active ageing and elderly care
The Malta Independent on Sunday 2 August 2020
5 activities that can protect your mental and physical health as you age No one is immune to developing chronic illnesses such as heart disease, cancer or arthritis as they get older. But research shows social activities, like joining clubs, interest groups or volunteering, are linked to better mental and physical health and a longer lifespan, write researchers Paul E. Jose, Ziggi Ivan Santini and Vibeke Jenny Koushede. Photograph Micaela Parente.
Exercising with friends is one way of protecting your health as you age.
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ur own recent research found that that the more that people participated in social activities, the less risk they had of developing or accumulating chronic conditions. We looked at people aged 50 and older from 12 European countries over a five year period, and studied how volunteering, education, joining a club or being involved in religious or political groups impacted their likelihood of developing major chronic illnesses. We found that weekly participation in social activities reduced the risk of developing a chronic condition by 8% compared to no participation, and reduced the risk of developing two or more chronic conditions by 22%. Even if you’re busy, our findings suggest that just a few hours spent on a social activity every week can protect your health. Not only are social activities important for keeping physically active, engaging in activities with other people is shown to benefit your mental wellbeing, which in turn further protects your physical health. With that in mind, there’s a wealth of research that shows doing just one of these five activities regularly will provide benefits. LEARN SOMETHING NEW Taking time to be inspired by new things is good for our health. Studies show that people who read books live longer, and bilingual people have better cognitive health. Pursuing new knowledge or learning new skills is known to promote wellbeing and memory function. Activities like attending an art or music class are associated with enhanced brain health, as they improve the communication between different brain regions. They can also improve psychological resilience,
meaning that they can improve people’s ability to cope better and persevere through stressful or challenging situations. People who have made a habit of learning throughout their lifetime generally have better physical and mental health, including reduced risk for heart diseases and obesity, healthier habits (such as good nutrition, exercise, and not smoking), better wellbeing and cognition, and a stronger sense of purpose in life. JOIN A SPORT OR SOCIAL CLUB Research shows joining a handball or football team has multiple health benefits, such as lower blood pressure, better heart rate, lower fat mass and musculoskeletal fitness. People are also more motivated and have better wellbeing. Even less common activities like rock climbing reportedly ward off symptoms of depression, while hiking is shown to promote emotional health, creativity, a sharp mind and healthier relationships. This might be because living in the moment can be a healthy distraction from stress and worries. Physical activity might let someone experience “flow”, the state of being completely absorbed, focused and involved in something. During flow, people typically report deep enjoyment, creativity and happiness. Even non-exercise group pastimes are beneficial. Mentally stimulating activities, such as card and board games, videogames, needlework or crafts, have been shown to improve and sustain good mental and cognitive health. Joining a choir not only protects physical and mental health, enhances wellbeing and reduces loneliness, it also promotes lung health and reduces anxiety as a
result of controlled breathing practices. Group activities such as singing, knitting, painting, playing board games or football have also been shown to increase social belonging and help people bond. VOLUNTEER The old saying that it’s better to give than to receive might be true. Research shows that spending time volunteering is associated with enhanced mental health, higher physical activity, fewer functional limitations and lower risk of mortality. We have previously shown that weekly volunteers are twice as likely to have optimal mental health compared to non-volunteers. Other researchers have reported similar links to acts of kindness in general. Volunteering can benefit mental health by providing a sense of meaning and purpose, improving competence, selfesteem, solidarity and compassion, as well as opportunities to connect with others. POLITICAL OR COMMUNITY INVOLVEMENT Being able to contribute to one’s community is also key to mental health. This is because humans have an intrinsic need to both be connected with a community and have a role to play in it. One way to do that is through political or civic group activity. Community engagement is generally associated with better physical and mental health and wellbeing, and some research even shows civic involvement at age 33 is protective against cognitive impairment at age 50. This means that being active in a civic group is linked to sustained cognitive health over 15 years. Continues on page 2
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active ageing
The Malta Independent on Sunday | 2 August 2020
REVERSING TYPE 2 DIABETES
MEET THE PROFESSOR REVERSING TYPE 2 DIABETES Reverse your diabetes – and you can stay diabetes-free longterm says Professor Roy Taylor. A 2016 study from Newcastle University showed that people who reverse their diabetes and then keep their weight down remain free of diabetes. Article and photograph courtesy of Newcastle University, UK.
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n addition, the team found that even patients who have had Type 2 diabetes for up to 10 years can reverse their condition. The 2016 study, published in Diabetes Care, is part of ongoing research from worldrenowned Professor Roy Taylor, Professor of Medicine and Metabolism at Newcastle University, who also works within Newcastle Hospitals. The research is part of a growing body of evidence showing that people with Type 2 diabetes who successfully lose weight can reverse their condition because fat is removed from their pancreas, returning insulin production to normal. A previous study led by Professor Taylor, published in 2011, showed that diabetes could be reversed by a very low calorie diet. This caused
Reverse your diabetes - and you can stay diabetes-free long-term says world-renowned Professor Roy Taylor, Professor of Medicine and Metabolism at Newcastle University, who also works within Newcastle Hospitals.
