Physiological changes in your aging parents: Are you taking the right care?

According, to the National Statistical Office (NSO)’s Elderly in India 2021 report, the elderly population aged 60 years and above will increase up to 41% in the next 10 years. That means in the coming 10 years we have to understand the changes that occur in our parent’s bodies as they age as well as be equipped to take care of them while those changes occur. 

Why should you take care of your aging parents?

Well apart from the love and care we hold for our parents and the ethics and morality of it, there are other things that we need to understand.  Once we are familiar with what changes happen at the physiological level, our understanding of the reasons for their health status and the consequences of the aging process will be something that we understand much better and thus we will be more equipped to take care.

Ageing is a natural process and everyone undergoes certain physical and physiological changes in their body as the age. A physical change is a change in the growth of the physical body like bones, muscles, hair or any other physical aspect of our body. On the other hand, Physiological change is a change in our body’s ability to function. 

So, what are the 6 physiological changes your aging parents are going through? Let’s find out:

1. Cardiovascular System

As our parents are ageing, 

• Their heart is slowly losing its elasticity
• There is a build-up of fatty tissue around the heart and arteries
• The heart walls start to thicken

These reasons cause the heart to work harder and add pressure on the heat in order to pump blood to the rest of the body. It puts a load on the heart, lowering the stamina and ability to do normal chores and activities which they could do easily before. 

What does this extra effort put on the heart lead to?

Well overtime along with an unhealthy diet and sedentary lifestyle can lead to major heart problems like:

• High blood pressure (hypertension), 
• Atherosclerosis (hardening of arteries), 
• Heart attack or even a 
• Stroke. 

How can this be prevented? 

1. Diet should include a high fibre diet from whole grains, fruits and vegetables. 
2. Avoid foods with high trans-fat, saturated fat, and sodium. 
3. Smoking may aggravate the process of the thickening of the arteries and should also be avoided. 
4. Engage in at least 150 minutes of aerobic exercises like walking or jogging (after fitness check by physician)per week
5. Engage in at least 2 – 3 sessions of resistance training per week (after consulting your physician and exercise specialist). 
6. Avoid high salty foods or foods with high sodium especially packaged or processed foods like ready-to-eat foods, frozen or canned foods, pickles or papads. Avoid bakery foods like biscuits, cakes, toasts and kharis as well.

2. Nervous System

With age, the capacity of our brain to communicate and transfer signals slows down. Some elderly may experience the following symptoms:

• Loss of brain function
• Memory loss
• Change in behaviour
• Irritability and 
• Aggressiveness

Some may even experience extreme neurological disorders like Dementia and Alzheimer’s which is characterized with memory loss, change in behaviour, decline in performing daily living activities, aggressiveness and mood swings. 

Neurological issues indirectly affect the nutritional intake of the elderly as well.

How can you identify them and how will you overcome the symptoms? Let’s find out:

1. They may experience loss of appetite: Give them small and frequent meals. Make sure to alter the food as per their acquired taste and preferences.  
2. In conditions where memory loss is seen, they may tend to forget to eat major meals or may even eat twice causing either weight loss or weight gain issues:  Keeping a regular check on their eating schedule is important. 
3. Some may even experience loss of motor skills which makes it difficult to hold a spoon or eat: Providing cutlery that is easy to operate or having a caregiver to help them with eating may be required. 
4. Sedentary behaviour sets in and they may feel tired easily after any physical activity: Involving them in your daily household chores as small as the task may be may also help them in staying active and feel wanted. 
5. A major downfall along with the decline in neurological function is the psychological burden some parents might feel. They may feel unwanted and even frustrated to not be able to perform their daily living activities without the help of someone: Patience with their change in behaviour and allowing them to perform certain activities by themselves with supervision may boost their confidence, help them cope better and may improve quality of life.

3. Gastro-Intestinal System

As our parents cross the age of 60, issues in the Gastro-Intestinal (GI) Tract may occur. IF you’re wondering which part of the GI tract is affected, you’re in the right place. Let’s find out!

