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1 October, 2018 11:08:29 AM
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Observing the International Day of Older Persons

Growing older does not diminish a person’s inherent dignity and fundamental rights
Mohammed Abul Kalam PhD
Observing the International Day of Older Persons

International Day of Older Persons Celebrated Annually on October1st. Resolution 45/106, passed by the United Nations General Assembly on December 14th 1990, declared October 1st to be the International Day of Older Persons. The theme for the 2018 celebration is “Celebrating Older Human Rights champions”.
On this 70th anniversary of the Universal Declaration of Human Rights (UDHR), the United Nations International Day for Older Persons (UNIDOP) celebrates the importance of this Declaration, and reaffirms the commitment to promoting the full and equal enjoyment of all human rights and fundamental freedoms by older persons.
Growing older does not diminish a person’s inherent dignity and fundamental rights.Almost 40 years following the adoption of UDHR, issues of human rights for older persons were taken up in 1991 in the formulation of the United Nations Principles for Older Persons, which provided guidance in the areas of independence, participation, care, self-fulfillment and dignity.

The 2018 theme of UNIDOP is “Celebrating Older Human Rights Champions“. What better way to celebrate this Day than by celebrating the older people around the world who dedicate their lives to championing human rights?The 2018 theme aims to: (1) Promote the rights enshrined in the Declaration and what it means in the daily lives of older persons; (2) Raise the visibility of older people as participating members of society committed to improving the enjoyment of human rights in many areas of life and not just those that affect them immediately; (3) Reflect on progress and challenges in ensuring full and equal enjoyment of human rights and fundamental freedoms by older persons; and (4) Engage broad audiences across the world and mobilize people for human rights at all stages of life.

Changing Age Structures and Their Implications:The world population will also continue to age, with variations by country. By midcentury, projections indicate that 16 percent of the world population will be ages 65 and older, up from 9 percent now. The percentage of people in this age bracket in the world’s more-developed countries is projected to reach 27 percent, up from 18 percent now, while the percentage of adults ages 65 an older in less-developed countries is projected to double to 14 percent. The age structure data and analysis show that: (1) By 2050, 82 countries are projected to have at least 20 percent of their population ages 65 and over, up from 13 countries today; (2) The population ages 65 and older in Northern Africa is projected to nearly quadruple by 2050; (3) The percentage of the population ages 65 and older in the United States is projected to increase from 15 percent in 2018 to 22 percent in 2050. The percentage of the U.S. population under age 15 is projected to decrease from 19 percent in 2018 to 17 percent by 2050; and (4) In Japan, more than one-third (36 percent) of the population is projected to be ages 65 and older by 2050, up from 28 percent now.

Many older people find they’re not able to move as freely as they did when they were younger. They describe their movements as feeling stiff or restricted. In particular, feeling stiff when getting out of bed first thing in the morning or after sitting for a long period. The feeling does eventually ease with movement as the muscles “warm up”, but it can be troublesome. There are a few reasons this happens.As we age, bones, joints and muscles tend to become weak. Movements’ feeling stiff is often our perception of the increased effort required to perform daily tasks. Many older people have ageing-associated conditions that can contribute to muscle stiffness. These include osteoarthritis (breaking down of the cartilage in joints), osteomalacia (a softening of the bones due to a lack of vitamin D), osteoporosis (where bone mass is reduced causing bones to become brittle), rheumatoid arthritis, inflammation of the joints, and muscle weakness due to sarcopenia (the natural loss of muscle mass and strength).

People with type 2 diabetes are at risk of a number of complications from the disease such as nerve damage, kidney disease and vision disorders. So it’s no surprise that clinicians devote a lot of time in consultations looking for early warning signs of these complications. But for many patients grappling with diabetes, the here and now is often far more important. Patient concerns such as loss of strength and mobility, which make it difficult for them to get around the house independently, to go walking or to climb stairs, are far more likely to cause anxiety than the potential for future complications.These immediate concerns, however, don’t tend to elicit the same attention from physicians – particularly when it comes to older patients, whose increasingly frailty may be viewed with a certain inevitability.  To be fair, there hasn’t been a large body of scientific evidence to date to warrant much attention. But researchers are now attempting to determine whether diabetes exacts another burden, in addition to the known complications of the condition.Perhaps most importantly, researchers are now attempting to determine which parts of type 2 diabetes are strongly linked to physical dysfunction.

At a broader level, this prompts some interesting questions about what health professionals can learn by listening more closely to their patients. It’s not a novel approach by any means, and one only has to look to history for many examples.

The links between inactivity and the development of chronic disease are increasingly being documented, but more research is needed to understand if there are links between the degenerative loss of skeletal muscle mass associated with ageing known as sarcopenia, inactivity and type 2 diabetes.

It is hypothesized that low muscle mass may be an early predictor of diabetes susceptibility. But there is a long way to go before we understand if and how diabetes might be linked to physical dysfunction and to conditions such as sarcopenia.So why has it taken so long to focus on frailty? It is said that the hardest thing about research is to come up with a good question, and lots of questions seem so obvious afterwards.

Blood flow may also play a part. As we age, our arteries become stiffer and less flexible, meaning blood can easily pool, particularly in the feet.When we get up after sitting or lying down for a long period of time, the stiffness may be due to a lack of the lubricating fluid in the joints. Once we move around for a while and warm up, more of the lubricating fluid, called synovial fluid, is moved into the joint, so the joint surfaces have less resistance to movement and can move more freely.

