Ageing

In 2015, two grandfathers from China went viral, earning them the nicknames “hottest grandfather” and “muscular grandfather” respectively.

The former was Beijing-based Wang Deshun, then 79, whose toned physique and fierce attitude during his shirtless catwalk during that year’s China Fashion Week took the world by storm. The latter was Guangzhou native Shen Hua, then 81, whose daily one-hour high-intensity strength-training sessions at the gym thoroughly impressed netizens.

Building our muscles is probably the last thing on our mind as we age, so it is probably even more impressive that these two men only started working out seriously at the ages of 50 and 70 respectively.

Wang, whose daily routine includes three hours a day at the gym doing a combination of weights, cardiovascular exercises and stretching, started his workouts as part of maintaining his career as an artiste and actor. Shen, on the other hand, started working out as a way to slow down the process of ageing.

For the rest of us though, the process is more likely to be the opposite – we are more likely to grow more sedentary the older we get, especially after retirement.

Consultant geriatrician Professor Dr Tan Maw Pin notes that because of our Asian respect for elders, we tend to rush to relieve those older than us of physical chores, for example, carrying items or household work. This, however, does them no favours as it deprives their muscles of use.

“Unfortunately, a lot of our older people, because they don’t maintain their muscle strength, it deteriorates so fast that usually by the time they retire, they already need some form of care because they can no longer be independent, so they cross the threshold of disability,” she says.

It also does not help, she adds, that Malaysians in general tend to lead a more sedentary lifestyle. “This is even more apparent when they fall ill,” says the Universiti Malaya lecturer. “Because they have low muscle strength to begin with, as soon as they fall ill, their muscles start shrinking away.”

Ageing, muscle health, building muscles, HMB, leucine, Wang Deshun, hottest grandfather, old model, Star2.com

Wang Deshun on the runway that earned him the title “hottest grandfather”. Photo: Hu Sheguang

When seniors fall

Prof Tan notes that the World Health Organisation (WHO) has been emphasising on physical activity for all ages for years. In fact, one of the WHO’s physical activity recommendations for adults aged 65 and above specifically states that they should do muscle-strengthening exercises involving the major muscle groups two or more days a week.

Another recommendation is that: “Older adults, with poor mobility, should perform physical activity to enhance balance and prevent falls on three or more days per week.”

Falls are a major concern when it comes to senior citizens as they can lead to disability, loss of independence, and even death. The US Centres for Disease Control and Prevention (CDC) reports that one in five falls lead to serious injuries such as broken bones and head trauma.

And even when a fall does not result in a serious injury, many elderly who have experienced one become scared of falling again, and thus, limit their physical activities. This, ironically, actually increases their risk of falling again.

According to the WHO, falls are the second leading cause of accidental or unintentional injury deaths worldwide (after road traffic injuries), and adults aged 65 and over are the ones suffering the highest number of deaths and injuries.

In Malaysia, a 2015 study published in the Medical Journal of Malaysia found that one in five (19.1%) of those aged 60 and above had experienced falls.

And it is not just the effect on the health of the affected person that is an issue; there is also the matter of cost. While the main focus tends to be on the healthcare cost, e.g. hospital bills, Prof Tan says: “The other issue is social care.

“We all know that the social care bill is now going up a lot when it comes to the general population – a lot of family members are crying out because they can no longer hire maids to help their older folks.

“And when the older person needs care, they are now spending a lot of money to hire private nurses, or even, sometimes they have to give up work themselves, and occasionally, when they have no choice – they cannot give up work and they cannot hire anybody – they put the older person in a nursing home.

“And all this is because the older person is dependent, and a large cause of the dependency is low muscle strength – they cannot do things for themselves.”

Males not as strong

According to Prof Tan, our muscle strength gradually increases from the time we are born to around the age of 25.

“At that point, we know that muscle bulk starts going down, muscle strength starts going down, but the rate of decline is really dependent on the person’s physical activity, and also, if they have been unlucky enough to have illnesses, then it deteriorates more quickly.”

In general, males tend to have much more muscle strength than females, thanks to the influence of higher levels of the testosterone hormone. Shares Prof Tan: “When we test muscle strength in my practice, we use a grip-strength dynamometer, and we know that on average, men can actually grip 10kg more than women.

“But very interestingly, when we did research to determine the normal range for Malaysians, we found that the discrepancy between men and women in Malaysia is a lot less than the discrepancy in other societies.” She says with a smile that it may be because our women are “much more industrious”.

There is also no significant difference in walking speed, a measure of fitness, between Malaysian men and women, she adds.

“The truth is, in our society, a lot of our men are very sedentary, and as soon as they retire, actually take on less physical activity than their spouses. So we have a huge issue in that men are very unhealthy,” she says.

This is especially as women, particularly those of the generation that are senior citizens now, tend to do almost all of the housework. They are also more diligent about taking care of their health and exercising, compared to men.

