Silver Talkies Magazine

Many physiological changes are associated with aging, which can also be impacted by how medications are administered to older adults.

As we age, our body loses its ability to retain water, and muscle mass also starts to reduce. The body starts to retain more fat, and hepatic metabolism becomes slow with time.

The liver, which is in charge of processing and breaking down the medications administered, starts to lose its capabilities; the kidney, in charge of drug excretion, starts to slow down due to slowed renal excretion functions. All these slowed metabolic actions can impact the effectiveness of medications.

At the same time, as people age, the likelihood of taking multiple medications increases, making it a significant challenge for older adults to manage their medications effectively. The intake of more than five medications is known as polypharmacy. With the average older adult taking more than 5-7 prescription medications daily, the risk of adverse interactions, medication errors, and non-adherence to treatment plans grows. Taking non-prescribed Ayurvedic, herbal, and other types of drugs can also impact the overall medical diagnosis. This complexity can have severe consequences, including decreased quality of life, increased healthcare costs, and even hospitalization.

Dr. Naganath Narasimhan Prem, the Chief Consultant Geriatric Medicine and Elderly Care Specialist from the Department of Geriatric Medicine at Mumbai’s Jaslok Hospital, shared his tips on managing different medications.

1. Keep the medication list short. Try to use daily medication only once a day; this will ensure that you can recall the dosage well. Consult with your doctor regularly.
2. Use a pillbox to store your medication properly. Review the medication regularly to check for expiry dates. Keep a list of all the medications you take and what each of them is for, and keep it in an accessible place.
3. Keep a list of all the medications and other non-prescribed creams and lotions you use in an easy list.
4. Read all the prescriptions and labels carefully to properly see the instructions on how to take the medication, what it should be taken with, and the side effects.
5. Ask what side effects your medications can cause; if you have a bad reaction to a medication, or if the medication is not working, please visit your doctor.
6. Please avoid over-the-counter medications without consulting your doctor and having the right prescribed doses.
7. Make sure to understand the labels and directions; ask for help if they are unclear; take help if opening medicine bottles and pouring medications is tough.
8. If a tablet is hard to swallow, you can grind and crush it and even dissolve it in water; many medications also come in chewable form.
9. Swelling of the feet, nausea, and drowsiness are common symptoms of most high-dose medications. In case the medications are causing issues with your bowel movement, body pain, physical fatigue, or any pain, consult your caregiver and doctor.
10. If you miss one dose of medication, taking it at another time of the day is fine. However, it is unhealthy to miss medications for more than 2-3 days, and in those cases, consider consulting your doctor.
11. While taking more than five medicines, take each medication slowly, with at least a minute between each, to allow for the digestion process to occur effectively.
12. Never take a medicine, increase or decrease the dosage, and stop medication, without informing your doctor, family, or caregiver.

Tips for Caregivers

As a caregiver, it is important to be efficient, calm, and organized, to help maintain the health and medication management of the person you are caring for. Here are some tips to help manage this:

1. Always choose fruits and vegetables, to be eaten before supplements and medications.
2. Get frequent doctor checkups and visitations done.
3. Mental well-being for yourself is very important; consult the right mental health services when needed.
4. Keep in constant touch with the family doctor or a geriatric doctor.
5. Download a Pill Reminder app that allows you to customize the medications and manage a calendar of reminders.
6. Maintain a medical diary to track the intake of medications.

A combination of all the above processes, along with frequent checks with your doctor, as well as adequate tracking, can help you manage medications better.

Many physiological changes are associated with aging, which can also be impacted by how medications are administered to older adults.

As we age, our body loses its ability to retain water, and muscle mass also starts to reduce. The body starts to retain more fat, and hepatic metabolism becomes slow with time.

The liver, which is in charge of processing and breaking down the medications administered, starts to lose its capabilities; the kidney, in charge of drug excretion, starts to slow down due to slowed renal excretion functions. All these slowed metabolic actions can impact the effectiveness of medications.

At the same time, as people age, the likelihood of taking multiple medications increases, making it a significant challenge for older adults to manage their medications effectively. The intake of more than five medications is known as polypharmacy. With the average older adult taking more than 5-7 prescription medications daily, the risk of adverse interactions, medication errors, and non-adherence to treatment plans grows. Taking non-prescribed Ayurvedic, herbal, and other types of drugs can also impact the overall medical diagnosis. This complexity can have severe consequences, including decreased quality of life, increased healthcare costs, and even hospitalization.

Dr. Naganath Narasimhan Prem, the Chief Consultant Geriatric Medicine and Elderly Care Specialist from the Department of Geriatric Medicine at Mumbai’s Jaslok Hospital, shared his tips on managing different medications.

1. Keep the medication list short. Try to use daily medication only once a day; this will ensure that you can recall the dosage well. Consult with your doctor regularly.
2. Use a pillbox to store your medication properly. Review the medication regularly to check for expiry dates. Keep a list of all the medications you take and what each of them is for, and keep it in an accessible place.
3. Keep a list of all the medications and other non-prescribed creams and lotions you use in an easy list.
4. Read all the prescriptions and labels carefully to properly see the instructions on how to take the medication, what it should be taken with, and the side effects.
5. Ask what side effects your medications can cause; if you have a bad reaction to a medication, or if the medication is not working, please visit your doctor.
6. Please avoid over-the-counter medications without consulting your doctor and having the right prescribed doses.
7. Make sure to understand the labels and directions; ask for help if they are unclear; take help if opening medicine bottles and pouring medications is tough.
8. If a tablet is hard to swallow, you can grind and crush it and even dissolve it in water; many medications also come in chewable form.
9. Swelling of the feet, nausea, and drowsiness are common symptoms of most high-dose medications. In case the medications are causing issues with your bowel movement, body pain, physical fatigue, or any pain, consult your caregiver and doctor.
10. If you miss one dose of medication, taking it at another time of the day is fine. However, it is unhealthy to miss medications for more than 2-3 days, and in those cases, consider consulting your doctor.
11. While taking more than five medicines, take each medication slowly, with at least a minute between each, to allow for the digestion process to occur effectively.
12. Never take a medicine, increase or decrease the dosage, and stop medication, without informing your doctor, family, or caregiver.

Tips for Caregivers

As a caregiver, it is important to be efficient, calm, and organized, to help maintain the health and medication management of the person you are caring for. Here are some tips to help manage this:

1. Always choose fruits and vegetables, to be eaten before supplements and medications.
2. Get frequent doctor checkups and visitations done.
3. Mental well-being for yourself is very important; consult the right mental health services when needed.
4. Keep in constant touch with the family doctor or a geriatric doctor.
5. Download a Pill Reminder app that allows you to customize the medications and manage a calendar of reminders.
6. Maintain a medical diary to track the intake of medications.

“With time, not only can you manage hypertension, but you can also reverse it.”

- Dr. Bhavani Swaminathan

In conversation with a few Silver Talkies members, Dr. Bhavani Swaminathan, diabetes and nutrition specialist at Aakanksha Desire for Wellness in Mumbai, discussed alternative ways to manage hypertension, which is also known as high blood pressure. If not managed well, hypertension can lead to heart attacks, seizures, and even strokes. By explaining five holistic approaches to managing hypertension in all age groups, especially older adults, Dr. Swaminathan detailed the Ayurvedic components of bodily healing from hypertension.

Tip 1: The Alkaline Diet

According to Dr. Swaminathan, the most common method of reducing blood pressure is by reducing salt intake. At the same time, an alkaline-based diet is more suitable to beat hypertension. Her other tips are as follows:

1. Drink 2-3 glasses of warm water as soon as you wake up, and before brushing your teeth.
2. After brushing your teeth, drink another glass of warm water, but this time, add a bit of lemon to it. Take a lemon shot if that suits your body. Doing this not only allows for the acidity in the lemon to cleanse your digestive system, but the process of digestion converts the acid into an alkaline form, which also helps in managing various issues such as cancer, diabetes, and blood pressure.
3. After 45 minutes, have a glass of fresh juice or coconut water. Even though it might seem challenging, try to avoid drinking tea and coffee in the mornings.
4. After an hour, have a light, fruit and vegetables-based breakfast, with minimal oil and salt.
5. Before lunch, have a light bowl of salad and a handful of dry fruits; consume food such as rice, dal, and vegetables, all cooked in minimal oil.
6. In the period between lunch and dinner, around 4:30-5:00 pm, while having tea/coffee, do not consume fatty snacks; instead, have low-fat and fresh snacks such as makhana, and some fruits.
7. Do not consume fruits after 5:00 pm, as the acidity can fluctuate and can go high.
8. Have your dinner by 7:30 pm, so that there is an adequate 14-hour gap between dinner and breakfast the next morning.

Dr. Bhavani also suggests a vegan diet as the healthiest option; the saturated fats in meat and other animal-based products can negatively impact blood and cholesterol levels. A vegan diet also helps in maintaining a healthy body mass index.

Tip 2: Regular Exercise

Physical fitness not only promotes homeostasis and good vitals but also aids in the active aging process. A daily exercise routine of almost an hour, especially sweaty exercises that release toxins such as brisk walking, running, and yoga, is beneficial.

Along with stretching and yoga to balance breathing, a practice of Pranayama for 10-15 minutes can improve health, manage blood pressure levels, and prevent hypertension. Exercising outdoors in the sunlight can also help to remove toxins through sweating, helping the body to maintain normal alkaline levels.

Tip 3: The Mind Check

According to Ayurveda, negative emotions are seen as hindrances to a healthy body and are associated with toxins traveling through the body, causing further harm to internal health management. Emotional stress, anxiety, and anger can transiently elevate blood pressure and are factors that lead to hypertension. Additionally, avoid looking at phone, tablet, or TV screens for the first 90 minutes after waking up.

Keeping one’s mind positive and learning to stay happy is key to achieving total well-being. Hypertension is often associated with psychosomatic issues and emotional constraints such as prolonged low moods, and even depression. Treating our minds with care is of utmost importance in cases of severe issues such as hypertension, to understand our bodies, and provide efficient care for ourselves, holistically and emotionally.

Tip 4: Psycho-Neurobic Techniques of Meditation

Dr. Swaminathan shared the mindful practice of traditional meditation, and how that can help to manage hypertension. The Psycho Neurobic Technique, when incorporated into daily practices, can prevent hypertension in the long term. This technique is formulated using three forms of therapies, and combining them into one easy practice.

Mudra Therapy: Sit comfortably, either with your legs crossed or even on a chair. Straighten your back but do not stress it backwards. Touch the tip of your index finger to the tip of your thumb, while curling the remaining three fingers gently. Place your hands comfortably on your thighs.

Sound Therapy: As you breathe in deeply, make a long, drawn-out "E" sound while exhaling. Repeat this for 5 minutes, focusing on the sound and your breath.

Color Therapy: Place a green object, such as a piece of cloth or paper, in front of you (before you take the seated position, of course). Gaze at the green color while practicing the mudra and sound therapy. Green is associated with the heart chakra, which is the focus of this meditation.

By activating the Anahata chakra (heart chakra) and engaging multiple senses at the same time (touch, sound, sight), this technique helps with mental focus and aids in managing hypertension by reducing stress and promoting relaxation.

Tip 5: Wet Pack Therapy

Wet pack therapy is another similar holistic approach to managing hypertension. This technique usually involves wrapping a wet cloth around specific body areas to draw out toxins and promote relaxation. This therapy has significant positive effects, especially in managing hypertension, particularly in combination with meditation and diet.

Through the process of detoxification, anxiety and stress levels can be maintained, which helps in reducing the chances of fluctuating blood pressure. Wet pack therapy also helps in blood circulation, reducing the chances of hypertension, and you can do this yourself at home.

1. Use three cotton cloths, with the cloth for your abdomen being larger. Soak the clothes in warm water and remove excess water. The clothes need to be put in warm water only once.
2. Wrap the wet cloth around the forehead, neck, and abdomen. Ensure the clothes are tight but do not constrict blood flow.
3. Maintain the wet pack for 25-30 minutes. This duration allows for effective detoxification and relaxation.
4. Practice wet pack therapy after the morning lemon water and before exercise. This timing helps to cleanse the digestive system and prepare the body for physical activity.

Hypertension can be managed and prevented by combining all the above processes, along with regular exercise and a healthy diet, as well as adequate sleep.

Always wanted to try Shinrin-Yoku or Forest Bathing but didn't know how to go about it? Here's a handy guide from a practitioner who takes you on a soothing journey through the world of nature and trees.

Trees are often considered mere accessories to our surroundings, only noticed when they bloom or when we seek their shade within our concrete jungle. However, there is a lot more happening within these inanimate beings. Trees, regardless of their size, selflessly generate fresh energy by utilizing the elements in their surroundings, providing the entire microenvironment and its flora and fauna with vital resources for their survival. Unfortunately, in our pursuit of material gain, we tend to forget the importance of nature's gifts and the love it bestows upon us. One of the emerging exercises is the practice of Shinrin-Yoku or forest bathing, which involves immersing ourselves in green spaces to rejuvenate our inner selves.

