The last decade has witnessed a stupendous boom in Indian fitness industry. The rising influx of people in fitness centres rapidly coming up in most metros and tier two cities across the country is a testimony to the realisation among people that good health is non negotiable. This transformation of mindset among people is especially remarkable as barely a decade ago the awareness about lifestyle induced health complications was not as mainstream. India despite having about half of its population under twenty five years of age, continues to witness a spiraling rise in both communicable as well as non-communicable diseases, the latter being more prominent in metropolitans. While the various kinds of communicable and non- transmittable disorders are usually defined, categorised and managed in different ways, the deep overlap between the two is often misunderstood.
The current Covid-19 pandemic which the entire world is confronting, has demonstrated how deeply interlinked various kinds of health issues are with one another. It has also shown how the lack of adequate preventive health care management can entail a heavy price to pay in impending years.
One of the major impediments in maintaining sound healthcare systems in the western and developing countries alike is a reductionist approach to the healthcare domain. We live in a world plagued by specialised diseases which has also demanded a highly specialised and sophisticated approach towards medicine. What gets completely overlooked is a holistic view towards human health. Unless health is viewed as an interplay of several intrinsically related aspects such as genetic predisposition, lifestyle, psychological state of being, social behavior and environmental factors, a sustainable healthcare management will remain elusive. No wonder then that contemporary health management is curative in nature rather than being preventive. In analysing the segment of population targeted by the novel coronavirus, two most conclusive facts emerged. One was the link between immunity levels and vulnerability to the virus and other was advanced age as a reason for susceptibility. At some level both these observations pointed towards the absolute need for ensuring robust immunity and physical strength for the geriatric population. However are we as a country boasting of a highly sophisticated medical potential, doing enough on the front of preventive health care for the geriatric populace?
What exactly constitutes preventive health care management for the elderly population?
Geriatric care management involves planning and ensuring care of the elderly with physical or mental challenges in order to meet their long term care needs and improve the quality of life for them. While medical interventions to help the elderly are one aspect of geriatric caretaking, the other fundamental aspect is a preventive health care regimen for them. This includes many dimensions like nutritional and mental wellbeing as well as a systematic fitness programme. Preventive healthcare has become important given the rise in prevalence of chronic diseases and deaths from these diseases across the globe. Few leading causes of a majority of preventable deaths include cardiovascular diseases, diabetes, obesity and infectious diseases. However, despite an increasing number of Indians willing to adopt a professionally designed fitness and diet regimen in larger cities, only a thin margin among them constitutes people above sixty years of age. The reasons behind this misrepresentation are many- including lack of awareness, financial constraints, lack of fitness programmes customised for their physical requirements and dated cultural norms.
It is scientific wisdom that with increasing age the T cell turnover in the human body responsible for an efficient immune system declines steadily. This makes the body a softer target for the newer, more mutated and complex pathogens that are emerging rapidly. The critical illness and mortality caused by the coronavirus in the immune deficit and older people is an instance of the same. More often people do not understand that a balanced diet alone does not strengthen the body’s immune system. It is a prerequisite to combine a healthy diet with a healthy lifestyle. Taking a proactive approach towards health involves a lasting commitment to routine workout.
Unfortunately when it comes to the senior population segment, the attitude towards fitness remains obsolete. For most elderly people physical fitness is synonymous with only leisurely walks, stretches and moderate to light in house activities. Professionally curated workout regimes are believed to be the sole preserve of people of younger age groups. This is as paradoxical as it can be because it is only after fifty years of age that the body experiences a steady loss of muscle mass and weakening of bones. The risks associated with these are an increased vulnerability to repeated injuries, falls and chronic disabilities. A systematic and customised fitness programme aimed at musculoskeletal strengthening, flexibility work and relaxation activities is needed. This should exclude all contraindicated techniques and inadvisable training methods, given the risk of joint or soft tissue injury in older people. There are several fitness coaches and setups in cities which have obtained senior fitness certifications and excel in providing customised programmes to the elderly. The benefits of a professionally curated workout plan are not merely physiological but are also experienced at a psychological level. While reducing the effects of chronic ailments, boosting immunity and strength, systematic exercising also improves symptoms of depression, stress and anxiety in people. All these contribute to a stronger immune system in the long run. Sport activities and yoga are equally helpful in keeping the body and mind in good shape. Ironically more serious health damages are being experienced by the older population by not participating in exercise programmes, rather than from being involved in them.
Thus in the wake of rising threat from infectious and lifestyle disorders, it becomes pertinent that the most vulnerable segment of the population equips itself to confront the challenge. Exercising and taking expert fitness advice become more important with advancing age rather than the other way. The present upheaval caused by the ongoing pandemic is just an eye opener to the need for building stronger and more resilient preventive health mechanisms in the country. Sensitising the community on the necessity of more robust geriatric fitness programmes and the need for participating in them should become an unrelenting agenda for the government. Providing professional and expert fitness guidance to people at affordable prices should also be a priority. The youth must be encouraged to take up senior fitness and nutrition on professional lines and more dedicated centers for the same must be established through public private partnerships. A wholeheartedly implemented preventive health policy will go a long run in reducing the incidence of complex diseases which are germinating globally at an alarming pace.
(The author is a retired civil servant)
Monday, 27 July 2020 | Neeraj Kumar Pande | Dehradun