THE STAR, TUESDAY 14 MAY 2019

YOUR HEALTH

Open to learning new things

While one may not have control over age-related mental issues, keeping the
mind sharp and alert can help delay or slow the progression of these conditions.
2 Your Health
Regain your youthful vigour
“SUDDENLY, I’m not half the man I used to
be.” The familiar lyrics of the popular
Beatles song make a lot more sense to men
after the age of 40, compared with when
they are younger. “Half the man” that one
used to be in terms of physical and mental
performance. No longer as strong, sharp, fast
and efficient.
Declining testosterone levels is the main
culprit of the downhill spiral of bodily
performance, which implies that lower
levels of testosterone means the body is no
longer able to maintain male characteristics
effectively. The decline usually starts at
around the age of 40, and is medically
termed as the start of andropause, or more
commonly known as “low T” condition.
Early signs of andropause include lack of:
l Energy
l Concentration
l Muscles and strength
l Agility
l Stamina
l Interests
l Vigour
l Confidence
What is andropause?
There are increasing scientific and
medical reports showing that men suffer
from hormonal problems, just like women in
menopause, but with a slower, more gradual
onset which often goes undiagnosed. In fact,
most men assume that the symptoms they
are experiencing are just “a normal part of
getting older”. It’s because these symptoms
appear slowly and are somewhat vague,
making the diagnosis of andropause easily
missed.
Starting at around 30, men experience a
10% drop in testosterone every decade. Even
though the body still continues to produce
testosterone, it is no longer as effective.
Testosterone is inactivated rapidly by a type
of protein called globulin (SHBG), the
production of which increases as the body
ages. This can lead to the decrease of active
testosterone in the blood, and thus cause
functional symptoms of low testosterone.
Activate your natural
testosterone
Testofen is an extract of the herb
Medical reports
suggest that men, too,
suffer from hormonal
problems, just like
women in menopause,
but with a slower,
more gradual onset.
fenugreek, which is commonly used in East
Asian cuisine. It is standardised into saponin
glycoside called Fenuside, a unique
compound which displaces testosterone
from SHBG, hence releasing more active
testosterone into the blood to be circulated
around the body.
In a paper published in The Aging Male in
January 2016, it was found that men taking
Testofen demonstrated improvement in
testosterone-related properties. This includes
an increase of male functions (androgenic
function) and an increase in muscle tone and
THE STAR, TUESDAY 14 MAY 2019
Declining testosterone
levels is the main culprit
of the downhill spiral of
bodily performance, which
implies that lower levels
of testosterone means the
body is no longer able to
maintain male characteristics
effectively.
strength (anabolic function).
In a 2018 study titled Testofen (Trigonella
foenum-graecum extract) for increasing
muscle strength, endurance and lean body
mass in men, researchers found that 85.2% of
men between the ages of 25 and 52 who
received 600mg of Testofen per day for six
weeks showed an overall positive effect, and
reported an increase in muscle strength,
energy levels and well-being. When
combined with exercise, men who took
600mg of Testofen a day for at least a month
displayed a significant increase in muscle
mass and strength.
Living a youthful and interesting life in
your 40s is possible with the reactivation of
the testosterone levels. A supplemented diet
and regular exercise is the secret to uplift
active testosterone levels.
This article is brought to you by the
in-house pharmacist at Cambert (M) Sdn Bhd.
n For more information, call 1300 881 712
or email ask-prime@cambert.com.my
THE STAR, TUESDAY 14 MAY 2019 3
4 Your Health THE STAR, TUESDAY 14 MAY 2019

Treatment for dry eyes

THE tear film is an important layer
on the eye that maintains the
smoothness of its surface for good
vision and comfort. It is made up
of three layers – mucin, water and
lipid. A disturbance in the balance
between the three components
may lead to symptomatic dry eyes.
Dry eye disease is a common
pathology affecting more than 20%
of the population, and symptoms
increase with age. Conditions of a
modern lifestyle, including
working on computer screens,
driving cars, exposure to artificial
light and air pollution and using
contact lenses make dry eye
syndrome more prevalent.
It is usually caused by an issue
with the tear film, either caused by
insufficient tear production or
excessive evaporation. A majority
of dry eye cases are caused by
excessive evaporation, mainly
because of insufficient lipid
secreted by the eyelids’ meibomian
glands.
Dry eye disease is an unpleasant
sensory and emotional experience
for patients. Burdened with
discomfort and fear, patients often
feel miserable because they don’t
know how to accurately describe
how they’re feeling. Most end up
exasperated because no one
understands their experience. Mild
conditions can lead to frequent
visits to eye care practitioners
Dry eye disease is a
common pathology
affecting more than
20% of the population,
and symptoms
increase with age.
whereas moderate to severe cases
are often associated with
significant pain, limitations in
performing daily activities,
reduced vitality, poor general
health and, in some cases,
depression.
Treatment is especially
frustrating for both patients and
practitioners as it often interferes
with the overall management and
perceived patient satisfaction.
There are significant symptoms,
which are either not treated
effectively or ignored by the eye
care practitioner. This usually
happens when it is perceived that
the complaint is insignificant or
untreatable. Although lubricating
eyedrops may provide some relief,
it is often not enough in more
severe conditions. Depending on
the cause of the dry eye, treatment
can include eye drops such as
cyclosporine, steroid eyedrops, lipid- six months to two
based drops, manual expression, years after the third
meibomian gland probing and a and fourth sessions. IPL
procedure called BlephEx. therapy is a promising mode
The latest addition to this of treatment to help alleviate the
armamentarium is intense pulsed ordeal of having dry eyes. –
light (IPL) therapy. It involves By Dr Norazlina Bachik Ng,
applying perfectly calibrated, cataract, refractive and
homogenously sequenced, sculpted anterior segment surgeon
light pulses. The energy, spectrum
and time period are precisely set to n For details, call KPJ Pusat
stimulate the meibomian glands Pakar Mata Centre for Sight
into returning to normal function. at 03-4022 6222 (Kuala
Each treatment session only takes Lumpur)/03-7880 8222
a few minutes, during which the (Petaling Jaya)/03-6093 1051
patient is seated comfortably. The (Rawang) or visit
ophthalmologist will fit patients www.kpjcfs.com
with protective eyeware to protect KKLIU No.2720/2018
the eyes from the light. A hydrogel
is then applied to the skin under the
eyes for protection, after which a
series of five flashes is applied
under the lower eyelid. The
procedure is repeated under the
lower eyelid of the other eye.
