Commentary: Here’s how our elderly can better protect themselves against COVID-19

SINGAPORE: After almost two months in circuit breaker mode, Singapore is progressively re-opening.

On the similar time, all of us must proceed to make concessions and restrict our motion till the combat in opposition to COVID-19 is really over. Central to that is the necessity to look out for our seniors.

In March, authorities figures confirmed one in 4 individuals contaminated with COVID-19 in Singapore was aged 60 and above.

The aged are extra susceptible to COVID-19 as their immune techniques are at increased threat of being overwhelmed by infections on account of their superior age.

In some circumstances, aged COVID-19 sufferers could have undiagnosed undernutrition and poor muscle well being, in addition to pre-existing power circumstances equivalent to diabetes and hypertension, that are recognized to extend the chance of poor outcomes and loss of life.

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The aged are all too conscious of this. As a geriatrician, I’ve noticed the next degree of tension within the aged.

Many fear in regards to the threat of an infection, particularly these admitted to the hospital. With the help of their households, these sufferers typically ask to be discharged as quickly as attainable.

But these sufferers can solely be discharged if they’ve sufficient physiological reserves, which is demonstrated by good vitamin, lean muscle mass and bodily power to make sure a quicker restoration. In any other case, their restoration at residence could also be compromised by a pre-mature discharge.

In order all of us attempt to keep wholesome, what extra can seniors do to guard themselves, past limiting their social interactions and taking further care with private hygiene and protected distancing?

Singapore Phase 2 Toa Payoh Central durian

Members of the general public go to a durian stall at Toa Payoh Central on Jun 19. (Photograph: Jeremy Lengthy)


Staying energetic is essential as it might enhance the immune system to assist defeat invading viruses. Since our immune techniques weaken with age, it’s important for the aged to maintain transferring – even when indoors.

For sufferers at excessive threat of problems from COVID-19, the European Society for Medical Vitamin and Metabolism recommends conventional workout routines equivalent to Tai Ji Quan, Qigong and yoga as home-based workout routines for the older individuals.

As well as, bodily and mentally in a position seniors are additionally inspired to do resistance coaching equivalent to lifting mild weights or workout routines, utilizing their very own physique weight to enhance muscle, bone and total bodily well being.

That is one thing I advocate every day in my observe, notably in my outpatient clinics. Certainly one of my octogenarian sufferers performs 30 squats at residence daily, despite his superior age and having a number of medical circumstances.

Seniors who’re reluctant to take action can flip to easy family chores equivalent to cooking, carrying groceries, or watering the backyard to take care of muscle power. On-line public train programmes by the Well being Promotion Board (HPB) also can assist them maintain match.

On the similar time, the aged shouldn’t over exert themselves since this may erase the advantages of exercising and put them prone to damage, in response to analysis by the Human Efficiency Laboratory and the Division of Vitamin and Well being Care Administration on the Appalachian State College.

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Common train helps to guard in opposition to ailments, and is central to enhancing cardiovascular well being, reducing blood stress, controlling physique weight and sustaining muscle power.

Particularly, sturdy muscle groups are related to immune system regulation, and play an integral function in our capability to take care of good well being.

For the aged and people caring for them, we should be aware that age-related muscle loss can have an effect on those that could in any other case appear wholesome, in response to the Strengthening Well being In Aged Via Vitamin (SHIELD) research.

The research by Changi Normal Hospital, SingHealth Polyclinics and Abbott revealed that one in 5 individuals aged 65 and older has low muscle mass regardless of regular dietary standing. The medical research additionally confirmed that the lack of muscle mass will increase annually after the age of 65, with girls extra in danger than males.

People wearing mask at Orchard Road Singapore Feb 3 (32)

A person pushes an aged man on a wheelchair, each carrying masks, at Orchard Highway, Singapore on Feb 3. (Photograph: Gaya Chandramohan)

A subsequent research involving over 800 independently-living, community-dwelling older adults prone to undernutrition in Singapore discovered 4 in 5 individuals had low muscle mass, in contrast with the findings within the earlier group of individuals with regular dietary standing.

