Old age is often characterised by poor health, frailty, morbidities, and disabilities. Of course, elderly people are also the most vulnerable group when it comes to the Covid-19 virus. This is because they are more likely to develop severe symptoms, especially if they have pre-existing conditions like heart disease or high blood pressure. Luckily, you can give yourself the best possible chance simply by making a few tweaks to your everyday habits. Discovery Vitality’s Deepak Patel joins BizNews founder Alec Hogg to discuss the importance of exercise for people over the age of 65. Plus, we find out what Discovery is doing to encourage this. – Claire BadenhorstÂ
Deepak Patel is the principal clinical specialist and head of research at Vitality, and he joins us today to talk about enhancements for the 65 plus age group. Life expectancy, which has expanded over perhaps the last half century – just outline that for us. How much older are we going to live to now on average?
So, there have been dramatic increases in life expectancy over the last century. I think there are a few things that have contributed tremendously to this drop in infant mortality and a decreased number of deaths from infectious diseases early in life. So, in industrialised societies, we have now a life expectancy well over 80. But even in poorer countries, a person who’s about 60 can expect to live at least till 70 in industrial countries, a person who’s currently 60, you can expect to live till 90.
What that means is that the demographics of the population has changed. The proportion of older people of any population, including South Africa, is actually increasing. And so we need to address the needs of older people, make sure that they are fully integrated in society, be as healthy as possible.
We really want to find out what Discovery Vitality is doing to encourage people to have a healthier, older age.
“Generally, the best way to be healthy in old age is to be healthy entering old age.”
So, we take a life span approach and by and large, I think Vitality is encouraging that, from a very young age, one needs to engage in healthy activities. And they’re really quite simple. The current recommendations are a plant-based diet, mainly, not entirely. Secondly, being physically active. Exercise is important, but also activities of daily living. Thirdly, having adequate sleep. Fourth, making sure that you’re not smoking, drinking, not at all, if possible, or in absolute moderation. Being socially connected and engaging the brain, keeping the brain active. That has an overlap really with what the American Heart Association has called a simple seven.
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And they’re not that difficult on paper, but in practise, I guess, one man’s healthy existence is another man’s sloth. So, just starting there – what is enough exercise?
Exercise is medicine physically, and we know about the benefits of exercise on cardiovascular health, on reducing heart attacks and improving hypertension and strokes, reducing the incidence of strokes.
“And the minimum for that is at least about 30 minutes a day of moderate to vigorous activity for at least five days a week.”
You can vary that as long as you’re achieving about 150 minutes of moderate, moderate to vigorous activity in a week.
The other benefit of physical activity is mental health. You know, there’s now good evidence that physical activity and exercise not only treats depression and anxiety, and it’s as equivalent in a sense as psychotherapy, but it might also prevent mental illness, depression, particularly, and anxiety. So, physical activity is important for mental health, for bone health, for respiratory health, and a number of other physical kind of benefits.
When we go into Covid-19, and particularly the 65 plus high risk age group, how are you incentivising them to do this, again on exercise? When you talk about ‘vigourous’ – is walking sufficient?
Absolutely. We’ve made some changes for the 65 plus in terms of the points we give for physical activity. We are encouraging people to walk much more, and we’ll give you more points for the steps you take. If they engage in some activity, they should do more and try and get to the recommended levels of physical activity. So, that’s the one big change we’ve kind of made. Points for things like visual screening now, hearing, which we’re making available on the VHC – the Vitality Health Check which you get done at a pharmacy or wellness days.
We’ve also introduced something called a functional assessment. We know that the older you get and the more frail a person becomes, their functional impairments, physical function and impairments, so we’ve introduced a functional assessment, which is to be done. The biokineticist will also give you a set of exercises to improve your functional capacity.
So, there’s lots of nudges towards becoming healthier. When will these be introduced?
It’s a pretty unique programme. It will come into effect from September. One other thing that we’ve introduced, also in the Vitality Health Check, is something called a fall risk assessment. That’s a big problem with the 65 plus. In fact, the risk of falling is pretty high as you get older. And we’re quite convinced that if we can pick people up who are at risk for falls early, we can intervene with physical activity, with strength training, and with balance training.
How long did it take to research something like this before actually implementing?
It took us a couple of months. You know, we have to look at the current literature. Every programme we introduce to the market is thoroughly researched from a clinical or from a scientific point of view. It must be evidence based. We also spoke to members of the geriatric society. We consulted widely around this. And then what we’ve got to do is take the scientific evidence and convert it into what is a programme eventually, or a product of the Vitality programme.
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And the wonderful benefit, no doubt, is that you have the data that you can monitor to see whether people are in fact picking up on these spurs.
Yes, absolutely. We haven’t had the optimal engagement of 65-year-olds and this programme, we hope, is going to get more and more 65-year-olds involved. It doesn’t matter what your level of fitness is, it doesn’t matter really how healthy you’ve been. There’s an entry point for you and you can always build on that. But even if people have been somewhat remiss in their habits, this programme allows you, in a sense, to reduce your risks, mitigate your risk as much as possible in the old ages.
What about the context of how we are living today with Covid-19?
We know that Covid is, in fact, a very big issue for the elderly and people over 60, definitely over 65, we know from seven months, or eight months now of research, are at particular risk for severe Covid infection. And our guidance is to do what has been recommended, which is physically distance as much as possible, shelter at home if possible – particularly for people over the age of 65. Wash hands regularly, wear a mask when you’re outside, and don’t go outside if you don’t have to. Online shopping, etc.
We’ve got a programme – Vitality at Home – that we instituted, which would allow people to be physically active, to engage in meditation and mindfulness, and especially for the 65-year-olds, I think it’s important that they maintain their health. If they have diabetes, hypertension – to control those conditions is imperative, and then be physically active.
“Our data suggests that people who are engaged in our programme have much less severe Covid infections than people not engaged in the programme.”
So, being physically active, maintaining your weight as best as you can in the normal range, controlling your diabetes, controlling hypertension and other chronic diseases, asthma – all that is important, and especially so for people over the age of 65.
