Janet Turnbull looks at the wave of obesity and diabetes in younger age groups and hopes there will be good management for these people, to reduce their risk of disability in older age.
“If we could have people manage their lifestyles better, we would have fit and healthy old people,” says Dr Turnbull, a Wellington consultant geriatrician.
She sees many old people with disabilities, pain and low fitness.
Doing outpatient and community consultations, she is wary of multipharmacy and the problems inherent in each of the pain-relieving medications available.
Dr Turnbull talks patients through a plan to gradually walk more. For some, it might be around the mall or along the street. “Set the goals low, and then increase,” she says.
She cannot recommend strongly enough, “exercise, exercise, exercise, in the 60s and 70s, for prevention”.
It is part of keeping older people involved in community interaction. “It works for everything; the brain, the ticker, the joints. If you remain active, and support people to remain active, then most things are improved or maintained.”
ACC, the Ministry of Health and the Health Quality & Safety Commission have just put money into this concept.
Their Live Stronger for Longer programme acknowledges the poor outcomes of people who have falls in their 70s and 80s.
ACC corporate medical adviser Geraint Emrys says a first fall affects independence, and the older person rarely recovers completely from their second fall injury.
This age group has the highest number of serious falls, fractures and head injuries, Dr Emrys says. Helping the older person get fitter and stronger should “push out the negative outcomes from falls even further”, he says.
Muscle mass is important in earlier age groups, but the fact it declines in the later years makes strength training integral to the programme.
ACC’s first venture of this type and scale, it is aimed at ensuring over-65s’ strength and balance training classes, meeting specific criteria, reach most parts of New Zealand.
THE HEALTH ministry’s Dr Potter says children are active by nature, and “we should hang on to that ability as we age”.
Instead, most adults spend hours at desks and computers, as physically demanding jobs continue to decline.
Exercise is not a medicine, it is part of being human, he says.
“It is not that exercise adds something; it is that losing exercise subtracts something.”
Look for practical stuff to build into the day, walk or run at lunchtime, get off the bus and walk the last block to work, join a yoga group, cycle, play bowls.
Dr Potter has a solid international background in epidemiology, disease aetiology, diet, genetics and cancer. He says: “We know physical activity is beneficial. That is an empirical fact.” He also trusts experience. “We know it – deep in our hearts, we know it...
“Anything that improves people’s movement and physical activity in an increasingly inert and obese society is a good thing,” he says.