The HEALTH | AUGUST, 2018

Balance disorders is considered one of the geriatric giants

ANTAI Hospital Kuala Lumpur Consultant Geriatrician and Physician Dr Mohamed Seenikatty Abdul

Hakim( pic) pointed out that balance, mobility, cognition and continence are four common issues among older people.

“ Imbalance can be caused for a multiple reason such as physical, cognitive, drugs as well as environmental factors that may impact their balance such as when walking in an uneven pavement, through steps at home, tiles that are not laid out very well, a lot of carpeting as well as drugs.”

“ However, this may not present a challenge if it was in their home as they are already accustomed to it. But if the environment changes, for example – when they step outside, at the mall, when grabbing a cup of tea with their friends- then things start to change.”

“ Problems with the inner ear can also be a cause. The normal gate and walk may also be affected for those who have a previous history of strokes which caused weaknesses on certain limbs- upper limb or lower limb.”

“ Other patience may have problems with their visions – patience who have cataract and glaucoma – they cannot ascertain or look at the environment very clearly. For example, their ability to look, to perceive environmental hazards when walking through the door, walking past people in a busy crowded place, walking down steps – trying to perceive one step from the other, trying to place their foot down – all this can affect their ability to balance themselves.”

“ Then posture; laying down for prolonged period of time and then trying to sit up sudden. This can cause giddiness and dizziness. Apart from medications, as you grow older- the ability for the body to compensate and push the blood pressure up when you change postures might not be as good as it was before which is an attributing factor to cause dizziness as well.”

Mohamed Seenikatty explained further that antihypertensive medications and not consuming enough fluids for fear of frequent visits to the lavatory can cause dehydration.

“ Maintaining a good hydration is very important to maintain a good circulation volume,” he said.

• Red meat and organ meats such as liver, tongue and sweetbreads

• Shellfish such as shrimp and lobster

• Refined carbohydrates such as white bread, white rice, pasta, sugar

• Processed foods such as chips, snack foods, frozen dinners

• Sugary beverages

• Alcohol( If you drink, limit it to no more than one alcoholic drink for women and two for men within 24 hours.)

Pantai Hospital Kuala Lumpur Consultant Geriatrician and Physician Dr Mohamed Seenikatty Abdul Hakim explained that gout is more of a metabolic disease.

“ Patients who have a history of metabolic syndrome like diabetes, hypertension, high lipids as well as those who are very overweight are at risk of developing gout.”

“ However, gout tends to happen a bit more in older people because of the lifestyle that they lead. They don’ t drink enough fluids, but may consume medications such as diuretics which then tend to make them lose fluids. These drugs sometimes can trigger gout.”

“ As we grow older, there is also a tendency of becoming more sedentary which results in weight gain and other metabolic problems such as rise in blood pressure, high lipids and rise in weight which inadvertently causes gout. Foods very high in purine, meat and shellfish are another contributing factor. In addition to these, certain medical conditions such as kidney impairment and renal failure leads to gout as well.

“ There is also a very close familial link where if there are members of the family that have gout – they are in the risk of gout as well.”