CARING FOR ELDERLY RELATIVES

Caring for elderly relatives can be a burden, especially if they are mentally impaired or physically frail, but it can also be rewarding, as it is often a time when past problems and difficulties can be resolved.

Maintaining independence is usually high on the wish list of people in their later years, and many prefer to live alone after their partner has died. This is partly because adapting to another person's or other people's needs and habits becomes more difficult as we age. The choice of independence has to be respected, even when it involves some risk. In fact, choosing suitable accomodation in which to grow old is a decision that is probably best faced well in advance of the need arising, so that a local network of friends and support can be built up over time.

Spending time with their grandchildren gives people a chance to pass on their years of knowledge and experience.






Avoiding Isolation
Older people need more stimulation than younger people to keep the brain circuits in good shape. Reading and television are both helpful, but human contact is better. One useful rule is to encourage the elderly to have a conversation with at least three people every day: these can, of course, include delivery people, neighbours or shopkeepers. However, contact with people is likely to be more fruitful if it is of longer duration nd can include joint interests and shared memories.

Providing transport is a practical way to help. If you make contact by phone, you may find that making a brief telephone call every day or two to a parent or relative living alone is more beneficial than making a longer call once a week.

Depression
Depression is common among elderly people, and can be difficult to recognize because sadness may be absent. Symptoms are more likely to be loss of appetite , energy and enthusiasm. If the depressed person also withdraws from society they can appear to be crabby and unreasonable, rather than depressed. In elderly people depression usually results from changes in the chemistry of the brain rather than from psychological causes. This is because after middle age there are fewer cells in the brain producing substances known as neurotransmitters. These are vital chemicals that allow nerve cells to communicate with each other, and loss of the cells that produce them can lead to alteration in mood, including depression. This type of depression usually responds well to conventional antidepressant medications, which can make a considerable contribution to the maintenance of independence. Failure to recognize depression can lead to great suffering and even suicide.

Nutrition
Older people often have small appetites, but they need roughly the same amount of vitamins and minerals as younger adults. A one-a-day multivitamin and multimineral supplement can ensure that the intake of these is sufficient, but extra iron should be avoided if the diet contains plenty of meat. Adequate protein in the diet is important, as are plenty of water and sufficient fibre. Lunch clubs, shared meals with other people and taking turns to do the cooking all help to maintain good nutrition as well as social contacts. If chewing becomes a problem, investing in a food blender and juicer can make food preparation much less labour-intensive.

SEX AT 50+

There are a number of myths associated with sexual activity in later years, and these can cause concern in people whose sexual appetite remains strong. Some beliefs still linger: that sexual performance will decline rapidly after middle age and that the problems associatted with ageing will, in any case, preclude any interest in sexual activity. In fact, most loving couples are sexually active in their 60s and 20 per cent remain active into their 80s.

There are changes in sexual performance at 50+, but they are often regarded as blessings: urgency being replaced by calmer, more considered lovemaking. At 50+ there is oftten greater privacy, because the children are less frequently at home, and there may also be more time for sex after retirement. Sensual pleasure can become more important than achieving an orgasm. Honest talk about adjusting to changes in your sex life can be valuable, as can reading some books on the subject. However, if you do not have a regular partner, you should continue to practise 'safe sex' since AIDS is not confined to young people.

Physical Changes
After the age of about 50, it is normal for a man to achieve an erection more slowly, and less frequently. The reason is not clear: it may be the result of lower testosterone levels or due to decreased blood supply to the penis. The erect penis may be less rigid, ejaculation less powerful and the quantity of semen reduced. Some men choose not to ejaculate every time they make love, and in some cultures this practice is encouraged. When appropriate, your doctor can advise you about the use of Viagra (for erectile dysfunction), injections into the penis and other aids to achieving and sustaining erections.

Women's needs and desires are often changed by the menopause. Some are liberated by the freedom of not having to worry about contraception, while others lose their sexual desire. Loss of oestrogen after the menopause may delay or reduce sexual arousal, and also causes thinning of the lining of the vagina. Vaginal dryness can then become a problem, but normal lubrication will often eventually occur, especially in women who have regular sexual intercourse. If necessary, lubrication with proprietary lubricants or the use of local oestrogen creams can be useful.

If Your Libido Is Waning.....

• Warm baths before sex can help to relax you and also reduce joint stiffness; but some people say that cold baths improve your sex life.
• If anxiety is a problem, try to reduce stress generally, or adopt some home therapies, such as massage or aromatherapy. Moderate amounts of alcohol can lower inhibition.
• Regular exercise boosts sex hormones. Zinc and vitamin B6 may help in the production of testosterone. But note that high dosages of vitamin B6 (above 200mg) can cause peripheral neuropathy; high dosages of zinc (above 40mg per day for men and 32mg for women over six weeks) can impair immune function.
• Medication can alter your libido or sexual performance: your doctor may be able to suggest an alternative treatment.
• Increasing disability can lead to fear of hurting your partner or difficulty in finding a comfortable position. Try different position - there are plenty of ideas in books - or seek professional counselling; these problems can often be overcome
• Looking and feeling good creates a positive and very desirable image.

IMPROVING YOUR SLEEP

Most young people sleep well: only around 10 per cent report regular sleep problems. But with increasing age more people, especially women, experience sleep disturbances. The amount of sleep that individuals need can vary greatly: some people require at least 8 hours, but other people can do as well with 6 hours. Scientific studies have shown that the quality of sleep changes with increasing age. Dreams become less frequent and the deep restorative sleep, revealed by slower brain activity, diminishes. In particular the secretion of the hormone melatonin may decline.

Physical changes can also be a factor. Bladder weakness, stiff or painful joints, the increased likelihood of disturbance from snoring, either yours or your partner's, all change the quality of sleep. Sleep can also be disturbed throughout life by anxiety and worry, which can be worse if you start to worry about not sleeping. If you have recently started to take medication and your sleep pattern has changed, you should discuss this with your doctor.

Natural Ways To Improve Sleep

• After the middle of the afternoon avoid stimulants such as alcohol, tobacco smoke and caffeine, which is found in tea, coffee, chocolate, carbonated soft drinks and certain over- the-counter medicines.
• Include tryptophan-rich food in your evening meal. Tryptophan enhances the production of serotonin in the body, a chemical that induces sleep. Tryptophan is best absorbed from a meal that is richer in carbohydrates than in protein and its converson to serotonin requires vitamin B6 and magnesium, so include bananas, nuts, seeds or green leafy vegetables.
• Go to bed and get up at regular times, even after a bad night. Wind down slowly before going to bed. Have a warm bath and add a few drops of calming aromatherapy oils to the water or sprinkle some onto your pillow. Use a pillow that contains herbs.
• If you or your partner snores heavily, talk to your doctor. A few people suffer from sleep apnoea, a condition in which breathing stops and which can cause dangerous drowsiness during the daytime. Surgry may cure the problem, and weight loss can help if you are overweight.
• Regular exercise can improve the quality of sleep.
• Use aids that help you sleep. Reading or listening to music or the radio can be valuable, as can autogenic relaxation. If you are disturbed by early sunlight, buy thicker curtains or install a blind or shutters. Use earplugs if you are disturbed by noise.

Foods That Provide A Good Proportion Of Tryptophan

Alfalfa - chicken

Beans and bean sprouts - fish

Beef - milk and milk products

Beetroot - nuts

Broccoli - oats

Brussels sprouts - spinach

Cauliflower - watercress

Melatonin

Melatonin is a hormone that is secreted by the pineal gland in the brain, and should not be confused with melanin, which gives colour to the skin. The exact function of melatonin is poorly understood, but it is known to govern the internal 'clock' that regulates the secretion of a number of hormones, and to regulate sleep and wakefulness. The amount of melatonin produced can change with altered day length, which may be the reason why light therapy is beneficial in seasonal affective disorder (SAD). Melatonin supplements may improve the symptoms of jet lag. Chronic use of melatonin can cause depression. Dosae should be from 0.5 to 3.0mg and taken at bedtime. Government regulation of melatonin supplements varies from country to country.