Let's explore what this process entails. The process of connecting with nature begins by finding a green space in a park, preferably with an unstructured design that allows for the flow of energy. Once a clearing between 10-15 trees is located, it's time to divest ourselves of material things like mobiles, purses, books, and if possible, footwear too. Sitting on the grass or soil, we touch the ground and breathe in the fresh smells of leaves, wetness of soil, roots, and flowers. Gradually, we let go of the city noises and become aware of the gentle rustling of the leaves, the chirping birds, marching ants, itinerant squirrels and lizards, and other creatures of nature. In this peaceful setting, we can easily dissolve into the ambience and feel connected to the natural world around us.

It can be difficult to leave the lap and comfort of Mother Earth, but once we rise to our feet, we can begin our exercise. We start by curling our toes into the earth and reaching our arms up towards the sky. Warming up our bodies with gentle movements, we walk slowly and deliberately, feeling the uneven terrain beneath our feet. We then take a mindless stroll around the trees, taking a moment to feel the bark, the roots, and the girth of the trunk. We repeat this for three rounds, pausing in the middle for a break between each round. Once we've completed our rounds, we take the time to choose a tree to explore further. We hug it, feel the bark on our faces and cheeks, and even place our ears against the trunk to feel the gentle movement of energy within. If it doesn't feel right, we move on to the next tree until we find one that connects with us. Spending at least 15 minutes with the chosen tree, we touch it, hug it, sit beneath it, and feel its vibrations and energy. We let our minds wander and imagine stories about the tree, or talk to the beings that make their home there, whether it be birds, insects, or simply the breeze and sunshine. We can even take home a book and sketch the tree, create a mandala with the fallen leaves, or come up with abstract designs. Slowly but surely, the tree connects with us and shares our energy.

As you prepare to leave this environment, why not take a moment to enjoy a warm cup of water or herbal tea with your group? It will have a unique taste as your senses are immersed in the green surroundings. The colour green, the scent of the earth, and the sensation of nature all connect to our souls. As John Muir once said, "Into the forest, I go to lose my mind and find my soul." 

You may wonder how to connect with nature if you don't have the time to spend two hours practising Shinrin-yoku. Simply find a nearby park with multiple trees and sit silently under a different tree each day of the week. Eventually, you'll find the bench or tree that you're most comfortable under. After sitting silently for at least 15 to 20 minutes, at least three days a week, for a month or so, you'll gradually begin to befriend the tree. It will talk to you, entering your senses through the air you breathe, and the breeze will gently caress your skin. The subtle energy of the tree will slowly change and calm you from within. This exercise has been proven and documented in pranic healing and reiki, among other practices. Give it a try! This divine, pure, and spiritual energy is freely available, but we often don't take the time to notice it.

Images courtesy: Pixabay

Good to know: The term Shinrin-yoku was coined by the Japanese Ministry of Agriculture, Forestry, and Fisheries in 1982. It’s defined as making contact with and taking in the atmosphere of the forest.

Have you tried Shinrin-Yoku? Share your experience with us in the comments below.

Sleep often becomes elusive as we grow older. Here are some good sleep habits and expert advice.

Getting enough quality sleep is essential for people of all ages to maintain a healthy and fulfilling life. As we age, it becomes even more crucial to overcome the challenges that can disrupt our sleep. Thomas Dekker famously stated that sleep is the "golden chain" that connects our health and bodies, which rings especially true as we get older. According to Dr. Pankaj Jain, a critical care pulmonologist at Jehangir Multispecialty Hospital in Pune, sleep is an active break that helps restore our energy. To function at our best, it's important to get at least six hours of uninterrupted sleep.

Here are some suggestions for ensuring sound sleep:

Sleep disorders that lead to poor sleep:

Insomnia – is a condition defined by the presence of an individual's report of difficulty with sleep, according to the Journal of Clinical Sleep Medicine. People with insomnia face recurring trouble with falling or staying asleep.

Sleep Apnea - characterized by irregular breathing patterns during sleep. It happens when you stop breathing while sleeping. This occurs due to a blockage of your airway (obstructive sleep apnea) or because your brain does not appropriately manage your breathing (central apnea).

Circadian rhythm sleep disorder (CRSD)- Circadian rhythm refers to the body’s biological clock. The rhythms set in the hypothalamus region of the brain are 24-hour cycles which run in the background to carry out important functions. Also known as sleep-wake cycle disorders, CRSDs occur when your circadian rhythm is out of sync with your environment.

Restless legs syndrome - Restless legs syndrome (RLS) is a sleep disorder that produces a strong impulse to move the legs, usually in response to an unpleasant sensation. It usually occurs in the evenings or at night.

Benign prostatic hyperplasia: This is a health condition in older men characterized by the enlargement of the prostate gland. ‘Benign prostatic hyperplasia affects about 50 per cent of men between the ages of 51 and 60 and up to 90 per cent of men older than 80’, according to Medscape.

Psychiatric disorders: Psychiatric disorders can also be the reason. In a research study conducted by the SMS College Jaipur, it was found that ‘there was a significant association of depression with the increasing age of geriatric persons. The age group of 80 years and above was found to be more under depression (69.6%) than other age groups.’  

The most common comorbidities associated with insomnia are also psychiatric disorders. 

Physical pain: Physical pain from any source of the body. It can include ailments such as arthritis, joint pain, knee pain etc. 

Do away with worries to catch your Zzz’s

Sleep and stress work hand in glove. While inadequate sleep can make stress levels worse, stress can also have a detrimental impact on the length and quality of sleep.

An increase in stress leads to fragmented sleep and prolongs the time it takes to fall asleep. 

Here are some techniques that help in relaxation of the mind and body:

1. Progressive Muscle Relaxation (PMR) - It involves gradually tensing and then relaxing all the muscles in your body. Deep, steady breaths are taken throughout the workout. 
2. Breathing exercises – The following may work well:

Box breathing – also known as square breathing, Inhale to the count of four, and hold air in the lungs for four counts before slowly exhaling at the same count. Repeat the procedure until you feel grounded.

Colour breathing – Based on the principles of visualisation and colour theory, envisioning a colour during breathing can help you let go of stressors and represent how you want to feel.

Balloon breathing – Be seated in a comfortable position. When you inhale, imagine your belly as a balloon inflating with air. Slowly exhale, and imagine the balloon deflating. 

3. Speaking out loud – An unwanted spiral of thoughts can be banished by voicing them out aloud. 

4. Scheduling worry time– Dedicating a separate slot in the day for worrying helps with boosting concentration on other tasks for the day. 

5. STOP Technique – A mindfulness technique for centring oneself, the acronym stands for

S – Stop

T – Take a breath

O – Observe (Bodily sensations, surroundings)

P – Proceed

It can be accompanied by chanting or reading positive affirmations.

6. Keep a diary – Journaling is one of the most efficient coping strategies to release negative thoughts. Daily stressors hampering one’s sleep can be recorded in a sleep diary.

Try these strategies to achieve a restful and rejuvenating night of sleep!

Do you face sleepless nights too? Tell us your tips and tricks here.

Monsoon can be both beautiful and menacing. Here are some essential tips for older adults to navigate the rainy season.

Monsoon has arrived in all its glory and is a refreshing sight for sore eyes. The smell of the earth after the first rain shower can be a heady mix of nostalgia and happiness and a perfect time to sip your chai with hot snacks as you sit and watch the rain. As people find relief from the sweltering heat, heavy rainfall can also disrupt our daily routines, such as moving around outside, planning outdoor events or even a simple morning walk! If you are following the news, much of North India is currently experiencing severe monsoon. So the rainy season can bring joy but unfortunately, it also brings disadvantages. Here's a handy guide:

Monsoon Dampeners

During the monsoon, it is very common to find waterlogging in your surroundings that act as mosquito breeding grounds, bringing forth mosquito-related infections such as Dengue, Malaria and Chikungunya. These diseases tend to be more severe and prolonged for adults over the age of 60.

Respiratory illnesses such as flu and the common cold are other frequently occurring monsoon health concerns. Symptoms such as runny nose, mild fever and sore throat are part of the season. Older people need to take precautions against Bacterial Pneumonia, a common lung infection and dengue. The general duration of Dengue is 5-7 days but for older adults, it can last about 9-12 days. It applies not only to Dengue but Malaria and Chikungunya too, so stay away from those mosquitos!

• Mosquito-borne infections can be controlled by maintaining your surroundings well. Avoid stagnation by emptying the flower pots, trash cans and anything that can collect water such as coconut covers, plastic containers, buckets and other deep vessels regularly or once a week.

• Make sure to use mosquito-repellant creams. Wear full-sleeved, covered clothing, and socks to protect yourself. Use mosquito screens for your windows.
• Drinking clean water during the monsoon can help prevent contracting diarrheal illnesses. Simple measures like using water purifiers or boiling the water before drinking can help. Keeping your overall hygiene and washing your hands before consumption is very effective. Safer fruits to consume are those that can be peeled and eaten. Make sure to wash your fruits and veggies properly! Avoiding street food and eating properly cooked food at home is much safer.
• Routinely mopping and cleaning your home interiors especially open verandahs and toilets where slips often occur is an important step to take. Install handrails and dry mats that you can use to get a grip which can help avoid falls. There seem to be frequent power outages in many cities during stormy weather, make sure to keep a torch, matchbox and some candles handy. Place your medicines at your bedside table or an accessible area that you can even find in the dark.
• Avoid stepping out in a downpour as much as you can and if you need to go, please use an umbrella and accompany someone who can ensure your safety. Using vehicles in the rain may be dangerous, especially two-wheelers. Make sure to drive slowly as the roads get slippery.
• Consult your doctor and enquire about a routine DEXA scan which helps in diagnosing if your bones are fragile and getting the necessary treatment for it. “There are vaccinations available known as Influenza Pneumonia and Hep A vaccines that you can utilize. The Doxycycline tab for Jaundice due to leptospirosis (rat fever) is distributed in Public Health Centres (PHC) by the government,” advises Dr Annu Antony, MBBS, MD (AIIMS) Faculty in Al Azhar Medical College, Thodupuzha, Kerala.
• If fever, diarrhoea, cough and any other symptoms arise, you must consult a doctor as early as possible. Prompt diagnosis and initiation of treatment like taking Oral Rehydration Solution helps with safeguarding your health. Avoid taking over-the-counter antibiotics for flu or diarrhoea frequently without medical consultation as it does more harm than good.
•  Yoga or other exercises can help with immunity and overall mental health. Take care of your joints that can be extra sensitive and follow your doctor’s advice. Moody weather with constant rains might make you feel glum and lonely, but connecting with friends and loved ones online can really make a difference. If you live in flood-prone areas, stay calm but vigilant and take all the precautions necessary to tide over such a difficult time. Be sure to contact the nearest control room and the police for help and safety. Keep those numbers handy for times of need.

The monsoon can be a time of immersing yourself in nature even without stepping out of your time. Follow the precautionary measures but do enjoy the rain clouds and the soothing sound of water as it washes off the scorching summer heat.

 Images courtesy: Silver Talkies

What are your go-to monsoon tips and tricks? Share them with us below.

Japanese chef Atsushi Yonaha on the miracle of the Okinawa diet, the Japanese Blue Zone island he is from.

Did you know that Japan's Okinawa island has the highest number of centenarians (people 99 years or older) compared to other places worldwide? Okinawa is recognized as one of the world's most prominent Blue Zones, where people live longer and healthier lives. This is primarily attributed to the low frequency of obesity and chronic illnesses such as heart disease, diabetes, and cancer among the population. Experts believe that their local diet, the Okinawa diet, plays a significant role in maintaining good health.

Chef Atsushi Yonaha, Japanese Chef at Far & East, the Asian Brasserie at Four Seasons Hotel, Bengaluru, grew up in Okinawa. He told Silver Talkies why the Okinawa diet is considered so healthy by many.

"The Okinawa diet is famous for its association with longevity and overall health. People from my island have traditionally lived long and healthy lives! Our traditional eating pattern focuses on whole, unprocessed foods and emphasizes a plant-based diet. It also includes a lot of fruits, vegetables, legumes, and whole grains, while being low in meat, dairy, and processed foods," Chef Yonaha says.

There are many benefits associated with the diet, he adds. "Firstly, it is rich in antioxidants and phytonutrients from the abundant intake of colourful fruits and vegetables, which can protect against chronic diseases and promote healthy ageing. Secondly, the diet is low in calories and high in fibre, contributing to weight management and reducing the risk of obesity-related conditions. Moreover, including omega-3 fatty acids from fish and soy-based products may positively affect heart health and brain function."

Research has shown that people who follow this kind of diet have lower rates of heart disease, certain types of cancer, and age-related diseases. The emphasis on whole foods and portion control also promotes a balanced approach to eating, leading to increased satiety and better overall nutrition.

We asked Chef Yonaha if Okinawans have always eaten this way.  

"The Okinawa diet has evolved over generations on our island," he mentions, "and naturally offers a wholesome approach to nourishing the body and promoting health. By adopting its principles of plant-based eating, I believe that people can really benefit and live long and healthy lives!" 