As a result of pure ageing course of, adults on common lose eight per cent of their muscle mass each decade beginning at age 40, in response to Dr Low Yen Ling, co-author of the SHIELD research and Abbott’s vitamin divisional vp, scientific and medical affairs.

A few of the indicators of muscle loss embrace much less power, slower strolling velocity, decreased power, fatigue and basic weak spot.

“One of many easiest methods to evaluate muscle power in older adults is to have a look at their handgrip. In the event that they wrestle to open a jar lid, it is a sign that their palms could also be getting weaker and generally is a warning signal of a progressive lack of muscle power,” Dr Low mentioned through the research.

After the age of 70, the speed of muscle loss can double, particularly if they don’t seem to be exercising usually and making certain all their dietary wants are met.

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Exercising must be coupled with good vitamin to take care of good muscle well being. Actually, good vitamin, common bodily exercise, muscle well being and a wholesome immune system are inextricably linked. 

Amino acids, the constructing blocks of muscle groups, are important for the immune system to perform correctly.

Whereas amino acids could be derived from good vitamin and a food regimen with sufficient protein, our muscle groups kind a pure reservoir of those amino acids, offering a steady provide to combat infections and rebuild broken tissues.

Resistance band age related muscle loss seniors frailty

(Photograph: Unsplash)

Bodily workout routines not solely assist to take care of and construct this reservoir, analysis exhibits they immediately affect the immune system by priming it.

It’s because muscle groups are additionally a reservoir for immune cells and comprise virtually as many immune cells as that flow into within the blood. 

Research have proven that the quantity and exercise of immune cells within the blood system improve after reasonable train, and that is true for the older inhabitants too.

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Getting sufficient protein isn’t all the time simple, particularly since our protein wants improve with age.

Some seniors expertise a decreased urge for food, or encounter issues chewing meat which might hinder their protein consumption, so taking steps to make sure they eat sufficient protein is vital.

Regular sources of protein in each day food regimen are soybean, nuts, eggs, meat, fish and dairy merchandise. Oral dietary dietary supplements can be used if food regimen alone is inadequate to satisfy the each day necessities for older individuals.

As well as, there’s one key micronutrient which will help protect muscle mass – beta-hydroxy-beta-methylbutyrate (HMB). It’s an energetic metabolite of the amino acid leucine that happens naturally within the physique and is present in small quantities in meals like avocadoes, citrus fruits, cauliflower and catfish.

Analysis has proven that as we grow old, we produce much less HMB however extended supplementation of the metabolite can enhance muscle mass and strengthen the standard of muscle groups in older adults.

Plate of hard-boiled eggs with avocado on toast

(Photograph: Pexels)

The presence of enough quantities of amino acids can stimulate muscle protein synthesis and inhibit muscle breakdown. Resistance-based train additional enhances these results.

Dr Tan Ngiap Chuan, Senior Advisor and Household Doctor at SingHealth Polyclinics, reiterates that muscle loss begins from maturity if a person leads a sedentary life with a food regimen missing in proteins.

Moreover sustaining a protein-rich food regimen, seniors ought to subsequently interact in doses of workout routines for energetic and sleek ageing. Receiving the routine vaccination may also assist construct immunity and maintain you protected from different infectious ailments, which is particularly essential throughout this time.

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READ: How to protect yourself against age-related muscle loss


In these unprecedented instances, one of the simplest ways of lowering the chance of contracting any an infection, and making certain the best probabilities of restoration if one is contaminated, is to have a powerful immune system.

We can’t underestimate the worth of fine vitamin and common train to assist seniors keep good well being, enhance their immune system and scale back the chance of buying infectious ailments.

As we glance to resuming our common lives, the aged and people caring for them ought to purpose to construct up their immunity to make sure they’ll keep protected, each now and for years to return.

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Adjunct Assistant Professor Samuel Chew is Senior Advisor of Geriatric Drugs on the Changi Normal Hospital, and principal investigator for the Strengthening Well being in Aged Via Vitamin (SHIELD) Examine.

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