Abu Dhabi: The UAE is known widely as a developed economy, yet the health and well-being of one its key demographic groups — people over the age of 65 years — still need much more attention and care.
Speaking to Gulf News, doctors have said that many elderly residents in the country are facing pressing health concerns, though many of those can be resolved if diagnosed and treated in the early stages. And this is a key concern as population reports, including from reputed market research firms like Euromonitor International, suggest that this demographic group is set to grow in size by 484 per cent by 2030.
Dr Hans Fuchs
“We see a lot of elderly patients with diseases and medical conditions that should not progress to the advanced stages with proper care. Unfortunately, a combination of factors is blocking the provision of such care to older people. Not only does this put their lives at risk but it also prevents them from being as productive and healthy as they could otherwise have been,” Dr Hans Fuchs, orthopaedic consultant at Burjeel Hospital Abu Dhabi, told Gulf News.
As a result of this “inadequate care”, older residents are today facing a worsening of their metabolic diseases, orthopaedic illnesses and psychological health. Over time, these concerns develop into organ failure or neurological illness, or result in the patients become bedridden in a spiral of worsening health.
“This is why residents who are in charge of the care and well-being of elderly residents need to be especially vigilant. The burden of care lies with them, and they need to understand that old age, in itself, does not necessarily cause suffering and illness if adequate care is provided,” Dr Fuchs said.
Age not synonymous with disease
One of the main reasons why many older residents do not receive proper medical attention is because their caretakers are often not aware of the advances in medical care.
Dr Sarper Tanli
“For example, falls are a common occurrence among the elderly, and they result in debilitating orthopaedic complaints and deteriorating health.
"But today, many health-care providers can assist with remote monitoring technology that can provide immediate assistance in case a patient falls, or even point out ways in which the risk of falls can be mitigated,” said Dr Sarper Tanli, group chief executive official of home-care services provider Manzil Health Care Services.
There is also insufficient attention paid to the mental health concerns brought about by advancing age.
“As people get older, they retire from work and their children leave the nest. Loved ones can also succumb to illness, while physical strength and wellness is on the decline. So it can be very normal to feel depressed. But a range of activities and regular checks can help in ensuring that the depression does not affect day-to-day functioning abilities,” Dr Tanli added.
And as for all age groups, early diagnosis and treatment offer better outcomes for geriatric patients as well.
“I recently performed a bilateral knee replacement on a 70-year-old Emirati patient, but this treatment was delayed because she was morbidly obese when she first approached me. It is therefore incumbent upon caretakers to ensure that elderly patients follow a suitable diet and activity regimen so that medical procedures, when they become necessary, can be performed without delay,” Dr Fuchs said.
Financial outlays have sometimes stood in the way of geriatric care for expatriate residents, the doctors added. So although many expatriate families have elderly parents living as part of the household, these elderly residents do not receive medical care except in the most urgent medical instances.
One Abu Dhabi resident told Gulf News that he had been paying Dh600 every year to avail of the most basic insurance package but a new pricing system introduced last year had hiked the insurance premium for individuals aged 60 years or more.
“It is true that insurance coverage for most geriatric patients does not cover psychological counselling or even anything other than the most basic emergency care. But caretakers should at least look out for early warning signs in order to seek medical help that can prevent other complications,” Dr Tank advised.
Dr Mohammad Ali Seethakathi
For example, a common cold that can be easily fended off by healthy adults with over-the-counter medication can develop into influenza among the elderly. Or a case of diarrhoea can easily lead to dehydration and impaired kidney function if left untreated, warned Dr Mohammad Ali Seethakathi, internal medicine specialist at Universal Hospital.
“It might also help to organise support groups that allow the elderly to interact with people of a similar age. Unfortunately, this kind of social support is still quite lacking in the region. But if it can be arranged, it promotes better mental health and even resilience to disease,” Dr Tanli said.
