As you grow old, your health starts to deteriorate. Everything, whether it is your mental health or your physical health, starts to slow down. However, with age, your mental health gets overshadowed by your physical health.

Signs You Should Note

If you note these signs in your ageing parents or grandparents, take note of it. Try to get involved with them. It is also important to ensure that they have a separate social circle apart from the family. This way, they can have friends who they can also relate to.

With age, suggests Sinha, you are more prone to be depressed, and anxious. “Mental health conditions like schizophrenia or bipolar disorders are not something that happens when you grow older. You may have been living with these for the last 40 years, but the management differs, she suggests.

As you grow old, your symptoms start to overlap with other mental health conditions. For the proper treatment professionals use differential diagnosis, suggests Sinha. “The lines become blurred and to differentiate the symptoms from one mental health condition to another becomes difficult,” she says.

Preventive Measures

There are also food habits like eating leafy vegetables, nuts, fish, virgin coconut and beans that help with brain functions.

Sinha suggests that keeping a social circle and continuing your hobbies can help your mind stay healthy. “Men especially face this issue, after they retire, they feel like they are at the loss of authority, and they start to lose control. It is thus important to keep doing things and learning a new skill to keep your brain active. While for women, since they continue taking care of the house, their brain stays active,” she says.

Cognitive stimulation is the key, especially to managing dementia, she notes.

“Just with weight training, you push your body and after a while, it becomes your muscle memory. Same with the brain. However, one should not get into solving too many puzzles, or trivia after being diagnosed with dementia. Because that would mean you are making your already injured brain exercise which might lead to agitation,” she recommends.

How to support?

“The most important part is for the caregiver to understand what is happening and come to terms with the conditions. Because the elderly with cognitive conditions are not able to understand, they cannot be told or instructed to do anything. Thus, the responsibility is solely on the caregiver,” points out Sinha.

So, what can be done?

Awareness

Reach out to therapists and counsellors to know the ways to create such a healthy environment.

Be Patient

She suggests adopting the same approach that you do with kids and with your pets. This is when you focus on gestures, body language and mood over language. Due to cognitive disorders, parents experience a loss of language and the only way to communicate and to understand what they are communicating is through these means.

Be Empathetic

Create a healthy environment by agreeing with them and listening to their stories. The responsibility of creating a safe environment is totally with you.

There might be times when your parents may do socially unacceptable or non-compliance behaviour. But it is important to understand the triggers and ensure that the triggers do not occur anymore.

Help Them Stay Fit

Fatigue is one of the most common health complaints today. It is often blamed on busy schedules, stress, lack of sleep, or even aging. But what if persistent tiredness is not just a lifestyle issue? In some cases, it could be your heart signaling that something is not quite right.

A lesser-known but important cause of unexplained fatigue is a slow heart rhythm, also known as bradycardia. Recognizing this connection can play a crucial role in protecting overall health and well-being.

What Is A Slow Heart Rhythm?

Bradycardia refers to a resting heart rate of fewer than 60 beats per minute. While this can be normal for athletes or during sleep, it may become a concern when the heart is unable to pump enough oxygen-rich blood to meet the body’s needs.

The heart’s rhythm is controlled by electrical signals generated by the sinoatrial (SA) node. When this system slows down or becomes irregular, it can affect how efficiently blood circulates through the body. Over time, this reduced circulation may lead to symptoms that are often overlooked or misinterpreted.

Why Fatigue Is Often The First Sign

Unlike more dramatic cardiac symptoms, bradycardia often presents quietly. Persistent fatigue or a constant lack of energy is one of the most common early signs. Many individuals feel unusually tired even after adequate rest or find it difficult to complete routine activities that were previously manageable.

This happens because the body, and especially the brain, is not receiving enough oxygen to function optimally. As a result, individuals may also experience:

• Weakness or low stamina
• Dizziness or light-headedness
• Shortness of breath during mild exertion
• Difficulty concentrating or mental fog
• Occasional fainting or near-fainting episodes

Because these symptoms are non-specific, they are frequently attributed to stress, work pressure, or poor sleep, delaying the correct diagnosis.

When Fatigue Isn’t Just Fatigue

It is important to distinguish between general tiredness and fatigue that signals a deeper issue. A key indicator is persistence; fatigue that does not improve with rest, or is accompanied by other symptoms, should not be ignored.

In older adults, these signs are often mistaken for a natural part of aging. In active individuals, they may be dismissed as overtraining or burnout. However, when the heart rate remains consistently low and symptoms persist, it may indicate that the heart’s electrical system is not functioning properly.

This is why it becomes essential to pause, observe patterns, and decode your rhythm; understanding whether your body’s signals point to something more than everyday fatigue.

Who Should Be More Aware?

