fluid and blood. As the disease progresses, abnormal new blood vessels grow, affecting central and peripheral vision. Glaucoma can lead to blindness by damaging the optic nerve.


Treatment: Early cataracts can be corrected with glasses but surgery is usually required eventually. ARMD can be treated with laser therapy or anti-vascular endothelial growth factors (a drug injected into the eye). Diabetic retinopathy is usually treated with laser or by controlling one's diabetes. Glaucoma can be treated with medication, laser or surgery.


Prevention: Dr Lee Jong Jian, a specialist in ophthalmology at Raffles Hospital, said the elderly should go for basic eye screening regularly and eat more fruit, fish and vegetables, especially spinach.




When ageing starts: 50 and above.


What happens: The left ventricle of the heart, which is the engine, becomes slightly larger, thicker and works slower. With age, one's heart rate may become slower as the electrical conducting system becomes more fibrous and clogged with fatty substances. Cholesterol plaques may line coronary and other arteries, leading to high blood pressure, chest pain and heart attacks.


Treatment: Medication, a healthy diet and controlling risk factors like smoking and diabetes.


Prevention: Regular exercise and a diet low in saturated fat, trans-fat, salt and sugar are key.


Information provided by Dr Goh Ping Ping, the chief and senior consultant at the department of cardiology, Changi General Hospital; DrRaymond Wong, a consultant at the National University Heart Centre, Singapore




When ageing starts: 40 and above.


What happens: Kidney function is estimated to decline 1 per cent every year after one hits 40. Scarring of the kidney's filtering units and tiny tubes occurs. Its small blood vessels also thicken, resulting in less blood reaching parts of the kidney.


Treatment: Dr Titus Lau, a senior consultant at the division of nephrology at National University Hospital, said: 'Just like there is no cure for ageing of the rest of the body, there is no treatment to reverse ageing of the kidneys.'


Prevention: Staying healthy and controlling risk factors like obesity, high blood pressure and diabetes.


Muscles and joints


When ageing starts: 30 and above.


What happens: Muscle fibres decrease in size as muscle cells degenerate, atrophy and eventually die. The decline is faster in the thigh and leg muscles.


Your body loses 1 to 2 per cent of muscle mass every year after the age of 50. Collagen tissue in tendons and joint capsules becomes stiffer, reducing the range of motion and flexibility.


Treatment: Dr Roger Tian, from Changi Sports Medicine Centre at Changi General Hospital, said: 'Resistance training slows down age-related decline. Flexibility training preserves range of motion around joints."


Prevention: Regular exercise, a diet low in saturated fat, sufficient rest, stop smoking and reduce alcohol intake and stress.


Additional information provided by Dr James Loh Sir Young, a consultant at the department of orthopaedic surgery at Changi General Hospital; Dr Lim Lian Arn, an orthopaedic surgeon at Raffles Hospital




When ageing starts: 30 and above.


What happens: The outermost layer, or epidermis, thins out and loses its ability to retain water. The skin's middle layer, or dermis, loses collagen and elastin, resulting in loose, saggy skin. Fine lines and wrinkles show up as collagen fibres are weakened and reduced.


Skin cells which produce pigments, or melanocytes, start to malfunction, resulting in pigmentation problems.


Treatment: Skin ageing is reversible to a certain extent. Topical creams which contain alpha-hydroxy acids or whitening agents, minimally invasive procedures like radio-frequency treatment (for skin tightening) or invasive procedures like facelifts, can help.


Prevention: Dr Derrick Aw, a dermatologist at National University Hospital, said you can preserve your skin's youth by staying out of the sun and applying sunscreen daily.


Additional information provided by Dr Wang Yi Shi, an associate consultant dermatologist at Changi General Hospital; Dr Chris Foo, a specialist in dermatology at Raffles Hospital

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