ALTERATION OF MOOD: ANXIETY AND DEPRESSION

From around 50+, anxiety and persistent negative thoughts about the ageing process can be a problem. Fear of ageing is contagious and is made worse, particularly for women, by the current emphasis on physical appearance and the cult of youth. These may make you reluctant to go to the cinema, theatre or restaurants that are popular with younger people. If you experience such problems then there are options. Psychotherapy can be useful for individuals if they think that their unhappiness is due to painful childhood or adult experiences. Cognitive therapy, which teaches you to substitute positive thoughts and outlook for negative ones, is a great way to learn how to be optimistic.

Depressive Illness
This is less common in the fifth and sixth decades than at other times of life. Depression is not the same as bereavement and grief, which are normal reactions of distress and sorrow resulting from loss of a loved one or a cherished and important aspect of life. In general, these feelings resolve with time, but if, as occasionally happens, they persist and result in depression, then professional help should be sought.

Worry
Some people are born worries while others find that at 50+ they start to worry more than they previously did. A good way to counter this is to think about all the things that you have worried about in the past but which never happened - or if they did happen, how you rose to the occasion and overcame them. Most worrying is unnecessary, and it is important not to waste time and effort over things that you cannot influence or change.

Grow A Little Optimism
Unlike stress management, which is a way of dealing with problems as they arise, optimism is a more fundamental attitude to life that you may or may not be born with. But, as experts have discovered, optimism can be cultivated and this is worth tryig because optimists have a better quality of life and live longer, even when they have the illnesses as pessimists.

Think, Speak And Act Optimistically
This may seem a bit phony when pessimism is your natural inclination, but if you persist a more optimistic frame of mind will grow because we can influence the way we feel by acting as we would like to feel. In fact, neuroscientists cannot tell the difference in brain activity between people who are genuinely sad and people who make themselves think sad thoughts. If you act optimistically you will find yourself:

• Actively planning the best way to deal with your problems.
• Asking for advice when you need it, and trusting that you will obtain it.
• Getting help if you need it by asking your doctor for a referral to a therapist or for a medication that can make you ffel better so you can pursue psychotherapy or cognitive therapy.
• Accepting that something upsetting has happened, rather than denying it.
• Trying to learn from distressing experiences.
• Replacing the tendency to worry by saving your energy to deal with real crisis as they occur.

Talking To Yourself And Listening To What You say!
We all talk to ourselves all the time. We anticipate what will happen, or how things will turn out if we take alternative courses of action. It takes a little discipline to monitor these conversations and inject some positive thoughts, such as good advice we may have been given. Even if you have had a bad days, you can always forgive yourself and plan to do better tomorrow rather than bemoaning your failure.

EXERCISING YOUR MEMORY

Memory is one aspect of brain function that often becomes less efficient with age. This appears to be partly because the memory holds so much more than in younger years and partly because older people can experience problems in transferring information between short-term memory and long-term memory.

The 'memory pill' may be invented one day, but until then your memory can be improved by exercising it regularly. The following exercises may seem tedious, but they can make a real difference.

Remembering Names
Listen carefully to a name when you are introduced to someone or hear it on the telephone. Repeat the name to yourself several times, leaving an increasingly long gap between each repetition. Try to find a familiar 'hook' to fix the name in your memory. Whenever possible, try to associate each 'hook' with a mental image.

Try to create a pattern. This may not always be immediately obvious, but the longer you try, the more likely you are to remember them anyway. Elderly people, in one study, were able to remember up to 40+ or more digits after 30 training sessions. Some people remember telephone numbers better by grouping them in two, for example 34, 67, 68 may be easier than 346768.

Remembering What You Have Read
If you wish to remember something that you have read, think about it for a few minutes, and make a brief mental summary. Think of some questions about the topic and re-read the text again, checking the answers against your questions. Use other parts of your brain by talking aloud about the subject, either to yourself or to someone else, and by writing a brief summary. Repeat the exercise a couple of days later, recalling the subject matter from your memory.

Losing Things And Forgetting Things
Allocate a place to keep things - like keys - that you use every day. Try to make a habit of putting possessions away in their assigned places. If you change these places, such as after tidying a cupboard or drawer, write a list to remind yourself of the new locations. Whenever you go out or leave someone else's house, make a habit of checking that you have everything you need. When you are shopping, make a mental note of the number of items you are carrying. If you lose something, pause for a minute and try to visualize where or when you last used it.

Make Lists
Do not overburden your memory unnecessarily. It is often better to write down a list of what has to be done and cross off items as you do them. Add jobs as you think of them. You are likely to achieve more by doing one at a time, unless it is one of those complex tasks that you have done so often that it is recorded in the memory as a single sequence. When you have an idea, or think of something you want to tell someone, write it down.

Every Little Bit Helps.....

• Try not to get upset when your memory is having a hiccup. Relax! Given time you will often eventually remember what you had forgotten.
• Always eat breakfast. Breakfast boosts the mental function, especially when it contains some protein and fat.
• Exercise regularly, stand and sit erect: these help to boost the blood supply to the brain.

THE BRAIN: USE IT OR LOSE IT

Energy may be in increasingly short supply as we get older. This is entirely natural, but to keep your brain at its peak it is important to try to maintain your skills and interests and even to develop new ones. All the skills you have acquired remain stored in the brain, but retrieving them becomes increasingly difficult the longer they are left unused. As you learn a skill for the first time, circuits are established in the brain and the ability to perform it is maintained and enhanced with use.

Maintaining skills and interests takes a little time, but through regular practice you can avoid losing them altogether.

Take some risks in your life and do not be afraid to try new ventures.

Maintaing A Sharp Mind

• Challenge yourself: don't just accept other people's opinion if you believe they are misconceived or illogical. Challenge them by issuing your own opinion.
• Add and subtract mentally, checking with a calculator if you must. Play card games, do crosswords and play other word games.
• Plan one project at a time: mature minds work better this way.
• Avoid negative criticism, both of yourself and of others. Avoid developing a habitually negative attitude by cultivating ways of encouraging both yourself and other people to look positively at situations and events.
• Avoid striving for impossibly high standards. Try to enjoy what you are doing. Remember, you can derive pleasure from playing a game even if you don't win.
• Seek out new experiences. Make plans to visit new places and make the most of your visit by reading about them in advancve. Keep a diary or write an account of your visit later when you get home: re-reading it will refresh your memories.
• Long-term friendships can be a great boon at 50+, but it is also very important to make new friends.
• Take some risks. You may fail from time to time, but you will gain from the experience.

Long-term friendships can be great, but it is a mistake not to make new friends, too.

Learning New Things
At 50+ reaction time, memory, learning ability, problem solving and decision making may slow down. However, this simply reflects the fact that, if your brain is healthy, it processes, stores and uses informatiuon in different ways than it previously did, and this may alter the way you do things. It is known that large numbers of brain cells are lost during a lifetime, but these have been likened to the spare marble that is discarded during the carving of a statue. In the brain, the complex connections between the cells are more important than the existence of large numbers of cells, and these connections thrive on frequent stimulation. At least one scientific study has demonstrated that mental function can improve between the ages of 65 and 75. It is possible that new brain cells, and therefore new connections, may develop in older people: this is known to occur in some animals.

