Medical Aspects of Retirement

1. Medical Aspects of Retirement Dr B. R. Ahmed VIC Joint Medical Services

2. Definition of Health • The World Health Organisation defines health thus: “ Health is state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.”

3. Areas to be covered • Changes in the body • General measures • Specific conditions

4. Changes in the Body • Change is continuous throughout life • Senescence begins before puberty • Manifestation of major changes occurs as from middle age

5. Important Changes Body Composition: • Reduction in lean body mass • Relative increase and redistribution of body fat • Changes in body weight • Altered handling of some medications

6. The heart and blood vessels: • Structural changes in the heart and the blood vessels • Blood pressure tends to rise • Altered response to exercise • Cardiac output remains the same at rest NB: Impact of change minimized by good lifestyle choices

7. The lungs: • Reduced elasticity • Reduced respiratory muscle strength • No overall significant effect on function • Airways tend to close more readily • Other changes which increase risk of infection

8. The kidneys and urinary tract: • Reduced function • Reduced ability to conserve water • Reduced tolerance of acid load • Other changes: • Prostate • Urinary bladder

9. The digestive tract: • Reduction in appetite - later • Lining of stomach becomes thinner • Decreased mobility of bowel. Slowed transit time • Increased tendency to hiatus hernia • Increased tendency to gall stones • Liver, reduced mass, otherwise OK

10. The brain: • Structural and vascular changes • Functional changes • Intellectual function basically remains unchanged • Alteration of the sleep -wake rhythm • Reduced appreciation of temperature changes by the skin

11. Higher brain functions: • Intellect remains unchanged in most people • Problem solving skills remain intact • A small proportion develop deficiencies due to disease condition, not simply aging • Memory lapses – mild, more often subjective

12. Measures which preserve “brain health”: • Continued intellectual activity • Reduction of stress • Avoidance of head trauma • Physical activity • Diet rich in anti-oxidants • Social interaction

13. The skeleton: • Reduction in bone mass • Reduced strength • Joints: • Arthritic changes

14. Hormone replacement therapy: • Aim: to partially make up for the reduction in female hormone level after menopause. • Decision regarding HRT should be taken after consideration of several factors • Treatment should be tailored to individual needs and profile

15. The skin: • Becomes dryer • Thinning of outer layer • Reduced thickness of fat under skin • Increased tendency to bruises • Reduced elasticity • Reduced sweating

16. Maintenance of Health General Measures: • Nutrition • Exercise • Regular health checks • Other

17. Intake of nutrients in the right proportion Correct storage and preparation of meals Regularity of meals Taking cognizance of special dietary needs Adequate fluid intake Vitamin and mineral supplements Nutrition

18. Exercise Benefits of Exercise: • Improves cardiovascular and respiratory endurance and function • Assists weight control • Helps cholesterol control • Aids control of blood pressure

19. Exercise (continued) • Improves bone strength • Causes increased muscle strength and helps in maintenance of muscle mass • Improves coordination and balance • Improves general sense of well-being • Helps to structure the daily routine • Social benefits

20. Types of Exercise • Aerobic exercise for a minimum of 30 min per day, 3-4 times per week • Strength training • Other forms of exercise also recommended • Stretching • Balance

21. Important • Get a medical check up to determine physical fitness before commencing any new form o f exercise • Warm up and stretch for at least 10 minutes before and relax for at least 10 minutes after exercise • Use appropriate clothing and shoes for the weather and the sport • Heed warning signs

22. Preventive Measures • Regular medical check-ups Full Medical exam: At least once a year Follow-up visits as necessary • Timely attention to symptoms and other health problems

23. Blood pressure • Check at least once a year if normal • Implement control measures if hypertensive Avoid excessive salt intake Exercise regularly Reduce weight Stop smoking Regular medication if appropriate • Follow up and screen for complications

24. Cholesterol • An essential body substance • Harmful when blood level are high for prolonged periods • Risk of harm increases with the co-existence of other risk factors • Total cholesterol levels should be <200mg/dl • Maintain good lipid profile

25. Cancer • Primary Prevention: Screening Early detection

26. Women • Pap smear: enables detection of cancer, and of pre-cancerous lesions; successful treatment • Mammography: detects lesions at an early stage, before spread: improved outcome of treatment • Other female cancers: ovarian, uterine. No equivalent screening tests. Have regular exams, do not ignore symptoms

27. Men • Cancer of the prostate: common, but not necessarily lethal • Do not ignore symptoms- BPH is very common though • Regular urological examinations • Clinical exam of the prostate • PSA

28. Colorectal Cancer • Affects the 50+ age group • Screening : Faecal occult blood test Colonoscopy Other tests

29. Skin Cancer Types: • Basal cell carcinoma • Squamous cell carcinoma • Malignant melanoma Action: • Reduce exposure to sunlight • Surveillance of moles • Have suspicious lesions checked

30. The Eye • Glaucoma • Cataracts • Age-related macular degeneration • Diabetic retinopathy

31. Glaucoma • Risk Factors: • Family history • High blood pressure • Diabetes • History of eye injury • Screening

32. Cataract • Risk Factors: • Age • Genetic predisposition • Sunlight • Smoking • Medication • Diabetes • Screening

33. Age-related macular degeneration • Risk Factors: • Family history • Cigarette smoking • Early recognition important

34. Vaccinations • Annual influenza vaccination • Pneumococcal vaccine: Once only • Boosters of the routine vaccines as necessary (diphtheria, tetanus, polio) • Others if and when indicated- travel, outbreaks, etc

35. Other Aspects • Regular dental care • Hearing test

36. Summary • Maintain measures aimed at keeping healthy and preventing ill-health and disability • Have regular check-ups in order to ascertain the state of health and to detect problems early • Deal with health problems promptly and thoroughly

37. Definition of Health • The World Health Organisation defines health thus: “ Health is state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.”

39. With best wishes for excellent health throughout your retirement!