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.
Maintain those muscles
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 protein sources include fish, eggs, tofu, milk, beans, chicken and lean meat.
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.