It has also shown that older people can learn a new language or to play a musical instrument as effectively as younger people. But the way in which matrial is learned differs. Older brains appear to lump information together in chunks, and this may reflect techniques acquired from previous experience of learning new material. But experience can also be useful in other ways. Another study showed that the speeds at which older typists completed a task were roughly the same as those of young, competent college graduates. However, closer analysis revealed that the typing speeds of the older typists were slower, but that they compensated for this by using some timesaving strategies that they had developed over the years.

Experience Yields Better Judgement
At 50+ decisions may take longer because the brain has a greater body of experience to sort through before a reasonable decision can be made. This same experience of life also leads older people to seek adequate time in which to consider a situation or come to a conclusion rather than trusting blindly that everything will go well. In general, older people are safer drivers, but they can cause hazardous situations if they drive too slowly, and they are more prone to loss of concentration. Older drivers should allow time for breaks more frequently than when they were younger.

Brains And Oxygen
Physical exercise is another way to keep the brain working well. The circulation of blood to the brain may not be as efficient as it once was, but it can be improved with regular exercise. Indeed, the physical and mental reaction times in older people who have remained physically active have been measured and shown to be comparable to people many years younger.

Alzheimer's Disease
Alzheimer's disease is probably the most feared of all brain diseases. People dread its onset because of the resulting loss of independence and dignity. Families dread the isolation and burden of caring for a loved one who has loss of memory, disorientation, paranoia and hallucinations.

Can Alzheimer's Disease Be Avoided?
We still know too little about Azheimer's disease to be able to avert it. However, once you have passed 40 or so, there is little likelihood that you will develop the relatively rare inherited forms of the disease that start at a young age, and there is then little reason to examine your family history with dread.

Here are some simple steps you can take that may reduce the likelihood of developing Alzheimer's disease in later years:

• Get regular physical exercises.
• Take measures to avoid repeated head injury.
• Maintain lifelong learning and mental exercise: these keep the brain connections active and, just possibly, may stimulate the production of more brain cells.
• Take positive measures to manage stress.
• Eat well, including plenty of antioxidants, such as vitamin E.
• Keep up-to-date with research in medication and alternative therapies. Possible medication includes oestrogen and phyto-oestrogens, ibuprofen and Ginkgo biloba.

Brain tissue showing Alzheimer's disease.

Ginkgo Biloba
The world's oldest tree species, Ginkgo biloba, survived the ice Ages in China, where its leaves have been used in traditional Chinese medicine for nearly 5,000 years. Improved circulation and brain function are included among its medicinal properties. It appears to help prevent and treat Alzheimer's disease, but research is continuing. Ginkgo biloba seems to be very safe, but you should consult your doctor before taking it if you are also prescribed medication, especially for high blood pressure. An average dose cannot be recommended because each brand has greatly varying concentrations of the active ingredients. Look for products that are standardized to contain 22-27 per cent flavone glycosides and 5-7 per cent terpene lactones.

THE STRESS ENIGMA

Stress levels are difficult to balance: too much stress can make you ill; too little and you may become 'old' in the sense. Neuroscientists believe that if you overreact to external pressures you are not likely to live as long and may even increase the risk of diseases of the brain and nervous system, including Alzheimer's disease. In addition, if you overreact to stress in your life this can impact on your social life, often through fear of behaving in an appropriate way to stressful situations. A reduction in social contacts can provoke feelings of isolation,depression and failure, which may impair the immune system function and increse the risk of infection or the development of cancer.

On the other hand, many people think they are stressed when, in fact, they have depression or an anxiety or a sleep disorder. Furthermore, there can be physical causes of stress or anxiety, such as hypo or hyperthyrodism, anaemia or vitamin B12 deficiency. If you feel particularly stressed, you should see a doctor for evaluation and possible treatment.

Reaction To Stress
Reacting to stress in a way that you are comfortable with will usually include taking steps to learn about and practice relaxation. It can also mean taking charge of your life in ways that reduce the causes of your stress.


Creating Inner Calm

Because all stress cannot be eliminated, learning to calm the mind and body is an essential way of making stress harmless. A healthy person routinely relaxes by sleeping, by reading a book, by watching an interesting film or by taking exercise. Unfortunately, when you overreact to stress you may find that simply keeping still is almost impossible. In this case, you have to deliberately create an inner calm.

Learn to relax. This helps to balance the nervous system so that the sympathetic nervous system, which is designed to respond to danger, is in balance with the parasympathetic nervous system, which is designed to repair the body and maintain normal bodily functions. Relaxation needs regular practice, ideally 5-10 minutes or longer each day. Many techniques are available, including meditation, prayer and self-hypnosis, but if you are a beginner you could try breathing from your diaphragm.








Relax By Breathing From Your Diaphragm

• Sit or lie down somewhere quiet and comfortable, with your feet slightly apart. Place one hand on your chest and one on your abdomen.
• Breathe in through your nose and out through your mouth without raising your shoulders. Notice how your hands are moving.
• After a few breaths empty your lungs without straining, and then breathe in slowly through your nose to a count of four. Keeping your shoulders and chest still, push out your abdomen so that your hand moves out by about 2.5cm (1inch). Imagine the air you are breathing in is warm and that this warmth is being carried to all parts of your body.
• Pause for a count of four, and then breathe out through your mouth to a count of four. At the same time, imagine that all your feelings of anxiety and stress are leaving your body with the air you exhale. Allow your abdomen to move back to its original position.
• Repeat the process several times, aiming to feel calmer with each breath. When you are very stressed try this exercise two or three times a day. Do not worry if you do not achieve complete relaxation each time, it will come with practice. The important thing is to keep trying.

Eating For Relaxation
Eating regular meals in a relaxed environment can contribute to a feeling of calm. Meals should be based on the Optimum Diet, with a limited intake of caffeine and alcohol. Reduce the amount of salt you eat and increase your potassium intake by eating plenty of fresh produce. Avoid sugars and refined carbohydrates as stress can be increased when the level of sugar in the blood is poorly controlled.

You may also be helped by taking steps to reduce food intolerance and irritable bowel symptoms.

Take Charge Of Your Life
Lifestyle changes can radically reduce the amount of stress that you face each day. This means making choices about your life, about what you want to achieve for yourself and how you can best do this.

• Take charge of time: make lists and decide on priorities. Let go things you cannot control and make positive decisions. Perhaps limit the amount of time you are available to others on the telephone, fax machine or by e-mail.
• Adjust your pace: a sense of hurry left over from a busy life may not need to be continued.
• Learn from children: they don't hurry unless it suits them.
• Consider moving to a smaller house or flat if your are not enjoying the time needed to maintain your house and garden.
• Take frequent breaks, and adjust the balance between work and recreation. Take time out for music, reading, meditation, sitting and thinking or communing with nature, and practise relaxation.
• Plan regular holidays and use these to explore new places, even if they are only local and near your home.
• Take regular exercise: this can greatly reduce muscular tension and often improves sleep.
• Be adaptable: it is easy to get into a rut. Try new ideas or different forms of exercise. Do things for other people.
• Make a place for laughter in your life: rent an amusing video or read a comic book. Laughing is one way to lessen pain, and it is known to reduce the production of adrenaline, which causes anxiety, and to boost the immune system.
• Reduce the chemical stimulants and depressants that you consume, such as coffee, alcohol, tobacco and other drugs.
• Share your problems, and listen to other people's problems, but avoid becoming a bore: if necessary, find a professional listener, such as counsellor.
• Tune into your body: if your head aches or you feel anxious, try discover why, and then deal with the cause.
  
  
  
  
  

Make a place for laughter in your life.

PLANNING FOR RETIREMENT

Today, although life expectancy has increased dramatically, there is a move away feom the idea that everyone should retire at a predetermined age. There are people still working full-time at 80+, but others in their 50s, who are still fit and well, are faced with redundancy or are forced into early retirement. Unless they can find other suitably remunerative jobs, this reduces their ability to provide for their later years.

