115-year-old I-Apayao native Rufina Daluyon reflects the healthy lifestyle of the I-Apayao tribe and despite her age, the centenarian shows no signs of serious illness.

Apo Rufina can still talk and can still walk but she only speaks Ilocano. She shares her stories to willing listeners through her great granddaughter Susan.

1. Lifelong Physical Activity
The I-Apayao tribe is related to Isneg tribe and both tribes are known as good farmers.

2. Diet – mostly vegetables
Susan says being a member of the I-Apayao tribe, Apo Rufina is very fond of vegetables.

3. Good Genes
Apo Rufina’s husband lived for 126 years. Apo Rufina has three children, but only one among the three is still alive at a still remarkable age of 90.

4. Spirituality and Gratitude

5. Discipline
“Napakahigpit nya (Rufina) lalo pagdating sa pag-uwi ng maaga sa bahay at tamang pagkain. (She is very strict, particularly on curfews and eating the right food),” says Susan in jest.

Centenarian Northern Philippines

“Minsan tinatanong na rin nya kung bakit di pa sya namamatay at mukha daw nalimutan na siya ni Lord sunduin. (She often wonders why she’s still alive and that the Lord probably has forgotten about her),” says Susan who often visits her great grandmother and gives her a shower.

For her part, Susan says she is thankful for the life that God has granted Apo Rufina.

But Susan admits that things are getting harder for Apo Rufina. Susan says all they can do is to give her the love that she deserves while she is still alive.

The results showed no effect of folic acid in the prevention of cognitive decline (memory, speed of information processing, language and decision making) among individuals without preexisting dementia.

The pooled standardized mean difference
in cognitive function test scores was 0.01 (95% CI,
-0.08 to 0.10) after a median treatment of 6 months; an
increase of 1% of a standard deviation of a cognitive
function test score, with confidence intervals excluding
an improvement or a deterioration greater than 10% of 1
standard deviation.

Studies of longer duration are needed in order to address the role of folic acid in the prevention of cognitive decline.

Source: The American Journal of Medicine (2010) 123, 522-527

However, the DOH and FDA have clarified that discounted drug and medicine purchases, now extend to vitamins and minerals specifically prescribed by doctors for senior citizens for purposes of prevention, treatment, or diagnosis of a disease or illness. This excludes those classified as “food supplements with no approved therapeutic claim”.

This law also mandates that DOH is to provide free pneumoccocal and influenza vaccines to indigent senior citizens.

Moreover, the 20% discount also extends to the purchase of essential medical supplies, accessories or equipment like eyeglasses, dentures, hearing aids, walkers or wheelchairs, and even to geriatric diapers.

Wheelchair

Secretary Soliman emphasized that senior citizens who have queries and complaints may call the DSWD hotlines 951-7120 and cellphone number 0999-314-7425 or visit the National Coordinating and Monitoring Board (NCMB) website at http://ncmb.dswd.gov.ph and email at ncmb@dswd.gov.ph

“We also plan to set-up Help Desks at the DSWD Central Office and in all DSWD Regional Offices for senior citizens without access to phone lines and the internet,” Secretary Soliman added.

Secretary Soliman appealed to senior citizens to refrain from abusing the privileges under RA 9994. “The law is the government’s way of acknowledging and giving praise to senior citizens who contributed to nation building, and is designed for the sole enjoyment of the senior citizens, so please do not abuse these privileges,” Secretary Soliman stated.

DSWD Sec Dinky Soliman

Sinulat ni JD Agapito

Sa dami ng sakit sa ating lipunan

Sakit ng katawan ay kayang pigilan

Lalo na’t sa puso ang pag-uusapan.

Disiplina ang siyang tanging kailangan

Bakit ko nasabi ang huli kong linya?

Dahil ang sakit ay tayo ang may gawa.

Alam na masamang kumain ng taba.

Hanap nitong dila’y karneng mamantika.

Kung may pera nama’y panay rin ang punta

Sa mga food chains na prito ang siyang tinda.

Sa order na chicken, balat ang inuuna.

Mataas na kolesterol siyang ‘di iniinda.

Bukod pa nga rito’y ang hindi paggalaw.

Panay ang pag-upo’t di man lang sumayaw.