Could the Okinawa diet be adapted to Indian cuisine? Quite possibly. Much of our cuisine consists of plant-based foods.

The traditional Okinawa diet comprises very nutritious, primarily plant-based foods — especially sweet potatoes, which provide rich antioxidants and fibre. Chef Yonaha tells us this is what he grew up eating and training in during his formative years.

Fun fact: Incidentally, Chef Yonaha is a trained Fugu licence holder and is one of the acclaimed league of chefs who must undergo two to three years of training in preparing Fugu. This fish can be poisonous if prepared the wrong way. A fugu-preparing certification is a Japanese government-issued license for chefs who have mastered carving the fatally poisonous blowfish in Japan.

Chef Yonaha shared a plant-based recipe with Silver Talkies that could be easily replicated in Indian kitchens. 

Crispy Tofu Steak

This wonderful plant-based recipe is Grilled Tofu with signature chilli garlic ponzu sauce. This protein-packed Japanese Tofu Steak is healthy and quick to make. 

Preparation and cooking time: 20 minutes

Serves: 1 person (Please double portions based on the serving)

Ingredients

Tofu- 160 gm

Grated radish- 70gm

Chilli flakes-5gm

Garlic chopped-8gm

Coriander chopped-7gm

Salt-3gm

Lemon slice-3 slice

Ponzu sauce-15gm

Tempura flour-20 gm

Hajikami-2 nos

Refined oil-200ml

Method

In a bowl, add the chopped garlic, chopped coriander, chilli flakes and salt and pour four tablespoons of hot oil on the mixture to make the chilli garlic sauce and keep aside.

Dry the Tofu with a clean kitchen towel and dust it generously with tempura flour. 

Deep fry the tempura-dusted Tofu for one minute to make it firm and easy to grill.

Place the fried Tofu on the grill/pan to give it grill marks. Apply ponzu sauce while grilling the Tofu. Grilling also helps to remove excess oil.

Place the Tofu on a plate and garnish with grated radish, chilli garlic sauce, and lemon slices. If you can source it, place a piece of hajikami on top and serve hot. You can serve ponzu sauce in a bowl by the side.

Note from Silver Talkies: You can source Tempura, Hajikami (pickled ginger) and Ponzu sauce from stores that stock international foods or on Amazon. Rice flour can be substituted for tempura flour and turn out equally crispy. Likewise, you can substitute Ponzu sauce with soy sauce.

Have you heard of the Okinawa diet? If you try the recipe above, share a picture with us below or on the Silver Talkies app.

Rising temperatures and heat waves can impact the health of older adults in a significant way. Here’s what to watch out for.

Climate change is causing an increase in the frequency and intensity of heatwaves worldwide, including in India, making urban older adults particularly vulnerable. Heatwaves in India are becoming more frequent and intense, impacting cities such as Delhi, Mumbai, and Hyderabad. In Haryana's Gurugram, the temperature hovered around 44 degrees on May 22, prompting Anand Raj Sahai and his wife Mala, both in their 70s, to cancel an impending visit to the bank. "We take autorickshaws to travel, and the hot air after 11 am is unbearable. Why risk a heatstroke by stepping out?" Mala Sahai said.

The Sahais took the right decision.

"Hotter days can cause difficulty in the body's ability to regulate its temperature. This can be challenging for older adults, who typically do not adjust as well as others to sudden temperature changes. Additionally, older adults are more likely to have chronic medical conditions that affect the body's response to temperature," says Dr Naganath Narasimhan Prem, Consultant Geriatrician and Elderly Care Specialist at Jaslok Hospital and Research Center, Mumbai. 

As temperatures continue to rise, dehydration is one of the most significant health impacts. With rising mercury levels, the body loses fluids through sweating, leading to an increased risk of dehydration. For example, a 2015 heatwave in India caused a 43 per cent rise in hospitalisations due to dehydration among individuals who were 60 years and older. Older adults are also more susceptible to heatstroke, which occurs when the body's ability to regulate temperature fails.

According to a study by the Public Health Foundation of India, urban areas are at a higher risk of health problems during heatwaves due to the absorption and retention of heat by concrete buildings and asphalt roads, leading to higher temperatures than rural areas.

What are heat-related illnesses? 

According to Dr Narasimhan, heat-related illnesses can present as:  

• Heat syncope: sudden dizziness that can happen when you are active in hot weather.
• Heat cramps: painful tightening or spasms of muscles in your stomach, arms, or legs. Cramps can result from hard work or intense exercise.
• Heat exhaustion: a warning that your body can no longer keep itself cool. You might feel thirsty, dizzy, weak, uncoordinated, and nauseous. You may sweat a lot. 

Besides impacting older adults physically, rising temperatures can also restrict their mobility and daily activities outside, affecting other areas of their lives. "Decreased mobility is always a risk," says Dr Narasimhan. "Immobility increases dependency, and that affects the quality of life. However, adequate planning, including travel time, visiting cooler places, and always keeping water, can help older adults safely organise outings during extreme heat."

What measures should elders take to ensure they stay healthy through scorching hot summer days? Dr Narasimhan shared some pointers.

• Drink plenty of liquids, such as water, fruit or vegetable juices, yogurt-based drinks or drinks that contain electrolytes. Avoid alcohol and caffeinated beverages. 
• If you live in a home without air conditioning or fans, keep your space as cool as possible. Keep shades, blinds, or curtains closed during the hottest part of the day and open windows at night.
• If an older adult must leave the house to travel somewhere, it should be earlier in the morning so that you reach the place before midday. Another time to step out is later in the evening.
• If you do not drive or own a four-wheeler, consider taking an air-conditioned taxi if you travel. Don't stand outside in the heat waiting for a bus. If possible, avoid public transport that is open to the elements.
• Dress for the weather. Wear lightweight, light-coloured, loose-fitting clothing. Natural fabrics such as cotton may feel cooler than synthetic fibres.
• Avoid outdoor exercising and other physical activity when it is scorching. Instead, try to find someplace you can be active while staying cool indoors.
• Make sure to use a broad-spectrum sunscreen, SPF 15 or higher, and reapply it throughout the day, especially if your skin is continuously exposed to the sun. Wear a hat and other protective clothing, and sunglasses.
• It's important to talk to your geriatrician if you take any medications that could increase your risk of overheating or sunburn.
• Older adults with multiple diseases, different medicine combinations, immobility, and living alone are at greater risk and should be monitored by their family or doctor. 
• Remember to get out of the sun and into a cool, ideally air-conditioned place to keep heat-related illnesses from becoming a dangerous heat stroke.
• Shower, bathe, or sponge off with cool water.
• Lie down and rest as often as you can.

Does the changing weather and rising temperature impact your health? What are the measures you take to stay cool during a heatwave? Tell us in the comments below.

Images courtesy: Unsplash

Mathew Cherian has been a veteran warrior in age care and development. The CEO of HelpAge till June 2020, he is now the Global Ambassador for HelpAge International. A B.E. (Honours) in Civil Engineering from BITS, Pilani Rajasthan, and a PG Diploma in Rural Management from the first batch of IRMA, he is also an author. Cherian is the Board Chair of CARE India. He currently serves as an Amicus Curiae to the Supreme Court in elder rights, for pensions, homes, and the Maintenance Law, which has helped bring elder issues to the forefront—edited excerpts from an interview on eldercare in India.

What are the critical pillars of age care? 

The first pillar is building up communities of elders. It can be associations or organizations, and it can be any group. There is strength in elders joining together; it is an antidote to loneliness and various other things affecting them. The second pillar is appropriate medical care, which includes all types of medicine. So if somebody is interested in Ayurveda, it can be that or allopathic or even Unani. This also includes assistive technologies, from the simplest walking stick to motorized wheelchairs. The third pillar is enabling livelihoods and financial and digital literacy.

Tell us about your experience of working with elders over these years?

When I started with ageing, it was a relatively unexplored field. Helpage continued to work with rural and poor elders. We started Elders Self Help Groups (ESGs) because we found that during any crisis (The Tsunami, for instance), the elderly were the last to receive relief. So we set up a federation (for the ESGs) that has almost six lakh members now and is independently run. This was for rural elders.

We also started organizing urban elders into senior citizen associations around 2007. It began with middle-class colonies and spread across India. There was a group in Maharashtra called FESCOM doing the same work. So together, we set up an all-India body called AISCCON or The All India Senior Citizens' Confederation. (Note: AISCCON is currently the largest federated body representing nearly five lakh senior citizens.)  

We often read that by 2040 one in four people will be elderly. Can you break it down in simple terms and explain why we must pay attention to this data?

We are at the tip of a longevity revolution. All Indians are expected to live almost to be 90 years. So we have a 20-year extra burden of longevity. In these 20 years, we must have some policy intervention towards this area. Because you will live longer, but you will live unhealthier, and you need to promote active ageing, appropriate medical care, assistive technologies, etc., else old age will be tough. Senior citizen communities and associations are key to longevity and better old age. 

We are now poised at a huge demographic explosion. 

Currently, the number of elderly is 140 million. Imagine a triangle -- at the top of this triangle, there are 10 million elderly who are well off and have assets and liquid cash to care for their needs. And then the next bracket is a group of 30 million who are the middle class. They have financial remittances from children or fixed deposits and some savings in a corpus or mutual funds. Unfortunately, the last few years have been disastrous for them because falling interest rates resulted in their incomes dropping. The rest is 100 million, a segment that is both asset-less and without savings. This includes, at the bottom of this triangle, almost 60 million elders below the poverty line who can only be helped by social security or old age pension, which is currently at a very low level. By 2040, we will exceed the elderly population of China and will be almost 220 million. Our national population would reach about 1.8 billion. So then, we will need more money to look after these 220 million elders, which is where the real crisis is. It will be a difficult situation without adequate medical care and social security. 

How does the Indian middle class prepare for this?

The middle class needs to prepare for ageing from the age of 40. This is because if you are going to live for 90 years, you need a corpus of savings. Unless the retirement age changes, you will live 30 years after retirement. So you need some income for those years. So you need to create a corpus of funds. This 30 billion middle-class population needs to be prepared for the coming longevity because they will have healthcare, and so they will live long. But they may not live properly.

What would be an ideal way to spread financial literacy among people growing older besides media awareness, community-level talks, etc? 

Financial training should start in companies at the age of 40. Then, companies and their human resources departments should organize talks with staff about savings, financial literacy, etc., because it will become a need of the hour. If they don't do it from the age of 40, it will become very difficult to do this at 60. 

What are the barriers to ageing actively in India?

We have made a lot of progress when it comes to facilities. There are separate queues for the elderly and separate counters in many places. But there are still many challenges. Simple things like, you can get wheelchairs in some stations. But not in smaller stations. If you try to travel by train and get down at a small station, even in a state like Kerala, you'll find it very difficult because you will have to jump down three steps. So most of the elderly have to be physically carried and brought down. 

So whether it is disabled-friendly toilets, trains, technology, and communication, we need them to be age-friendly. We need age-friendly mobility, and we also need age-friendly buildings, including in our homes.

In India, there needs to be more culture of building your house for all ages. For instance, in Kerala, prosperity has led to people installing very smooth marble floors, even in the bathrooms. This is not conducive for older people as, culturally, we use a lot of coconut oil, which creates slippery floors in the bathroom. Many older people have died or become immobile due to falls in the bathroom there. These are problems in our architecture. We need to educate and create awareness. 

Are people aware of laws that help the elderly?

No, there is no awareness. Unlike Swach Bharat and other schemes with billboards advertising at almost every nook and corner, there has been no publicity of laws and schemes for elders. For instance, according to the Maintenance Law, every district has to set up a maintenance tribunal. I have noticed that only a few collectors are even aware of the law! In one location, the collector did not know that such a law existed, and he was the one who was supposed to be the chair of the tribunal. In some places, the tribunal office is on the third floor of a government building, and it is very difficult for elders to climb up there. So, these issues show a need for more priority given to elders in India.

What are the key challenges you're seeing and some solutions you could mention?

The key challenge is that we need to create an atmosphere where age-based discrimination is not practised. And secondly, we need to improve our social security system in the country. One good thing is that many players have entered the aged care field, and their numbers are growing. So there is increasing awareness starting now. 

Cover Image courtesy: Akshar Dave/Unsplash

What are your views on how ageing is unfolding in India? Share with us in the comment box below.

Addition: Mathew Cherian spoke to Reshmi Chakraborty

What is Sciatica, and is it common among older adults? Physical therapist Dr. Nidhi Kumar explores.

Sciatica is a common discomfort felt by many older adults. Sciatica refers to pain that travels along the path of the sciatic nerve. It is frequently characterized as a burning sensation that runs down the back of one or both legs from the lower back. The discomfort may start in the lower back and spread to the legs or affect any location between the back and the legs.

What Causes Sciatica Pain?