Some warning signs
Even though they may seem trivial, families cannot afford to ignore complaints about ill health from aged family members, as these can otherwise develop into more persistent complications. In addition, those with chronic illnesses must make sure to visit the doctor as often as prescribed.
Joint pain: Persistent pain in one joint or many joints, swelling of joints or prolonged early morning stiffness can indicate developing arthritis. Although joint replacement surgeries may be required, proper treatment can also greatly relieve discomfort, along with prudent weight management and physiotherapy.
Fever: Simple over-the-counter medications are often not enough to restore proper health for the elderly, and without the proper treatment, an infection that causes fever may develop into pneumonia. Medical experts, including with Abu Dhabi’s health-care regulator, the Health Authority Abu Dhabi, also recommend that those aged 60 years or more take the yearly flu shots.
Diarrhoea: Even though it is a common result of indigestion, diarrhoea in the elderly can quickly lead to dehydration, and further impair renal functioning.
Blurred vision: Vision loss is often considered to be a natural consequence of ageing. Still, unless medical help is sought, blurred vision from conditions like glaucoma can quickly progress to irreversible blindness. Falls, which are the biggest cause of death through injury among the aged, are also common among those with vision loss.
Hearing loss: Like vision loss, hearing impairments may be difficult to prevent. But without adequate support, hearing loss can result in social alienation, and even depression in the long run.
Incontinence: Trouble urinating and frequent nightly trips to the bathroom could indicate prostate cancer in men. The cancer is however treatable in the early stages, which is why doctors recommend regular screenings for the elderly. Incontinence can also point to uncontrolled blood sugar and worsening diabetes.
Forgetfulness: Though memory tends to decline with advancing age, repeated episodes of forgetfulness could be a sign of dementia. Although it cannot be cured, the right medications can slow down the progression of this debilitating neurological condition.
Persistent breathlessness: Breathlessness can point to a developing cardiac episode, especially as many overweight patients do not feel the chest pain that is characteristic of a heart attack.
Source: Dr Mohammad Ali Seethakathi, Universal Hospital
Most common health concerns among the elderly
Falls: A third of adults aged 65 years and older suffer from falls, and falls are the leading cause of injury death among the elderly. In addition to making bone diseases worse, these also place a tremendous burden on family members, who must devote much of their resources to taking care of the injured patient.
Cardiovascular diseases: These are the leading cause of death in the UAE, leading to 30 per cent all deaths in the UAE. As is well known, advanced age is one of the key risk factors for heart disease, but it can be partially mitigated by following a healthy lifestyle.
Obesity and metabolic diseases: Hormonal changes brought about by advancing age and a less active lifestyle make it easier for older people to gain excess weight. This is exacerbated with lowering muscle mass, which reduces metabolism. Nearly 60 per cent of the UAE population is already known to be obese or overweight, and it is much harder for those affected to lose this weight as they age. Advancing age also increases the risk of comorbidities prevalent in the population, including hypertension and hypercholesteremia.
Depression: The increasing burden of illnesses, a changing outward environment, the loss of loved ones and other social changes like retirement make clinical depression common among the aged.
Bone and joint-related diseases: The most common type of arthritis, osteoarthritis, occurs as a result of regular wear and tear, causing the cartilage between the bones to wear off with time. Naturally, it usually affects those aged 60 years and older, especially those who are overweight or obese, and can get progressively worse without adequate treatment and lifestyle changes.
Vision and hearing loss: Deteriorating vision is a common concern in old age as conditions like macular degeneration, glaucoma and cataracts because of wear and tear. The incidence of diseases like diabetic retinopathy is also heightened in the UAE due to the high prevalence of diabetes. In addition, hearing loss is known to affect nearly 40 per cent of those aged 65 years or more.
Cancers: Almost 4,500 new cancer cases are reported across the country each year, and cancers are the third leading cause of death. As with many other chronic illnesses, cancers are far more likely to affect those of advanced age, and the risk of developing many fatal cancers like colorectal, prostate and breast cancer increases with age.