Ageing, muscle health, building muscles, HMB, leucine, exercise, Prof Dr Tan Maw Pin, Star2.com

Prof Tan: Elderly patients should get up and move about from the day of their hospitalisation to avoid their muscles wasting away. Photo: The Star/Low Lay Phon

Exercise and diet

However, the problem is that the exercises senior citizens tend to do are not for building their strength or muscles. Prof Tan notes that one of the building blocks of muscles is resistance exercise, or strength training.

“A lot of people fail to realise this, so they keep on exercising and wonder why they are not getting their muscles,” she says. “It’s because they are just doing cardiovascular exercise – they just walk in the park. So they are just exercising their hearts, which is good, but often, our older generation think that strength training is not relevant to them.”

She suggests that older people can take up tai chi, which is good for maintaining balance and incorporates some strength training. There are also bodyweight exercises, which require no equipment and can be done at home, and the free outdoor gym equipment in public playgrounds or padang.

However, strength training is not enough if the person does not consume the building blocks of muscle, i.e. protein, sufficiently in the first place.

“Unfortunately, our Eastern diet, especially for the older generation, probably doesn’t contain as much protein – traditionally, our cuisine has a lot of carbohydrates. And also, there’s currently a lot of misgivings about protein, because people think protein cause gout and kidney problems,” she says, adding that for the kidneys, protein consumption only causes problems in very severe kidney disease.

“Another issue is that you need teeth to eat protein. A lot of older people had very poor dental care – prior to this, they couldn’t afford dental care – so, no teeth, cannot bite,” she adds.

While Prof Tan says that the quality of a person’s daily diet should be of utmost importance, supplementation is recommended for the elderly if they fall ill or are recovering from illness. Over the past decade or so, the amino acid leucine has been singled out for its critical role in muscle-building.

According to Prof Tan, the consumption of leucine helps to both reduce skeletal muscle loss and encourage the building of such muscles in the elderly who are ill or recovering from illness. In fact, there is now an even more refined version of this essential amino acid. (An essential amino acid is one that cannot be synthesised by the human body and needs to be obtained through our diet.)

According to Prof Tan, HMB (ß-hydroxy ß-methylbutyrate) is the useful part of leucine, which is a large molecule.

“It would do the same thing as leucine,” she says. “But if your body is not working so well (due to illness), you probably ought to have the essential ingredient because your body might not be breaking down leucine in the right way.”

She stresses that improving muscle health can, and should, be done at any age. “Even if your muscle strength deteriorates, it’s not too late; you can still do something. We have proof that even at 90 years old, we can still restore muscle strength.”

Prof Tan was speaking to the media during a recent interview session on muscle health and the importance of nutrition in this area organised by Abbott Malaysia.

People who are pessimistic about what life is like during old age may be helping to make their fears come true.

A new study finds that older Americans with negative beliefs about ageing were significantly more likely to develop dementia than their peers who embraced their senior years with zeal.

The difference was hardly trivial: Study participants who had positive beliefs about ageing were 44% less likely to develop dementia over the next four years than were their counterparts with negative beliefs.

Even after the researchers accounted for other risk factors for dementia – including smoking, diabetes and cardiovascular disease – they still found that the odds for the condition were lower among those with a positive attitude toward ageing.

Also striking: The apparent benefits of positivity were even greater among the subgroup of adults whose genes put them at greater risk of dementia. In fact, the researchers said, a positive attitude toward ageing could essentially erase the handicap associated with carrying a risky variant of the APOE gene.

The findings, published recently in the journal PLOS One, suggest that fighting negative stereotypes about ageing could have broad benefits for public health.

A host of earlier research shows that attitudes about growing older may influence cognitive performance, most likely because they affect stress levels. There’s even some evidence that the brains of people who are pessimistic are more likely to have the amyloid plaques and neurofibrillary tangles associated with Alzheimer’s disease.

Stereotypes aren’t easy to overcome. But considering that there are no treatments that can cure dementia (or even do much to slow it down), researchers are eager to spot any risk factor that people can actually change.

For the new research, a team led by Becca Levy of the Yale School of Public Health used survey results from the Health and Retirement Study, which is conducted every other year by the University of Michigan Institute of Social Research.

Levy and her team focused on a cohort of 4,765 older Americans (their average age was 72) who answered five questions about their attitudes toward ageing. For instance, participants were asked whether they were as happy now as they were when they were younger, whether they felt that things got better or worse with age, and whether they felt less useful as the years piled on.

The cognitive status of the study participants was assessed by a standard test conducted over the phone. Among other things, they were asked to count backward from 20, to name the president and vice president, and to recall a list of 10 items. Only people who did not have dementia when they entered the study were included in the analysis. Participants retook the test every two years.

Finally, most of the study participants provided saliva samples that were sent off to the National Institutes of Health to see whether they had a version of the APOE gene that put them at increased risk of getting Alzheimer’s disease. Among those who were tested, 26% had an e4 variant of the gene, which makes the disease more likely.

In the four years after joining the study, 4.6% of the adults with negative beliefs about ageing went on to develop dementia. So did 2.6% of the adults with positive beliefs.

Among those with an e4 variant of the APOE gene, 6.14% of adults with negative beliefs about ageing developed dementia, compared with 2.7% of those with positive beliefs.

