THE International Day of Older Persons is celebrated annually on Oct 1 to recognise the contributions made by older people to society and to raise awareness on issues affecting them.
The proportion of the population aged 60 years and older in Malaysia has been gradually increasing from 5.6% in 1990 to 6.2% in 2000 and 7.9% in 2010. Malaysia is predicted to be an aged nation by around 2030 when 15.3% of our population is 60 years and above.
The year 2020 has undoubtedly been a strange year for everyone. In this unprecedented Covid-19 era, this year’s International Day theme is “Pandemics: Do They Change How We Address Age and Ageing?”
All age groups are at risk of contracting Covid-19. Nevertheless, in this past nine months, evidence has shown that older adults and those with underlying chronic diseases face a significant risk of developing severe illness from Covid-19 infection. The majority of reported deaths and serious complications occurred among older adults, which may be due to physiological changes that occur with ageing and underlying comorbidities such as diabetes mellitus.
Evidence has emerged that poor blood glucose control among diabetic patients is associated with high risks of complications and mortality. Hence, good blood glucose control is even more critical in the Covid-19 era.
The general clinical guidelines on diabetes management have recommended treatment goals for glycated haemoglobin A1C (reflects blood glucose control), blood pressure, and LDL-cholesterol (bad cholesterol) – also known as “ABC”. The beneficial effects of attaining more treatment goals are incremental.
Yet, the proportions of patients achieving all ABC goals are under 10% in many places such as Hong Kong, European countries and the United States.
A local study showed that 5.8% of our patients attained all the ABC goals; the older adults seem to fare better than the younger diabetic patients. However, while the impact of Covid-19 on older people with diabetes remains to be quantified, this pandemic may affect their ability to manage their diabetes.
While the pandemic poses a threat to older diabetic adults’ physical health, it may seriously affect their mental health, too. Some issues of concern are depression, anxiety, isolation and loneliness.
Raising awareness on the importance of good blood glucose control and the impact of isolation and loneliness among older adults with diabetes can be made through various channels.
For example, MySejahtera apps can be leveraged to disseminate targeted information.
Increasing older people’s access to mobile technologies and social media can act as a tool to prevent loneliness and maintain social connections with their loved ones.
Telehealth services and applications can be used to meet the changing patients’ demands in the new norms.
Healthcare providers should be more mindful of optimal blood glucose control while managing diabetes patients during this pandemic
They should be alert to signs and symptoms of mental health among their patients, too.
The older adults with diabetes must comply with their overall treatment plan by taking medicines as scheduled, exercising regularly and eating responsibly.
If you are lonely, in distress, in despair or having suicidal thoughts, seek help immediately.
We all must work hand in hand, for we cannot afford to have another wave of Covid-19 (and movement control order). Let us celebrate this day by spending time with our parents and grandparents.
DR WAN KIM SUI
PROFESSOR DR NORAN NAQIAH HAIRI
PROFESSOR DR MOY FOONG MING
Centre for Epidemiology and Evidence-Based Practice
Department of Social and Preventive Medicine
Note: The letter was written by Dr Wan Kim Sui, Doctor of Public Health Student from the University of Malaya under the supervision of Professor Dr Noran Naqiah Hairi and Prof Dr Moy Foong Ming, to the Star Newspaper and was published on the 1 October 2020.