Sciatica pain is caused by irritation, inflammation, pinching or compression of a nerve, called the Sciatic Nerve, arising from the lower back. The most common cause is a disc bulge or herniation that causes pressure on the nerve root, producing a variety of symptoms like moderate to severe pain in the lower back, buttocks, thighs, and leg. It may also cause numbness, pins, and needles in the buttocks, thighs, and leg, and loss of strength or movement. Sometimes, it may even be associated with bowel and bladder control loss.

Is It Common Among Older Adults?

A study comparing sciatica in young subjects and elderly persons was carried out by Kevyan Mostofi and Morad Peyravi and published in the Journal of Orthopaedic Trauma in July 2019. They analyzed records of patients aged between 35 and 55 (first group) and between 65 and 85 (second group) between December 2009 and November 2018. They found out that In elderly patients, disc herniation from upper levels (L2-L3 and L3-L4) is more common than in younger people. Statistically, more elderly patients needed surgery in comparison with the younger population. 'Sciatica in elderly patients takes a different clinical aspect compared to the younger population. The clinical picture associates pain less severe but more persistent and resistant to treatment. According to the study, it is caused in less than 50% by disc herniation.

Cause of Sciatica Among Elders

As people age, their nerves and muscles slowly begin to degenerate. Over time, this can cause pain and muscle weakness. For seniors who are obese or overweight, the risk of developing sciatica is even higher.

Exercise for Sciatic Pain

Courtesy: Dr. Nidhi Kumar

Is it good to have goals to help older adults stay motivated toward pain reduction methods?

Older adults should not only develop goals for pain reduction but also fitness and a healthy lifestyle. Back pain may be debilitating but is never fatal. Those with existing sciatica issues can start rehabilitation once the acute phase settles down. Management of many risk factors is attainable, e.g., weight reduction, strength training, and mobility workouts, improved bone health, and diabetes management, among others. Remember, health is the only sector that reaps the best results if invested over time.

Cover image courtesy: Pinterest 

The AQI in Andheri, Mumbai, was 205 in the first week of November. In Delhi, it had touched a high of 450. So getting an air purifier even if you stay indoors may help.

During the winter, the air quality in North India and several other regions of India is terrible. Being cognizant of this is essential as air pollution kills over 6.5 million people globally every year, according to a May 2022 study in the Lancet.

The Air Quality Index (AQI) calculates the amount of air pollution. The six categories include Good (0–50), Satisfactory (50–100), Moderately Polluted (100–200), Poor (200–300), Very Poor(300–400), and Severe (400-500). On November 3, Delhi's air quality index (AQI) spiked to 450. Given their weakened lung capacity, seniors should exercise additional caution in such circumstances. An air purifier could be required even if they decide to stay indoors, as indoor air pollution can also be worrisome. 

  According to the SAFAR projection (System of Air Quality and Weather Forecasting And Research), Delhi's air quality will stay "extremely poor" for several days.  According to Dr. G.C. Khilnani, Chairman of Pulmonology, Critical Care, and Sleep Medicine at PSRI Hospital in Delhi, this danger causes cancers of all organs, heart disease, and strokes.  

"Besides a general sense of ill health, headaches, low energy, sleep difficulties, and decreased appetite all impact our daily lives. It is also critical to limit your exposure by exercising restraint, "he said. 

Even if you avoid stepping out much, your home, with its many pollutants, may not have as pristine air as you think. Getting an air purifier may easy the problem to some extent.

Here's what to keep in mind when looking for an air purifier.

What to buy: The most widely used are mechanical air purifiers with HEPA ((High-Efficiency Particulate Air)) filters. Advantage? They don't emit ozone and remove particulate matter. 

A carbon-filter-equipped air purifier will also catch gases and volatile organic compounds (VOCs) produced by common household cleaning agents and paints.

An air purifier with an air-quality sensor will activate when pollutants are detected, and it will frequently offer information about the air quality in the room. Additionally, a small air purifier sends detailed reports immediately to your smartphone.

Remember, though, that an air purifier can only remove a portion of the interior particle matter, not dust particles that have settled on the surface. Therefore, air purifiers cannot remove harmful and polluting gases either.

What to remember when you buy: When selecting an air purifier, one of the most crucial considerations is the area it will cover. Small air purifiers are designed for 299 square feet sized spaces. Air purifiers in the medium size cover 300 to 699 square feet (about 65 m2), while large ones cover 700 to 1,900 square feet. 

The noise level is another crucial aspect to consider. If an air purifier is very loud, it is usually of poor quality and best avoided.

What to avoid: The Environmental Protection Agency (EPA) advises against purchasing ozone-emitting air purifiers. These include plasma air purifiers, ionisers, electrostatic precipitators, and UV air purifiers.

Do you use an air purifier? What would your advice be for someone buying it for the first time?

Rima Pande spent two years trying to figure out her father's mind and unspoken words after a stroke he suffered. She shares excerpts from a book she wrote about it and urges children to connect with their parents more often than they do.

"Two years ago, the temporary short-circuiting in my head took on a monstrous new mutation. My mind was zapped in one wanton episode, leaving my legs useless. Another event followed within a few weeks, detaching all connections between my mind and body. My mind no longer controls my body; everyone else around me does. And every thought I have had in the past two years has stayed in my head, unable to be uttered. I have tried. Very hard. For nineteen years, I lived with the uncertainty of mini seizures that created havoc in my mind. And for the past two years, I have been helplessly paralysed. Now I am tired. I am ready to move on. There is no fear, panic, or regret, just a sense of peace, finality, and withdrawal. Every actor has an exit cue. The show goes on, but actors with no role cannot sit on the stage forever. They get in the way of life."

A few years ago, my father suffered two strokes within a few weeks of each other. The second left him paralysed and unable to speak or communicate. In the two years he lived after that, he was physically well taken care of, mentally stimulated and emotionally nurtured. My mother created a positive and normal environment where he was as happy as possible, given the situation. 

We stared at the constantly changing expressions on his face for clues. I often wondered what was going through his mind and how he was calmly dealing with this monumental crisis. So I tried to immerse myself in his stream of consciousness - and started writing a "diary" on his behalf. 

His Voice is a simple, conversational, lightly written first-person narrative. It is my interpretation of my father's unspoken thoughts, emotions and key life experiences during the two years he lived after the strokes. 

"There are 4 types of people in the world - those that have been caregivers, those that are caregivers, those that will be caregivers, and those that will need caregivers" - Rosalyn Carter.

Storytelling in healthcare can be powerful, empowering and transformative for caregivers. Sharing lived experiences lifts and energises us as we face our life crises, overwhelmed with the physical, mental and emotional challenges such situations bring. It makes the journey less lonely. We feel part of a community. We feel heard. We learn from each other. Sharing the burden lightens the weight. We find strength, sometimes inspiration, and we surprise ourselves when we realise that joy is always an option. In fact, it is not just an option. It is an essential component of caregiving that can transform our experience. 

I have distilled my learnings into what I call the 3R framework of caregiving - Respect, Resilience, and Realism. My experience with my father taught me how important it is to maintain the dignity of someone as they become less able and their world shrinks around them; how comfort and quality of life are critical to well-being. It taught me how each of us has to find our own reservoir of courage - through prayer, walks, cooking, shopping or conversation. I learnt to be realistic and to balance hope and effort with the reality that things don't always get better - we have to do our best and accept what we cannot control. 

In addition to the caregiver, we must consider the challenges associated with ageing, disability and palliative care from a patient's perspective, prioritising their needs, wants and decisions to the best of our ability. We naturally want to fix every problem and tackle every situation with whatever medical means available. However, let's always pause and think through long-term implications, unintended consequences and impact on a person's comfort and quality of life. His Voice is not just my father's voice but the voice of many - I speak for him and every patient to amplify the conversation on caregiver support and palliative care systems. 

"I've learned that regardless of your relationship with your parents, you'll miss them when they're gone from your life" – Maya Angelou

I was on an emotional roller coaster when my father was paralysed and unable to speak - grief and anxiety that I could not fully express, anguish, worry, helplessness, and the pressure to stay strong and happy. I struggled to balance worrying about my father's situation and living my "normal" life. Regret was a large component of my thought process - for everything I had not done, for not knowing my father better as a person. And there was a constant feeling of guilt, amplified due to me not being there all the time for my parents when they needed me the most. Even though we had two years to "prepare", my father's death created a giant vacuum in my life. I continued writing his "diary". 

I asked myself many questions when a crisis hit - but it was too late. So I am sharing my father's story to encourage you to pause and reflect on your relationships with your own family, friends and communities. Please call your parents. Don't take them for granted, don't wait, don't hesitate, don't postpone, don't judge, just call. Call them today - and listen. And be there when they need you, and sometimes even when they don't. 

All photographs courtesy Rima Pande

Did you connect with Rima's story? What have been the emotions you've experienced in your caregiving journey? Share your thoughts with us in the comments below. 

When is memory loss a red flag for Dementia? When is it an age-related memory problem?

When Geeta V's grandmother started getting confused about her medicines, food timings or whether she had brushed in the morning, Geeta chalked it down to advanced age. By the time she had taken her grandmother to the doctor and, after some tests, received a diagnosis of Dementia, her grandmother's behaviour had become uncontrollable without assistance. But is memory loss always a sign of Dementia? We asked Dr Soumya Hegde, Consultant Geriatric Psychiatrist from Bangalore, to shed some light on this. Here's what she had to say:

Dementia may not always present with memory loss; unfortunately, it may often be misinterpreted as a sign of ageing.

•Nearly 90 per cent of patients in India do not receive a diagnosis until a crisis or behaviour becomes impossible to manage at home. 

•The person may realise that something is not quite right with their behaviour but are afraid to share their concerns for fear of hospital investigations, bothering their family or because they are afraid that the doctor may confirm their fears.

•In several cases, the first sign may be disorientation in a familiar place or confusion. E g., Mr A steps down from the train while travelling from Mumbai to Pune to get a bottle of water. Once done, he boards the train going back to Mumbai instead of his train to Pune. 

•Some of these instances of confusion and memory loss may happen even years before the actual memory loss starts becoming obvious to those around the person.

• Personality change is another sign – excessive spending, a very elated mood, or overfamiliarity may happen for some people. In some cases, an outgoing person may start withdrawing from conversations and become extremely reticent. 

•When we talk about memory loss, it is important to differentiate it from normal age-related memory loss. In Dementia, we are referring to short-term memory. Long-term memories are intact for longer, and people can vividly recall their childhood and early adult years. What they forget would be their breakfast that morning or a conversation with their daughter the previous day.

• Another differentiating feature is the person's inability to retrace their steps. For example, Mrs A enters the home and walks straight to the kitchen to put something in the freezer and leaves her keys in there. She may find them later and recall how they got there. But a person with Dementia may not be able to do so. Inability to retrace steps or having no recollection of the event at all is of concern and should be evaluated

•You need to watch out for difficulty in remembering and performing familiar tasks such as operating the television remote or a washing machine, which they have for years.

• Language difficulty, especially the inability to find words is another sign.

When should you get concerned enough to seek help?

These instances must be consistent for at least six months for a diagnosis of Dementia. Family members are often unaware of these changes or tend to club them under "age." However, it's important to stay aware and seek help and support if you find an older loved one with any of these symptoms.

It’s important to stay hydrated as we grow older. A geriatrician tells us its importance. 

As one ages, the feeling of thirst tends to decrease, making older adults more susceptible to fluid and electrolyte disorders, which can lead to several complications. 

Dehydration is very common in older adults and frequently leads to an imbalance in fluid and electrolytes. The causes are varied. Certain medical conditions and medications can also affect the ability to retain fluids. Always have regular health check-ups with your geriatrician. Remember that your fluid intake might need to be modified depending on your diseases, especially renal, liver and heart disease.

Dementia patients may forget to drink fluids and might also have difficulty swallowing. Certain drugs can also cause frequent urination which might deplete water and electrolytes in the body. Furthermore, older adults who experience incontinence often purposely refuse or limit fluids to avoid accidents. Dehydration can occur more quickly than you might anticipate and can harm you before you have a chance to rehydrate. Here's how to watch out for it.

Symptoms of dehydration:

Here are the initial signs 

Headache, constipation, muscle cramps, dry mouth and tongue, and sleepiness or lethargy. Urine colour is another helpful indicator and should be clear or light yellow for someone who is properly hydrated.

Signs of Severe Dehydration

• Little or no urination
• Dark or amber-coloured urine
• Dry skin that stays folded when pinched
• Irritability, dizziness, or confusion
• Low blood pressure
• Rapid breathing and heartbeat
• Weak pulse
• Cold hands and feet

What are the remedies and how can we ensure older adults stay well hydrated?

How one serves beverages can also affect a loved one’s willingness and ability to drink them. Individual preferences vary regarding the palatability of different temperatures. Experiment with serving temperatures for beverages to see if you can make them more appealing. Increasing the number of juices like fresh lime water (Nimbu pani), coconut water (Nariyal pani), milkshakes, and smoothies could help.

