Tag Archives: Chronic Disease

Sexual Health and Intimacy in Later Life

The concept that older adults cannot have intimacy or a satisfying sex life is misleading. One basic need involves emotionally based relationships which play a vital role in the overall human experience. People have a universal need to belong and to love and having intimate relationships provides social networks and emotional support to older adults.

Photo Credit: Alex Proimos
Photo Credit: Alex Proimos

As people grow older, they want and need to be close to others. This includes the desire to continue an active and satisfying sex life despite changes in sexual behavior. Older adults may be impaired by infirmity but relationship needs such as closeness and sexual desire still remain. Many seniors can have sexual relationships, and probably a few others find ways to maintain or rekindle intimacy and a satisfying sex life as they age.

Health plays a key role in the level of older adults’ sexual activity. Many chronic health conditions such as pain as well decreased sexual desires due to emotional or health problems can affect sexual health. Health professionals have known that sexual dysfunction is not only a major problem for relationships and mental health, but can be an indicator of serious physical health issues such as heart disease. Older adults need preventive health screenings to reduce sexual problems. In addition, older women can improve the quality of their sexual experiences by aggressively managing their health conditions.

Age does not protect seniors from sexually transmitted diseases. In fact, older adults who are sexually active may be at risk for diseases such as syphilis, gonorrhea, genital herpes, among other sexually transmitted diseases (STDs). It has been reported that the number of older adults with HIV/AIDS is growing. While casual sex offers only a moment of emotional intimacy. It does not provide the love and commitment of a serious relationship.

In conclusion, older adults need to feel a sense of belonging and acceptance, whether it comes from a social group or connections. This desire to belong can bring about companionship and intimacy among seniors. Sex and older adults is still a taboo in some societies and often ignored. It is paramount that sexual health becomes a vital component of the quality of life for seniors.

Sophie Okolo is the Founder and Editor-in-Chief of Global Health Aging.

India is Diabetes Capital of the World

Photo Credit: Pixabay
Photo Credit: Pixabay

P Pushpam, a resident of Chennai, India, was denied her job appointment with the Indian Railways on the grounds that she was a chronic diabetic. The court ruled in her favor and pointed out the impracticality of discriminating against people suffering from diabetes in a country that has over 40 million diabetics.

As India makes its demographic transition toward lower birth rates and higher life expectancy, the prevalence of non-communicable diseases is on the rise. India is the “Diabetes Capital of the World” with over 60 million diabetics in the country, that is projected to at least double by 2030. The country ranks second, between China with 90 million and USA with 24 million diabetics. About 17% of the country has diabetes and about 77 million are considered to be pre-diabetic, which refers to those individuals who have higher than normal blood glucose levels, but not high enough to categorize them as diabetic.

Disability-adjusted life years (DALYs) is a measure of the burden of a specific disease in a population. A study shows that the DALYs attributed to communicable diseases in India such as malaria and TB will decrease. However, the DALYs associated with diabetes and other non-communicable diseases will increase. When compared to China, another country with a large and rapidly aging population, one sees a decrease in the DALYs for both communicable and non-communicable diseases.

Smoking, poor physical activity and alcohol use are some pertinent risk factors of diabetes in India. A survey revealed that close to 40% of Indian men are daily smokers and approximately 18% of the study respondents had poor physical activity levels. The survey also suggested that in addition to these individual level risk factors, environmental factors, specifically indoor air pollution contributes to the increasing prevalence of diabetes. The incidence of solid fuel use, contributing to air pollution in India is 83.5%. An urban lifestyle, and increasing strength of the food, fertilizer, pharmaceutical and beverage industries in the past decades, also contributes to a higher prevalence of diabetes.

A major obstacle to diabetes in elderly health is the lack of awareness of one’s status. A study in the urban slum of New Delhi reported that only 36% of their respondents were aware of their diabetic status. Low awareness among the elderly is linked with difficulties in screening, diagnosis and treatment abilities. Elderly patients tend to have lower mobility and are more likely to be dependent on their family members, delaying their ability to seek care.

The increasing prevalence of diabetes management among the elderly places a huge burden on the Indian health care system. While lifestyle modification is the most cost-effective solution to this growing epidemic, a more intense plan of management and care for elderly diabetics is needed.

Namratha Rao is currently pursuing her MSPH in International Health in Social and Behavioral Interventions at the Johns Hopkins University Bloomberg School of Public Health.

The Need to Address Chronic Conditions in Timor-Leste

Timor-Leste or East Timor is a small low income country in Southeast Asia with a population of 1,114,000. It has years of conflict, violence and brutality, and a tumultuous past with Portuguese and Indonesian forces. The conflict and political upheaval have left its marks on all aspects of development in the country. In 2002, Timor-Leste became an independent nation.

Being one of the newest countries in the world, Timor-Leste’s current WHO Country Cooperation Strategic Agenda 2009-2014 is primarily focused on developing a robust health system and improving capacity building. Key health issue focus areas are infectious diseases, maternal and child health and nutrition. There is an immediate need for data and adequate focus on chronic conditions, especially among the adult and elderly population. Although Timor-Leste has the lowest number of publications in medicine, available preliminary data particularly on cardiovascular diseases and diabetes highlights the growing burden of chronic conditions among the elderly. With increased urbanization and improved economic conditions, there is a need to address this growing burden among the elderly population.