The IPL doesn’t directly affect the
meibomian glands. It works
through the stimulation of the
nerves supplying the glands via a
series of chemical reactions that
take place after the procedure,
which stimulate the secretion and
contraction of the glands and
improve microcirculation.
The effect of the treatment is
cumulative. It generally lasts a week
after the first session, two to three
weeks after the second session and

What they need

at different stages
ALZHEIMER’S is a progressive,
irreversible and degenerative
disease of the brain that results
in impaired functionality and
memory loss. The affected brain
cells will cause gradual loss of
ability to perform even the
simplest daily activities.
The rate of progression of
Alzheimer’s varies greatly from
one person to another and can
cause one to eventually lead a
life of complete dependence.
Since the symptoms varies as
the disease progresses, it is
imperative to understand the
different stages to provide
proper care for a person with
Alzheimer’s.
Below are the symptoms that
manifest during different stages
of the disease:
l Early stage – The disease is
difficult to diagnose at this stage
because the symptoms are
similar to normal signs of
ageing, such as misplacing and
losing things and short-term
memory loss. The person
affected is still capable of
leading a normal life and is
usually aware of the
symptoms. Sometimes, this
awareness causes depression,
which can quicken the
progression of the disease.
l Middle stage – Memory
lapses become more
pronounced, with short-term
memory more affected than
long-term memory. There is
also the occasional confusion
regarding time, places and
people, which can lead to
activity impairment.
Many patients in this stage
are in denial of their
symptoms, causing them
anxiety and depression.
Confabulation to cover up the
occasional memory lapse is
also common. The symptoms
are more pronounced when
one is ill, stressed or fatigued.
> TURN TO PAGE 6
THE STAR, TUESDAY 14 MAY 2019
TWENTY years ago, my mother
started suffering from
osteoporosis and pain in both
knees. I was still studying at the
time, and as she didn’t have
insurance, my mother began
taking medication to relieve the
pain. Standing for even 10
minutes was a trying task for
her as her knees would get
swollen and red and felt warm
to the touch.
The painkillers worked for
the first two years, or at least
helped her go about her daily
routine. Even when she took
up to 12 pills a day (including
calcium and magnesium,
painkillers and nonsteroidal
anti-inflammatory drugs or
NSAIDs), she still experienced
slight pain, though she said it
was quite bearable.
However, towards the end of
the two years, an
orthopaedician recommended
that she switch medications
because her blood tests showed
inflammation in her kidneys
and liver. The new medication
was an NSAID, which I found
was banned in the United
Kingdom and the United States.
Just like that, we were back
at square one. We were keen
on having my mother try
alternative medicine instead to
see how that worked out. For a
while, she was able to go about
her daily chores and we
thought we had found a
solution, and again, she still felt
pain, though it was bearable.
Occasionally, she would need to
take painkillers, sometimes up
to eight pills a day.
Unfortunately, after a while,
the pain returned and she
experienced severe pain in her
knees even when she only did
Safe and good
results from
laser cataract
procedure
CATARACT procedures are
among the leading type of eye
surgery performed in
Malaysia. With technological
evolution, cataract surgeries
are becoming safer and,
subsequently, recovery
periods are getting shorter.
Dr Zainal Mohamad, senior
consultant ophthalmologist at
The Tun Hussein Onn
National Eye Hospital, says,
“During traditional cataract
surgery, surgeons will make
tiny incisions to remove the
cloudy lens of the eye using
traditional surgical tools and
blades. With LenSx, however,
your surgeon will be able to
remove the cataract using a
bladeless, femtosecond laser
to break up the cataract and
make the necessary incisions
to remove it, eliminating the
need for a blade.”
While all eyes generally
share similar basic anatomy,
each is unique in terms of
size, curvature, diameter and
other minute features. Even
the right and left eyes of the
same person will have some
differentials. LenSx allows
surgeons to tailor surgical
parameters to the uniqueness
Your Health 5
Easing pain in the joints
some light walking, and
eventually she was diagnosed
with osteoarthritis. She then
decided to take charge of her
health and started swimming,
exercising on her stationary
bike, stretching and undergoing
physiotherapy.
The new path worked well for
her, but she still found it
difficult to go up and down
stairs and her knees were
becoming inflexible. Walking
for more than 20 minutes
caused her pain.
On a trip overseas, my friends
told me about a substance used
to treat osteoarthritis and
rheumatoid arthritis called
undenatured type II collagen. At
that point, it was in the human
clinical trial stage and not yet
available commercially, except
from a few orthopaedicians.
Flaxical contains
undenatured type II collagen
derived from chicken sternum,
as well as calcium and
magnesium derived from
seaweed in Ireland and ginger
extract to treat pain and Flaxical contains undenatured type II collagen derived from chicken sternum, as well as calcium and magnesium
inflammation. derived from seaweed in Ireland and ginger extract to treat pain and inflammation.
Flaxical 3 in 1 is available at
selected pharmacies and retails
at RM148 per pack (RM108 per
pack when other opened or
unopened joint supplement
bottles are presented during
purchase).
n For more information, call
03-7772 7133 or 012-238 0133
(Monday to Friday, 9am
to 6pm).
Dr Zainal Mohamad.
of each eyeball.