Ideally, of course, planning for your retirement should start well before the age of 50+, but the increase in life expectancy means that many pension plans that were originated 10 or 20 years earlier are now likely to prove inadequate. Many of those who are fortunate enough to still be employed should therefore seek to pay more into their pension fund abd delay drawing on it. This is particularly important for many of the baby-boomer generation who have live through relatively prosperous times and who do not wish to have to change their lifestyles. But others may feel the time has come to live more simply and economically.

Money is important, but so is the need to avoid becoming 'old' too early. An increasing number of people are saying 'never retire'. This, of course, does not mean that you should continue with the daily grind of commuting to an unfulfilling job when there is no financial need to do so. Retirement may be an opportunity for a total change of direction. This can include working part-time, doing voluntary work, taking up a half-forgotten educational challenge or fulfilling ambitions that have been set aside in the face of commitments to work, financial stresses, parenting or coping with the problems of divorce.

New-Look Enterprises
Find a way to use your skills: as an older person you have much skill and experience to offer. You may choose to apply these in a formal position, such as a part-time consultancy or voluntary work. Traditional craft skills, such as sewing, knitting, woodwork or gardening, can be put to good use in many ways.

Learn new skills: you may have missed out college education, or simply studied the wrong subjects. Now could be a good time to fulfil those educational ambitions that had to be set aside. Learning does not have to be academic; try:

• Becoming computer-literate, keeping in touch with your grand-children by e-mail.
• Attend cooking classes or financial management classes.
• Learning self-defence.
• Taking up a craft or hobby, such as book binding, painting or needlework, or learning to play a musical instrument etc.

LIFESTYLE CHANGES

How do you feel influences how you look. A positive approach to life and good health radiate through your face and behaviour. At 50+ you may have lost your youth, but a mature appearance can be no less attractive - and is only enhanced by the wisdom gained from living.

THE WISDOM YEARS
Members of the baby-boomer generation, born after the Second World War, are now in their 50s. During their lives they have experiences radical changes in behaviour, attitudes and fashion, and many of them are more ambitious than their predecessors were at 50+. Actor Jack Nicholson at 55 said, ' Our parents' generation was ancient at our age, past it. We are more active, we take care of ourselves. We're the new old.'

For many people, being 50+ can be the best time of their lives. There is now less likelihood of becoming disabled: between 1980 and 1994 a 15 per cent drop in the level of disability was reported. Some firms are actively recruiting older workers because they find them more reliable than younger employees. In addition, increasing life expectancy is leading to greater pressure for the introduction of legislation against age discrimination

There is also now a sider choice of what to do at 50+. Finances are often less strained as children become independent and mortgages are nearly or completely paid off. More recreational and educational pursuits are available than there were for previous generations, and for many people there is a greater choice about the best age to retire.

Despite all these beneficial changes, it is not easy to shake off outdated ideas about growing old. This is partly because, at 50+, most people think back to what lfe was like for their grandparents' generation. Today many people ho are over 70 are living far more active lives than their parents did at the same age, and the majority of people in their 60s and 70s are happy, contented, active and fit. All the same , it is still common for old people to be categorized as lonely and poor. Some are, but loneliness and poverty can happen at any age.

There is also persistent belief that a midlife crisis is inevitable at 50+. In fact, such crisis are not particularly common and are far more likely to afflict people who have previously had to deal with emotional turmoil earlier in their lives. People who are naturally optimistic are less likely to undergo these crisis, but optimism can be acquired, even if it is for the first time.

Ageing And Becoming Old Are Not The Same Thing
We have no control over the passage of time. Each year we mark the day when we change the number that describes our age. In childhood, increasing age as a positive thing: birthdays marked steps towards independence, the first job, the first love affair and the first everything else.

We can truly be said to be old when life is no longer perceived as a journey into new territory. Loss of interest in living, belief that things can no longer be changed or that too much is changing, the feeling that life does not matter and that nothing exciting can ever happen again are signs of becoming old. However, they can also be signs of depression and, like any illness, this should be treated.

Even though there may be some decline in physical and mental capabilities, the people who are the least 'old' at 80+ are full of plans, and as involved as ever in whatever aspect of life interests them, whether this is socializing with friends, politics, the arts or advances in science. The goals they set themselves may have changed, but they continue to make commitments to themselves to others.

Many companies recruit older workers because they are considered more reliable than younger employees.

ALLERGY: THE IMMUNE SYSTEM IN OVERDRIVE

Allergies are best regarded as abnormally excessive reactions to otherwise harmless substances. However, allergies are becoming much more common for reasons that are not well understood. The orthodox approach to allergies is to suppress the symptoms with anti-histamine or steroid-based medication, but these can cause side effects, so many people turn to natural therapies for help. Homeopathy and herbal remedies are very often effective treatments for hayfever, house dust allergy and skin reactions to food, such as 'hives' (urticaria).

Prevention is another approach. One way to avoid the substances, known as allergens, to which you overact. This can be difficult when the allergens that affect you are numerous or have not been identified with certainty.

Preventing Allergies
Some doctors believe that you can benefit from even a modest reduction in exposure to the allergens that affect you, especially when this reduction is coupled with other lifestyle improvements, such as:

• Eating Optimum Diet, to keep your immune system healthy and working effectively.
• Avoiding the chemicals that are added to food and minimizing your exposure to other chemicals. In this way the burden on the immune system is reduced, so it is better to react normally to other substances and avoid allergic reactions.
• Paying attention to psychological health, as there is a growing awareness among scientists that our emotional and immune system are closely connected.

A healthy diet should include 3-5 portions of vegetables and 2-4 portions of fruit each day.

Food Allergy
True food allergies are normally lifelong reactions to a particular food. The food are usually easily identified and can be avoided. Allergic reactions to food include digestive upsets, a runny nose and watery eyes and the itchy rashes that are sometimes known as 'hives' or urticaria.

More seriously, food is one cause of a condition that doctors called anaphylaxis. This is a potentially life-threatening reaction that ofen starts with swelling around the mouth and throat, but also affects the whole body. It can be fatal if not treated urgently with medicine. Any swelling around your mouth after eating, or a serious reaction to an insect bite or sting. merits a consultation with your doctor.

Food Intolerance
Food intolerance is a more controversial subject than food allergy. The symptoms include a rapid heartbeat or sudden exhaustion after eating, painful joints and digestive discomfort, and generally feeling unwell. Many people refer to these reactions as 'allergies', but doctors usually disagree because the underlying causes remain unknown and may not even involve the immune system.

Food intolerance often results from food that are eaten every day, such as wheat and cow's milk. Finding alternatives to these common food for two or three days each week may help to reduce the risk of developing intolerance. For example, wheat can be replaced by rye, barley, rice, corn or other sources of starch, such as beans or root vegetables. Cow's milk can be replaced with soya or nut milk, or milk from another animal such as a goat or sheep. Many people find that the food which upset them change over time and it is often possible to reintroduce the offending food after they have beeen excluded fo a while. However, it is best then to avoid eating these more often than twice a week.

Excluding a wide range of suspect food from the diet can cause nutritional deficiencies and sadly, there have been some deaths from malnutrition when a strict exclusion diet has been followed unwisely. It is, therefore, essential before changing your diet to seek guidance from a qualified health professional with a special interest in allergic illnesses, especially if you seem to be intolerant of several food. Doctors who practise environmental medicine recommend minimizing the risk of developing food intolerance by eating fresh food in season and eating as wide range of different food as possible.

CANCER AWARENESS

Although cancer can have specific and known causes, such as cigarette smoke or exposure to high doses of radiation, the majority of cancer are likely to result from a series of complex factors, many of which are poorly understood. A tendency to cancer can be inherited, but a strong family history of the disease is merely one factor among many, including being 50+, that should spur the active avoidance of carcinogens and a nurturing of the immune system.