GI issues may affect from what they eat, what they can digest to what they can excrete.

1. Mouth: Because older people have receding gums, cavities at the root of the gum may occur. Dry mouth due to less decrease in saliva production can lead to bacteria build up further decaying the tooth. This may make consuming food difficult. In such cases, a soft cooked diet is better tolerated than raw and rough food. 
2. Oesophagus: Moving down the GI tract, the lower oesophageal sphincter that prevents the food from the stomach to enter back in the oesophagus may loosen and can cause burning sensation, acidity and damage of the oesophageal cells. If not treated early can lead to Gastro-oesophageal reflux disorder. To prevent this regurgitation of food, make sure that they are sitting upright or at a 45-degree angle instead of slouching while eating, avoid drinking too much fluid while eating food and avoid lying down right after eating. 
3. Stomach: When it comes to the stomach, most of our parents suffer from acidity. This may be due to many reasons. However, one prominent cause is due to different medications they are on. That is why doctors usually also prescribe an antacid (a medication to reduce acidity). In the long term, this medication can affect the release of gastric acid in the stomach causing indigestion. 
4. Gut: With age another aspect of the GI tract can be affected that is the small intestine and large intestine i.e., the colon. The intestine with age loses its motility as the walls of the intestine thicken. This can cause issues with the absorption of nutrients, gas, flatulence, bloating and even constipation. Because the motility of food is slow in the gut, certain carbohydrate rich foods tend to ferment in the gut causing a release of micro-organisms that increase gas, bloating and flatulence. Constipation is common and may worsen if the elderly are consuming less water and a low fibre diet. Due to these issues, being dependent on artificial fibres is a common practice. You may have experienced your parents not being able to pass a bowel movement without something like Isabgol. Isabgol does help in softening the stools and making defecation easy, but a daily intake may affect the natural ability of the guts function. This may relieve the symptom but not solve the problem. 

So what can you do to make sure your parents have a healthier gut? 

• A diet rich in fiber along with foods that are prebiotic and probiotic like curd, legumes, oats or bananas help maintain good gut bacteria and will relieve some GI symptoms. 
• Water along with a fibre diet is important for the stool to pass along the colon with ease. 
• At least consumption of 8 glasses of water (250 ml each) is recommended. 
• Do not consume any artificial fibre post the recommended dose. 
• Engage in regular physical activity.

4. Musculoskeletal System

The Musculoskeletal system involves the Muscle and the Skeletal system. As our parents cross the age of 60-70 years the following may be affected:

• Age dependent reduction in lean body mass: This is very commonly seen in the elderly and it happens due to the loss of muscle cells. 
• Effect on movement is due to skeletal changes: More than 85%of older people (above the age of 70 years) suffer from degenerative joint disease.

In such situations pain can be severe limiting their daily activities. So, how can you help?

• For elders who are unable to exercise, sitting exercises works wonders too – Chair Yoga being the best example. 
• An exercise specialist or physiotherapist can help in prescribing an exercise schedule which is feasible for your parents to adhere to.

5. Endocrine System

With increasing age, the decline in the function of insulin producing cells is also seen along with insulin resistance. What does Insulin do? Insulin’s function is to:

• Recognise glucose released in the body 
• Transport it to the cells of the body for it to perform its functions. 

With a decline in insulin production and insulin resistance, your parents may experience high blood sugars.

How can you manage high blood sugars?

• It is important to not only focus on providing foods with no added sugar but also to include foods that improve the function of insulin production and lower resistance like whole grain cereals, legumes, nuts, oilseeds, vegetables and certain condiments like onion, garlic, ginger, or methi seeds. 

Another part of the endocrine system that is affected are the reproductive hormones during menopause. Women when they are menopausal experience the following symptoms 80% of the time:

• Hot flushes and raise in body temperature
• Changes in the skin 
• Insomnia
• Risk of cardiovascular diseases (CVD) and diabetes increases
• Low bone density and osteoporosis 
• Mood swings

Hormonal therapy may be required to handle certain symptoms. It is best to consult your physician or gynaecologist. 