“LenSx technology is a great
leap in our cataract service. Its
greatest value is the peace of
mind that I have as a surgeon,
knowing that my patients
undergo a safe procedure with
predictable results,” says Dr
Zainal, who has been offering
LenSx to his patients over the
past six years.
n For more information, call
03-7718 1488.
KKLIU No.0948/2019
6 Your Health
Wellness starts with the heart
AGE is often correlated with an increased
risk of developing cardiac and other
metabolic disorders. Keeping cholesterol
levels in check ensures a healthy heart, but
good heart health also requires a stable
blood glucose level. According to a 2013
finding by the International Diabetes
Foundation, people with elevated blood
glucose levels are two to six times more
likely to develop cardiovascular disease
than normal people. Regular exercise and
a diet rich in oat beta glucans can go a long
way to staving off the worst symptoms of
ageing.
Though there are many types of soluble
fibres, beta glucan from oats is the most
extensively studied, with a large body of
documented human trials. A Health
Ministry study shows that consuming 3g of
oat beta glucans a day can significantly
reduce total cholesterol and low-density
lipoproteins (LDL) in the bloodstream,
improving stamina, mental acuity and
physical function.
However, not all oat beta glucans are
produced equally. According to the
European Food Safety Authority (EFSA) in
a 2011 guide by its Panel on Dietetic
Products, Nutrition and Allergies, it is the
increased viscosity effect produced in the
gut by bioactive oat beta glucans that can
confer cholesterol-lowering and blood
glucose stabilising benefits.
Therefore, it is imperative for
general consumers to find out
whether their choice of oat
product provides high-quality
and clinically tested oat beta glucans.
Other health claims for oat beta glucans,
approved by EFSA and the Health Ministry,
include its ability to lower blood glucose
levels, provided it is not consumed together
with other food, and its ability to contribute
to the reduction of glucose after meals.
Biogrow Oat BG22 is sourced from the
finest quality Swedish oat bran and
subjected to a sophisticated processing
technology which ensures the integrity of
the product while retaining the beta-glucans’
high molecular weight, for enhanced
viscosity and absorption upon consumption.
Providing health benefits in a small and
easy-to-consume serving size, Biogrow Oat
BG22 offers:
l Clinically-tested bioactive oat beta
glucans with more than 20 published human
studies for cholesterol-lowering and blood
glucose-regulating effect, including
Biogrow
Oat BG22
is high in
fibre, protein,
magnesium,
iron and zinc.
Preparing for the road ahead
> FROM PAGE 4
l Late stage – At this stage, there is an
almost complete loss of functionality, with
the patient unable and unwilling to perform
everyday tasks such as bathing, going to the
bathroom or dressing herself. She will also
stop communicating because of loss of
vocabulary and ability to think, reason or
plan.
She may feel growing frustration because
of these challenges and become more
withdrawn. However, depression usually
resolves on its own at this stage because of
the patient’s decrease in situational
awareness of her situation.
Long-term memory loss also sets in at this
stage, leaving the patient unable to
recognise even loved ones. Most of the time,
she will be unable to recall information and
may become agitated
and combative
because of it. At
this stage,
behaviour is
mostly guided by
past experience
rather than sense.
THE STAR, TUESDAY 14 MAY 2019
People with elevated blood
glucose levels are two to six
times more likely to develop
cardiovascular disease than
normal people. Regular
exercise and a diet rich in oat
beta glucans can go a long
way to staving off the worst
symptoms of ageing.
Physicochemical properties of oat β-glucan
influence its ability to reduce serum LDL
cholesterol in humans: a randomized clinical
trial, published in The American Journal of
Clinical Nutrition in 2010.
l Two scoops daily provides the
recommended 3g of bioactive oat beta
glucans for optimal health benefits.
l Laboratory-tested low in glycaemic
index (<55), suitable for prediabetic and
diabetic patients.
l High in fibre, protein, magnesium, iron
and zinc.
Biogrow Oat BG22 contains no added
sugar, artificial additives or preservatives. It
provides an effective and natural way of
managing cholesterol and blood glucose
levels. Remember, healthy cholesterol and
blood glucose levels are keys to healthy
ageing.
This article is brought to you by Legosan
(Malaysia) Sdn Bhd.
n For more information, call 03-7956 2220
(9am to 5pm) or email info@biogrow.com.my
l Advanced stage – A patient at this
stage will become completely withdrawn
from his surroundings and not recognise
anyone. There is complete loss of speech
and total inability to perform any task.
Brain function is hampered so much that
the person cannot even remember to chew
or swallow their food. As a result, rapid
weight loss and incontinence is common.
He will also be unable to walk; this
immobility leading to other health
problems such as bed sores and
contracture. He may also become
aggressive, occasionally yelling or
screaming to communicate his frustration.
As a caregiver, it is important for you to
understand that a person with Alzheimer’s
disease is helpless in dealing with or
controlling themselves, especially in the
later stages.
Thus, although it is bound to get more
difficult as the disease progresses and you
feel that nothing can adequately prepare
you for the challenges it brings, you can at
least learn to recognise the symptoms
when they appear and provide the patient
with the appropriate care.
As a caregiver,
it is important
to recognise
the different
levels of care
required at
different
stages of
Alzheimer's
disease.
THE STAR, TUESDAY 14 MAY 2019
MADAM Lim’s right knee started giving her
troubles in her 60s. An avid gardener, she
realised that she could no longer tend to her
garden or squat. Her friends introduced her
to various types of joints supplements such
as glucosamine and chondroitin.
Although these seemed to help in the
beginning, her knee problem kept coming
back. Having arrived at the point of giving
up, Madam Lim wondered whether she had
to resort to joint replacement surgery.
She is among 60% of the world population
suffering from osteoarthritis (OA) – a
degenerative joint disease. OA is the most
common type of arthritis and accounts for
about 90% of primary hip replacement
surgeries and 99% of primary knee
replacement surgeries, according to the
National Joint Registry for England, Wales,
Northern Ireland and the Isle of Man’s 14th
Annual Report 2017.