Kahit na minsan lang sa buong isang araw.

Maglakad lakad ng taba ay matunaw.

Maging sa inumi’y di displinado.

Kung uminom ng softdrinks sadyang bigay todo.

Dapat ay minsan lang sa buong ‘sang linggo.

Mas maraming tubig ang dapat sa iyo.

Kaya’t mas marami ang may hypertension.

Dahil sa kinai’y mayr’ong alta presyon.

Dagdagan pa natin ng lahat ng tensyon.

Dala na rin mismo ng mga sitwasyon.

Kaya kung ikaw ay hindi magbabago.

Lalo pa kung ika’y naninigarilyo.

Tiyak ang buhay mo ay mamimiligro.

Sakit sa puso ang tatapos sa iyo.

Dito sa aking tula ‘y may hihilingin.

Pwede bang pagkain ay sadyang isipin

Para makontrol ang taba maging asin.

Mga simpleng bagay ‘wag ng problemahin.

Kaya’t sana ay hindi pa mahuli.

Itong aking payong hangad ay mabuti.

Upang maiwasan itong maatake.

At di na mangyari itong pagsisisi.

Dahil may dalanging kasama ang tula.

Itaas sa Diyos ang nais na sadya.

Sa kanyang patnubay lahat magagawa.

Kung buhay ay maayos, siya’y matutuwa.

Contributed by COMADD NIH Member
Prof JD
June 28, 2010 5:00

The study revealed that most medical schools do have Geriatrics as part of a required course and 61% enjoy institutional support for developing said course. However, although 70% of the graduating medical students believe they are prepared to take care of the elderly in outpatient clinics and hospitals, only 61% of their teachers think they possess the necessary KAP (knowledge, attitude and practice) for such a job!

Some of the contributors to the lack in KAP of fresh graduates include the crowded medical course schedule and the lack of a curricular map of subjects that teach them how to take care of the elderly. Medical students learn the basics during the first three years of med school (classroom) but may not possess the skills in the final clinical years called internship (hospital exposure). The lack of clinical teachers and researchers were also identified as obstacles to the development of a good Geriatric program.

This study also contains recommendations as to how the situation can be rectified; how we can mold our future doctors into providing excellent and compassionate healthcare for the elderly. We can begin by increasing the number of doctors that are trained and dedicated to teaching, and by establishing a well mapped curriculum in Geriatrics. We also need to support researches that lead to improvement of the health and quality of life of the aging Filipino. The Association of Philippine Medical Colleges, DOH, DSWD, NIH and CHED can help lead this change.

About the NIH and Aging Study Group:

The National Institutes of Health (NIH) was created on January 26, 1996 by the UP Board of Regents as an institutional home of a network of various research and extension units specializing in health and socio-biomedical concerns. This thrust is consistent with the country’s vision of “Health for All”.

Currently, the NIH has various research institutes and active study groups that continue to develop and produce outputs that serve as vital guideposts in shaping national programs and policies. The Aging Study Group and the Committee on Aging and Degenerative Diseases (COMADD) has contributed greatly to current clinical and educational programs and policies on Aging. The vision of COMADD is “The Filipino elderly enjoying a healthy body, mind and spirit, being treated with dignity, and valued as a productive member of society, in a dynamic process unique to himself, and beginning a life of unlimited possibilities”.

Principal Investigator:
Shelley F. de la Vega, MD., MSc
Chair, Aging Study Group
Institute of Health Policy and Development Studies
UP Manila-NIH

Co-Investigators:
Jose Alvin Mojica, M.D., MHPEd
Chair, Department of Rehabilitation Medicine
Philippine General Hospital

Josephine Agapito, PhD
College of Arts and Sciences
UP Manila

Click here to view related post in Manila Bulletin Online

Risk Factors for Complications of or Severe Illness with 2009 H1N1 Virus Infection.

