Behaviour change programmes needed to promote healthy ageing

THE 2025 National Health and Morbidity Survey (NHMS) reported that 85.3% of our elderly citizens are not ageing healthily. Out of the 7,528 senior citizens (aged 60 and above) surveyed, only 14.7% said they were enjoying their golden years in accordance with the established criteria of “healthy ageing” (“Ageing, but not well”; The Star, April 21).

Healthy ageing is defined as elderly citizens having strong social support, do not suffer from chronic non-communicable diseases and cognitive impairment such as dementia or stroke, and are able to perform their daily activities independently.

The NHMS 2025 survey noted that elderly persons who are ageing unhealthily suffer from various non-communicable diseases such as diabetes (39.1%), hypertension (73.1%), high cholesterol (76.2%) and dementia (9.8%).

The findings of the study should be a clarion call to implement a public health intervention programme in behaviour change to curb the escalation of unhealthy ageing in the future.

We officially became an ageing nation in 2021 and are heading towards aged nation status by 2040 with 14.5% of the population comprising elderly citizens.

Behaviour change interventions are crucial in surmounting the root causes of unhealthy ageing, including sedentary lifestyle, inadequate sleep and poor dietary habits. A sedentary lifestyle together with over-consumption of ultra-processed food with little nutritional value but high in sugar and sodium can lead to obesity and overweight.

It is a time bomb that needs to be defused today, especially as the 2023 National Health and Morbidity Survey (NHMS) had found that 54.4% of Malaysian adults were overweight (32.6%) or obese (21.8%).

The study also indicated that 29.8% of children aged five to seven years old are either overweight (15.0%) or obese (14.8%).

Time is of the essence to implement behaviour change strategies based on the adage that prevention is better than cure.

The World Health Organisation (WHO) recommends that adults and children reduce their daily intake of free sugars to less than 10% of their total energy intake. One can of sugar-sweetened soda contains 40g or 10 teaspoons of free sugars.

Free sugars comprise all monosaccharides (glucose/fructose) and disaccharides (sucrose/table

sugar) added to foods and beverages by the manufacturer, cook or consumer. Free sugars are not related to sugars in vegetables, fresh fruits or milk.

Sodium is essential for the human body because it maintains fluid balance, regulates blood pressure and enables proper nerve and muscle function. But when daily consumption of sodium exceeds the body’s requirement, it may affect blood pressure.

WHO recommends that adults consume less than 2,000mg or 5g of sodium per day. However, global health data shows that salt consumption in most countries remain higher than the WHO recommendation.

The problem of ageing unhealthily among the elderly is compounded by lack of savings to finance their daily undertakings. Elderly citizens who are facing financial distress and also suffering from non-communicable diseases constitute the most vulnerable group that needs public healthcare and support.

Currently, public healthcare facilities and care institutions under the Health Ministry and Social Welfare Department are stretched to their limits. If the problems of obesity and overweight are left unchecked, the government would ultimately need to commit more funds from the national budget to build more hospitals and care centres.

The cheaper option is for the Health Ministry to implement a nationwide public health intervention programme to encourage the public to adopt health lifestyles by staying active and adopting a balanced diet.

DATUK WEE BENG EE

Tumpat, Kelantan