Below are some myths about OA, as well
as the facts:
Myth OA is an inevitable part of the
1 ageing process
Fact: OA affects only certain individuals.
Although you’re more at risk of developing
it as you age, people without OA do have
healthy, functioning joints well beyond their
80s.
Myth OA is not a serious health
2 problem
Fact: OA can cause permanent joint
damage, leading to physical disability. It can
greatly affect quality of life.
Myth OA affects men and women
3 indiscriminately
Fact: Certain factors predisposes a person
of developing OA, such as being a woman,
having a family history of OA and having
sustained a joint injury.
It is now known that the wear and tear of
cartilage is not the only contributing factor
Lasting relief
from joint problems
Approximately 60% of the world population suffers from osteoarthritis, which can cause
permanent joint damage.
to joint degeneration. It is also driven by a
biochemical imbalance of joint-ageing
enzymes known as matrix metalloproteinases
(MMPs). In certain at-risk groups, it is the
overexpression of MMPs that cause joints to
break down faster than they can rebuild,
leading to the worsening of OA symptoms.
Natural remedy
First introduced in the 1970s, Biolane is an
active New Zealand green-lipped mussel
extract with more than 40 years of research
history. It is a natural joint-ageing enzyme
inhibitor that specifically targets the
destructive MMPs within joints. Through its
ability to counter the damaging effects of
MMPs, Biolane can complement other joint
therapies at various stages.
It should be noted that joint recovery takes
time since this restorative process involves
tackling the root of the problem. Seventy per
cent of patients with moderate to severe
arthritis experienced significant
Your Health 7
improvements in their joint condition after
taking two Biolane capsules twice daily for at
least three months, according to findings
published in the July 2000 issue of Townsend
Letter for Doctors and Patients.
Biolane is not a painkiller substitute.
Patients who are on long-term painkillers for
their joint problems may still need to
continue with their pills before the benefits
of Biolane kick in. Once patients experience
recovery in their joint capabilities, they may
find themselves able to be less reliant on
painkillers.
In 2005, the Australian Centre for
Complementary Research and Education
awarded Biolane the Ideal Anti-Arthritic
Agent accolade. Biolane is used by medical
practitioners in more than 25 countries
worldwide, including Malaysia.
Back to gardening
Madam Lim’s daughter persuaded her to
take Biolane per the pharmacist’s advice to
keep taking it for at least three months. A
little over three months later, Madam Lim
discovered she could walk without her knees
aching, even managing to walk up and down
the stairs without problems. After a while,
she was once again able to tend to her
garden.
This article is brought to you by the
Nuvaceuticals Division of Nuvanta Sdn Bhd.
n For more information, call 03-5636
3758/1300 881 712 or e-mail pharmacist@
nuvanta.com
8 Your Health
Forget me not
By NGEH CHEE YEN
AGEING is part and parcel of life. As we age,
changes manifest in our body, including
slower motor skills, deteriorating eyesight
and memory loss. While age-related memory
loss is common in the overall population,
there is another, more debilitating
manifestation of this condition – dementia.
According to the World Health
Organization (WHO), around 50 million
people are living with dementia as of 2017.
The number is estimated to rise by an
additional 10 million people per year, with
dementia as the seventh leading cause of
death in the world. In a separate report by
WHO in 2012, it was estimated that 115.4
million people are projected to suffer from
dementia by 2050, with 70% of those affected
concentrated in low- to middle-income
countries.
Because of this potential surge in
dementia patients, it is even more important
for us as potential or current caregivers to
prepare for the rising numbers of people
with dementia. However, where can we
start?
Not a normal part of life
A spokesperson from Alzheimer’s Disease
Foundation Malaysia (ADFM) defines
dementia as an umbrella term that describes
a group of symptoms caused by a range of
diseases associated with an ongoing decline
of the brain and its abilities. Some of the
more common forms of dementia are
Alzheimer’s disease, vascular dementia,
Lewy body dementia and frontotemporal
dementia.
Symptoms of dementia include short- and
long-term memory loss, disorientation and
confusion in a familiar setting and
experiencing problems with everyday
activities.
She says, “While it largely occurs in the
elderly, it is not a normal part of ageing.
Dementia can trigger mental health
problems such as personality changes,
Self-care to be your best
Mellisa (not her real name) has been a
caregiver for her mother ever since she
was diagnosed with Alzheimer’s disease
seven years ago. She first started noticing
changes when her mother started
forgetting what day it was, repeated
herself constantly and was losing interest
in her hobbies.
Ever since Mellisa’s mother was first
diagnosed, annual memory test results
have shown further deterioration in her
mother’s condition as she ages, and she
was put on medication to manage the
condition.
One common experience for caregivers
is the loss of freedom and time for
themselves when they care for the
patient. However, Mellisa thinks this
is not how it should be for all
caregivers.
She says, “It is true the things that I
normally do have changed. My focus has
shifted to taking care of my mother rather
than taking care of myself. At one point, I
felt that I had no one to turn to about my
struggles. It was only when a doctor
referred me to Alzheimer’s Disease
Foundation Malaysia (ADFM) that I finally
got help.”
Through caregiver support groups,
experiences are shared, and Mellisa
learnt that in order to provide proper
care for a dementia patient, you must
have time for yourself. If not, you will get
stressed and depressed. In general, she
feels there should be more centres in
Malaysia so more caregivers can have
access to these support groups.
Still seeking a foundation
Because diagnosis and dementia
treatment in Malaysia is not widely
known, Mellisa sees a need for awareness
THE STAR, TUESDAY 14 MAY 2019
While it largely occurs in
the elderly, it is not a normal
part of ageing. Dementia
can trigger mental health
problems such as personality
changes, anxiety, mood
swings and depression.
In more advanced stages,
it can also strip the patient
of the ability to get up and
move, or the interest to eat
and drink.
anxiety, mood swings and depression. In
more advanced stages, it can also strip the
patient of the ability to get up and move, or
the interest to eat and drink.”