Risk Factor Examples and Comments
1. Age <5 yr Increased risk especially for children <2 yr of age; highest hospitalization rates among children <1 yr
2. Pregnancy Risk of hospitalization increased by a factor of 4 to 7, as compared with agematched nonpregnant women, with highest risk in third trimester
3. Chronic cardiovascular condition Congestive heart failure or atherosclerotic disease; hypertension not shown to be an independent risk factor
4. Chronic lung disorder Asthma or COPD, cystic fibrosis
5. Metabolic disorder Diabetes
6. Neurologic condition Neuromuscular, neurocognitive, or seizure disorder
7. Immunosuppression Associated with HIV infection, organ transplantation, receipt of chemotherapy
or corticosteroids, or malnutrition
8. Morbid obesity – but not yet proved to be an independent risk factor for complications requiring hospitalization or ICU admission and possibly for death
9. Hemoglobinopathy Sickle cell anemia
10. Chronic renal disease Renal dialysis or transplantation
11. Chronic hepatic disease Cirrhosis
12. Long history of smoking Suggested but not yet proved to be an independent risk factor
13. Long-term aspirin therapy in children Risk of Reye’s syndrome; drugs containing salicylates should be avoided in children with influenza
14. Age ≥65 yr Highest case fatality rate but lowest rate of infection

* COPD denotes chronic obstructive pulmonary disease, HIV human immunodeficiency virus, and ICU intensive care unit.
† Morbid obesity is defined as a body-mass index (the weight in kilograms divided by the square of the height in meters)
of 40 or more.

Violence and aggression

“Violence and aggression are caused by the illness.”

From time to time, the person may become angry, aggressive or violent. It is not a personal attack on you, but a part of their illness. There are many reasons why a person with dementia may feel angry. They may not like being helped with things they used to do on their own, or may simply be frustrated due to an inability to do things.

These short-term changes happen for a variety of reasons such as the person’s sense of loss of social control and judgment, loss of the ability to express negative feelings safely, and loss of the ability to understand the actions and abilities of others. It is therefore worth finding and avoiding the causes of unwanted certain reactions.

If the person feels angry, aggressive or violent, keep calm and try not to show fear or alarm. Give them more space and try to draw their attention to a calming activity.

This is one of the most difficult things to cope with for a caregiver, and if violence occurs often, you will need to seek help. Talk to someone for support, and speak with your doctor about help with managing the person.

Alcohol and cigarettes

“Supervise drinking and smoking to make sure accidents don’t happen.”

There is no problem for a person with dementia drinking alcohol in moderation if their medication allows. However the person may forget they have just had a drink and so have another one. This cycle can lead to repetition with the person becoming drunk or unmanageable.

1. Do not buy or store alcohol at home.
- reduce the number of bottles of alcohol available in the drinks cabinet
- empty or dilute some of them.
2. Distract the person with another activity, so that they do not think about drinking.
3. Provide water, juice, light soda, and other healthy cool drinks.

Cigarettes introduce a greater danger because of the risk of fire and damage to health.
1. Do not buy or store cigarettes at home.
2. Always supervise the person when smoking
- but remember the dangers of second-hand and third hand smoke!!!
3. Discourage smoking altogether and enroll in a smoking cessation program
4. Make sure that the clothes they wear and the furniture in the house are fire-resistant.
5. Install a smoke alarm, which can alert you to any danger.

1. Cognitive Engagement.

Cognitive Training – modest benefits on cognitive functioning and a small but statistically significant effect on reducing the extent of age-related decline in cognitive function at a 5-year follow-up. Very small but statistically significant benefit on instrumental activities of daily living—for example, managing finances, managing medications, keeping house, and, in a subgroup analysis, benefit on driving performance in the elderly.

However, these results from a single trial must be replicated to confirm the benefits of cognitive engagement on preventing
cognitive decline over a longer time period and in study subjects with varying levels of baseline cognitive abilities before a firm recommendation can be made.

2. Physical Activity. Increased physical activity, including walking, may help maintain or improve cognitive function in normal adults.

Although encouraging, these data should be viewed as preliminary. Work is ongoing to further investigate the benefits of
physical activity.

Factors associated with decreased risk of Alzheimer’s disease and cognitive decline were cognitive engagement (as indicated by literacy and social enrichment), physical activities in later life, and a diet low in saturated fat and high in vegetable intake. Light to moderate alcohol intake
is reported to be associated with reduced risk of Alzheimer’s disease, but results are inconsistent for cognitive decline

Source: NIH State-of-the-Science Conference:
Preventing Alzheimer’s Disease and Cognitive Decline
April 26–28, 2010