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Recommendations for people over 60

Ramadan is generally safe for practitioners, and age is not in itself an obstacle to observing it. But it is wise in any case, according to Dr Khadija Moussayer, specialist in internal medicine and Geriatrics, to take stock with your doctor so as not to put your health at risk, and to show responsibility, especially after 75 years when fasting is rather inadvisable.

Thus, the president of the Moroccan association of autoimmune and systemic diseases (AMMAIS), advances, in an analysis delivered to MoroccoLatestNews UKthat people over the age of 60, as well as those around them, should know that their “ settings physiological, very different from a younger person, requires them to be more vigilant and even wise.

In this sense, she reviewed all the evolutions of the body of the elderly person (AP) and what they imply as recommendations at the time of Ramadan, in particular medication and fasting, the frequent lack of appetite in the person elderly, vigilance with regard to hydration disorders as well as the risks of a loss of muscle mass.

Medicines and fasting: a reasonable arbitration between two contradictory elements

In this section, Dr. Moussayer explains that drugs remain in larger quantities and longer in the body of an elderly person than in a 30/40 year old adult. Their renal elimination slows down their accumulation in fats, and their more aggressive passage in the brain makes PAs much more fragile in the face of drugs.

She thus cites as an example paracetamol, an analgesic used against pain and/or fever, which according to her is eliminated twice as slowly, or even diazepam (valium), which is a tranquillizer, four times slower, and the elimination of half of the given dose sometimes takes up to 80 hours (3 days), and which, with daily intake, can accumulate to intoxication.

Also, Dr. Moussayer returns to the misuse of certain drugs, such as those against hypertension combined with muscle weakness, and which can cause falls with serious consequences.

The fracture of the neck of the femur is thus often a source of loss of autonomy and even death. In France, between 15 and 20 people out of 100 die in the year following this accident”, explains the specialist, noting that the observance of Ramadan is thus sometimes problematic when faced with taking medication, even seemingly innocuous. Especially when we know that drug poisoning is responsible for a third of hospitalizations of APs in developed countries”she warned.

But this situation is also present in Morocco, emphasizes Dr. Moussayer, especially since PAs still practice medical nomadism too much, according to her, leading them to be treated by several doctors, hence a tendency to over-medication. , whereas, as in Europe, they should have a single referring doctor, the doctor of ” family », which takes care of them globally by coordinating all the care.

It is therefore imperative for all these reasons, according to Dr. Moussayer, to respect the medical prescriptions, the recommendations of the instructions for use and not to indulge in self-medication.

Lack of appetite common in the elderly

The elderly often tend to reduce their food intake without their energy needs being reduced, says the specialist, noting that this lack of appetite which occurs with age is partly due in particular to the alteration of perceptions of odors. and taste (which thus stimulate less).

The ability to discriminate weakens, resulting in difficulty in identifying and appreciating foods. The detection threshold of the 4 basic flavors is thus increased on average by 11.6 times for salty, 7 for bitter, 4.3 for acid and 2.7 for sweet compared to a young individual! Contrary to popular belief, the nutritional needs of the elderly are almost identical to those of young adults: 2000 kcal/d for men and 1800 kcal/d for women compared to 2800 and 2200 respectively at 30 years old. », explains Dr. Moussayer.

Therefore, she points out that the combination of a decrease in appetite and the observation of long hours of fasting can compromise the nutritional status of AP and lead to a spiral of unfortunate consequences. She thus insists on the fact that the PA must not restrict her usual food consumption after breaking the fast without pouring into equally harmful excesses (regardless of age!).

Concerning the recommended nutritional intake in particular during Ramadan in animal proteins (meat, fish, etc.) and/or vegetable proteins (almond, pistachio, cashew nuts, red beans, lentils, chickpeas, split peas, mushrooms, dates and dried figs , cereals, etc.), according to Dr. Moussayer, it must be higher than that of young adults, namely 1 to 1.2 against 0.8 to 1g/kg/day, or 12 to 15% of the nutrients.

Eating vegetables and fruits is beneficial for filling up with essential vitamins and nutrients and also allowing good intestinal transit (salads in particular). Avoid fried and processed foods high in fat or sugar. “, recommends the specialist.

A great vigilance with regard to hydration disorders

In this part, Dr. Moussayer argues that AP naturally tends to lower its water intake, the threshold of perception of thirst also dulls with age.

Water losses from AP are also greater because of the stronger resistance of the kidney to the action of a substance that limits urine loss (antidiuretic hormone). In addition, the regulatory mechanisms are less well assured, and the elimination of excess sugar or sodium is accompanied by a greater loss of water. Water balance is also threatened by certain medications (diuretics, neuroleptics, etc.) “, she explains.

For all these reasons, Dr Moussayer explains that drinking water needs are always higher in AP than in young adults (1.7 l/d versus 1.5 l/d), especially since the signs of dehydration, especially during Ramadan, are often late and not always easy to interpret.

Manifestations of sudden drowsiness, neuromuscular disorders, constipation or accelerated heart rate must lead to emergency rehydration and this without wasting time discussing on the part of the person and / or his entourage “, she recommends.

Beware of the loss of muscle capital

According to Dr. Moussayer, muscle capital decreases in AP, which worsens nutritional and hydration status. Water reserves (73% of the body’s total water are stored in the muscles) decrease in effect correlatively with the reduction in muscle mass (17% of body weight at 70 years old against 30% at 30 years old), explains she.

This phenomenon, sarcopenia, has considerable repercussions due to the weaknesses it causes: infectious risks due to a drop in the protein reserves necessary for the immune defences, possible falls and fractures compromising the autonomy of the PA, etc. “, she says.

To avoid worsening muscle wasting, Dr. Moussayer recommends a higher protein nutritional intake, which is imperative, while emphasizing the need to maintain physical activity.



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