Both of the differences remained statistically significant after the researchers controlled for age, sex, educational history, initial cognitive performance, health conditions and other factors that influence dementia risk. In the entire group, having a positive attitude toward ageing was associated with a 19% reduced risk of dementia; in the high-risk group, those with a positive attitude were 31% less likely to develop dementia.

“Age beliefs tend to be internalised early in life and then remain stable over the lifespan, without interventions,” Levy and her colleagues wrote. “Our finding could provide a rationale for a public-health campaign to combat the societal sources of negative age beliefs.”

The study was funded by the National Institute on Aging. – Tribune News Service/Los Angeles Times/Karen Kaplan

Maybe it’s the extra exercise, the mental challenges, or simply a psychological effect – but older people who spend a lot of time with their grandchildren are healthier and live longer, a new German study has found.

Psychologist Ralph Hertwig and his colleagues at the Berlin-based Max Planck Institute for Human Development evaluated data from the Berlin Aging Study, in which more than 500 people aged over 70 were interviewed between 1990 and 1993, and followed until 2009.

They found that half of the grandparents who looked after their grandchildren were still alive 10 years after the first interview, while half of those who didn’t – and also, non-grandparents – died within five years.

“But it’s false to conclude that the more you help, the longer you’ll live,” Hertwig warns, noting that previous studies have shown no longevity benefits for grandparents who mind their grandchildren round the clock, which is stressful.

The tipping point varies from person to person.

“It’s important to find a happy medium,” he says, adding that the motivation should be intrinsic. “Expecting something in return can quickly leave you frustrated if you get nothing.”

Erhard Hackler, managing director of the German Senior Citizens League (DSL) and a grandfather himself, says that caring for the little ones helps to keep him physically and mentally fit.

“You simply take part in everything, whether it’s playing tag or going swimming,” he says. “Without grandchildren, you probably wouldn’t do that.”

Nevertheless, he says there’s nothing wrong with not wanting to babysit all the time, and that you should be open about this with your child.

“You can say: ‘We love the grandchildren, but we raised you and now need some space for ourselves.’”

People without grandchildren who nevertheless keep busy with other social commitments have also been found to have a longer life expectancy.

“For a good, long life, the most important thing is to feel that you’re needed,” says Christoph Englert, a researcher at the Leibniz Institute on Aging in Jena, Germany.

Having a sense of purpose is important in old age – whether it’s minding the grandchildren, or something else entirely. – dpa

People the world over pay a pretty penny to look young. Many don’t realise, however, that staving off wrinkles, age spots and thinning hair has little to do with cosmetic creams and lotions.

Take, for instance, the skin, the body’s largest organ. “Twenty to 30% of changes in the skin are attributable to genetics,” says Jean Krutmann, director of the Leibniz Research Institute for Environmental Medicine in Dusseldorf, Germany. “The other 70% to 80% are caused by environmental factors, for example ultraviolet radiation and air pollution.”

Your skin says a lot about you, too., “Ageing never affects a single organ only – it’s always the entire organism that ages,” points out Martin Denzel, research group leader at the Cologne-based Max Planck Institute for Biology of Ageing in Germany. “Outward changes are therefore linked to the ageing process as a whole and can be a sign of the body’s condition.”

A fatty diet, alcohol consumption, smoking and overexposure to the sun subject the body to biological stress. In people young and old, this causes molecular damage in cells – in DNA, for example – a thousand every minute. While a young body can repair the damage quickly, an older one is increasingly unable to.

“Ageing means the body is less and less capable of dealing with stress,” Denzel says. “As a result, DNA mutations accumulate in the body’s cells, making organs more likely to fail or tumours to develop.” Denzel says.

These cell alterations have two visible effects on the skin. “For one thing, pigmentation changes,” says Krutmann. “It becomes inhomogeneous, and age spots can form. Secondly, the skin’s elasticity decreases, so wrinkles appear. Everyone gets fine wrinkles from ageing. If environmental influences are added, the wrinkles become much deeper. More collagen, a protein in connective tissue, degrades.”

Krutmann and his colleagues test the effects of various substances on skin in the laboratory. While the harmful and even carcinogenic impact of ultraviolet radiation and tobacco smoke are already proven, research on air pollutants is still in its early stages. “If you coat skin with airborne particulates, it quickly browns,” Krutmann says. “Soot from diesel engines, in particular, has been shown to be harmful.”

Along with environmental influences on the skin, a major factor in how old we look is what we ingest.

A recent study by the National Institute of Public Health at the University of South Denmark, published in the London-based Journal Of Epidemiology And Community Health, found that high alcohol consumption and smoking encourage “visible age-related signs” including earlobe creases, yellowish plaques on the upper or lower eyelids, and a greyish-white arc or ring around the cornea.

A harmful lifestyle or environment doesn’t affect everyone’s health and appearance equally, of course. “People have different genetic makeups. Some live to be well over 100 years old although they smoked and drank alcohol,” notes Denzel. “The chronological and biological clocks can be decoupled. A youthful appearance can be a sign that a person has remained biologically young.” – dpa