international interest, but the study was very short as it was only eight weeks and the question remained whether the diabetes would stay away. In this new study, 30 volunteers with Type 2 diabetes embarked on the same diet of 600 to 700 calories a day. Participants lost on average 14 kilograms - just over 2 stone. Over the next 6 months they did not regain any weight. The group included many people with longer duration diabetes, defined as more than 8 years and ranging up to 23 years. Overall, 12 patients who had had diabetes for less than 10 years reversed their condition. 6 months later they remained diabetes free. In fact, after 6 months a thirteenth patient had reversed their diabetes. Though the volunteers lost weight they remained overweight or obese but they had lost enough weight to remove the fat out of the pancreas and allow normal insulin production. Professor Roy Taylor said: “What we have shown is that it is possible to reverse your diabetes, even if you have had the condition for a long time, up
to around 10 years. If you have had the diagnosis for longer than that, then don’t give up hope – major improvement in blood sugar control is possible." “The study also answered the question that people often ask me – if I lose the weight and keep the weight off, will I stay free of diabetes? The simple answer is yes!" “Interestingly, even though all our volunteers remained obese or overweight, the fat did not drift back to clog up the pancreas." “This supports our theory of a Personal Fat Threshold. If a person gains more weight than they personally can tolerate, then diabetes is triggered, but if they then lose that amount of weight then they go back to normal." “Individuals vary in how much weight they can carry without it seeming to affect their metabolism – don’t forget that 70% of severely obese people do not have diabetes." “The bottom line is that if a person really wants to get rid of their Type 2 diabetes, they can lose weight, keep it off and return to normal." “This is good news for people who are very motivated to get
rid of their diabetes. But it is too early to regard this as suitable for everyone. That is a separate question and a major study is underway to answer this.” Participants in this study had Type 2 diabetes for between six months and 23 years. The team showed that Type 2 diabetes could be reversed even in people who had the condition for 10 years. The team were able to identify in advance participants who would not respond to adequate weight loss by reversing their diabetes as at the start they had almost absent insulin production from the pancreas. The study was funded by a National Institute for Health Research Biomedical Research Centre (NIHR BRC) grant. A larger trial involving 280 patients is already underway. This will examine how successfully people can reverse their diabetes through weight loss simply under the care of their family doctor and nurse. It is being funded by Diabetes UK. The research was made possible through Newcastle Academic Health Partners, a collaboration involving Newcastle Upon Tyne Hospitals NHS Foundation Trust,
Northumberland, Tyne and Wear NHS Foundation Trust and Newcastle University. This partnership harnesses worldclass expertise to ensure patients benefit sooner from new treatments, diagnostics and prevention strategies. The diet consisted of: 3 diet shakes per day and 240 grams of non-starchy vegetables taking in between 600 and 700kcal a day for 8 weeks. Volunteers then gradually returned to eating normal food over the next two weeks with very careful instruction on how much to eat. Volunteers were seen once a month and supported with an individualized weight maintenance programme over the next 6 months to keep weight steady after the weight loss, they were eating around one third less than before the study. For more information on this research visit the Diabetes Research page on the Newcastle University Website. It is important that people with diabetes discuss their management with their own doctor. Remember to always consult with your doctor before embarking on any diet programme.
Religious or spiritual activities can also protect your mental and physical health as you age Continued from page 1 RELIGIOUS OR SPIRITUAL ACTIVITY A large volume of research shows that religion and spirituality in general are beneficial to mental health. These mental health benefits positively impact physical health and decrease the risk of disease by improving immune function and lowering the stress response. When becoming ill, many use their religious beliefs to cope with illness, which is important since poor
coping skills can lengthen hospital stays and increase patient mortality. Accordingly, some evidence suggests that religious people tend to have better recovery when ill or having undergone surgery. Attending religious services is associated with long life and better brain health, as well as increased resilience against depression – even for high-risk people. No matter what activity you choose, all of them have three behavioural principles in common that we have written about before, known as Act-Belong-Commit.
Getting active, getting social, and getting involved can help you maintain good mental and physical health in general and as you age. Ziggi Ivan Santini is a Postdoctoral Associate at the University of Southern Denmark; Paul E. Jose is a Professor of Psychology, Te Herenga Waka - Victoria University of Wellington, New Zealand; and Vibeke Jenny Koushede is Head of the Department of Psychology, University of Copenhagen. This article first appeared on The Conversation.
active ageing
The Malta Independent on Sunday | 2 August 2020
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Dealing with
Dementia Sense of belonging and community is crucial for older persons in long-term care, says Nicolette Sant, facility manager at Villa Messina. Photography by CareMalta.
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orldwide, around 50 million people have dementia, and there are nearly 10 million new cases every year, according to the World Health Organisation. One of the major causes of disability and dependency among older people, dementia is a syndrome in which there is deterioration in memory, thinking, behaviour and the ability to perform everyday activities. “Exercise is a promising non-drug intervention for preventing and treating depression in older persons during long-term care. Every single day, through activities that involve movement, we witness tangible positive results and benefits in the well-being of our residents.