A person living with dementia will slowly
start to experience physical, mental and
social deterioration and find it difficult to
lead a normal and independent life. While
medication can be provided to slow down
the symptoms of dementia, it is currently
incurable.
Giving the right care at the right
stage
A dementia patient requires personalised
care as his condition progresses. Because of
this, it can be a challenge for family and
loved ones to care for him without proper
resources. The Alzheimer’s Association, a
United States-based voluntary health
organisation specialising in Alzheimer’s care,
support and research, divides caregiving
> SEE NEXT PAGE
among members of the public on the
nature of the condition and the actual
experiences of the patients and
caregivers.
“Most people know about dementia, but
they do not understand how bad the
situation can get as the condition
progresses. Taking care of a dementia
patient is very different from a person
who has age-related memory loss.
Therefore, when I shared my struggles
with a friend, she got the impression that
I was complaining about how my mum is
a burden, but that was not what I wanted
to convey.”
Not words, but a lot of heart
As an experienced caregiver, Mellisa
has some words of advice for those who
find themselves in a similar situation.
“Personally, I believe that although the
dementia patient may not remember
what you say to them, they will always
remember how you made them feel. My
mother likes it very much when you
praise her, such as telling her that she is
pretty, or that she’s wearing a nice dress.
While she forgets what was said, she
knows how you made her feel. So, I think
that caregivers should always be
supportive.”
As for advice on being a caregiver, she
asserts, “Never ever think what you are
doing is not good enough. Taking care of a
dementia patient is never easy, so don’t
underestimate yourself and what you are
doing for the patient, even if they do not
show appreciation because of their
condition. I find peace knowing that no
matter what I do, I am doing the best I
can for my mother, and I am happy with
that. Therefore, you must be very patient
and never give up hope.”
THE STAR, TUESDAY 14 MAY 2019
Caring for dementia
patients requires patience
> FROM PREVIOUS PAGE
into three categories, to be paired with the
stage progression a patient goes through.
l Early stage – At this stage, the patient
is still mostly independent and only shows
mild symptoms. The caregiver is more of a
care partner than caregiver, as the patient
may not need much assistance yet. For the
caregiver, this is the best time to equip
himself with caregiving skills and, together
with the patient, working out how to best
move forward as his condition progresses.
l Middle stage – A caregiver’s
responsibility will gradually increase as the
patient’s functional independence
decreases. Focus is placed on the patient’s
safety, while making changes in his daily
routine to accommodate his condition. It is
good to take extra steps to ensure he can
communicate with you and provide him
with opportunities to do purposeful
activities.
l Late stage – The caregiver’s role shifts
to preserving the quality of life and dignity
of the patient. At this point in the disease,
the world is primarily experienced through
the senses. You can express your care
through touch, sound, sight, taste and smell,
such as playing his favourite music, cooking
his favourite food, or brushing his hair.
Follow your instincts
Caring for a dementia patient is never
easy, but it can be made easier when there
is a bond between the caregiver and
patient. With proper understanding of their
needs and personality, the ability to adjust
and try new methods can be beneficial for
Where to seek help
According to a 2014 report by
Alzheimer’s Disease International (ADI),
Dementia in the Asia Pacific Region, it is
estimated that there are 123,000
dementia patients in Malaysia in 2015.
The number is expected to increase to
590,000 by 2050.
According to ADFM, these statistics
are an understatement, as this number
only shows people who are diagnosed
with dementia, but there are many
more patients in rural areas who do not
have access to awareness, diagnosis or
treatment. There is still a lack of care
centres focusing on the elderly with
dementia in Malaysia and a lot more
support is needed to help patients and
caregivers.
Nevertheless, this news should not be
a deterrent if you are a dementia
patient or caregiver. Reaching out for
help at your local dementia care centres
or caregiver support groups will
A person living with dementia will slowly start to experience physical, mental and social
deterioration and find it difficult to lead a normal and independent life.
Your Health 9
both parties.
Mellisa (not her real name), has been
caring for her mother, who suffers from
Alzheimer’s, for the past seven years. She
says that every dementia patient is
different, and thus requires different
methods of care.
“When a person is diagnosed with
dementia, it can be equated to them
entering a second childhood. They no
longer know or remember how to lead a
normal life, and are prone to mood swings
according to how they are currently
feeling.”
“In my case, I try to keep my mother as
comfortable as possible. She can get a bit
aggressive, no doubt because of her
independent personality. She has high
blood pressure and diabetes, so we have to
keep her calm, but it is hard to do so as she
forgets (why we are trying to help her).
Therefore, I will let her blow off steam
instead of arguing about it, as she will soon
forget about what happened.”
Mellisa also sees the benefit in letting her
mother socialise with others, as it sparks
activity in the brain and improves her
symptoms. A dementia patient requires personalised care as his condition progresses. Because of this,
“Nowadays, I bring her to the care centre it can be a challenge for family and loved ones to care for him without proper resources.
regularly, because even if dementia patients
struggle to speak or socialise, they still need
to be active and have a social life. The
centre helps patients carry out activities
such as colouring and exercising. Even if
my mother doesn’t participate, it keeps her
going. Keeping her cooped up at home will
make her symptoms worse. Going to the
centre also helps with her routine as she
will feel tired when she goes home and
sleep right after having dinner.”
actually benefit both parties.
They will not only provide you
resources to improve your quality of life,
but you will also be part of a community
whose members hold each other up
when they are faced with challenges
during this journey.
Currently, there are a few dementia
organisation chapters in Selangor,
Penang, Perak, Melaka and Johor. As for
caregiver support groups, they can be
found in many places such as Kuala
Lumpur, Selangor, Johor, Perak,
Kelantan, Melaka, Seremban and Sabah.
If you are hesitant to reach out for
help, you can start by going to various
talks and events organised by dementia
organisations for more information,
such as the 21st Asia Pacific Regional
Conference by ADI on Aug 16 to 18 to
provide resources and disseminate
knowledge to local health professionals
and caregivers.
