“Aging Gracefully” Dr CP Wong MBBS(HK) FRCP(Lond, Edin, Glasg) FHKCP FHKAM MHA(NSW) Chief of Integrated Medical Services Consultant Geriatrician in-charge.

““Aging Gracefully”Aging Gracefully”Dr CP WongDr CP Wong

MBBS(HK) FRCP(Lond, Edin, Glasg) FHKCP FHKAM MHA(NSW)MBBS(HK) FRCP(Lond, Edin, Glasg) FHKCP FHKAM MHA(NSW)

Chief of Integrated Medical ServicesChief of Integrated Medical ServicesConsultant Geriatrician in-chargeConsultant Geriatrician in-charge

Ruttonjee & Tang Shiu Kin HospitalsRuttonjee & Tang Shiu Kin Hospitals

Outline Outline Your OutlooksYour OutlooksLessons from the CentenariansLessons from the Centenarians4 tricks: Diet, Exercise, Rest, Water4 tricks: Diet, Exercise, Rest, Water

Expectation of Life at BirthExpectation of Life at BirthHong Kong 2014Hong Kong 2014

MALEMALE FEMALEFEMALE 81.0681.06 87.25 87.25 82.44*82.44* 88.18* 88.18*

** If you are still alive at 50 of age If you are still alive at 50 of age

The Truth Is:The Truth Is: 1 in 15 of you will end up in 1 in 15 of you will end up in

an aged homean aged home 1 in 2 of you will live with 1 in 2 of you will live with

children; 1 in 4 of you will children; 1 in 4 of you will live with spouse only; 1 in 8 live with spouse only; 1 in 8 of you will live alone.of you will live alone.

1 in 5 men will be widowed1 in 5 men will be widowed 1 in 2 women will be 1 in 2 women will be

widowedwidowed

The Truth Is:The Truth Is: 1 in 7 of you will have NO major 1 in 7 of you will have NO major

chronic diseases (6 will have)chronic diseases (6 will have) 1 in 3 men will die of cancer (28% 1 in 3 men will die of cancer (28%

women)women) 1 in 7 men will die of heart attacks 1 in 7 men will die of heart attacks 1 in 3 of you will have 1 in 3 of you will have

hypertension; 1 in 5 of you will hypertension; 1 in 5 of you will have diabeteshave diabetes

ALL of you will have joint problemsALL of you will have joint problems

CentenariansCentenarians Record oldest 122 (died 1997)Record oldest 122 (died 1997) 85% female; Genes DR185% female; Genes DR1 Siblings of centenarians 8xSiblings of centenarians 8x Middle age mothers 5x; Late Middle age mothers 5x; Late

menopausemenopause Diet & exercise; Not Very different!Diet & exercise; Not Very different! Only 10% overweight !Only 10% overweight ! Attitude: Positive, Active SociallyAttitude: Positive, Active Socially Screen for diseasesScreen for diseases

Our Physical DevelopmentOur Physical Development

0 30 10050

100%

Aging Gracefully

Average

The Miserable

The Importance of DietThe Importance of Diet No Fatty FoodsNo Fatty Foods No Salty FoodsNo Salty Foods No SweetsNo Sweets No Processed Foods (Salt)No Processed Foods (Salt) Vegetables (Fibers)Vegetables (Fibers) Balanced DietBalanced Diet Plenty of WaterPlenty of Water No CigarettesNo Cigarettes Moderate Drinking ??Moderate Drinking ??

McCay CM et al. J. Nutrition 1935, 10: 63-79McCay CM et al. J. Nutrition 1935, 10: 63-79 McCay, C. M., and M. F. Crowell. 1934. Prolonging the life McCay, C. M., and M. F. Crowell. 1934. Prolonging the life

span. Science Monthly 39:405–414.span. Science Monthly 39:405–414.

The Cornell Rat ExperimentThe Cornell Rat Experiment

More than that !More than that ! Maintain youthful activity levels longer.Maintain youthful activity levels longer. Maintain immune function longer.Maintain immune function longer. Better performance in memory tests (water maze), Better performance in memory tests (water maze),

retain memory abilities longer.retain memory abilities longer. Fewer tumors.Fewer tumors. More resistant to carcinogens.More resistant to carcinogens. Less oxidative damageLess oxidative damage

Collagen crosslinks form slower (less AGEs).Collagen crosslinks form slower (less AGEs). Fewer free radicals.Fewer free radicals.

Lower mean blood glucose.Lower mean blood glucose.

The Magic of ExerciseThe Magic of ExerciseKeeps you strong and trim Keeps you strong and trim Protecting your heart and bonesProtecting your heart and bones Improving your mood, sleep, memory Improving your mood, sleep, memory

and toiletingand toiletingWarding off breast and colon cancerWarding off breast and colon cancerReducing your overall risk of dying Reducing your overall risk of dying

prematurelyprematurely

What Sorts of Exercise?What Sorts of Exercise?Aerobic: Rowing, Swimming, Jogging, Aerobic: Rowing, Swimming, Jogging,

Hiking, Basketball, Tennis, Hiking, Basketball, Tennis, Badminton..Badminton..

Gymnastics: Tai-chi, gym-works, Gymnastics: Tai-chi, gym-works, Yoga, stretchings…Yoga, stretchings…

What amount of exercise?What amount of exercise?Start low, go slow, but has to be Start low, go slow, but has to be

PROGRESSIVE!PROGRESSIVE! Just start to sweat, breathless, heart Just start to sweat, breathless, heart

palpitatespalpitatesDaily for 30 minutes optimalDaily for 30 minutes optimal3 times a week, 20 minutes minimal3 times a week, 20 minutes minimal

My 5 Exercise PrinciplesMy 5 Exercise PrinciplesPersistencePersistence IncrementalIncrementalBreaking the ThresholdBreaking the Threshold Interval TrainingInterval TrainingCross TrainingCross Training

Sleep Early!Sleep Early!Best time to sleep 10 pm to 4 amBest time to sleep 10 pm to 4 amRecovery time!Recovery time!

Stayed Connected & EngagedStayed Connected & Engaged

• A psychological featA psychological feat• HobbiesHobbies• CompanionsCompanions• Cope with stressCope with stress• Drive & resilience – don’t quitDrive & resilience – don’t quit• Laughter and PleasureLaughter and Pleasure• Exercise your brainsExercise your brains

Screen for DiseasesScreen for Diseases

Breast (1/24) & Cervical (1/94) CancersBreast (1/24) & Cervical (1/94) Cancers Yearly Check Ups for High RisksYearly Check Ups for High Risks 5 Yearly Check Ups if normal5 Yearly Check Ups if normal Do not add stress to yourselfDo not add stress to yourself

Diseases & Your LifeDiseases & Your Life

70% of Diseases are caused by bad life 70% of Diseases are caused by bad life style habitsstyle habits

30% of Diseases are gene-determined30% of Diseases are gene-determined 80% of chances of having chronic 80% of chances of having chronic

diseases when olddiseases when old Live Happily with Your Diseases !Live Happily with Your Diseases !

In ConclusionIn ConclusionHalf of you will live beyond 84 yearsHalf of you will live beyond 84 yearsHealth is our First WealthHealth is our First WealthExerciseExerciseDietDietGood Social AttitudeGood Social AttitudeScreening for DiseasesScreening for DiseasesLiving Happily with Your DiseasesLiving Happily with Your Diseases

May I wish all of you May I wish all of you could Age Gracefully !could Age Gracefully !