Give your immune system a rest by minimizing exposure to cigarette smoke, which is associated with nearly all lung cancer, as well as some cancer in the upper digestive system, pancreas and bladder. Also ty to reduce your exposure to other potentially harmful chemicals.


Overexposure to the sun causes most types of skin cancer and we are now advised to protect our skins by applying sunblocking creams and sitting under the shade. Unfortunately these creams interfere with the production of vitamin D in the skin. It has been calculated that in latitudes you can overcome the problem by exposing the skin of your forearm, without sunblock, to summer sun in the middle of the day for about 15 minutes. During the winter, at the same latitude, the sun is never strong enough to produce vitamin D in the skin and you will have to rely on dietary sources, or take a supplement.

Malignant melanoma is a particularly dangerous type of skin cancer.

The Cancer Awareness Diet
The particular features of the Optimum Diet that may help to reduce your risk of developing specific cancers are :

• Eating 3-5 servings of vegetables and 2-4 servings of fruit every day may reduce the risk of cancer of the digestive system and, in women, of breast cancer. It is thought that vegetables of the cabbage family, such as broccoli, Brussels sprouts, kale, bok choy, mustard greens, kohlrabi and turnips, are particularly beneficial. Other valuable vegetables are lettuce (especially the dark green varieties), spinach and parsnips.
• Limiting the amount of red and processed meat that you eat to about 90g (3oz) per day on average. This level is thought to reduce the risk of cancer of the rectum and colon, without your losing out on iron and the other essential minerals that are present in meat.
• Limiting or avoiding smoked, salt-cured, pickled, fried and barbecued food. These methods of treating food introduce chemicals, which, if eaten in excess, may increase cancer risks.
• Avoiding obesity. This is associated with an increased risk of breast and womb cancer, and possibly also some intestinal cancer.
• Increasing the fibre in your diet. This may reduce the risk of cancer of the rectum, colon, breast and possibly, the pancreas. Try to obtain fibre from eating a variety of fruits, vegetables, pulses and wholegrain cereals, rather than by adding fibre supplements, which may reduce the absorption of minerals. Nuts and seeds are rich in fibre, but high in calories, although the fat they contain is mostly unsaturated.

Over exposure to the sun causes most skin cancer

INFECTIONS OLD AND NEW

Mankind has always suffered from infections. In the past couple of centuries, however, there have been triumphs over infectious diseases. These include the eradication of smallpox and in developed countries, at least, improvements in hygiene, and the introduction of various vaccine and more effective drugs. We are also gaining a better understanding of how much to nourish and bolster our immune systems. As a result more people are surviving into old age.

But it would be a mistake to become complacent. Researchers have known for several decades that microbes can mutate, and we are often now faced with bacteria that are resistant to current antibiotics. Old problems thought to have been largely overcome, such as tuberculosis, are returning, and new problems, such as acquired immune deficiency syndrome (AIDS), have emerged. The full name for AIDS is a chilling reminder that a virus can somehow learn to undermine the immune system.

The Yeast Syndrome and Immune Suppression
In the 1990s, some doctors began to recognise that a pattern of symptoms was occurring among patients who received either frequent or prolonged treatment with antibiotics. The symptoms include various degrees of fatigue, headaches, memory problems, allergies and other disorders of the immune system, depression and an aversion to cigarette smoke and other chemicals, such as perfumes and household cleaning agents. Digestive disturbances that also often occur irritable bowel syndrome, bloating and intolerance of certain food.

It has been assumed that the symptoms of this condition, which has been labelled the 'yeast syndrome', are caused by an excessive amount of Candida Albicans in the digestive system. Unfortunately, there is as yet no scientific proof to support this assumption, and some doctors prefer to use the term 'fungal-type gut dysbiosis', which means an intestinal dysfunction caused by a yeast.

The yeast syndrome may be one cause of a 'leaky gut', which allows the absorption of inadequately digested protein. Because these are foreign protein they stimulate the immune system into action, and divert it from tackling chronic infections, such as recurrent sore throat, herpes infections (cold sores) and fungal infections of the skin, like athlete's foot and ringworm.

Because the diagnosis of yeast syndrome remains controversial within the medical profession, getting advice is not always easy. If you think that you suffer from the yeast syndrome it is important to consult someone who is properly qualified, such as doctor, naturopath or nutritional therapist, before embarking on treatment. The strict dietary restrictions that may be involved can themselves cause ill health.



Reducing The Chances Of Developing Yeast Syndrome
- Avoid antibiotic and steroid medicines, unless they are absolutely necessary.

- Adopt the Optimum Diet and be sure to include plently of garlic and yoghurt.

- Avoid refined sugar and lilmit the amount of fruit juice that you drink.

We can now combat infectious diseases more effectively, so more people are surviving into old age.

Candida Albicans
This yeast, which lives in the intestine (and the vagina in women), is normally quite harmless. However, like many microbes it can cause infection if it becomes too widespread, as has long been known to happen when the immune system has been damaged by diseases, such as cancer, or by certain drugs, such as steroids.

Many doctors have found difficulty in accepting that Candida can be responsible for the yeast syndrome, which usually occurs in people without serious illness and who have not been taking drugs known to suppress the immune system. All the same, treatment can transform the quality of life for some people.

BREAKING HABITS AND ADDICTIONS

Tobacco smoke contains not only at least 50 substances that can cause cancer, but also thousands of other chemicals that are known to damage the heart and circulation. Therefore the biggest boost you can give your immune system is to stop smoking and avoid the company of those who still do.

Smoking is an addictive habit and, as with all addictions, stopping is not easy, but it can be done. Millions of people have stopped, and the scientific evidence suggests that 'just stopping' is the most successful method. If you have been a heavy smoker, however, it is probably wise to cut down gradually over a few days or weeks, or to use patches or chewing gum that contains nicotaine for a few weeks.

The following tips might help you to quit smoking:

• Write down your reasons for not smoking, and read the list every day.
• Set the day and tell your friends! Don't make quitting more difficult than necessary by choosing a day when temptation will be high, such as the day of a party.
• The night before you intend to stop, throw away any unsmoked cigarettes, empty the asthrays and air out the house well.
• Plan subsitutes: have raw vegetable sticks already prepared in the refrigerator to occupy your hands and mouth when you have an urge to smoke.
• Try deep breathing exercises, or go for a walk when you have the urge to light up.
• Take one day at a time: the urge to smoke will eventually leave you.
• Join a support group.
• For a few weeks at least, avoid situations that you associate with smoking.
• Put aside the money you save by not buying cigarettes and spend it on something pleasurable, but try to avoid high-calorie rewards.

Alcohol
Alcohol is a toxic substance that can suppress the immune system in a number of ways - not least by diverting the liver, which detoxifies alcohol as a priority, from some of its other tasks. The presence of alcohol in the body can reduce the effectiveness of some of the specialist cells of the immune system, causing drinkers to be more prone to infections than non-drinkers. Direct contact with alcohol can damage the cells that line the mouth, gullet and stomach, increasing the risk of developing cancers in these areas. In the intestine, the presence of alcohol can interfere with the absorption of nutrients, which are important for the function of the immune system.

One Unit Of Alcohol Equals:
1 glass of table wine
1 small glass of sherry
Half pint of beer or cider
A single measure of spirits

Aids To Safe Drinking

• Limit your intake of alcohol to two units a day for women and three units for men, and aim to have two alcohol-free days a week.
• Quench your thirst with a non-alcoholic drink.
• Dilute your drink with a mixer.
• Keep down the level of alcohol in your blood: delay its absorption by eating low-salt carbohydrates, such as bread or raw vegetable sticks, cheese or olives.
• If you have drunk too much alcohol, take some vitamin C and a B-complex vitamin supplement and drink plenty of water before going to bed.
• Never replace a meal with alcohol.
• If you feel that you cannot do without alcohol, you may have an alcohol problem and should consider seeking professional advice.
  

