The Jewels in the Crown. The diamond Queen Lucien Freud Portrait

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Transcript of The Jewels in the Crown. The diamond Queen Lucien Freud Portrait

  • Slide 1
  • The Jewels in the Crown
  • Slide 2
  • The diamond Queen Lucien Freud Portrait
  • Slide 3
  • The Jewels in the Crown Jewels of Healthy Aging Gold of exercise Pearls of Diet Diamonds: The sparkle of social interaction and community involvement in healthy aging. The jewel in the crown. Prevention of disability and dementia what we can do to prepare and keep ourselves healthy as we age
  • Slide 4
  • George IV diadem
  • Slide 5
  • Slide 6
  • Long lived diamonds
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  • Even she gets a senior moment
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  • Queen Elizabeth (II) Oldest reigning British and Canadian Monarch Oldest reigning British and Canadian Monarch Lives in Palaces with lots of servants Lives in Palaces with lots of servants One of her houses burned down One of her houses burned down Three of her four children divorced Three of her four children divorced But we like her new grand daughter in law But we like her new grand daughter in law Still working aged 86 Still working aged 86 IDT8
  • Slide 9
  • Queen Elizabeth Long lasting Marriage (celebrated her diamond wedding in 2007) Long lasting Marriage (celebrated her diamond wedding in 2007) Keeps Breakfast cereal in Tupperware boxes Keeps Breakfast cereal in Tupperware boxes Simple diet, likes fish Simple diet, likes fish Occasional glass of wine Occasional glass of wine Life long non Smoker Life long non Smoker IDT9
  • Slide 10
  • 10 Successful aging
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  • They are not the only ones
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  • Population Aging Canada population over 80 increased by 41% in the years 1991-2001 Expected to have increased by another 41% by 2011 1.3 million Canadians Population Pyramid IDT12
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  • Baby Boomers More educated More money Greater Expectations Greater Life expectancy One still does not have a job IDT13
  • Slide 14
  • Barriers to Healthy aging Modifiable risk Factors Unhealthy Diet Physical Inactivity Tobacco Use Raised blood pressure Raised Blood glucose Abnormal lipids Over weight /obesity Heart disease Pulmonary disease Intermediate Risk factors
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  • The Rectangular Survival Curve IDT May 2010 155/13/2015
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  • Sarcopenia (Age related loss of Muscle Mass) Google Images :Reebok's Guide to Fitness Dana Farber Web Site Survivor's Guide to Fitness DVD Lean Body mass less than 2 standard deviations From sex specific mean For young healthy person Importance of Vitamin D in muscle function IDT May 2010 165/13/2015
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  • Impact of Frailty Most adults die from heart disease, cancer or dementia but for the oldest old the factor which limits their ability to live independently till death is muscle strength. Lambert:: Science 1997 IDT May 2010 175/13/2015
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  • Frailty Non specific state of increasing risk reflecting multi system physiological change Strongly age related Not necessarily overtly disease related Rockwood 2007 Genes Environment Lifestyle Morley 2006 IDT May 2010 185/13/2015
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  • Ag e related physiological deterioration Exercise Nutrition Social activity Mental activity Presence of disease Frailty Functional decline Disability Hospitalization Institutionalization IDT May 2010 Stressful event 195/13/2015
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  • Impact of Frailty Most adults die from heart disease, cancer or dementia but for the oldest old the factor which limits their ability to live independently till death is muscle strength. Lambert:: Science 1997 IDT20
  • Slide 21
  • Successful Aging High Level function High Level function Physical Activity Physical Activity Life satisfaction Life satisfaction Active engagement Active engagement Independent function Independent function Positive adaptation Positive adaptation (Freedom from Chronic diseases) (?) (Freedom from Chronic diseases) (?) IDT21
  • Slide 22
  • Successful aging Genetics Genetics Diet Diet Freedom from diseases in childhood and adult hood Freedom from diseases in childhood and adult hood Education Education Exercise Exercise Ability to handle stress Ability to handle stress Support systems Support systems Environment Environment IDT22
  • Slide 23
  • The Gold of Exercise
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  • Studies of Healthy Aging Predictors of Stability moderate/strenuous exercise ( no difference in walkers and joggers) Good exercise patterns life long Strengthening exercises IDT24
  • Slide 25
