1. Medical Aspects of Retirement
Dr B. R. Ahmed
VIC Joint Medical Services

2. Definition of Health
The World Health Organisation defines health thus: “ Health is state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.”

3. Areas to be covered Changes in the body General measures
Specific conditions

4. Changes in the Body Change is continuous throughout life
Senescence begins before puberty
Manifestation of major changes occurs as from middle age

5. Important Changes Body Composition: Reduction in lean body mass
Relative increase and redistribution of body fat
Changes in body weight
Altered handling of some medications

6. The heart and blood vessels:
Structural changes in the heart and the blood vessels
Blood pressure tends to rise
Altered response to exercise
Cardiac output remains the same at rest
NB: Impact of change minimized by good lifestyle choices

7. The lungs:
Reduced elasticity
Reduced respiratory muscle strength
No overall significant effect on function
Airways tend to close more readily
Other changes which increase risk of infection

8. The kidneys and urinary tract:
Reduced function
Reduced ability to conserve water
Reduced tolerance of acid load
Other changes:
Prostate
Urinary bladder

9. The digestive tract:
Reduction in appetite - later
Lining of stomach becomes thinner
Decreased mobility of bowel. Slowed transit time
Increased tendency to hiatus hernia
Increased tendency to gall stones
Liver, reduced mass, otherwise OK

10. The brain:
Structural and vascular changes
Functional changes
Intellectual function basically remains unchanged
Alteration of the sleep -wake rhythm
Reduced appreciation of temperature changes by the skin

11. Higher brain functions:
Intellect remains unchanged in most people
Problem solving skills remain intact
A small proportion develop deficiencies due to disease condition, not simply aging
Memory lapses – mild, more often subjective

12. Measures which preserve “brain health”:
Continued intellectual activity
Reduction of stress
Avoidance of head trauma
Physical activity
Diet rich in anti-oxidants
Social interaction

13. The skeleton:
Reduction in bone mass
Reduced strength
Joints:
Arthritic changes

14. Hormone replacement therapy:
Aim: to partially make up for the reduction in female hormone level after menopause.
Decision regarding HRT should be taken after consideration of several factors
Treatment should be tailored to individual needs and profile

15. The skin:
Becomes dryer
Thinning of outer layer
Reduced thickness of fat under skin
Increased tendency to bruises
Reduced elasticity
Reduced sweating

16. Maintenance of Health General Measures: Nutrition Exercise
Regular health checks
Other

17. Nutrition Intake of nutrients in the right proportion
Correct storage and preparation of meals
Regularity of meals
Taking cognizance of special dietary needs
Adequate fluid intake
Vitamin and mineral supplements

18. Exercise Benefits of Exercise:
Improves cardiovascular and respiratory endurance and function
Assists weight control
Helps cholesterol control
Aids control of blood pressure

19. Exercise (continued) Improves bone strength
Causes increased muscle strength and helps in maintenance of muscle mass
Improves coordination and balance
Improves general sense of well-being
Helps to structure the daily routine
Social benefits

20. Types of Exercise
Aerobic exercise for a minimum of 30 min per day, 3-4 times per week
Strength training
Other forms of exercise also recommended
Stretching
Balance

21. Important
Get a medical check up to determine physical fitness before commencing any new form o f exercise
Warm up and stretch for at least 10 minutes before and relax for at least 10 minutes after exercise
Use appropriate clothing and shoes for the weather and the sport
Heed warning signs

22. Preventive Measures Regular medical check-ups
Full Medical exam: At least once a year
Follow-up visits as necessary
Timely attention to symptoms and other health problems

23. Blood pressure Check at least once a year if normal
Implement control measures if hypertensive
Avoid excessive salt intake
Exercise regularly
Reduce weight
Stop smoking
Regular medication if appropriate
Follow up and screen for complications

24. Cholesterol An essential body substance
Harmful when blood level are high for prolonged periods
Risk of harm increases with the co-existence of other risk factors
Total cholesterol levels should be <200mg/dl
Maintain good lipid profile

25. Cancer
Primary Prevention:
Screening
Early detection

26. Women
Pap smear: enables detection of cancer, and of pre-cancerous lesions; successful treatment
Mammography: detects lesions at an early stage, before spread: improved outcome of treatment
Other female cancers: ovarian, uterine. No equivalent screening tests. Have regular exams, do not ignore symptoms

27. Men Cancer of the prostate: common, but not necessarily lethal
Do not ignore symptoms- BPH is very common though
Regular urological examinations
Clinical exam of the prostate
PSA

28. Colorectal Cancer Affects the 50+ age group
Screening : Faecal occult blood test
Colonoscopy
Other tests

29. Skin Cancer Types: Basal cell carcinoma Squamous cell carcinoma
Malignant melanoma
Action:
Reduce exposure to sunlight
Surveillance of moles
Have suspicious lesions checked

30. The Eye Glaucoma Cataracts Age-related macular degeneration
Diabetic retinopathy

31. Glaucoma Risk Factors: Screening Family history High blood pressure
Diabetes
History of eye injury
Screening
Age
No risk factor
Risk factor
Below 45
Every 4 years
Every 2 years
Over 45
yearly

32. Cataract Risk Factors: Screening Age Genetic predisposition Sunlight
Smoking
Medication
Diabetes
Screening
Age
No risk factor
Risk factor
Below 40-65
Every 4 years
Every 2 years
Over 65
yearly

33. Age-related macular degeneration Risk Factors:
Family history
Cigarette smoking
Early recognition important

34. Vaccinations Annual influenza vaccination
Pneumococcal vaccine: Once only
Boosters of the routine vaccines as necessary (diphtheria, tetanus, polio)
Others if and when indicated- travel, outbreaks, etc

35. Other Aspects
Regular dental care
Hearing test

36. Summary
Maintain measures aimed at keeping healthy and preventing ill-health and disability
Have regular check-ups in order to ascertain the state of health and to detect problems early
Deal with health problems promptly and thoroughly

37. Definition of Health
The World Health Organisation defines health thus: “ Health is state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.”

39. With best wishes for excellent health throughout your retirement!