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Ageing is inevitable – and in today’s world, all the more likely. It is projected that in the next five years, England’s population of those living over 65 will increase by 10 per cent, and those 85 and older by 8.2 per cent. If we look further into the future, those sections of the population continue to grow. With a bigger portion of the population expected to be living in the over 65 bracket, our healthcare system will need to be better equipped to deal with the myriad of conditions that often come with ageing – or, perhaps, our healthcare system can help its population in preventing these conditions in the first place.
Nutrition
Focusing on a well-rounded diet can have a hugely positive impact on mental and physical health. It is important that customers continue to eat well as they age. Even if they are less active, they still need to nourish their bodies with nutritional foods. Every person is different; one person may require less water than another, while another may need more vitamin C, but all customers should be aware of the basics.
Fruits, vegetables and vitamins
Fruits and vegetables contain vitamins and minerals essential for good health, whilst being low in fat and high in fibre. Studies show that a diet high in fruit and vegetables lowers the risk of heart disease, stroke, diabetes and some forms of cancer. The NHS recommends that five portions of fruit and vegetables should be consumed each day, whether that be fresh, frozen, dried or canned. An easy way to help customers reach this target is by having a fruit smoothie once a day, this can include multiple fruits and vegetables.
Leafy green vegetables like spinach, cabbage and broccoli and pulses like soya beans, lentils and chickpeas are high in calcium, a mineral the body needs to build and maintain strong bones. As older people – especially women – are prone to developing osteoporosis, which weakens bones and increases the possibility of fractures or breaks if one falls, customers should make sure they are consuming enough calcium. If customers are worried that they are not getting enough calcium from their intake of vegetables, they can also find calcium in milk, cheese, yogurt and fish with edible bones like sardines, or they can take a calcium supplement, but overall calcium intake per day should not exceed 1500mg. Vitamin D is also crucial in developing and maintaining healthy bones (and teeth and muscles), and can be found in eggs, oily fish and some fortified foods. The Government recommends that all adults should take a daily vitamin D supplement of 10 micrograms between October and March when there is less/weaker sunlight in the UK – or all year round for those who spend much of their time indoors.
Fats
There is a great difference in the nutritional value of saturated and unsaturated fats. A diet consisting of many saturated fats (e.g., butter, lard, biscuits, pies, pastries, chocolate and the white fat on red meat and poultry) can raise blood cholesterol levels and increase the risk of heart disease. Saturated fats are high in calories, which can lead to weight gain and, in combination with other factors like inactivity, can lead to obesity. Obesity in turn can increase the risk factor of heart disease, diabetes, respiratory problems, osteoarthritis and other musculoskeletal disorders.
Unsaturated fats lower blood cholesterol levels, ease inflammation, support brain function and growth and reduce the risk of heart disease and stroke. They can be found in vegetable oils like sunflower, olive and peanut oil, in nuts and seeds, avocado and oily fish. Oily fish such as herring, salmon, trout, pilchards and mackerel are rich in omega-3 fats, which are regarded as an essential fatty acid the body needs for brain function and cell growth. They can also slightly lower blood pressure and strengthen heart health, protecting against heart disease.
“Loneliness and social isolation increase health risks in older people”
Encourage older customers to join a social or activity group to motivate them to get out, whether that be for walking or playing chess!
The benefits of mental and physical exercise
The saying ‘healthy body, healthy mind’ is, according to research, incredibly accurate. A symbiotic relationship, our mental and physical health is fed by some of the same things, such as nutrition and physical activity, as well as some things having specific benefits to mental wellbeing, such as socialising and cognitive exercises. “Things we do to keep our body fit and healthy are also associated with staying mentally sharp later in life,” says Age UK, one of the UK’s charities for older people.
Making moves
“Get moving throughout the day and do physical exercise and activities that you enjoy – or try new ones. An active lifestyle and regular exercise are linked to healthier brains and sharper thinking skills later in life,” Age UK continues. The Government recommends that older adults over 65 should aim to be physically active every day. Activity should be focused on improving strength, balance and flexibility. At least 150 minutes of moderate intensity activity a week or 75 minutes of vigorous intensity exercise – or a combination – is recommended if the person is already active. Those getting into exercise for the first time in a while – or those with a health condition – should speak to their GP before beginning. Some of the best exercises for older adults are weight bearing exercises, where the weight of the body pulls down on one’s bones, helping to strengthen these muscles:
- Walking
- Climbing stairs
- Tai chi
- Yoga
- Jogging
- Dance
- Tennis.