10 Your Health
“ALL disease begins in the gut”, a quote
from the father of modern medicine,
Hippocrates, still holds true today. Physical
inactivity, alcohol abuse, chronic laxative
use, diets low in fibre but high in red meat
and colon inflammation triggered by
bacterial infection are common causes of
poor gut health.
A 2017 study titled How many cancer
cases and deaths are potentially preventable?
Estimates for Australia in 2013 published in
International Journal of Cancer suggests that
almost 40% of cancer deaths, including
colon cancer, could have been preventable
with lifestyle changes. These changes can
include adopting a plant-based, fibre-rich
diet, exercising regularly and ensuring
regular bowel movement.
Most individuals resort to laxatives as a
quick fix for bowel irregularity. Frequent
use of laxatives can cause the bowel to
become dependent on them and lose its
normal function, which eventually leads to
a condition known as lazy bowel syndrome,
in which our bowels move slowly and
sluggishly.
Datuk Dr Rajbans Singh, consultant
physician and geriatrician, says, “Chronic
use of laxatives depletes our body of
minerals and hydration and disrupts our
gut microbiota. Consumers are highly
advised to be cautious when using
supplements that contain drug-like
ingredients such as senna or cassia, even
though they are usually marketed as
natural.”
According to Dr Rajbans, a diet high in
soluble and insoluble fibre with plenty of
beneficial bacteria is key to improving
bowel movement and restoring gut
function. People with constipation had
lower levels of Bifidobacteria in the large
intestine, found a 2012 study titled
Bifidobacteria for Life Betterment published
in World Applied Sciences Journal.
These good bacteria in our gut decrease
as we age, so in addition to sufficient daily
fibre intake, dietary supplementation with
probiotics may be necessary to ensure
optimal gut function.
Stay healthy by
keeping your gut happy
Protect your gut with fibre and
probiotics
Biogrow ProGut is made from a natural,
food-form formula that contains Swedish oat
fibre with dual action from the well-
researched Oat BG22 fibre powder and
Bifidobacteria lactis – a BB-12 probiotic
strain from Denmark and the world’s best-
documented Bifidobacterium with more
than 300 scientific publications, including
over 130 clinical studies.
One sachet (≈7g) taken daily provides a
synergistic effect for improved intestinal
function and balanced gut microbiota. Take
one or two sachets mixed in a glass of cold
water or fruit juice or sprinkle it on cereal or
yoghurt. It is recommended to be taken after
meals but can be ingested anytime
convenient. Each sachet contains 2.4g of
soluble and insoluble fibre and a guaranteed
potency of one billion colony-forming units
(CFUs) of live probiotic cultures.
This dose of one billion CFUs of BB-12 has
been clinically tested and shown to have the
desired benefits on defaecation and bowel
movement frequency, according to a 2015
study titled Effect of the probiotic strain
Active brain, sharper mind
IT is heartbreaking to witness a loved one
succumb to dementia. People living with
diseases such as Alzheimer’s slowly lose
touch with reality, forgetting everything
from memories to, at later stages of the
disease, how to swallow.
Dementia can happen to anyone. As there
is no cure for Alzheimer’s, is there anything
that can be done to prevent or delay its
onset?
Some healthcare professionals and
researchers are of the opinion that there are
certain steps that can be taken to prevent
Alzheimer’s, such as sleeping well, avoiding
stress, keeping active, maintaining a healthy
eating habit and exercising the brain by
keeping it stimulated.
While there is no conclusive evidence that
brain-stimulating activities can help prevent
or delay the onset of dementia, pursuing
these would not cause any harm, either. So,
why not give it a try and hope for the best?
Learn a new language
A research article titled Does Bilingualism
Influence Cognitive Ageing published in
Edinburgh Research Explorer suggests that
bilingualism has a positive effect on later-life
cognition and can help prevent dementia. It
also suggests that when a person chooses to
learn a new language has no influence on
THE STAR, TUESDAY 14 MAY 2019
Datuk Dr Rajbans Singh.
Bifidobacterium animalis subsp. lactis,
BB-12®, on defecation frequency in healthy
subjects with low defecation frequency and
abdominal discomfort: a randomised, double-
blind, placebo-controlled, parallel-group trial
published in British Journal of Nutrition.
Biogrow ProGut is suitable for all who
wish to maintain or improve gut health, as it
offers a natural way to manage bowel
movement with fibre and probiotics. It is
available at all pharmacies nationwide.
This article is brought to you by Legosan
(Malaysia) Sdn Bhd.
n For more information, call 03-7956 2220
(9am to 5pm) or email info@biogrow.com.
my
the outcome.
Hence, it is not too late to learn one or two
new languages. Even if it does not prevent or
delay Alzheimer’s, you can explore a new
culture and hopefully make new friends
with your newly acquired foreign language
proficiency. Socialising is known to stimulate
your brain, too.
Learn to play a musical
instrument
One of the ultimate brain exercises is
learning to play a musical instrument.
Researchers at University of Texas Arlington
conducted a study on musicians and
concluded that they show greater ability in
retaining and recalling long-term memory.
There have also been studies that suggest
that musicians have faster reaction times,
implying that their brains are well
stimulated.
Solve puzzles
It goes without saying that puzzles, such as
sudoku and crosswords, stimulate your
brain. By making your brain work hard to
solve tough puzzles, you can ensure that
your brain stays active and sharp.
Apart from sudoku, you can also try
playing board, card and memory games.
Read a book
Instead of spending a considerable
amount of time on your phone or staying
glued to the television, read a book, as it
might help you fend off Alzheimer’s.
Reading stimulates the brain by
making you think, imagine and create
a picture of what you are reading in
your mind.
It will also help you sleep better,
which is another contributing factor to
keeping many diseases, including
Alzheimer’s, at bay.
