The 2025 National Health and Morbidity Survey (NHMS) Older Persons Health report paints a sobering picture of ageing in Malaysia
Many older Malaysians are living with frailty, sarcopenia, chronic diseases, reduced mobility, depression, memory problems and difficulties carrying out daily activities independently
The report also highlights significant caregiver burden, reminding us that ageing does not affect older persons alone; it affects entire families
However, the findings should not lead to hopelessness
One of the most important messages from geriatric medicine is this: even when someone is already ageing less healthily, there is still a great deal that can be done to improve quality of life, maintain function, reduce complications and slow further decline
Healthy ageing is not necessarily about being disease-free
Many older adults live meaningful and fulfilling lives despite having chronic illnesses
The goal is not perfection, but maintaining dignity, independence, comfort, mobility, emotional well-being and social connection for as long as possible
One of the biggest mistakes older adults make after becoming weaker or unwell is becoming too inactive
The 2025 NHMS report showed high rates of frailty and sarcopenia, which are the age-related loss of muscle mass and strength
Unfortunately, inactivity accelerates these problems further
When seniors become less active, muscles weaken more rapidly, walking becomes slower, balance worsens and confidence declines
Eventually, many become trapped in a vicious cycle of weakness and dependency
Many older adults avoid exercise because they fear falls, pain or injury
However, appropriate physical activity is actually one of the most effective treatments for frailty and muscle loss
Exercise does not need to be intense
Simple activities such as walking, tai chi, chair exercises, stretching, gardening, dancing or climbing stairs can significantly improve strength, balance, mood and mobility
Even short periods of movement throughout the day are better than remaining sedentary for prolonged hours
Strength training is particularly important
Many seniors focus heavily on controlling blood sugar or cholesterol, but forget about muscle health entirely
Yet muscle is essential for independence
Without adequate muscle strength, older adults struggle with standing up, walking, climbing stairs, carrying groceries and preventing falls
Simple exercises such as repeated sit-to-stand movements from a chair, resistance band exercises or light weight training can help maintain muscle strength safely
Focus on food
Nutrition is another major pillar of healthier ageing
Many older adults eat poorly because of reduced appetite, dental problems, swallowing difficulties, loneliness, depression, financial limitations or chronic illness
Unfortunately, poor nutrition worsens frailty, weakness, infections, wound healing, fatigue and recovery after illness
Protein intake is especially important
Older adults require adequate protein to preserve muscle mass and strength
Good proteinat
Unfortunately, some seniors unnecessarily reduce protein intake because they fear worsening kidney disease or other medical conditions
Dietary advice should therefore be individualised, rather than based on assumptions
Hydration is equally important
Older adults may not feel thirsty even when dehydrated
Dehydration can worsen dizziness, confusion, constipation, falls and kidney problems
Families should encourage regular fluid intake unless there are specific medical reasons for fluid restriction
ALSO READ: Nutrition during the golden years
Control those chronic conditions
The 2025 NHMS report also highlighted high rates of diabetes, hypertension (high blood pressure) and high cholesterol among older Malaysians
Good chronic disease control remains extremely important because uncontrolled medical conditions increase the risk of stroke, heart disease, kidney failure, visual impairment, dementia and disability
Regular follow-up appointments, medication adherence, blood pressure monitoring and healthier dietary habits are therefore crucial
At the same time, treatment goals should be individualised
In frail older adults, overly-aggressive treatment can sometimes cause more harm than benefit
For example, very tight blood sugar control may increase the risk of dangerous low blood sugar episodes, falls or confusion
This is why regular medical review is important, especially when health status changes
Medication review itself is often overlooked
Many older adults take numerous medications prescribed by multiple healthcare providers
This increases the risk of side effects, dizziness, falls, confusion and drug interactions
Families should periodically review medications with healthcare professionals to determine whether all medications remain necessary and appropriate
ALSO READ: Helping older or forgetful loved ones manage their medications
Feeling and thinking
Mental health deserves far more attention than it currently receives
The 2025 NHMS reported significant rates of depression among older Malaysians, yet many cases likely remain undiagnosed
Depression is not simply “part of ageing”
Persistent sadness, poor sleep, loss of appetite, social withdrawal, hopelessness, irritability, low motivation or loss of interest in previously enjoyable activities may indicate depression