We may not think of it, but attractive drinkware can be important in making an older adult take in fluid. Someone with low vision might be able to see an opaque, brightly coloured cup more easily than a traditional water glass and therefore drink from it more often. Particularly resistant seniors may find a beverage more appetizing if it is served in a pretty glass or garnished. 

For those with swallowing difficulties, tremors, arthritis, motor skill problems or muscular weakness, there’s specialised drinkware that may help. Cups with two handles, a no-spill lid, a built-in straw, or ergonomic features may simplify the process and prevent spills.

Hydrating foods for Older adults

Raw fruits and vegetables work well, including cucumber, tomato, watermelon, grapes, oranges and apples

If older adults have an aversion to raw fruits and vegetables, try adding berries in desserts, yoghurt and cereal.

If you are an older adult or a caregiver to one,  be alert to dehydration as it is preventable and saves you from future health complications.

To our readers: How do you remind yourself to drink water/fluids regularly? Share your trips and tricks with us.

Images courtesy: Pixabay

We decode if superfoods are a must have and what you need to pair them with.

What are superfoods? The Oxford dictionary defines them as 'a nutrient-rich food considered especially beneficial for health and well-being.' Other standard definitions call it 'food that is rich in compounds such as antioxidants, fibre, or fatty acids and beneficial to health.'

The question is, do you need superfoods? And if you do, are they enough? We asked nutritionist B Usha Dharmanand to explain. Here are some points from an exciting talk she did for Silver Talkies:

Superfoods have always been there. You can trace the term's origin to the early 20th century when the United Fruit Company used bananas as a food marketing strategy. They initiated an advertising campaign to promote the major import of bananas. Initially, the company had advertised the practicality of bananas in a daily diet, being cheap, nutritious, and in a natural germ-proof package. Then, to get people to eat more, they suggested adding bananas to cereal, salads, and even fried with meat for dinner. Physicians endorsed the diet and published the efficacy of the diet in treating conditions like celiac disease and diabetes. And lo and behold, a new superfood (that had existed for centuries) was born! 

These days, thanks to social media and the constant information barrage on our devices, superfoods are "born" almost weekly! Flaxseeds, for instance, have been used in North Karnataka for centuries daily. But thanks to their current 'superfood' status, we may look at them more interested than ever!

Are superfoods essential or just a super fad? Of course, yes. Superfoods are foods that have a very high nutritional density. This means they provide a substantial amount of nutrients and very few calories. E.g., Non-starchy vegetables like green leafy vegetables, beans, capsicum, bottle gourd and cabbage have low calories and high nutrient density. 

Here are some of the top superfoods in the news these days: Avacados, pomegranate, berries, broccoli, seafood, garlic and onion, mushroom, nuts and seeds, green leafy veggies, kombucha, kimchi, dark chocolate, ancient whole grains, chia seeds, flax seeds, wheatgrass. 

The ORAC unit (Oxygen Radical Absorbance Capacity), or ORAC value, is used by scientists to quantify the antioxidant potential of various foods. Foods with higher ORAC scores have the better antioxidant capacity and more effectively neutralise damaging free radicals. ORAC value tells you (or your nutritionist) in practical terms just how much benefit you will get from consuming a substance. 

E.g., Ground cloves have the highest level of antioxidants of any food in the world, with an ORAC score of 314,446 (broccoli, for comparison, has a score of 3083). But because they are different types of foods, the consumption is also different. You can't (and shouldn't) eat as many cloves as broccoli, right?

The United States Department of Agriculture (USDA) has suggested a daily intake of around 5000 ORAC units to make things easier. At the same time, the UK's FSA recommends the classic (and easier to follow) 'five a day of fruit and vegetables, which works out to around 3500 ORAC units. 

But, should you have only superfoods?

No. The idea is to take everything together and make a balanced plate. E.g., one apple, three apricots, a medium-sized banana and about two big broccoli florets will get you antioxidants and other fibre and minerals.

Like in every other area of your life, your diet too needs diversity. The European Food Information Council has stated that it is impractical to have a diet based only on superfoods. Nutrients are provided readily from a diet based on the diversity of foods, especially a diet including fruits and vegetables. In other words, traditional diets we have been consuming for years.   

What's the best kind of diet to live a long healthy life?

To know that, let's look at the five known Blue Zones or regions of the world where a higher proportion of people live more than 100 years. People in Blue Zones typically eat a 95 per cent plant-based diet rich in legumes, whole grains, vegetables and nuts, all of which can help reduce the risk of death. In addition, caloric restriction and periodic fasting are common in Blue Zones. Both these practices can significantly reduce risk factors for certain diseases and prolong healthy life. Blue Zone residents also have alcohol in moderation, have exercises incorporated into their daily activity, get enough sleep, socialise and have a purpose in life.

Variety in our diet is necessary to benefit from eating a wide array of essential vitamins and minerals and prevent one from overeating (or eating too little) of a particular nutrient. According to the Harvard School of Public Health, one disadvantage of superfoods is that the title may cause people to focus on a few specific foods, blinding them to other equally nutrient-rich but less hyped options.

So should we have superfoods at all? Yes, for sure but with the right combinations. Focus on creating a "super plate" full of different healthy and flavorful foods. For instance, pair your Idli Sambhar for breakfast with papaya for a balanced meal; Make a balanced homemade Chinese dinner with a bowl of rice (fewer carbs), vegetable gravy and some sauteed greens. Have fruits in a variety of colours. Don't stick to one superfood.

For instance, Chia seeds are considered a superfood. This is because they contain several components that, when consumed as part of a plant-rich diet, may help prevent the development of various chronic diseases. But research confirms that chia seeds can't act alone. It's only when combined with a varied plant-rich diet and other healthy lifestyle behaviours that it can help prevent disease.

So do have your superfoods on a plate balanced with other super nutrients too!

What is your very own superfood? Tell us in the comments below

Deep breathing is a strong tool all of us have within us. Here's why it's important to learn how to do it right.

Did you know that we take more than eight million breaths per year? Did you also know how important breathing the right way is for our wellbeing? Deep breathing is a relaxation technique that may help reduce stress and anxiety.

Yoga Acharya Dina Khimasia, the expert conducting the Silver Talkies' weekly Yoga classes, says shares the importance of deep breathing with us:

• Deep breathing or diaphragmatic breathing is a practice that lets more air enter your body. This results in calming your nerves and reducing stress and anxiety. Deep breathing could help with many good things, such as reducing our anxiety, depression, stress management and improved focus.

• As we grow older, sleep is often elusive. Instead of medication, why not try this? Deep breathing exercises can help you sleep better. It leads to a calmer nervous system and more production of melatonin, the hormone that regulates sleep-wake cycles.

• When you breathe deeply, your body releases endorphins. These are feel-good hormones and the body's natural pain killer. Deep breathing activates the vagus nerve. This is the nerve that oversees your mood, digestion and heart rate.

• Deep breathing can also send more oxygen to your brain and other organs. Better functioning vital organs mean a more robust immune system. So it's good for your immunity too!

• As we all know, if you are anxious, deep breathing can help. Try it out now. Could you take a good deep breath and let it out? If you did it right, you are feeling a bit lighter. Deep breathing slows your heart rate and signals the brain to wind down. It also balances your hormones, thus lowering the cortisol levels and increasing the endorphin rush in the body.

• Did you ever think that deep breathing is good for your posture? Deep breathing can rearrange tension patterns of the spine and improve posture. Regular practice of deep breathing allows you to maintain good posture for several minutes as you strengthen underused neck, shoulders, and back muscles.

• Deep breathing helps to detoxify the body. Our bodies release 70 per cent of toxins through breathing. For example, carbon dioxide is natural toxic waste from the body's metabolic processes. It is transferred from the blood to our lungs and expelled through our breath. However, with shallow breathing, the body has to work harder to remove this waste. Here's where deep breathing helps.

• Deep breathing can lead to better digestion by supplying more oxygen to our digestive system. In addition, the increased blood flow due to deep breathing encourages intestinal action and improves your overall digestion.

• You would have noticed the change in your breath when angry. Your breathing becomes shallow. It results in the body not getting the oxygen it requires. Long deep breathing reverses this process, allowing you to become calmer.

How to breathe:

Focus on breathing from your stomach. Push your stomach out each time you inhale. Take longer breaths and count to at least three breaths for each inhalation and exhalation. It may feel uncomfortable at first but keep going. Slowly, you will start to notice your body feeling more relaxed. Deep breathing may sound very simple, but it isn't easy and requires consistent practice.

"Mastering breathing the right way is very difficult," says Dina. However, with regular practice, you can get there. "It is said in Yoga that when the breath wanders, the mind is unsteady, and when the breath is still, so is the mind."

It's time to focus on the tool we all have within us: Our breath.

Do you practice deep breathing? Let us know how it has helped you in the comments below.

Here’s what you need to know about the right food pairings for good health.

With increasing age, adequate nutrition becomes an essential prerequisite to remain healthy, both physically and psychologically. And that’s exactly when smart diets work for older adults. Did you know that certain foods when paired together and consumed, can provide the best nutrition, especially as we age? 

David Jacobs, a researcher from the University of Minnesota found that “food influences our health in complex and highly interactive ways when certain foods are paired together.” He showed that certain food pairing helps to enhance bioactive compounds - compounds that promote good health and help in prevention of cancer, heart disease and various other ailments.

Usha Dharmanand, consultant nutritionist at Vikram Hospital Bangalore is a great advocate of pairing foods and shares some best practices of pairing food to enhance nutrition.  

Plant based iron and Vitamin C: Iron from iron rich foods like whole pulses, green leafy vegetables and dals gets better absorbed by our body when eaten with vitamin C rich foods like bell pepper, guava, tomato, strawberry, lime and more. 

Turmeric and black pepper: Curcumin in turmeric and piperine in black pepper, when consumed together,  have been shown to improve health due to their anti-inflammatory, antioxidant and disease-fighting qualities. 

Vitamin D and Calcium:  Our body can absorb more calcium if we have optimum levels of Vitamin D in our body. That’s why it is important to try out certain Vitamin D rich and Calcium rich foods together. For Vitamin D, you can try out salmon, mackerel, eggs (yolks), cheese, fortified products and of course get exposed to natural sunlight. Simultaneously, you can consume Calcium rich foods like til seeds, poppy seeds, spinach, shepu or dill, green leafy vegetables, paneer, cheese, milk or curd. 

Protein with healthy carbs and complementary proteins: When these are combined and consumed, the amino acid absent in one is compensated by its presence in  another. Besides, the combined food helps in lowering the sugar level of the food. Like, beans, chickpeas or rajma with rice, vegetable khichdi or lemon rice with lots of dal and peanuts in tadka eaten along with veggies. 

Fat and fat soluble vitamins: When tomato and avocado or carrots are tossed with a little fat like olive oil or when green veggies are eaten with nuts, the fat present in them helps our body to better absorb the fat soluble vitamins like Vitamin A,D,E,K. 

It also helps in enhanced absorption of protective phytochemicals. A recent study measured how well phytochemicals were absorbed after people ate lettuce, carrot, and spinach salad with 2 to 1/2 tbsp of avocado (good fat). The avocado-eating group absorbed 8.3 times more alpha-carotene and 13.6 times more beta-carotene (both of which help protect against cancer and heart disease), and 4.3 times more lutein (which helps to amp up eye health) than those who did not eat avocados along with the salads. 

Improper food combinations to be avoided

While some food combos are great for your health, some are not and must be kept at an arm’s length from your diet. 

Spinach and dairy products: Foods such as spinach, chocolate, and tea contain oxalate - an antinutrient that can bind with calcium to form an insoluble compound. For people who are prone to certain types of kidney stones, consuming calcium sources such as dairy products with oxalate-containing foods can increase the risk of developing kidney stones. On the other hand, combining oxalates and calcium decreases the absorption of calcium. For most people, this is no problem in the context of a balanced diet. However, for people who don’t eat much calcium in the first place or who eat a diet very high in oxalates, this interaction might cause a problem.

How to reduce oxalates?

• By drinking plenty of water to help your body flush oxalates out. 
• By consuming enough calcium, which binds to oxalates during digestion.
• By limiting sodium and sugar intake, which may contribute to formation of kidney stones at high levels 

Water with food: Avoid drinking more than 200 ml of water with your meals as it can dilute stomach acids which are needed for the digestion of food.

Drug and nutrient absorption: Certain drugs can mess up with nutrient absorption capacity of your body.

Acid blocking drugs like antacids can reduce the absorption of Calcium, Vitamin B12 and Protein. Also, drugs that protect us from infection can do the same. 

Diabetic medicine like Metformin can reduce Vitamin B12 & Folic acid absorption.

Lipid-lowering medicines like Statins can affect coenzymes like Co Q 10 and anti-epileptics can affect  Vitamin D.

Consumption of Vitamin K-rich foods like green leafy vegetables needs to be reduced when on Anticoagulant drugs like Warfarin.

Note: If you are on any of these medications, please consult your physician or nutritionist for any dietary changes.