  • Benefits of Exercise Moderate Intensity Exercise beneficial WALKING -Few complications associated with exercise safest, cheapest and overall most effective -Does not need to be prolonged. Often most effective with associated social interaction Good to have a friend to walk with you IDT25
  • Slide 26
  • Weight bearing exercise May slow the rate of bone loss Improve muscle strength
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  • Type of exercise Even standing rather than sitting is exercise Walking is good safe exercise Strengthening exercises, repetitions, walking up stairs Best to start in program with expert supervision if you have not done it before Standing up from a chair and sitting down several times a day
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  • Exercise Start Slowly If it causes no symptoms it is doing no harm Be cautious in warm weather
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  • A word of warning Dont exercise in the heat Drink Extra water in the heat Dont stand in the rain for three hours with nothing to drink
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  • Get a pet IDT30
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  • Walking
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  • Pearls of Diet
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  • Diet She drinks her claret strengthened (I would have said spoiled) with malt whisky WE Gladstone Moderate quantities of red wine Moderate amount of food Dental Care Mediterranean Diet Fish Omega 3 fatty acids and Olive oil IDT33
  • Slide 34
  • Diet Prevention of obesity Keeping to the recommended salt intake Mediterranean diet > Fish low saturated fats and lots of vegetables and fruit Adequate Calcium Vitamin D for muscle strength (you can get it in fish oil,milk and out in the sunshine
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  • Salt intake No Hypertension in societies with low salt intake Canada has one of the highest salt content in fast food Issue for immigrant elders High content of salt in designer bread and processed food. Recommended daily intake 1200mg /day for persons over 70 ( 1200-2300)
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  • Prescribed Drugs that can adversely affect cognition Drugs for incontinence Sleeping Pills Any sedative drug including Gravol And Many others IDT 2010 36
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  • Medications The more the medications the more likely the adverse reaction Ask about side effects Dont share medications Ask your doctor or pharmacist about over the counter drugs Dont look for a pill for every ill Get them blister packed if you are forgetting to take them
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  • Copyright 1997 BMJ Publishing Group Ltd. Rochon, P. A et al. BMJ 1997;315:1096-1099 Fig 1 Prescribing cascade 385/13/2015
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  • Smart Drugs Viagra for the Brain ? No-otrophics Coffee Amphetamine like Drugs Donepezil and other cholinesterase inhibitors No evidence that they effect dementia incidence Irene Turpie 201039
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  • Ginkgo Biloba.. $250 million /year spent on Ginkgo in US Commonly used supplement No evidence of effectiveness in large randomised controlled trial or 3069 normal community volunteers followed for six years Given placebo or 120mg twice daily IDT 2010 40
  • Slide 41
  • Depressive Symptoms MacArthur Studies of Successful Ageing Depression associated with a higher mortality and increased use of medical services Physical disability a strong predictor of depression Associated with loneliness IDT41
  • Slide 42
  • Artist Chris Levine Aspreys Crown Jewellers Diamonds of Social Interaction
  • Slide 43
  • Good support system A good social support system correlates with successful aging extended family cohesiveness and frequent contact a feature of centenarians Social Engagement with other people Community involvement IDT43
  • Slide 44
  • Importance of Family Life IDT44
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  • Community Involvement Seniors largest percapita donor to charity 69% of Canadian seniors provide assistance to spouse, children, grandchildren, friends or neighbours
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  • Social Interaction 65% of Canadian seniors provide care for other persons Seniors are an important source of Volunteer activity Frequency of social involvement correlates with self perceived health Social involvement more difficult for older people especially if language and mobility a problem
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  • Most people want to live at home the environment is what allows us to maintain our state of health. We rely on health care when genetics, and our environment and social policies have failed us the environment is what allows us to maintain our state of health. We rely on health care when genetics, and our environment and social pol