DIY project
Residents at Villa Messina interacting with one another, while enjoying various activities with a parachute through movement. One of the residents is seen watering plants on a wooden decorative piece created from reused items – part of a DIY project by the residents for the home’s garden.
When they are socially interacting within a large group, they generally feel much better, their mood improves and the activity stimulates in them a need to feel good,” says Nicolette Sant, facility manager at Villa Messina. One of nine elderly homes operated by CareMalta, Villa Messina organises dementia-related activities for its residents on a regular basis. Equipped with high dependency and special care units, this private nursing home offers professional care to a special segment of residents who need focused attention and dedication through a specialised programme tailored to their needs. “Engaging in exercise may also have the capacity to counteract common symptoms of depression in older persons living with dementia, such as negative thoughts and low self-esteem, thus improving self-evaluation and encouraging a love of learning and bravery, while also filling them with a sense of achievement,” Ms Sant explains. “Furthermore, applying the theories of positive psychology – which aims at refocusing psychology in the
direction of not only studying negative outcomes and pathology but to emphasising positive traits, emotions and behaviour – has the ability to foster a general feeling of well-being among older persons living with dementia.” In fact, residents at Villa Messina are involved in normal day-to-day activities that help them feel useful and remain active. One such example was a recent DIY project, during which residents contributed to the upkeep of the home by creating their own works from reused items. Wheels from damaged wheelchairs were turned into decorative frames for hanging plants, while wooden planks from pallets were used as shelving. “We cannot emphasise enough the importance of belonging and sense of community among our residents – two crucial elements that greatly help older persons, especially those living with dementia,” Ms Sant says. For more information about Villa Messina, one of nine homes operated by CareMalta, call 2145 4889 or e-mail villamessina@caremalta.com
Why you get shorter as you age ...and how to prevent it happening While you may be aware that a loss of vision, hearing and memory is a sign of ageing, something that is perhaps not so noticeable is a reduction in height. This apparent shrinking is due to several factors relating to changes in bone, muscles, joints and other tissues in your body, writes Adam Hawkey, Associate Professor, School of Sport, Health and Social Sciences, Solent University.
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hile a certain amount of height loss is a normal part of ageing and unlikely to be associated with any health problems, significant height loss may indicate underlying issues. Understanding what happens to your body as you age is important so you can counteract some of the negative effects of ageing. As early as your thirties, agerelated muscle loss, known scientifically as sarcopenia, can mean you lose muscle mass at a rate of 3-5% each decade. Of particular concern are those muscles in your torso, which are primarily responsible for keeping you in an upright position. A reduction in their ability to maintain your posture can make you look stooped and hence shorter. Another reason for height loss as you age is your bone health. Bone is an extremely complex
connective tissue that can adapt its size and shape in response to mechanical loads. This enables your bone to remodel itself throughout your life. In your younger years, you go through a growth stage, depositing bone so rapidly that 90% of your peak bone mass is reached in your late teens. This growth is consolidated in your mid-twenties when peak mass is reached. Around the age of 35-40, you begin to lose more bone than is generated. Eventually, this loss of bone leads to a condition known as osteoporosis, which is characterised by low bone mass and increased bone fragility. Combined, these factors result in a greater risk of fracture. While the hips and forearms are common sites for the disease, it is most common in the vertebrae (spine) where it has a negative impact on stature. Also located in the spine and responsible for maintaining your posture are the vertebral discs.
These gel-like cushions sit between the vertebrae and act as shock absorbers, helping to keep the back flexible. When we are young these discs, which are about 80% water, are strong and supple. As you age, the discs gradually compress and flatten. Consequently, the spaces between the vertebrae are reduced. A similar effect is seen in the arches of the foot as you age when the ligaments begin to degenerate. This leads to flat arches, causing you to walk with a more flat-footed style. KEEP YOUR STATURE While most height loss is determined by your genes, there are some lifestyle factors you can follow to help maintain your height and, perhaps more importantly, reduce the effects that ageing has on your health and wellbeing. Regular exercise, especially activities that incorporate some form of weight-bearing, are good for generating bone. While you
In the Golden Girls episode Blanche and the Younger Man, Blanche says: Dorothy, look at me. I have turned back the hands of time. Since Dirk asked me out, I've dropped ten years. Why, my face is smooth, my body is taut, and my gears are grinding. Dorothy: No matter what you do to your face, your body, or your gears, you are still your age. Sophia: Of course you are. Gravity always takes its toll. Look at me! I used to be a tall, voluptuous blonde with a butt like granite. Image screenshot YouTube.
are never too old to receive some benefit from exercise, research has shown that developing strong bones in the teenage years (when most peak-bone mass is established) offers some protection as you enter older age. This kind of exercise inherently benefits muscle growth too, and so has the potential to protect against both osteoporosis and sarcopenia. While a healthy balanced diet is essential for general health, foods high in vitamin D and
calcium, including almonds, broccoli and kale, also contribute to bone health. Not smoking or drinking alcohol and limiting caffeine consumption also helps. While a bit of shrinking is a normal part of ageing, it can suggest more serious issues. Ensuring that you maximise bone health and wellbeing throughout your life is vitally important. This article first appeared on The Conversation.