Among the 50-96 year population, cardiovascular and circulatory diseases account for approximately a 25% of the total disability adjusted life years (DALYs). For the population aged 70 years and above, these diseases account for approximately 36% of the total DALYs. Specifically, ischemic heart disease in 2010 accounted for approximately 12% and 16% of the total DALYs for 50-69 year and 70+ year population respectively. The disease burden of diabetes mellitus (in terms of DALYs) among the 50-69 and 70+ year population has also increased from 3.6% to 4% of the total disease burden affecting this population. The overall diabetes prevalence in Timor-Leste is currently low at 2.9%. Available data indicates that 7 out of 10 cases occur in those over 40 years. Furthermore, there is very low awareness of diabetes in the country which is a risk factor for increased diabetes prevalence. Urbanization and economic development have the potential to rapidly increase the prevalence rate. Currently, Timor-Leste does not have a national strategy in place to address the diabetes.

As Timor-Leste works on creating a robust and comprehensive health system, it will be imprudent if chronic conditions affecting older populations are not taken into account. With increased economic growth, access to health services and urbanization, the rising burden of chronic conditions can lead to the high prevalence of communicable and non-communicable diseases i.e. the double burden of disease. Collection of valuable data and surveillance, and strategies to improve awareness and reduce the current burden of chronic diseases are ideas for sustainable good health in Timor-Leste.

Namratha Rao is currently pursuing her MSPH in International Health in Social and Behavioral Interventions at the Johns Hopkins University Bloomberg School of Public Health.



The Threat of Food Insecurity Among the Elderly in the U.S. and Beyond

In 2012, 1.1 million (9.1 percent) U.S. senior citizens living independently were considered food insecure. This number is expected to increase by 50 percent in 2025 as the U.S. population continues to age. Data reported by American Association of Retired Persons (AARP) described increases in the number of older adults experiencing food insecurity since 2007. It was shown that food insecurity rose by 25 percent among individuals aged 60 and older between 2007-2009. According to AARP, individuals were more likely to report food insecurity if they were non-white, Hispanic, renters, widowed, divorced or separated, high school dropouts, unemployed and with a disability, had an income below the federal poverty line, and those with grandchildren living in the household.

                                                                                                        Photo Credit: Pixabay

Defined as “limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways”, food insecurity is directly related to a household’s ability to acquire the foods that are necessary for daily living. Among vulnerable and dependent populations such as the elderly, food insecurity can be particularly pronounced.

Individuals who are considered food insecure are at risk for experiencing poor health due to malnutrition. Health risks of particular relevance to the elderly include impaired cognition, diminished immune function, and the potential decrease in life expectancy. In addition to physical health concerns, mental health risks may also accompany malnutrition including feelings of powerlessness and isolation as well as stress and anxiety. Among the elderly, feelings of anxiety related to food insecurity are more pronounced than among young people. For the elderly living with chronic diseases (a number that has grown exponentially worldwide) such as cancer, heart disease, and diabetes, having access to a nutritious diet is a key factor in their ability to manage their condition.

While food insecurity is closely tied to having the financial resources necessary to purchase food, among the elderly, additional barriers may impact their access. In a series of interviews conducted with 46 elderly households in New York state, additional barriers to food access that participants reported were: transportation limitations, mobility limitations, lack of motivation/ability to prepare meals, financial compromises (purchasing food vs. other expenses), and food compromises (quality vs. quantity).

From a global perspective, ensuring that the aging population has adequate access to the resources necessary for healthy living (including safe, nutritious, and affordable food options) should be a priority. Advocating for such resources requires concerted efforts locally, regionally, and nationally. This is particularly important as our global society continues to confront multidimensional problems that threaten environmental, economic, and social stability.

Diana Kingsbury
is a PhD student and graduate assistant in prevention science at Kent State University College of Public Health.

Singapore: Prevention is Better Than Cure

As we all know, in today’s world, people have longer life expectancies. In fact, 75% of the world’s population is older than 60 years of age (WHO). We live longer but the fact is the fact is that we are not aging very well. Once we reach a certain age, chronic diseases occur and hinder us from living a healthy long life; two out of three global deaths are due to chronic diseases such as heart disease or stroke. Due to the aging population, these chronic diseases and necessary expensive treatments put a financial burden on nations’ healthcare systems. As Dr. Lim states in the video, “the healthcare system in Singapore has worked well the last few decades, but was not built for such an aging population and a population that struggles with chronic diseases.”

                                                                                          Photo Credit: Niall Kennedy

Singapore has responded to the trend and puts emphasis on preventative health strategies rather than on just treating or curing the diseases. In Singapore, many fitness parks with workout stations have been built, which not only help the elderly to get active and stay physically healthy, but also to meet and get to know one another. With the increasing aging population possibly living alone, the social aspect of these fitness parks is important and improves the mental state of the elderly.

Public Health professionals can only hope that such preventative initiatives towards healthy living situations for the elderly, or better yet all age groups, will be continued not only in Asia. If we can persuade the entire family to get involved in these types of physical activities, we will have healthier children, adults, and elderly and can lessen the financial burden on the healthcare system. Other community organizations may get involved by offering exercise classes and promoting fitness among seniors.

In addition, local governments need to be convinced that building fitness parks has a positive impact not only on the elderly, but all residents’ physical and mental health. Governments overall need to rethink and focus on disease prevention, and not only treatment and cure.

What else can WE do to improve the health of our community members?

Martina Lesperance is a Health Educator and Screening Technician in El Paso, Texas.