THE STAR, TUESDAY 14 MAY 2019
VITAMIN K is often referred to as
the forgotten vitamin because it is
continually overlooked in favour of
more well-known nutrients. This
fat-soluble vitamin is essential to
building strong bones, as it serves
as the biological glue that helps
plug calcium into your bone
matrix.
Since its discovery in the 1920s,
vitamin K has been classified into a
few types. Vitamin K1 is a blood
clotting factor commonly found in
green leafy vegetables, while
vitamin K2 is an altogether
different type of vitamin K that
plays the crucial role of calcium
regulation. Vitamin K2 is further
divided into subtypes depending
on structure length.
Menaquinone (MK-7) is the
natural form of a vitamin K2
subtype, which is found only in the
Japanese delicacy natto, which is a
steamed, fermented and sticky
soybean dish that has a pungent
flavour and smell. We lack MK-7 in
our diet because most people don’t
eat natto regularly, if at all. MK-7
has been creating interest as
studies have shown that it helps
improve bone density while
preventing heart disease by
effectively depositing calcium
where it belongs: in the bones and
teeth.
Without vitamin K2, calcium
MK-7, a subtype of vitamin K2, has been identified as a nutrient that aids calcium and vitamin D3 in improving or
preserving bone health.
Honey with medicinal properties
EUCALYPTUS marginata,
commonly known as jarrah, is a
timber tree that can grow up to
40m in height. Jarrah generally
flower every two years, usually
from December through January in
the early summer. The nectar
produced has a low moisture
content and is collected by
honeybees.
Jarrah produces a dark, thick,
tasty honey with a caramel
aftertaste. It is not as sweet as
other types of honey thanks to its
low-glucose, high-fructose nature,
and pure jarrah honey will not
crystallise.
This therapeutic honey is
antimicrobial and antibacterial, as
well as low in glucose, high in
fructose and antioxidants, free
from Varoa mites, chemicals and
preservatives, boosts immunity
and has high total activity (TA).
Jarrah honey is considered
TA 10+ = UMF 10+ = MGO
263 (Antimicrobial strength is
relatively equivalent to UMF
10+)
TA 15+ = UMF 15+ = MGO
514 (Antimicrobial strength is
relatively equivalent to UMF
15+
TA 20+ = UMF 20+ = MGO
829 (Antimicrobial strength is
relatively equivalent to UMF
20+
Maintaining
bone health
floats freely in the bloodstream and
tends to deposit in the arteries
(calcification), progressively
making the arteries stiffer and
narrower and impeding healthy
blood flow to and from the heart.
MK-7 activates bone-building
proteins that are dormant in its
absence. These proteins bind
calcium to the bones and teeth and
keep them from depositing in the
arteries, thus preventing arterial
calcification and heart disease.
A 2007 study found that vitamin
K2 plays a role in maintaining bone
health among post-menopausal
women, confirming the benefits of
consuming adequate amounts of
vitamin K2 daily. Using the natural
form of vitamin K2 extracted from
natto, a 2015 study found that
supplementation with vitamin K2
decreased arterial stiffness among
post-menopausal women. Vitamin
K2 supplementation is also
recommended for women who are
healing because it has unusually
high levels of antimicrobial
properties (measured at TA 10+
or higher), which is thanks to its
naturally occurring hydrogen
peroxide activity. Because of this,
jarrah honey can be used internally
and externally for treating wounds,
burns, sunburn and skin infections.
Scientists have developed a
process to certify jarrah honey’s
medicinal and antimicrobial
properties. The TA Rating of Active
Honey denotes the strength of the
antibacterial potency of honey,
measured by the standard (phenol)
bacteria-killing scale.
Opceden Jarrah Honey is
laboratory-tested and issued a
certificate that details its TA
score, which has reached as
high as TA 35+.
The West Australian Jarrah
Honey Committee announced
that Western Australia’s
jarrah honey has been
proven to possess high
antioxidant levels,
following a recently
completed research
project.
The independent
research project was
undertaken by Dr Charles
Dragar, who conducted
antimicrobial activity
testing of honey as well as
a variety of other honey-
based tests.
Jarrah honey was found
Your Health 11
at higher risk of bone fractures.
Population-based studies have shown
that women in Japan who consumed
more natto generally show low rates
of bone fractures.
Calcium, vitamin D3 and vitamin K2
have a synergistic effect on bone
health and the body. Dietary calcium
is linked to many benefits, especially
bone health. This is why
recommended daily calcium intakes
were established. Furthermore,
vitamin D3 helps your body absorb
calcium and vitamin K2 directs the
calcium to where it is needed.
In other words, without the help of
vitamin K2, the calcium that your
vitamin D3 so effectively lets in may
be working against you by building up
in your coronary arteries rather than
your bones. Thus, calcium taken
together with vitamin D3 and
vitamin K2 may well be the solution
necessary for healthier bones while
circumventing your risk of developing
heart disease.
It is recommended that patients
receiving anticoagulant treatment not
take vitamin K2 supplements without
first consulting their doctors.
This article is brought to
you by Vitamode.
n For enquiries, call 1300
800 228 or email enquiry@
medispec.com.my
to have significantly higher levels of
antioxidants than manuka honey
from New Zealand or leatherwood
honey from Tasmania, with two to
three times higher antioxidant
concentration.
Dr Dragar commented that all
samples of jarrah honey tested
showed remarkably high antioxidant
levels in addition to high
antimicrobial activity, with levels up
to 50% greater than that of manuka
honey.
n For more information, call 03-6156
2836/2936.
12 Your Health THE STAR, TUESDAY 14 MAY 2019

For mobility and

independence
MANY people believe that arthritis
is a condition that only affects
older people. Osteoarthritis is
indeed a degenerative joint
disease mostly seen in older
people, but there are other kinds
of arthritis, such as rheumatoid,
psoriatic and gouty, that can affect
people of any age.