Food facts that you must keep in mind

• Deficiencies can occur due to various factors like ageing, boredom to cook, and food rigidity, among many other reasons.
• Soaking, germination, fermentation, and the right cooking methods can make many proteins, minerals and vitamins easily absorbable by the body.
• Vitamin and mineral supplementation to be done at a time when NOT taking any medications.
• Food combinations and rainbow colours on your plate can enhance good nutrition. Following the right food pairing along with diversity in the diet can bring about an appropriate, balanced diet.
• You can start ‘pairing for health’ and enjoy the nutritional benefits of tasty food combinations. 

Some interesting food tips 

Eating fruits along with a meal or immediately after a meal can be beneficial

The higher the glycemic index, the easier the digestibility and the quicker the sugars are absorbed in the blood after digestion. Many fruits have a lower glycemic index except for cantaloupe and watermelon. So, eating fruit with or just after a meal may actually be beneficial in controlling the sugar increase due to our simple carbohydrate diet.

Do  not peel off the apple skin unless you find wax on it

Keep an apple in a big bowl and pour a glass of hot water on it. If there is wax on it, it will run down the apple as wax melts and you may be able to see an oily layer floating on the surface of the water. If so, please remove the skin of the apple and consume it. If not, enjoy extra nutrients by consuming the skin. 

Intermittent fasting is good for older adults

Numerous research has indicated good health benefits of intermittent fasting like better sugar control, blood pressure control, weight loss, etc. Hence, it is worth a try. 

Being aware of appropriate nutrition is of immense importance, especially if you are 50 and above. Try out these food pairings and follow these expert tips to enjoy healthy ageing. 

Are there any food pairings you live by? Tell us in the comments below.

As the world opens up, it’s time to step out but with caution. Here’s a short guide. 

As we are into the second year of the pandemic, three waves of COVID-19 have risen and fallen. For the first time since the start of the pandemic in 2020, things have opened up. In India, we are better placed as far as covering most of the population with vaccination is concerned. However, it would still be in the best interests of older adults that they exercise caution.

As you prepare to step out and embrace the world again, here are the tips to be followed:

Understand the risks 

Remember that any activity one engages in outside might still come with the risk of getting COVID-19. Does that mean you still stay locked up inside the house? No. The key to staying safe is to understand your risk factors, the level of COVID-19 infection risk in your community and your comfort level.

Follow public health guidelines

Monitor public health guidelines in your area and follow all recommendations designed to keep community members safe. These recommendations may include wearing a face mask, practising social distancing, washing hands, avoiding crowds, and limiting the size of gatherings. The guidelines are fluid and might change with time.

Care for your mental health 

It is certainly reasonable for older adults and their family caregivers to experience some anxiety related to the world reopening and stepping out. In contrast, some older adults may have had trouble coping with prolonged isolation during the COVID-19 pandemic. Older adults should continue to embrace technology and stay connected with friends and family. If you feel anxious or depressed, contact your healthcare provider.

Continue to use delivery and virtual services

As much as possible, continue using delivery and virtual services for essentials such as groceries, prescriptions, medical visits and keeping in touch with friends while maintaining social distancing. Although you will still have to leave home from time to time, using these services can reduce the amount of exposure you have to others. Most medical practitioners now offer online consultations, as do several other service providers.

Establish safety rules at home

If you allow visitors into your home, consider asking them if they are vaccinated and allow them as per your comfort. It may make sense to limit the number of visitors to your home and continue to practice hand hygiene if you are worried about infection and exposure.

Stay healthy

Keeping oneself healthy is always the priority. Maintain a good lifestyle, consume a healthy diet and exercise. The pandemic is not over as of now. But we are better placed now than at the beginning of the pandemic. Prevention is better than cure. Most importantly concentrate on being healthy.

Make every day a good hair day with these handy tips to help with aging hair conditions.

Who doesn’t like to flaunt thick and strong, gorgeous locks? Increasing age is certainly no exception in wanting to have healthy hair and shiny silver locks have got their own charm. However, maintaining your hair properly when you are older can sometimes be a challenge due to underlying health conditions that may contribute to hair loss and thinning. Silver Talkies got in touch with trichologists and dermatologists to understand age-induced hair conditions older adults may face and the various ways of dealing with them.

Common Age-Related Hair Conditions 

Androgenetic Alopecia: This is a very common form of baldness, especially among elderly men where they lose hair over the front, mid-scalp, and crown regions. This is mostly caused due to hereditary issues and effects of hormones with increasing age. 

Chronic Telogen Effluvium: Hair loss among elderly women where they lose hair from all over the scalp due to nutritional deficiency and stress. 

Female Pattern Hair Loss: This kind of hair loss is widely observed among elderly women where they lose hair from the center of the scalp with an increase in the partition width and hair thinning due to hormonal issues. 

Dr. Kala Vimal, Trichologist at Hairline International Hair & Skin Clinic, Bangalore, says, “In elderly males, hair loss is related to the effect of hormones and in elderly females, hair loss can occur due to nutritional deficiencies and the effect of hormones. Chronic systemic illnesses like diabetes, hypertension, thyroid issues, systemic illnesses related to vital organs, protein loss due to organ dysfunction, a few medications are taken for chronic illnesses and chemotherapy can also lead to hair loss among older adults.”

If you’re a woman experiencing sudden hair loss after 50, you must be more cautious, highlights Dr. Sachith Abraham, Consultant - Dermatology, Manipal Hospital, Bengaluru. “It could be due to androgen producing tumors. Certain fungal infections can also be a cause. Scarring hair loss may be due to several autoimmune conditions. Alopecia Neoplastica, a rare form of cutaneous metastasis in which underlying cancer spreads to the scalp, can be due to breast cancer metastasis.”

Healthy Hair Tips For Over 50s

• In your routine health check-up, do check your Haemoglobin, Ferritin, Vitamin B12, and Vitamin D levels, thyroid profile, and protein levels in the blood. Also, check for protein loss in urine and an additional serum-free testosterone level in females for female pattern hair loss. Anything abnormal in the reports has to be corrected. 

• Wash hair regularly or alternate days, use anti-dandruff shampoo and caffeine, peptide-based shampoo without paraben and sulfates. 

• Any lice infestation or dermatitis of the scalp needs to be addressed by a Dermatologist.

• Regarding oil application to the hair, if the scalp is very dry or hairs are frizzy, coconut oil can be used, maybe once every 15 days. You can keep the oil for 2 to 4 hours and wash it with regular shampoo. Never leave the oil overnight as it may cause dandruff and folliculitis. 

• Eat a complete protein-rich diet. Iron is important for hair. Do not use harsh products on your scalp and choose the right products. Use gentle shampoos and conditioners. 

A multidisciplinary approach is required if facing severe hair issues after 50, believe experts. “There are various advanced treatments available apart from topical and oral medications like lower-level laser therapy, derma roller to stimulate hair growth, hair transplant if fit for surgery, and a good donor is available. You can also opt for a neurosurgical modality plan for hair systems like toupes, patches, wigs, or hair fibers,” says Dr. Vimal.

Dr. Abraham suggests consulting your dermatologist who will assess what tablets or products are good to increase hair growth. “The doctor will weigh the pros and cons and discuss with you all the options including hair transplants. Certain tablets like finasteride which is given to men for prostate issues also tend to increase hair growth. Stem cell therapy, hair follicle culture are futuristic techniques which may still be materialized in time,” he says. 

Your hair needs extra care and attention as you age just like any other part of the body and these tips can help you maintain #goodhairdays on all days irrespective of how old you are.

Do you have a special hair care routine? Let us know in the comments below.

Images courtesy: Gabriella Clare Marino/Unsplash; Pixabay

Following the right diet can amp up your brain health and cognitive skills 

Ageing is a natural process. There is no magic pill to prevent cognitive decline, and no single almighty brain food to ensure the sharpest brain. What we as nutritionists emphasize is to follow a healthy dietary pattern that includes a lot of vegetables, fruits, legumes, and whole grains. Also, one must try to get protein from plant sources and fish and choose healthy fats, such as olive oil or canola, rather than saturated fats.

Key brain-health nutrients

Omega 3 fatty acids

The brain is made of 60 per cent fat. In fact, the brain, after adipose tissue, is the organ richest in lipids, whose only role is to participate in membrane structure and repair brain cells.

• The 3 most important Omega 3 Fatty Acids are ALA, EPA, and DHA. 
• Consuming a diet rich in foods like fatty fish, kale, spinach, soybeans, walnuts, and seeds, such as chia, flax, and hemp, seed oils like flaxseed and rapeseed, can enrich the brain with healthy Omega-3s.
• Consuming such a diet has also been shown to reduce inflammation and may help prevent chronic diseases such as heart disease and arthritis.

B – Vitamins 

Eggs, chicken or red meat (liver and kidney), dark green vegetables, such as spinach and kale, whole grains and cereals, beans, such as kidney beans, black beans, and chickpeas, nuts, and seeds are rich in B-vitamins which may help prevent dementia and boost the production of neurotransmitters, improving brain health.

Antioxidant-rich foods 

Antioxidant-rich foods reduce cellular stress and inflammation, reducing brain ageing and neurodegenerative disorders, such as Alzheimer’s disease. Including berries, dark chocolate which are rich in flavonoids, beta-carotene rich foods like carrots, and dark green leafy vegetables would ensure adequate antioxidants in our diet. 

Emerging brain-boosting diets

*Mediterranean diet: There is some evidence that people who eat a Mediterranean diet have a lower risk of developing dementia and have improved cardiovascular health.

• Zone diet: The ‘Zone diet’ has also been shown to reduce inflammation and help brain health. It includes restricting simple carbohydrates in the diet (like maida and white rice) to 40 per cent, protein and fat to 30 per cent.
• Ketoflex diet 12/3: Taking food within a 12-hour feeding window period and finishing the last meal 3 hours before sleeping is also a brain-healthy diet.
• Calorie restriction: Studies have also shown that calorie restrictions like reducing 10 per cent to 20 per cent of calories from our daily diet can also help our cognitive health.
• MIND: Researchers have developed and are testing another diet, called MIND, a combination of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. According to observational studies of more than 900 dementia-free older adults, closely following the MIND diet was associated with a reduced risk of Alzheimer’s and a slower rate of cognitive decline.

Other important factors that affect brain health are: sleep patterns, physical activities like walking and resistance strength training, ensuring social cohesion and strong community interaction,  reducing stress, learning new skills or involving in brain-stimulating activities.

Ultimately, the brain is part of our body, and what nourishes the body nourishes the brain too!

Are you conscious of improving your brain health through food? Share your experience with us in the comments below.

A growth mindset ensures that you never stop learning. Here’s why we need to develop it.

When I started researching happiness many years back, I came across Carol Dweck’s findings on the theory of mindsets and their impact on our wellbeing. Carol is an academic and psychology researcher at Stanford. She says there are two types of mindsets, a fixed mindset, and a growth mindset.

If you have a fixed mindset, you believe that your abilities and your personal qualities (such as intelligence) are literally carved in stone. There is only so much you can do and nothing more. On the other hand, if you have a growth mindset, you believe that you can enhance and change your abilities and your personal qualities over a period of time. So literally, if you put your mind to it, there is nothing that you cannot do!

So how does this relate to wellbeing and happiness?

Your mindset has a great impact on how you behave and how you live your life. Let’s say you are a pessimist, with a fixed mindset. You will believe that there is no way you can change. However, with a growth mindset, you always believe that there is room for change, and it’s never too late to drive it. When you are a growth mindset person, you are constantly open to new experiences, new learnings, and forging new connections. All these three traits are researched, and the results prove that they enhance your happiness.

Why is a growth mindset important?

Let’s look at the positive emotions that we experience through learning or experiencing something new. Joy, Interest, Hope, Pride, Amusement, Inspiration, Awe – these are some of the happy emotions we experience with new learning. Let me ask you then, why would we not subscribe to a growth mindset that sets off these ‘happy chemicals’ through our body and mind?

The people with growth mindsets are ones that look at the journey and the process and the enjoyment of uncovering something new along the way, unlike fixed mindsets that only look at a goal and go straight for it, with their minds focused on the final achievement. The journey itself is not important and is often filled with stress and fear along the way of the possibility of non–achievement of the goal.

The Chinese book of the philosophy of Life by Lao Tse called the ‘Tao de Ching’ actually translates to “The Way!”

How does one develop a growth mindset?

1) Be open to new learning at all times. There is always something to learn from everybody and every situation! Gurus are not just human beings, they could be family, friends, books, talks, your relationships, and even difficult situations that you encounter!

2) Introspect regularly when the day is done. Run through the events in the day, bring your awareness to what went wrong and what you could have done differently and in a better way, and follow through with the change process.

3) Embrace changes willingly and with a positive mindset. We all know that ‘change’ is the only constant in life!

How has it worked for me?

Presently, my life is filled with many activities, all of which I love to do – be it reading, researching, painting, writing, sports, cooking, and more. I love the process and the learning. I’m always in awe at the variety and depth of knowledge that is freely available to us through technology today!