Reduce your alcohol intake by drinking non-alcoholic drinks or diluting your drinks with a mixer.

THE IMMUNE SYSTEM

A major task of the immune system is to protect the body from infections caused by bacteria, viruses, fungi and other microbes. The first lines of defence are the skin and the mucous membranes lining the nose, mouth, digestive system and other parts of the body. Additional protection is provided by chemicals contained in the mucus and other secretions, such as saliva and tears.

Additional defences are mobilized once a microbe has entered the body. These defences include the white blood cells, antibodies and chemicals that act as messengers to alert and control the immune system. These immune system components have the ability to distinguish between the cells of the body that they defend and the cells of invading microbes, which contain foreign proteins that have to be destroyed. The immune system is also able to 'remember' certain infections, such as those from the viruses causing measles or mumps. The antibody response when the same virus is met again is therefore very quick, so a second illness is normally prevented.

The proteins in food are also foreign proteins, but the digestive system breaks them down into their building blocks, the amino acids. In a healthy person these are absorbed either individually or in small groups, so that the immune system is not usually triggered into action.

In addition, when digested food is absorbed into the bloodstream it is transported to the liver, where any harmful substances that have survived the digestive process are detoxified, before the nutrients are released into the rest of the circulation.

As part of he body's internal repair and maintenance capacity, the immune system also provides protection by removing ageing or damaged cells from the body before they can do harm. These include potentially cancerous cells that may have been damaged by free radicals, or cells that have resulted from imperfect cell division.

Loving Your Liver
The liver plays a major role in both the immune system and the process of detoxification. Almost two quarts of blood pass through the liver every minute, and it filters out bacteria, viruses, dead cells, cancer cells and other foreign and dangerous particles. It also breaks down chemicals, including drugs and pesticides, that have entered the body and which may cause damage. In a healthy person, the liver performs these functions efficiently, but it can become overwhelmed, especially if it has been damaged, for example, by alcohol.



Clinical Ecology
Today, it is generally accepted that gross chemical contamination is harmful, but the effecs of eposure to chemicals at low levels remain controversial. Clinical ecologists use the term chemical sensitivity to describe the adverse reaction that some individuals appear to experience when exposed, even at a very low level, to toxic chemicals. Although some of these reactions are true allergies, many of them result from the failure of the body to detoxify harmful chemicals. In practical terms, however, the symptoms are often similar, as are the measures that will provide protection.

Alcohol abuse can cause your liver to work inefficiently; or even to cease functioning.

Strengthening The Immune System
At 50+ the immune system is likely to have sustained some damage from illness, exposure to pollution and from deficiencies in the diet. There is also increasing evidence that both physical and mental stress can suppress the effectiveness of the immune system. However, the body has a great capacity to heal itself, and you can support this process by reducing stress, by taking regular exercise and by ensuring you get adequate rest: try to sleep for at least seven hours at night.

Nourishing the body, and therefore the immune system, can be achieved if you follow the guidelines for the Optimum Diet (see previous post), paying particular attention to the following:

• Eat ample vegetables, especially greens.
• Keep added chemicals, including salt, to a minimum and avoid unnecessary medication. Choose organic produce when possible.
• Eat regularly, and make sure that you are obtaining enough protein, as this is needed for the repair and replacement of the components of the immune system.
• Avoid being overweight as this can suppress the immune system.
• If you choose to drink alcohol, do so in moderation and stop smoking.

Coenzyme Q10
This enzyme, which occurs naturally in the human body, supports the immune system by enhancing the body's ability to protect itself from many conditions, including heart diseases, and from some of the effects of prescribed medications. Unfortunately, the amount produced tends to decline with advancing age just at the time that it is most needed. A good diet helps the body to manufacture coenzyme Q10, but higher doses are often recommended and you should seek professional advice if you are uncertain.

Ensuring A Low-Toxin Environment
You may believe that your home is a safe place in which to live, and that in your work environment the law protects you from exposure to harmful chemicals. Yet neither may be true. Conditions reportedly resulting from contact with indoor pollution include asthma, chronic sinus infections, headaches, insomnia, anxiety, fatigue and joint pain. In the 50+ age group, many of these conditions are attributed to getting older, and yet they may be totally avoidable.

Tips For Detoxifying Your Home

• Air your home every day by opening your windows for 15 to 20 minutes once or twice a day, and decrease the use of chemicals: indoor pollutants include paints, cleaning agents, solvents, dyes, glues and household sprays.
• Avoid buying carpets treated with fungicides and permanent stain-resistant chemicals.
• Have your gas appliances and boiler or furnace serviced regularly, and if you have an open fire keep the chimney swept. Avoid portable oil and gas heaters.
• Reduce your use of pesticides both inside the house and in the garden.
• Avoid wearing outdoor shoes in the house because they will track in pesticides and other chemicals.
• Avoid added chemicals in food; eat organic produce when possible and consider using a water filter.
• Hang new and recently dry-cleaned clothes in the fresh air for a few hours, so that any chemicals remaining in the fabrics have a chance to disperse.
• Choose solid wood furniture, or seal composite bonded materials with a low-toxicity sealant.

After gardening, remove your shoes before entering the house.

A HEALTHY IMMUNE SYSTEM

A healthy immune system protects the body against infections, allergies and the development of cancer. There is growing evidence that the immune system can play a major role in preventing, or at least minimizing, a number of other ailments, such as arthritis and some heart conditions. At 50+, therefore, nurturing the immune system should be a priority if you wish to remain healthy.

TAKE FIVE MINUTES

If you sit at a desk for long periods or are confined to a chair at home, try the following gentle exercises to stretch your muscles. If you have severe arthritis or osteoporosis ask your doctor if the exercises are safe for you before you begin. Initially do the exercises once a day, but as you become stronger, repeat each exercise more often and hold the positions for longer.

The Exercises
Arms

• Keeping your back straight, shrug your shoulders and then roll them around to the back, then down, then forward, and rest. Repeat the exercise moving in the reverse direction.
• Hold your right arm straight out to the side with your palm downward. Bend your right elbow and bring your hand around until it is just below your chin. Reach out to the side again. Repeat once. Do the same exercise with the left arm.
• Stretch your right arm forward, level with your shoulder, palm upward, and then bend the elbow and lightly touch your right shoulder. Straighten your arm and repeat once. Do the same exercise with your left arm.
• Tuck your elbows into your sides with the palms facing each other, and then bend your wrists so that the tips of the fingers almost touch. Repeat twice. Then move your hands around in circles one way, then the other.
  

Trunk
If you have had a hip replacement or have osteoporosis of the spine ask your doctor or physiotherapist if these exercises are suitable before you try them.

• Place your hands on your hips, turn from your waist to look towards the right, hold for 2-3 seconds, relax and turn to the left. Repeat.
• Face forward with your hands in your lap. Keeping your back straight, rotate your trunk clockwise twice. Pause, then repeat the exercise in a counterclockwise direction.
  

Legs

• Sit upright as far back on the chair as possible. Straighten your right leg. If necessary, support yourself by holding the sides of the chair. After holding the position for 2-3 seconds, replace your foot on the floor. Do the same on the left, and then repeat once.
• Sit with both your feet flat on the floor, then lift the heel of your right foot. After holding the position for 2-3 seconds, place the heel back on the floor. Do the exercise with the left foot. Repeat once. Then lift the front of the right foot, leaving the heel on the floor and stretching your toes. Hold this for 2-3 seconds before putting your toes back on the floor. Do the same with the other foot. Repeat once.
• Still sitting, cross your legs, right over left, and move the right foot to make a circle first clockwise, then counterclockwise. Repeat with the left foot.
  Do not attempt this exercise if you have had a hip replacement operation.
  