Normal healthy ageing results in a loss of joint cartilage, particularly of the knee. This cartilage provides a smooth articulating surface between bones at the joint that wears down, becoming thinner and providing less cushioning between the articulating surfaces. This may account for stiffness felt during movement.

Another contributing factor is the change in ligaments, tendons and muscles that are relatively relaxed and flexible when we are young. These lose that flexibility with ageing and disuse. In fact, many of the age-related changes in muscles, bones and joints are the result of disuse.

As we reach adulthood, we notice changes in our bodies at every stage of ageing. We might find we need glasses when we hit our thirties, we can’t keep weight off as easily into our forties, we mightn’t feel as strong playing sport with the kids in our fifties, and we can’t hear a conversation across a crowded dinner table in our sixties.

All of these occur because the cells and processes in our bodies have existed for longer and longer periods of time. There are many theories as to why our body ages, but two main explanations are that the DNA within our genes determine how long we will live; the other is that over time, our body and DNA are damaged until they can no longer function as before, often referred to as “wear and tear”.

As we age, the volume of the brain declines. There are many explanations for this, including cell death, in which the brain cells’ structure declines over time. Although the precise reasons for the decline in brain volume remain unclear, some research indicates it may be due to hormone levels, and wear and tear.

Some also believe that the volume of blood reaching the brain decreases due to conditions within the blood vessels and associated systems. However, this doesn’t have a great impact on a person’s ability to remember, as the brain has the ability to compensate for these changes.

While the risk of dementia increases with age due to many of the hundreds of causes being more present as we age, it is not a normal part of the ageing process. It is a result of damage to the brain. The reason why it is more likely to occur as we age is simply because the longer we live; the longer we expose ourselves to possible damage to the body through disease or injury, which are the main causes of dementia.

The Alzheimer’s diseasehttps://images.theconversation.com/files/147688/original/image-20161128-32054-3jpxms.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip, the most common cause of dementia in Bangladesh, occurs when there is plaque build-up in the brain. This is as a result of protein build-up over time that inevitably causes tangles in the neurons (brain cells).

As we age, there’s a decrease in the amount and strength of muscle tissue, due mostly to the influence of decreasing hormones. To make up for the muscle mass lost during each day of strict bed rest, older people may need to exercise for up to two weeks. However, additional decreases in muscle occur due to a decrease in activity, not just as part of the normal ageing process.

As the body ages it absorbs less calcium from food, a vital mineral for bone strength. At the same time, changes in hormone levels affect the density of the bones. Ageing people also often spend less time in the sun, thereby reducing their Vitamin D intake. This in turn reduces calcium absorption.

https://images.theconversation.com/files/147689/original/image-20161128-32054-1h9h55k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clipChanges that occur directly as a result of ageing include those to vision, hearing, taste and smell. Impacts of the changes in vision are usually the first things noticed, making a person feel that they are ageing.

Changes to the eye that occur as part of the ageing process include stiffening and coloring of the lens, a reduction in the number of nerve cells, and a decrease in fluid in the eye. These lead to difficulty in focusing on close objects, seeing in low light becomes more difficult, and the ability to adapt to changes in light decline.

Some people appear clumsy, as their ability to judge the distance between objects - a cup and table, for example, or the height of stairs - becomes a problem. Many people do not realize their spills and trips are occurring as a result of shifts in their vision, known as depth perception changes. Eyes can also become drier, making them feel irritated. This can be treated with lubricating drops.

Changes in hearing include changes in registering high-pitched sounds, and words may become difficult to understand. Speaking more loudly to someone in this circumstance does not help, as the pitch is the problem, not the volume. Instead speaking slightly slower and concentrating on complete words can be helpful.

Taste and smell often decrease as part of the normal ageing process, as the cells responsible decrease in number and the ability to regenerate worn out cells decrease with age. The results make food less tasty and people less likely to eat. In addition, people’s taste can change altogether, so people who loved chocolate as a young person may prefer chilli as they age.  Move it or lose it:As we get older, we tend to become less physically active. While that’s understandable and reasonable, reducing the amount we exercise too much or stopping exercise altogether can exacerbate these age-related changes. Muscles need to be stimulated by physical activity in order to maintain strength and mass.  Bones also need stimulation through loading to keep their density. Joints too need stimulation from movement to keep that feeling of stiffness to a minimum. And aside from our muscles and joints, the heart, lungs and circulatory system also need to be stimulated by exercise to maintain their ability to function optimally.

While there are many factors that contribute to this common feeling of restricted movement or stiffness, the most important action we can take is to move more. This can be achieved through a number of measures.

There’s a lot of truth to the old adage “move it or lose it”: if we don’t keep moving, we lose our ability to do so. Exercise can be fun and finding something enjoyable will help us to stick to it. The social interactions that come with exercisingis an added advantage which also has mental health benefits.

The writer is former Head, Department of Medical Sociology,

Institute of Epidemiology, Disease Control & Research (IEDCR)

Dhaka, Bangladesh

E-mail: med_sociology_iedcr@yahoo.com

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Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

Editor : M. Shamsur Rahman
Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

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