Lighter activities that also count towards keeping active can be something as simple as making the bed, getting up to make tea, cleaning and dusting, vacuuming and getting around the home. Customers should be encouraged to exercise with caution if they have not done so in a while, but also to remember that “age is just a number. If you’ve always run, or you’ve always played tennis, don’t stop because you’ve turned 70, or 80. There may come a point where you need to slow down a little. But there’s no need to suddenly stop,” says Rachel Thom, musculoskeletal physiotherapist at Swanage Community Hospital. Rachel, in collaboration with the British Heart Foundation, encourages people over 60 to move more. More vigorous activity, once customers are more comfortable with exercise, can be anything from swimming to aerobics. The health benefits linked to exercise are innumerable, contributing to a lower risk of developing many long-term conditions like heart disease, type 2 diabetes, stroke and some cancers, whilst also improving bone health by increasing bone density, lowering the risk of fractures. Exercise is also known to improve quality of sleep, boost mood and self-esteem and reduce risk of stress, clinical depression and other cognitive diseases like dementia. “We also recommend keeping physically fit and taking regular exercise if you are able,” says Caroline Scates, deputy director for Admiral Nurse Development at Dementia UK. “Exercise is known to improve blood supply, reducing the risk of heart disease, high blood pressure and vascular problems, which are factors that can increase the risk of vascular dementia, the second most common type of dementia.”
Exercise does not need to look like running or playing a sport – it can be as simple as moving and stretching.
Sharpening the mind
Dementia affects around 944,000 people in the UK. One in three people born in the UK today are likely to be diagnosed with dementia in their lifetime. However, Caroline notes, this number can be changed. “Although getting older is the biggest risk factor for dementia and cognitive decline, we know that up to one in three cases of dementia could be preventable. Evidence suggests that keeping the mind active and engaged can help improve memory and concentration.”
Similar to how we know that physical exercise can benefit our overall general health, mental exercise and activities that challenge the brain could help to stimulate the brain and possibly reduce our risk of developing dementia.” Caroline recommends taking up a hobby or activity to keep minds stimulated, like listening to an audiobook, doing puzzles or learning a new language or instrument. “Staying socially active has also been shown to have a protective effect on the brain, so maintaining regular contact with family and friends or joining local social clubs or online groups with people who have similar interests to you can be beneficial for overall brain health.” Reducing alcohol intake to 14 units or less a week, stopping smoking (smoking is linked to a thinner cortex, the brain’s outer layer crucial for thinking skills) and going for regular checkups to detect high blood pressure, high cholesterol and diabetes are other ways customers can reduce the risk of developing dementia.
The risks of loneliness
Everyone will experience loneliness throughout their lives, and this is natural and normal. However, if the feeling of loneliness extends beyond a moment here and there, it can become harmful to health, and this is especially important when looking at older people’s health. Marmalade Trust interim CEO, Ron Moody, commented: “Loneliness and social isolation increase health risks in older people. Various life events, such as retirement, bereavement and ill health, can reduce social networks and make it harder to stay active socially.” For elderly people, who are more at risk of being forgetful or falling, for example, being alone does pose a threat to their health. Elderly people experiencing long bouts of loneliness are also more likely to develop depression, one of the most common conditions affecting the elderly population in the UK.
“Loneliness is a part of life and something that most of us experience at some point. But when loneliness is severe or lasts a long time, it can have a negative impact on our health and well-being. Recent studies suggest that long-term loneliness is one of the largest health concerns we face. It is as harmful as obesity or smoking 15 cigarettes a day. Feeling lonely can lead to depression, increased blood pressure, anxiety, disrupted sleep and stress. People who feel lonely are more than twice as likely to develop Alzheimer’s (and other forms of dementia) than those who do not feel lonely.” Older people, who are very vulnerable to loneliness, should be encouraged by pharmacy teams to maintain their social interactions. “Pharmacy teams can encourage older people to stay connected by joining a club or social group or using technology,” Ron adds. “Other ways to feel less lonely include meeting new people through volunteering, taking up a new hobby, proactively staying in touch with friends and family, signing up for a course or getting a pet.” Pharmacy teams are well placed to notice if someone is feeling lonely, and to reach out to customers who they know have perhaps recently lost someone, moved or are living alone.
Pets are great companions for elderly people who may live alone or are prone to loneliness.
“Up to one in three cases of dementia could be preventable”
State of the nation
The State of the Health and Care of Older People 2023 report by Age UK investigates the quality of care older people can expect in the UK. It emphasises the impact of the Covid-19 pandemic as well as the growth of the ageing population; in 2023, there were 11 million people over 65 in England. In the next five years, this number is expected to be 12.1 million, reaching 14.5 million by 2043. While the general takeaway is that people can expect to live longer, this is not completely true. Life expectancy varies depending on socioeconomic factors and areas of deprivation and impacts not only one’s life expectancy, but how long they are predicted to live with a long-term illness, for example.
The report also found that 86 per cent of people over 85 live with at least one long-term health condition, more than one in four live with two or more conditions and 1.6 million people over 65 have unmet care needs. The report suggests that emphasis needs to be placed on community health services and social care “so that more older people get more help, earlier, enabling them to stay well for longer at home and reducing their reliance on crisis care in hospitals”.
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