Neck
Start and finish each exercise looking straight ahead.

• Lower your chin as far as it will go comfortably, then lift it gently back again. Do not bend your head backward. Allow your head to nod gently up and down two or three times.
• Turn your head to the right as far as it will comfortably go and then to the left, and return to the starting position. Repeat twice.
• Drop your head sideways gently towards your right shoulder, and then towards your left shoulder. Keep your shoulders relaxed. Repeat twice.
  

EXERCISE: ALMOST EVERYONE CAN WALK

Walking is often the most convenient way to begin getting more exercise. Almost everyone can walk and you can start with a very gentle programme. If there is no convenient circular route for your home, just walk for half your alloted time before turning around and returning home again. Walking costs nothing and can be introduced gradually into anyone's daily activity. Best of all, perhaps, walking can reduce stress, because just the rhythm of putting one foot in front of the other is relaxing.

It is important to walk briskly enough to increase your heart rate. However, if you have been very sedentary or are overweight you may find that your heart rate is increased even when you are walking slowly. Do not be discouraged; just give yourself time.

Seven Ways To Walk More

• Get off your bus one stop early, or park a little way from the office, and walk the rest of the way to work.
• Use the stairs rather than the lift or escalator. Start off by walking down, and when your legs are stronger, start walking up as well.
• Don't use the car for short trips, such as going to the local shop or posting a letter.
• Fit a walk into your lunch hour.
• If you don't own a dog, offer to exercise a friend's dog.
• Encourage a routine of family walks during the weekend.
• Choose a time of day that rewards you. Some people like the early morning; others find they sleep better after an evening walk.

Safety
If you walking at night, walk facing the traffic and wear light-coloured clothing, preferably with reflective stripes.

EXERCISE: ENERGY AND DIET

Once you start doing more exercise, it is important to continue with the Optimum Diet. You can refuel your body's stores of readily available carbohydrate (glycogen) after your exercise period by eating a meal that is rich in unrefined carbodydrate. If you feel shaky and a bit wobbly during exercise, it is likely that your sugar level has dropped too low. Eating a snack that contains unrefined starchy food two hours before exercise can help to prevent this: avoid caffeine and sugar, even fruit sugar, especially if this is taken as juice. If the problem persists, carry a banana or apple in your pocket for emergency use.


When people of normal weight start an exercise programme, they may find they can maintain a higher calorie intake without gaining weight, and therefore maintain an adequate intake of minerals and vitamins more easily. Overweight people do not usually increase the amount of food that they eat when they start exercising. Hopefully, the extra energy they are using will come from their fat stores, and they should continue to eat a diet that is rich in unrefined carbohydrates and low in fat.

Water and Sweat
As you exercise, your muscles warm up and you will start to sweat; this is the body's way of controlling its temperature. Loss of fluid through perspiration is best replaced by drinking water, before, during and after exercise. Caffeine and alcohol should be avoided because they increase fluid loss by increasing the amount of urine produced. Minerals, including sodium, potassium, magnesium an chromium, are lost in perspiration, but the Optimum Diet is rich in all of them.



Walking is a very beneficial form of exercise, it is good for reducing stress and doesn't cost anything.

EXERCISE AND THE MIND

Few people can avoid some degree of stress in their lives. The body is designed to react to stress and sudden physical danger by producing a burst of adrenaline, which prepares us for 'fight or flight'. Neither reaction may be appropriate or possible as we get older, so the adrenaline surges through the body, raising the blood pressure and causing physical tension.

Exercise
A safe way to use up the excess adrenaline is a good workout. There is ample scientific evidence to support the psychological benefits of exercise, but the reasons are more complex than just using up spare adrenaline.

Regular exercise is like a mini-holiday and much of the benefit may simply be a result of having time to think or to take your mind off your problems. On a physical level, exercise improves the circulation, which delivers oxygen to all tissues, including the brain.

Depression and Anxiety
For many people regular exercise can help reduce the negative feelings of depression and anxiety. This may be because in exercising you are physically active, and the sense of achievement can help you to feel better about yourself and more in control of your life. Repetitive movement, as in walking, jogging or cycling can be very relaxing because it temporarily suspends the need to make decisions. The companionship and friendship of competitive sports can help overcome feelings of isolation.

Spend time with your grandchildren as they will keep you physically active and mentally alert.

EXERCISE AND THE JOINTS

Stiffness in the mornings and the occasional painful joint become more common at 50+ and one of the causes may be lack of exercise. Even if you develop one of the many forms of arthritis, regular exercise should be continued whenever possible. It helps by contributing towards a healthy heart and maintaining normal weight, mental alertness, better sleep and optimum balance and posture. More specifically, execise keeps the joints fully mobile and relieves muscle tension - which can add to joint pain - while maintaining strength in the muscles surrounding the joints.


Choosing Your Exercise
Choose activities that do not strain or jar your joints. Select your footwear carefully: good-quality supportive shoes are particularly beneficial because they absorb some of the jolt that may be transmitted to the joints when the heel hits the ground. Swimming and water aerobics are good choices for people with painful joints because the buoyancy of the water removes much of the body weight from the joints.

How Much Exercise Is Safe?
You should not continue with any exercise that causes you pain or discomfort, but it is worth trying it again a couple of weeks later when your muscles are stronger. If any discomfort you experience after exercise lasts longer than two hours you have probably done too much, and should cut back. If you have arthritis you should not exercise an acutely inflammed and painful joint. Moving it gently within the range of movement that is relatively pain-free, however, can reduce stiffness.

Exercising with a friend can be an encouragement on the days you are tempted to stay at home.

EXERCISE AND OSTEOPOROSIS

Osteoporosis , which literally means 'porous bones', results from the loss of calcium and the other minerals that are essential for strong, dense bones. Although osteoporosis is generally thought to be a condition that mainly affects women, it is now being diagnosed with greater frequency in men.

Doing an hour of moderate exercise three times a week can be sufficient to prevent osteoporosis. Exercise has also been shown to increase bone density even when osteoporosis has already commenced. However, if you have developed osteoporosis you should seek professional advice. Exercise should be gentle at first to avoid fracturing any bones, and continued for life because any benefits to your bones are lost within a year of stopping.


Exercising outdoors brings an added benefit. Exposing the skin to the sun for short periods without sun-blocking creams enables the body to make the vitamin D that is needed to help calcium be absorbed by the body. It is best to avoid the midday sun, which is more likely to burn the skin and cause skin cancer.

What Sort Of Exercise Is Best?
Exercise for osteoporosis should stretch, compress, bend and twist the bones. This means that many everyday activities, such as gardening , housework and even carrying the groceries home, are all valuable for the arms and upper body. Gardening is a good, inexpensive and can be gentle or as strenuous as you like. Walking, dancing, jogging if you are fit enough and going up and down stairs all benefit the bones of the spine and the legs, including the


hips, which are among the commonest bones to be fractured. For elderly people any type of daily activity, including chair exercises can be beneficial because calcium leaves bones very rapidly when a person is immobile, even for a few days. Cycling, swimming and yoga are of limited benefit for counteracting osteoporosis.

Can Dietary Changes Help?
At 50+ the differences in bone density between meat-eaters and vegetarians become more marked, probably because calcium is lost from the bones more slowly in vegetarians. The Optimum Diet will help to prevent osteoporosis because it limits intake of protein and refined sugar, both of which can deplete calcium. In addition, a generous intake of green leafy vegetables provides plenty of calcium, boron, magnesium, potassium and vitamin K, all of which help to strengthen the bones.