So never give up learning! And never believe for a moment that you don’t have the skill. Research shows that people who excel at any activity or knowledge – sportsmen, artists, researchers, and others, have spent more than 10,000 hours honing their skills, so don’t ever give up!

Also, make sure you surround yourself with your own Personal Learning Network (PLN). These could be family, friends, organizations, or groups that support your learning! Social interaction is as important as having a growth mindset if you want to be happy and live longer!

Let me end with this famous quote by Albert Einstein! It’s self-explanatory!

“Once you stop learning, you start dying.”

Here's all you need to know about the benefits of Reiki for older adults.

You may deal with acute knee pain, arthritis, migraine, anxiety, insomnia, anger issues, memory loss and more on a daily basis and blame your increasing age for all of them. But have you ever considered the concept of emotional healing to address these physiological and psychological difficulties? 

What is emotional healing?

Emotional healing is body and mind coordination and is particularly essential for older adults. Why? Because they face a plethora of issues - be it physical or psychological. Emotional healing helps people learn to tap certain nerve centres in just about 10 minutes to manage these problems and restore their wellbeing. 

Reiki, an inevitable part of emotional healing

A 94-year-old retired professor was tired of his constant knee pain until he attended a few sessions of Reiki distant healing. Another 90-year-old gained relief from excruciating pain which she got following an accidental fall. A 60-year-old was able to manage his insomnia and anger issues and get a healthy sleeping pattern via distant healing. Yes, Reiki can do wonders. 

Reiki is a complementary system of healing, originally from Japan, that involves activating all chakras of the body without any side effects. “Reiki self healing involves just ten minutes of your time, thereby promoting mind-body coordination and emotional healing,” says Nagesh BA, Master in Usui and Karuna Reiki, Pendulum Dowsing and Crystal Therapy who left his senior position with the Karnataka Government and got drawn towards Reiki following immense work pressure, health issues and demise of his mother. There are various ways in which Reiki can be beneficial for older adults, he told Silver Talkies.

How can Reiki help older adults?

“Physically, Reiki helps alleviate pains. By spending just ten minutes a day and using the hand positions, you can energise all chakras of the body. This keeps you active throughout the day. Psychologically Reiki promotes good sleep patterns, reduces stress, helps you bond well with family and friends, get rid of Ancestral Trauma - ??which are psychological effects that the collective trauma experienced by a group of people has on subsequent generations in that group,” says Nagesh. 

The Best Way To Open Your Mind To Reiki & Practice It

“A lot of Indian older adults are familiar with Reiki but hesitant to take up learning. Indian groups are still to come to grips with Reiki. In the present context sufficient groundwork has to be done for popularising Reiki on social media,” says Nagesh who has a dedicated Facebook page to promote Reiki - Healing through Energy Reiki. 

“You can learn Reiki through a Master/Grand Master. There are three levels- Level One: self healing, Levels Two and Three: healing others through Reiki Symbols. Mastership is required for distance healing. There are no side effects with Reiki practice. In fact, when we heal others either through distance healing or physical healing, our energy levels increase,” says Vinay Rao, Nagesh’ son, who followed his father’s footsteps and specialised in using Binaural Beats (A binaural beat is an illusion created by the brain when you listen to two tones with slightly different frequencies at the same time) to cure people of  various ailments.

Some lesser known and fun facts about Reiki

According to Rao, Reiki is not related to health issues alone. There are a lot of fun things to do like

• You can have a trouble free drive
• You can get protection and shielding from viruses and negative environment
• You can help heal workspace
• You can have safe travel
• Retrieve lost documents
• Restore lost relationships
• Heal ancestral trauma
• Lose weight

Intrigued? Perhaps give this technique of emotional healing a try and let us know if it worked for you as it has for many older adults.

An expert guide on how reflexology can work for older adults

You may be aware of the concept of massage as a luxury or a spa therapy. But did you know that reflexology, a type of massage, is also an ancient healing technique that is considered as an insured medical practice in several countries like the USA and Denmark? Reflexology is an essential part of healthy ageing and a significant contributor to the wellness factor, especially among older adults. It comes with a wide range of physical and psychological benefits and Indian older adults can immensely benefit from it. Ravneet Grewal, a Bengaluru based reflexologist tells us why. 

Reflexology and a little history

Reflexology is an ancient medical science developed in China about four and a half thousand years ago to provide relief to people from pain. “There are a lot of corresponding points which the Chinese call the reflex points on the feet, hands and at the front and the back of the ears, which when pressed would alleviate pain in the corresponding organs of the body parts. That’s how removing pain came into being,” says Grewal. Why is reflexology mostly done on the foot? Because it is a larger area and is constantly used for balancing the body. “When we press on the feet, the corresponding organ or body part gets a faster and better result,” Grewal adds. 

From the Chinese, reflexology was taken over by the Egyptians who even immortalised it in their ancient paintings as it was practised as a popular healing technique. 

It was in the early 1900s when reflexology was recognised as a relevant practice in medicine and introduced as a method of pain alleviation in hospitals by Dr William Fitzgerald who’s known as the Father of Reflexology. He discovered Zone Therapy and developed pain zones on the feet that would correspond to organs and body parts. Later, Dr Eunice Ingham, a pathologist who stated, ‘perfect health spells perfect feet,’ mastered the technique of reflexology and brought the technique to a larger number of people. 

Reflexology and its impact on older adults

Now that we are done with history, here's how reflexology could work for everyone including older adults. “In India, most people tend to consider reflexology as a foot massage but it is much more than just massaging. The movements on the feet are focused and you are making those movements with an understanding and an intention. When you’re moving from the heel to the centre toe in a straight line, you are taking care of the entire lower back, the intestinal area, the kidneys, the adrenaline gland, the lungs and then the head. Thus, this one-movement takes care of almost all the vital organs in your body,” says Grewal. 

Reflexology brings about a caring and safe touch besides immense relief from pain, thereby reducing the production of stress hormones in the body. It enhances Serotonin, a chemical in the body that affects our emotions and thoughts positively. Here’s how the relaxation response obtained from reflexology can help: 

• Slow down heart and breathing rate 

• Reduce blood pressure 

• Decrease the production of stress hormones 

• Relax our muscles 

As a result, reflexology can benefit both psychologically and physically, especially for older adults. Reflexology may also reduce the risks associated with stress such as hypertension, cardiac arrhythmias, anxiety, insomnia, persistent fatigue and digestive disorders.  

The physical manipulation in reflexology has two major impacts:

1) Increase in blood and lymph circulation.

2) Relaxation and normalisation of the soft tissue like muscles, connective tissues, tendons and ligaments. 

Reflexology induced improved circulation helps enhance the delivery of oxygen and nutrients to muscle cells; improves cellular health and helps tissues function more efficiently. This better functioning leads to the removal of waste products, increases the absorption of excess fluids and reduces swelling in soft tissues. Reflexology therapy also helps in reducing painful contractions and spasms and reduce nerve compression, says Grewal. “Organs also benefit from reflexology, as they share neurological pain pathways with muscles, bones, and nerves. When muscles, bones or nerves are distressed, organs can sometimes reflect distress and dysfunction. Therapeutic reflexology can therefore improve symptoms associated with the functioning of both the organ and the muscles,” she adds. 

Did you know that Reflexology and Acupressure are not the same?

Acupressure is more about pressing on the point alone - could be one point or two or more corresponding points. Whereas reflexology is not limited to points. Rather, it is focused on an entire zone and covers it entirely.

Many older adults love reflexology, why?

“Because they get the comfort, they feel pampered and experience the feel-good factor.,” says Grewal. “Besides, the pain goes down considerably and there’s an enhancement in mobility and improved balance which not only soothes them physically but also emotionally. Also, reflexology could be a very good post-operative healing procedure and rehabilitative procedure following an accidental fall and trauma. Reflexology provides significant relief to seniors with oedema related issues too.” 

Grewal uses almond oil and cream to do the movements on the sole of the feet. She adds that Reflexology stimulates 7200 nerve endings, 107 ligaments, 26 bones and 19 muscles in each leg and also gives a diagnostic overview of an underlying condition. “We can assess and analyse which body part or organ needs medical attention,” she notes. 

What’s new on the reflexology block?

Face workouts! Facial reflexology strengthens your facial muscles, enhances oxygen flow, releases endorphins, offsets stress, removes sluggishness, reduces mild to moderate swelling and reduces pigmentation naturally. 

“Older adults who are healthy may opt for reflexology once a month but those with specific health conditions must go for it every week,” says Grewal. If you are choosing to opt for this, please check with your doctor first.

Ageing healthily and gracefully is essential and reflexology is a great way to obtain that. Explore it and share your reflexology experience with us. 

Here's how to safeguard mature skin during winters

Winters could be the best season for travelling, eating loads of fresh, green veggies, decking up for weddings and of course, soaking in the festive spirit of Christmas and New Year. However, the chilly months of December and January could be tough on your skin, especially if you’re 50 plus. Ageing and winter skin are not too favourable for each other and can result in skin issues among older adults, both men and women. 

Skin issues that older adults should be cautious of during winter

Dr Shireen Furtado, Consultant, Medical & Cosmetic Dermatology at Aster CMI Hospital, says, “With age, the skin gets thin and produces less oil, thus making it susceptible to dryness and fragility. During wintertime, the already dry weather causes a condition called xerotic eczema.

What is Xerotic Eczema?

Commonly referred to as ‘Winter Itch’, Xerotic Eczema is caused due to extreme dryness of skin during the cold months of winter when the wind becomes harsh for the skin, especially that of older adults. Why? Because the activity of the sebaceous and sweat glands decreases as one ages and it becomes difficult for mature skin to retain sufficient moisture. 

This could be caused due to Xerosis or abnormally dry skin, Zinc deficiency, Hypothyroidism, certain retinoids (a group of compounds having effects in the body like those of Vitamin A) and diuretics (type of drug that causes the kidneys to make more urine). 

In case you’re using indoor heating during winters, you must be extra careful as the dry ambient indoor air caused due to the heating can provoke a flare-up among those already prone to Eczema. 

Some of the common signs of Xerotic Eczema include lesions along the legs, a patchy venous appearance, a hard, rough texture in affected areas, small, crusty or dry scales lining the skin and more. 

Preventing Xerotic Eczema

Did you know that shaving, your woollens, dish cleaners, ingredients in certain moisturisers and even fragrant soaps can enhance Eczema? Hence, it is important to avoid skin irritants that can cause a flare-up. Use mild soaps instead of harsher deodorant ones, bathe in warm water for not more than 10 to 15 minutes and do not stay in hot water for a prolonged period, moisturise daily with lotions having camphor and install a home humidifier to prevent your skin from becoming too dry during winter to avoid Eczema. 

Skin Dryness And Wrinkling Among Elderly Women

Since women lose the protection of oestrogen post-menopause, their skin loses collagen faster and skin wrinkling and dryness is more, says Dr Furtado. The dryness can be experienced in the body, hands and lips. 

Body Dryness: During the winter months, the body skin may become dry and can cause a lot of itching and discomfort among older adults. They may end up scratching the skin hard resulting in redness and irritation. At times, the scratching can be so hard that it can break the skin and open it up for infection and wounds which may take time to heal. 

Dry Hands: Dry hands are most common during winters and pretty difficult to manage. Mostly at the time of a pandemic when the hands get washed frequently to avoid virus contraction. Dry hands get aggravated due to extensive washing with harsh, fragrant soaps. 

Dry Lips: Chapped lips are not just uncomfortable but could be painful as well when they develop cracks and sores. Frequent licking of lips or otherwise wetting them can make it even worse. 

Tips to tackle mature skin during winter

Dr Swathi Shivakumar, Consultant - Dermatologist, Aster RV Hospital comes up with simple tips that can help older adults prevent dryness and tackle winter skin issues. 

• Use extra virgin coconut oil and apply on the body before bath
• Take a quick bath with lukewarm water
• Generously use moisturiser after bath
• Reapply moisturiser at bedtime
• Use soothing oils that are fragrance-free and light before bathing. Make sure to bathe carefully and avoid slippage after applying oil. 
• Using a good sunscreen during the day with a minimum SPF of 30 can prevent sun-induced skin ageing.
• Use face creams containing retinol at night to delay fine lines and other signs of ageing.
• Moisturise exceptionally dry areas like feet, elbows and knees 
• Wash hands in lukewarm water using fragrance-free and dye-free soap and pat them dry with a towel. 
• Use a light lotion after you wash your hands. 
• Use a thicker cream and apply it to your hands before bedtime.
• You can try wearing light cotton gloves while sleeping as they infuse the skin with moisture and keep your hands hydrated.
• Apply a good-quality lip balm throughout the day, especially after eating. 
• Cover the lower part of the face with a scarf or mask while stepping out to keep the lips moisturised. 
• Keep yourself hydrated even though it is cold outside. Do not cut down on the number of glasses of water you take. Unless advised by your doctor to drink less for any condition, having eight glasses of water in a day is important. 

These simple ways can help you keep your skin hydrated during the winters, lessen your discomfort and amp up your mood to enjoy the yearly chills. 