Unfortunately, many older adults suffer silently because they do not want to burden family members, or because emotional struggles remain highly stigmatised
Social connection is therefore extremely important
Older adults who remain socially engaged generally experience better emotional well- being and cognitive health
Regular interaction with family members, neighbours, friends, religious groups, hobby clubs or community activities helps reduce loneliness and isolation
Even simple daily conversations can make a meaningful difference
Technology can also help older adults stay connected through video calls and messaging applications, especially when family members live far away
Cognitive stimulation is equally valuable
Reading, puzzles, music, games, conversation, learning new skills or participating in educational activities may help maintain cognitive function
Older adults should never assume they are “too old” to continue learning
Sleep, prevent, treat
Sleep health is another commonly neglected issue
Poor sleep contributes to memory problems, fatigue, falls, mood changes and poor concentration
Maintaining regular sleep routines, staying physically active, reducing excessive daytime naps and limiting caffeine intake may improve sleep quality
Falls prevention is especially important because falls are one of the leading causes of disability among older adults
Simple home modifications can greatly reduce fall risk
Removing loose rugs and clutter, improving lighting, installing grab bars in bathrooms, using non-slip mats, wearing proper footwear, and ensuring walking aids are appropriate and safe, can all help create a safer environment
Vision and hearing problems should also be addressed early
Untreated hearing or visual impairment increases the risk of falls, depression, social isolation and cognitive decline
Unfortunately, many seniors delay getting hearing aids or eye assessments because they assume these problems are simply part of ageing
However, appropriate treatment can significantly improve quality of life and independence
Rehabilitation should also be emphasised much more strongly
Many older adults assume disability after illness is permanent
In reality, physiotherapy, occupational therapy, nutritional support and rehabilitation programmes can often help restore function and independence
Even after stroke, fractures, surgery or prolonged hospitalisation, meaningful improvement is frequently possible
The goal may not always be complete recovery, but maximising independence and quality of life
Caregiver concerns
Families and caregivers also play a critical role
The 2025 NHMS highlighted substantial caregiver burden among families caring for dependent older adults
Many caregivers quietly experience exhaustion, sleep deprivation, emotional stress, financial strain and burnout
Some caregivers spend years providing round-the-clock assistance for loved ones with dementia, stroke-related disability or severe frailty
Caregivers must understand that looking after themselves is not selfish
They also require adequate rest, emotional support, medical care and occasional respite
Family members should try to share caregiving responsibilities whenever possible
Even small acts of assistance with shopping, transport, meals, medications or supervision can significantly reduce caregiver burden
Community services can also help
Daycare centres, rehabilitation services, home nursing, support groups, religious organisations and volunteer networks may provide practical and emotional support for both seniors and caregivers
Technology may also support caregiving through medication reminders, emergency alert systems, mobility aids and remote monitoring devices
Families should also recognise warning signs that additional help may be needed
Frequent falls, weight loss, wandering behaviour, medication mistakes, recurrent hospital admissions, difficulty bathing or toileting, increasing confusion and caregiver exhaustion should never be ignored
Seeking help early often prevents more serious crises later
Advance care planning is another important, but sensitive, issue
Families should discuss future healthcare wishes, caregiving preferences, finances and living arrangements before emergencies occur
Although these conversations may feel uncomfortable, they reduce confusion and stress later
Have a purpose
Importantly, older adults should continue finding meaning and purpose in life
Purpose strongly influences emotional well-being
Some seniors find fulfilment through religion, volunteering, hobbies, gardening, mentoring younger generations, travel or community activities
Healthy ageing is not only about avoiding disease
It is about maintaining dignity, connection, independence, purpose and quality of life
Even when chronic illnesses exist, older adults can still age positively and meaningfully
With proper support from families, healthcare providers, communities and policymakers, many seniors can continue living active, fulfilling and dignified lives despite health challenges
Dr Tay Hui Sian is a consultant geriatrician and internal medicine physician. This is the second in a three-part series on ageing healthily. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