Stretching your muscles and moving your joints on a regular basis can help to reduce stiffness.

Other Bone Preserves
Giving up smoking, restricting alcohol intake to 14 units a week for women and 21 units for men and avoiding carbonated drinks, which are high in phosphate, all help to preserve your bones. You should avoid antacid medicines that contain aluminium and the use of aluminium saucepans, because the aluminium dissolves in acidic food and can interfere with calcium absorption.

Supplements To Consider

• Calcium (Caution: avoid calcium supplements from dolomite, bonemeal or oyster shell, unless the manufacturer guarantees they are free of lead contamination).
• Vitamin D: especially during the winter or if you are housebound. Avoid high doses, which may adversely affect magnesium levels.
• Magnesium
• Vitamins B6, B12 and folic acid: for the elderly who often have a dietary deficit.
• Silicon: may be helpful in the treatment of established osteoporosis.
• Phyto-oestrogens: these oestrogenlike substances from plants have been used in many conditions that are now treated in orthodox medicine by oestrogen. Found in soya products such tofu and soya milk, their benefit for ostoeporosis is not yet scientifically established, but they are thought to be helpful.

EXERCISE AND OBESITY

In general, obese people get less exercise than people of normal weight, but it is uncertain whether this is a cause of obesity or its result. Either way, regular exercise is a must if you want to lose weight, and is more effective when combined with a lower-calorie diet. Moderate to intense exercise can also reduce your appetite.

You should restrict weight loss to 0.5-1kg (1-2lbs) per week: a greater loss than this after the first week or two suggests that you are losing muscle. Once you have achieved your target weight you should continue to exercise to avoid regaining the weight you have lost.

As a calorie-restricted diet progresses, the body naturally tends to conserve energy and weight loss therefore slows or stops. This is counteracted by exercise, which increases the rate at which energy is used both during exercise and for several hours afterwards.

The best exercise for weight loss is of long duration (45-60 minutes per session), and of low intensity (about 60 per cent of your maximum heart rate). Good examples are walking or cycling, at least three or four days a week. Swimming seems to be less effective.


Exercise and Late-Onset Diabetes
Late-onset diabetes is most likely to affect people who are overweight, but it can often be entirely reversed when the programme described above results in weight loss. If you have any of the eye complications of diabetes, you should avoid exercise that jars your body (unless your doctor recommends otherwise). In this case, swimming is a good choice.




Swimming is an ideal form of exercise for diabetics, as it does not jar the body.

EXERCISE YOUR HEART, LUNGS AND CIRCULATION

Not so long ago people were told to rest after a heart attack. Today, there is ample evidence that a gradual exercise programme can extend and improve the quality of your life after a heart attack, and may even help prevent another one from occuring.

The heart is a muscle, and like every muscle in the body it needs oxygen from the blood. Exercise increases the number and size of the blood vessels in all the muscles of the body and it reduces the likelihood of a clot forming in one of the heart's blood vessels, which is one cause of a heart attack. Blood vessels also become more elastic as you exercise, so they are less likely to rupture under pressure. Exercise increases the efficiency of the heart muscle, so that it pumps blood more efficiently through the body.

The Lungs
Exercise enables your lungs to function more effectively. A gentle, gradually increasing exercise programme can help to overcome the problems, such as the fear of not being able to breathe deeply enough, caused by asthma and emphysema. Mild emphysema is a common lung condition in which the alveoli (air sacs) of the lungs become overextended and less efficient, usually as a result of smoking and pollution.
Although exercise does not reverse the underlying damage to the lungs, it can increase the amount of activity that can be undertaken. Even people with severe emphysema, who become breathless after the slightest effort, can benefit and as a result, maintain or regain some independence. Cycling is good cardiovascular exercise. When undertaken three or four times a week, it can help with weight loss.

EXERCISE: WHERE, WHY AND HOW

Many of the current 50+ generation are not as fit as they should be. During the second half of the twentieth century almost everyone came to benefit from the use of a car and labour-saving domestic appliances in the home. Many people drive instead of walking to do their errands, or spend too much time watching television or surfing the web. The resulting lack of exercise and physical exertion has been one of many factors contributing to the epidemic of diseases that doctors label 'degenerative', such as heart attacks, obesity, late-onset diabetes and osteoporosis.

HOW REGULAR EXERCISE HELPS

Most people make financial plans for retirement, but they often neglect to invest in their continuing physical well-being. They assume wrongly that nothing can be done about gradual loss of physical fitness that starts at about the age of 30. The truth is that people who don't stay in shape age more quickly than whose who look after themselves, and an inactive lifestyle hastens the ageing process.

Positive Action
There are major benefits to keeping in shape. For most people, at least some investment in regular exercise will be required if they are to keep their mind, heart, muscles and bones in good shape. Even if exercise does not prolong your life, it is likely to improve its quality, and 50+ is not too soon to take the need for regular exercise seriously.

It should be possible to undertake a beneficial amount of exercise without major changes to your routine. If you exercise regularly you should continue with what you enjoy. However, before commencing a new exercise regime at 50+ it is a good idea to check that your doctor has no objections. This is essential if you have any health problems.

Getting Started
Congratulations! You have decided to begin exercising regularly, and you are now raring to go. However, if you have been sedentary you should ease yourself into your exercise programme slowly, partly to avoid problems with your muscles and joints and partly to allow your heart time to adapt to working a litte harder. Start by setting aside 10 minutes three or four days a week. If you have had a heart attack or other illness, your doctor may suggest that you start with 3-5 minutes three times a week. Gradually, extend your exercise time as you become stronger.

As a rough rule of thumb, to build up to a full programme you will need about a month for each year of sedentary living, or longer if you have had any health problems.

How Much Is Enough?
Your breathing provides a guide as to whether your exercise is challenging you enough, or too much. During exercise you should be breathing more rapidly than usual, but still be able to talk. A more accurate measure of the effect of exercise on your heart is to take your pulse, either at the wrist or just in front of the upper part of the ear at the back of the cheeckbone. Count your pulse beats for 10 seconds and multiply by 6 to give the rate per minute. Your heart will benefit from any regular exercise, but the greatest benefit occurs when it is beating at between 70-85 per cent of the maximum rate for your age for 15-20 minutes, or longer when you are fit.

If your heart rate is higher than the target for your age, you are overdoing it and should slow down. As you get into shape you will find that you keep your heart rate safely within the target range.

Listen To Your Body
Do not take these figures for heart rate too literally: try to respond to what your body is telling you. Exercise should not cause discomfort, and if you experience pain in the chest, jaw or neck, you should consult your doctor. Be prepared to slow down in cold or windy weather, or when going up a hill. Remaining excessively tired an hour or more after finishing exercise may indicate that you are attempting too much. Exercise should be enjoyable: it is not a punishment.

Warming Up and Cooling Down
Starting your exercise slowly will give time for the temperature in your muscles to rise, so they become more elastic and less vulnerable to injury. Stretch your muscles five minutes into the warm-up.

Let your body return to its normal temperature gradually by slowing the pace of your exercise a few minutes before stopping. This will help prevent the stiffness that can occur if you stop suddenly.

What To Wear
Start with loose, comfortable clothing that absorbs sweat and washes easily. The only real essential is a pair of high-quality shoes designed specifically for the type of exercise you are doing. Women also need a comfortable bra that provides support.

What About The Weather
In hot and humid weather drink plenty of water before, during and after exercise. If possible, exercise early in the morning or during the evening. Dress warmly in cold weather and wear a hat. If you have had any heart problems ask your doctor whether it is safe for you to exercise in cold or windy weather.

Increasing Your Exercise
Once you comfortably manage the starting level you have chosen for your exercise, increase your exercise time by 2-5 minutes per session. Rest days are important, so only exercise five days a week.