These valuable hacks will help you to prevent falls among older adults

Falls are very common among older adults and can cause injury, several other complications and could be fatal too. According to Dr Arvind Kasthuri, Professor of Community Health, Mentor, Senior Citizen Health Service at St. John’s Medical College, falls in the elderly are preventable. Dr Kasthuri provides an insight on how to tackle falls and most importantly, prevent them. 

Why falls are a major problem among older adults?

Fall is called a geriatric syndrome and it is called so as it is fairly common in elderly people and has multifactorial reasons why it happens. 

The World Health Organisation (WHO) estimates that 28 per cent to 35 per cent of older adults experience a fall each year that makes up almost 1 in 3 older adults. Also, the incidence of falls, globally, increases with age, with as much as over 40 per cent of people above 70 years susceptible to them.

“While falls often result in minor injuries, many falls can lead to serious injury resulting in illness, disability and more,” says Dr Kasthuri. 

What is a fall?

A fall is defined as an event that makes you come to rest inadvertently on the ground or at a lower level suddenly. 

Why do older people fall?

1. Visual Problems
2. Hearing Impairment
3. Muscle Weakness
4. Arthritis
5. Walking Difficulty, Unsteadiness
6. Not using a stick or walker as required
7. Floor slippery, loose rugs and carpets
8. Clutter on floor, stairs, toys , pets
9. Poor lighting
10. Health related issues like sudden falling of blood pressure when one gets up from the chair
11. Side effects of certain medications
12. Neurological diseases like Parkinson's, Dimentia etc.

What happens when older people fall?

In an interactive talk with Silver Talkies, Dr Kasthuri said that 13 per cent of falls lead to no consequences but 62 per cent of them can result in injury among older adults and 25 per cent of them can cause fracture which is severe. 

“Fracture or other injury can cause difficulty in walking around, a fear of falling and hesitation to walk around among older adults. This results in less mobility that leads to muscle weakness and makes them more prone to falls. At times the hesitation to walk may make them mentally withdrawn too. For caregivers, a fall means an increase in expenditure on healthcare. They may need to hire a nurse that involves quite a bit of work. Also, the older person may need to be admitted to a facility,” says Dr Kasthuri. Keeping this in mind, fall prevention or at least working towards it is important, especially for older adults above 60.

What should you do if you fall accidentally?

1. Don't panic. A fall is not necessarily a life threatening thing
2. You continue lying down and then check yourself - face, neck, arms, hands, torso, hips and legs
3. Try to get help - could be a phone call, switching on light, getting a chair and call a person
4. Try crawling to the nearest help point.
5. Turn over and go on hands and knees if no injury
6. Reach out for help 

What should bystanders/caregivers do?

1. Don’t panic
2. First and always, speak reassuringly
3. Call for help — family member, neighbour, if it appears serious, then call an ambulance
4. As the person continues lying down, loosen clothes if wearing a tight belt or something similar.
5. Check for injury in face, neck, arms, hands, torso, hips and legs. 
6. If legs are okay, raise them about 1 foot to 2 feet above the ground on a pillow or other support. will help blood circulate back to the central part of the body. 
7. If injury/bleeding, compress the wound with a clean cloth, apply ice around the wound
8. If unable to move a limb, do not force movement and wait till you get appropriate help.  

How do we prevent fall among older adults

Tips on prevention of fall should be divided into four domains: home, bathroom, healthcare and lifestyle, diet and activity

 At home

1. Be careful with threshold and steps at the entrance
2. Have good lighting
3. Maintain non-slippery floor, use handrails when needed
4. There shouldn’t be any loose rugs on the floor, clutter and wires
5. Use beds and chairs that are easy to get on and off - must be of such a height and accessibility that’s easier for seniors
6. Be careful about pets coming in and out of the way

Bathroom

1. Should be well-lit, easy switch to access
2. Grab rails/bars all around the bathroom, especially near the commode or bathing area
3. Do not keep high shelves
4. Maintain non-slippery floors
5. Use a raised toilet seat
6. Be careful with mat and rug outside

Healthcare

1. Check vision and hearing
2. Review with doctors about remedications, do away with unnecessary medications to escape major side effects
3. Report for joint pain, arthritis
4. Report if dizziness, unsteadiness
5. Report for depression, excessive forgetting, lack of concentration
6. Check feet, use good footwear 

Lifestyle, diet and activity

1. Use stick/walker or other assisted device if needed. There shouldn’t be any stigma around it.
2. Ensure physical activity for 30 minutes a day
3. Do muscle strengthening exercise once or twice weekly
4. Do exercise for balance, practice Tai Chi and other balance exercises, consult a physiotherapist if need be. 
5. Do not smoke and take less alcohol
6. Go for a high calcium diet like dairy, greens
7. Take Vitamin D supplements as they help in enhancing bone strength 

Image credit: Pixabay

Active ageing and oral health. Here’s all you need to know. 

A genuine smile comes from the heart, but a healthy smile needs good dental care, goes a famous saying. Oral health is an essential piece of the puzzle when it comes to staying healthy and unknown to many, it is also an important component of active ageing. The proportion of older people is growing faster than any other age group. The impacts of oral diseases on the general health and quality of life of people is tremendous, especially with older individuals. Most oral health disorders are preventable and can be treated in their early stages.

What are the threats to an older adults’ oral health?

Over the years, the oral cavity of an individual is susceptible to many external environmental factors. If combined with poor hygiene, dry mouth, use of antibiotics, extensive usage of tobacco, consumption of aerated drinks and sugar, bacteria build-up can cause moderate to severe oral infection. Plaque generation, dental caries, tooth loss, a high rate of periodontal diseases, and dryness of the mouth can negatively impact an individual’s day to day life. Chronic oral ulcers and infections can damage the teeth as well as the support structures in the oral cavity. If not treated promptly, it can spread to surrounding tissues. 

Ailments such as diabetes can also impact oral health including increasing the likelihood of thrush, a yeast infection that grows in one’s mouth, throat slowly spreading to other parts of the body.

Poor oral functioning can be detrimental to the nutritional status and health of an individual. Mouth ulcers, dental caries, tooth loss, loose painful teeth, ill-fitted dentures cause difficulty in chewing food, impacting the appetite, and leading to poor eating habits. A Compromised diet further undermines the functioning of the oral cavity. Insufficient calorie intake results in increased calcium, iron and zinc deficiencies aggravating the situation further. 

The slowed function of the salivary gland is also associated with ageing. Saliva protects the oral cavity, upper airway, digestive tract, the absence of which causes mouth dryness and dental caries. Many medications induce dry mouth as a side effect. To add to it, a decline in the functioning of the oral mucosa also exposes an individual to a series of pathogens and chemicals. 

How Can Older Adults Maintain Better Oral Hygiene?

The onset of oral diseases and other non-communicable diseases can be reduced in elderly people, by providing preventive as well as timely restorative care. For the same, the initial step is to create an awareness and appreciation for regular oral care.

Promoting a well-balanced diet that is low in sugar and salt with optimum use of water is preferable. Adults need to consume adequate amounts of calcium, which can be prescribed by a physician. This will help prevent osteoporosis, which can affect the bone surrounding the teeth. Eliminating or reducing the usage of alcohol, tobacco in all forms, tea, coffee, sodas especially sweetened is advised. Adoption of good hygiene includes the use of a flexible rotating/oscillating toothbrush, high fluoride toothpaste, and flossing twice a day. 

Dentists may also sometimes prescribe therapeutic oral rinses that contain chlorhexidine, sodium benzoate, sanguinaria, fluoride, or other remineralizing agents which promote oral health and prevent chronic disease build-up. They may additionally suggest a chlorhexidine rinse upon closer examination, which can be used to control plaque, bacteria formation and treat gingivitis.

Furthermore, if medication is the primary cause of dry mouth, one is advised to consult with a doctor for available medicine substitution. If no substitute is available, one can drink plenty of water and chew sugar-free gum. Any kind of fitting or dentures needs special care. Following the instructions recommended by the dentist and getting regular checkups are recommended.

It becomes even more important, as one becomes older, to prioritize dental care, which is directly and indirectly linked to one’s overall health, especially in later years. The major block in oral health care of older individuals today is a lack of awareness regarding the need for oral health care. With our changing attitudes towards the importance of this crucial aspect of our overall well-being, the new goal is to evolve and incorporate a comprehensive dental regime. This will safeguard older adults from serious oral complications, enabling them to live healthy.

All you need to know about keeping your heart healthy.

Heart is undoubtedly the most powerful yet fragile organ of our body and it needs a lot of care. Unhealthy hearts claim most lives in the world. The World Heart Federation estimates that Cardiovascular Disease (CVD) is the biggest cause of death in the world. 1 in 10 in the age group of 30 to 70 years die from CVD and it is responsible for 31 per cent of all deaths globally. In India too, it is no different and is the leading cause of death. 15.4 lakh Indians die every day due to Cardiovascular Disease. 214 billion to 351 billion dollars go behind the cost of heart disease and we lose 137 billion dollars worth of productivity due to CVD. Not a good story, yes. But the story can have a happy ending with proper awareness and clarity about heart health and measures to keep the heart healthy. Dr Tausif Ahmed Thangalvadi, Medical Director and General Manager at NURA helps us through the awareness journey about your heart health. 

What stops the heart from functioning well?

According to Dr Thangalvadi, it is important to be aware of the risk factors of heart diseases in order to keep it healthy. He classifies the risk factors in two categories - non-modifiable and modifiable risk factors.

Here are the non-modifiable risk factors on which we don’t have control. 

Genes: Somebody with a history of heart disease in the family is at a greater risk of heart ailment. 

Age: As you age the risk of heart disease increases. 

Gender: Compared to women, men are at a greater risk of heart disease until women’s reproductive age as until then, they get protected by oestrogen. The moment they hit menopause, their heart ailment risk increases and becomes as much as men. 

Here are the Modifiable risk factors which can be changed if one wants:

Smoking: Not just cigarettes, any form of tobacco - be it chewing or smoking, is bad for the heart.

High blood pressure: if you can’t control it, it can be bad for your heart. 

High blood cholesterol: There are two kinds of cholesterol: LDL and HDL. LDL is the bad cholesterol; it takes the cholesterol from the liver to blood vessels and deposits it there.HDL does the opposite, it clears off the cholesterol from the blood vessels and takes it back to the liver. That’s why for a healthy heart, your HDL cholesterol should be high but your LDL must be low. 

Physical inactivity: No physical activity leads to diabetes and obesity which are the two most common and critical risk factors of heart disease. Get your walking shoes on now! 

Mental stress: This is another factor increasing the risk of heart disease. Those who are impatient, too aggressive and work obsessed are more stressed out and can be at a greater risk of heart ailments. 

What problems could the risk factors cause?

All of the above mentioned risk factors cause heart disease which are of five kinds - Myocardial Infarction or Heart Attack, Sudden Cardiac Arrest, Coronary Artery Disease, Heart Failure and Arrhythmia. Majority of people suffer from Coronary Heart Disease, as much as a whopping 48.2 percent, 16.4 percent suffer from stroke, 8% from high blood pressure, 7.3% heart failure, 3.4% disease of arteries and 16.7% from other heart related issues. Also, about 45 percent of all heart attacks are silent, reveals the American Heart Association. 

Covid-19 and heart disease

Among patients with Covid-19, there is a high prevalence of cardiovascular disease and more than seven percent of patients experience myocardial injury from the infection.. The American Heart Association reports that 22% of critically ill patients severely affected by Covid-19 virus experience heart issues.

Signs to watch out

Apart from chest pain and discomfort, there could be other symptoms like dizziness, shortness of breath and palpitations when it seems that the heart tries to beat out of your chest. Jaw pain, nausea, and vomiting are some of the additional symptoms. 

How do I keep my heart healthy?

Diet: Limit the intake of the following:

1. Saturated fats: butter, milk products, cheese, coconut oil, etc. Using ghee is healthier.
2. Added sugars: Natural fruit sugar is better than added sugar. 
3. Sodium: You should take less than 2.5 grams of salt per day. With less salt the water in the circulating blood will decrease and you will be putting less strain on your heart. 

Heart healthy foods

1. Vegetables and whole fruits - all varieties 
2. Grain: 50 per cent of your diet should be whole grains
3. Consume low fat dairy products
4. Protein food like seafood, lean meat poultry eggs
5. Oils: unsaturated fats

Lifestyle changes 

For children and adolescents (6 to 17 years)

1. 1 hour or more exercise daily
2. Moderate to vigorous activity
3. Muscle and bone strengthening 
4. Limit sedentary time and screen time - less than 2 hours. All these can increase the risk. 

For adults (18 to 64 years) 

1. Avoid inactivity
2. Moderate activity - 150 minutes per week
3. Vigorous intensity - 75 minutes per week
4. Muscle strengthening - 2 or more days per week

For older adults ( 65 above)

1. Be as active as their abilities allow
2. Do exercises that maintain or improve balance
3. Safety is paramount. Do not be very aggressive with your workout and use safety gear if necessary 

Change your habits