“There are quite a number of
conditions that fall under the
umbrella term of arthritis, but the
most common are rheumatoid
arthritis and osteoarthritis,” says
Dr Benjamin Cheah Tien Eang,
consultant rheumatologist at
ParkCity Medical Centre.
The scary thing about arthritis
is that there is no known
permanent cure. Nonetheless, it is
a condition that is treatable with
medication, physiotherapy and
sometimes surgery.
When you are the enemy
Rheumatoid arthritis is an
autoimmune condition that
predominantly affects women, at
a ratio of around three women to
one man.
Rheumatoid arthritis is known
as the disease of the young, as Dr
Cheah explains, “Most are
diagnosed around age 40, which is
the peak of many people’s lives.
While it can also affect people in
their 20s, it is rare in older
people.”
He mentions that although
there is no national registry to
confirm the number of
rheumatoid arthritis cases, it is
Dr Benjamin Cheah Tien Eang
more common than people
realise.
“There is a dire lack of
awareness among people about
rheumatoid arthritis because it is
not a disease that causes death.
However, if untreated, this
condition can leave people
completely immobile, with some
being unable to even perform
simple tasks such as holding a
cup.”
Rheumatoid arthritis causes
swelling and inflammation of the
joints. A long-term effect of this
condition is severe deformity of
the affected limb.
“There is treatment that can
relieve the pain, but medication
that can significantly slow the
progress of the disease is
expensive and it is difficult to get
government aid since it is not a
life-threatening disease such as
cancer.
“Nevertheless, the fact remains
that people becoming immobile
in the prime of their lives will
burden the economy since they
can no longer work and earn,”
says Dr Cheah.
He also opines Malaysia needs
more support groups for people
affected with rheumatoid
arthritis to cope with the
repercussions of the disease,
because there are few such
communities at present.
The natural process of
ageing
Another common form of
arthritis is osteoarthritis, which is
mostly diagnosed in older people.
“With age, our bones begin to
disintegrate like every other
organ in our body. Osteoarthritis
is caused by erosion of the joints,
bones and cartilage,” explains Dr
Cheah.
He adds that there is no way to
prevent this gradual deterioration
of bone health, but keeping active
can slow the progress.
“There are not enough activities
for the elderly because they are
mostly neglected in our society.
However, keeping them active for
longer can delay osteoarthritis
and help them stay independent
for longer.”
Many have the misconception
that after being diagnosed with
osteoarthritis, one must protect
the joints by resting as much as
possible and becoming inactive.
Dr Cheah dismisses this, saying,
“If you stop being active, your
muscles waste away, putting more
pressure on your joints.”
The treatment for osteoarthritis
includes medication that relieve
pain and slow bone degeneration.
Surgery could be a patient’s only
solution in extreme cases.
“There are many alternative
medicines and supplements
available in the market but there is
no known cure that can reverse
the damage completely. Any claim
about completely curing
osteoarthritis is baseless and
people should be careful about
believing it.
“Supplements such as
glucosamine can sometimes
provide relief to some people, but
they must exercise caution and
seek medical advice before taking
anything,” says Dr Cheah.
He reiterates the need for
increased awareness about
arthritis so that people do not end
up harming their health more by
trying to cure an incurable disease.
n For more information, call
03-5639 1212.

Regaining pain-free motion

LIVING with severe osteoarthritis
in the knee is painful and
KNEE REPLACEMENT
debilitating. However, with total
knee replacement (TKR) surgery,
you could regain quality of life.
Datuk Dr Lim Boon Ping,
consultant orthopaedic surgeon
at Subang Jaya Medical Centre,
says, “TKR is a common surgery
performed on elderly patients. It
involves opening the knee joint,
resurfacing the worn, painful
joint with a metal alloy and using
a high-density polyethylene
(plastic) between the surfaces of
the joint.”
However, he notes that TKR is
suggested only to those with
severe osteoarthritis, and not
mild or moderate cases. It is
advised only as a last resort after
it is determined that painkillers Datuk Dr Lim Boon Ping.
and lifestyle modifications have
failed to reduce the pain in the knee. He says, “The replaced knee
knee when conducting daily usually lasts around 25 years with
activities. Healthy joint Osteoarthritic joint Knee implant Replaced knee normal usage for a patient of
average weight. While there are
Clear expectations suitability to go under
anaesthesia and blood tests for
patient is encouraged to use his
full body weight on his lower
continue physiotherapy exercises
at home to ensure smooth
risks with this surgery, the
probabilities of occurrence are
Before proceeding with TKR, it underlying medical conditions limbs and bend and stretch the recovery. only 0.5% for infections, 0.001%
is important for a patient to are performed during knee as much as he can. The for deep-vein thrombosis leading
understand the full procedure
and what to expect before,
preparation for surgery. In
addition, patients are asked to
more this is done, the faster his
recovery. Thus, a patient with
Walking through life to pulmonary embolism and 20%
for residual mild pain and
during and after surgery. fast six hours prior to surgery. better pain control who moves anew weakness that do not require
Dr Lim summarises, “Before The surgery takes between one and exercises his knee and ankle analgesics or painkillers.”
surgery, the doctor will explain and two hours and is performed more frequently will recover After TKR, Dr Lim states that TKR is a relatively low-risk
the procedure and risks involved. through an anterior (front of the faster.” almost all patients should be able surgery with a high success rate
The patient’s history of illnesses knee) incision. After the patient is able to to walk long distances, jog, cycle and not only gives you the ability
and allergies are discussed and Dr Lim continues, “After walk well with a walking frame, and climb hills or stairs with ease to walk painlessly again, but also a
managed, to reduce risks before surgery, a physiotherapist will he will be discharged from the and painlessly within three to new lease on life.
admission for surgery.” guide the patient through lower- hospital. He will still be required four months.
X-rays of the knees, an limb exercises and, subsequently, to undergo follow-ups as There is also no need to worry n For more information, call
assessment of the patient’s walking, the very next day. The determined by his doctor and about the longevity of your new 03-5639 1212.