Diet plays a major role in preventing post-menopausal symptoms:

• Low energy diet is recommended to prevent metabolic disturbances
• Low fat-low carbohydrate and moderate to high protein may help in reducing the risk of CVD and Diabetes.
• The Mediterranean diet is a high fibre diet including foods like whole grains, vegetables, legumes, fruits, nuts, seeds, herbs and spices. Low fat milk and milk products, eggs, chicken and fish are taken in moderation. It has shown to help in preventing CVD and reduce low bone mass density in postmenopausal women. 
• Other nutrients like Calcium, Vitamin D, Vitamin K, Selenium, Magnesium, and Beta-carotene may also help in improving bone mass density.

6. Genito-Urinary (GU) System

With age, the Genito-Urinary system also gets affected in various ways. Genito -Urinary system includes the Kidneys, Bladder and the Prostate. Do you know how these systems are affected? Well let’s find out!

The following changes occur with age in the GU system:

• A gradual reduction in the size, weight and volume of kidneys
• Kidney cells reduce from 1,000,000 to 700,000 by the age of 65 years
• Kidney functions decrease causing changes in blood levels of urea nitrogen
• Glucose gets excreted in the urine on a large amount
• Capacity and control of bladder decreases 
• Prostate may enlarge in men by the age of 80 years, blocking the urinary tract and causing urinary retention

With all these physiological changes happening, the elderly may feel the need to be dependent on their children and need constant support and help. Providing them the correct medical help based on their need is the first step to handle these issues. Some parents may need help going to the washroom and some may even need to use adult diapers. Some might even need surgery. 

One of the most important concerns is that the elderly quit drinking adequate water due to the inconvenience and the embarrassment and dependence in voiding of urine. This leads to another set of problems like an increased incidence of constipation and in a few cases urinary tract infections. The answer lies not in decreasing the amount of water intake, but in getting the support required – like adult diapers and the family’s assistance. Make the way to the washroom easy for them so that they do not stumble and fall in the night.

During this time psychological support is also necessary. It is important to understand that the dynamics of dependency have changed. Like your parents helped you walk, fed you, bathed you, changed your diapers, you might have to do the same for them and that’s okay! 

Physiological changes in elderly that are happening internally affect so much more on the outside as well. It affects their movement, mobility, nutrient intake and behaviour. But most importantly it affects the quality of life and to attain a healthy lifestyle, you should focus on the symptoms or changes you see in your parents and help them manage to live a healthy longer life. 

We at Nutritionwithvibha.com believe that the focus of life, the center of it is love and care and nurture and nourishment. Like we take care of ourselves, a time will come to take care of our elderly – with a mindful, proactive and meditative nature. 

Isn’t the cycle of life beautiful – our parents took care of us and now we do so with the same love and gentleness and awareness. How can we forget – soon it will be our turn to age. Our children who see us loving our parents and caring for them will do the same for us. And life goes on and on – the circle of Divinity.

To know a gist of dos and don’ts in taking care of an elderly person’s physiological changes

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References:

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3. Boss, G. R., & Seegmiller, J. E. (1981). Age-related physiological changes and their clinical significance. Western Journal of medicine, 135(6), 434.
4. National Statistical Office (NSO)’s Elderly in India 2021 report. https://theprint.in/india/indias-elderly-population-to-rise-41-over-next-decade-to-touch-194-mn-in-2031-govt-report/710476/
5. Picetti, D., Foster, S., Pangle, A. K., Schrader, A., George, M., Wei, J. Y., & Azhar, G. (2017). Hydration health literacy in the elderly. Nutrition and healthy aging, 4(3), 227-237.
6. Silva, T. R., Oppermann, K., Reis, F. M., & Spritzer, P. M. (2021). Nutrition in Menopausal Women: A Narrative Review. Nutrients, 13(7), 2149. https://doi.org/10.3390/nu13072149