While bradycardia can affect anyone, certain groups should be particularly mindful:

• Older adults, due to age-related changes in the heart’s electrical system
• People with chronic conditions such as diabetes or hypertension
• Individuals on medications that may slow the heart rate
• Those with a history of heart disease or prior cardiac events

Additionally, even healthy and active individuals should be cautious if they notice a sudden change in energy levels or exercise capacity.

Diagnosis: Simple Yet Crucial

Identifying bradycardia is relatively straightforward. Tests such as an electrocardiogram (ECG) provide a snapshot of the heart’s rhythm, while Holter monitoring tracks heart activity over an extended period to capture intermittent issues.

These tools help doctors assess not just how slow the heart is beating, but how effectively it responds to activity and rest. Early diagnosis can prevent complications such as falls, injuries, and a decline in overall functional capacity.

Managing Slow Heart Rhythms

Treatment depends on the underlying cause and severity of the condition. In some cases, addressing contributing factors such as medication adjustments or correcting metabolic imbalances may resolve the issue.

For individuals with persistent or symptomatic bradycardia, pacemaker therapy is often recommended. These devices help regulate the heart’s rhythm and restore adequate blood flow.

Recent advancements have introduced leadless pacemakers; small, self-contained devices implanted directly into the heart through a minimally invasive procedure. Compared to traditional systems, they offer reduced risk of complications, quicker recovery, and greater comfort. Importantly, with appropriate treatment, most individuals can return to active and fulfilling lives.

Listening To Your Body

Fatigue is easy to dismiss, especially in a fast-paced world where feeling tired has become the norm. However, persistent or unexplained fatigue should not be ignored.

Your body often provides early warning signs when something is amiss. Paying attention to these signals, seeking timely medical advice, and understanding the underlying cause can make a significant difference.

Conclusion

Not all fatigue is harmless. In some cases, it may be the heart’s way of indicating that it is struggling to keep up with the body’s demands. Recognizing this connection is the first step toward better health.

If tiredness feels unusual, persistent, or is accompanied by other symptoms, it may be time to look deeper. Because sometimes, the key to feeling better starts with understanding your heart and listening to its rhythm.

One of the major challenges in rehabilitation is that patients may discontinue midway through the recovery process. In rehabilitation, it is not just the physical journey; it involves both emotional and psychological factors.

When patients begin the rehabilitation journey, they are usually informed of the prognosis, which helps them start the journey with hope. During the process, they might face unexpected encounters such as slow progress and fatigue during exercises. Financial burden, family responsibilities, and social pressures can further add to their stress.

Some patients will not expect the recovery to be too long. Unlike a surgery, where results may appear immediately, rehabilitation demands repeated efforts and commitment for weeks or sometimes months. This might make the patient feel like they have put in a lot of effort, but results might be delayed.

As a rehabilitation physician, it is important to understand that this is not non-compliance or laziness. In a few cases, it is the patient’s exhaustion, fear, and loss of confidence. Additionally, patients might also experience a lack of engagement and fatigue in the exercises. They might feel uninterested in the exercise routine. Once these problems are addressed, there will be more measurable progress. The core idea of rehabilitation is not only to treat the body but to support the patient's mental and emotional well-being.

Barriers To Rehabilitation

The main barriers in rehabilitation are fatigue and pain. For instance, in a spinal cord injury, stroke, post amputation, orthopedic condition such as chronic musculoskeletal pain, and polytrauma, the patient will already be experiencing pain due to the injury. In rehabilitation, physical therapy, and occupational therapy, experts will make the patient do repetitive movements, resulting in emotional fatigue.

From a rehabilitation perspective, repetition is necessary for the development of neuroplasticity; the nervous system learns from repetition. On the contrary, from the patient's perspective, it might feel like a punishment. Even though they understand the benefit, they are frustrated, and it might alleviate the pain. This pain might develop into a fear response associating exercising with suffering, affecting the rehabilitation process.

Rehabilitation must be patient-centered, engaging, and goal-oriented. Today, several newer technologies are helping improve patient involvement and engagement in therapy. Approaches such as gamification and functional training can make rehabilitation more interactive and motivating for patients. For instance, new age AI-enabled devices such as ‘ArmAble’ that have games like chapati rolling, mosquito swatting, dosa making, etc. keep the patient very engaged as they do those activities. Though it might be repetitive, it is still very engaging for the patients.

Importance Of Progress During The Recovery Journey

Small achievements and visible progress can make a significant difference to the patient. For example, standing for 10 seconds longer, climbing one extra step, or moving a finger that could not be moved earlier. As human beings, when we begin to notice progress, hope naturally starts to grow. That hope becomes an important part of rehabilitation.

The challenge in rehabilitation is that progress is often slow in neurological recovery. Improvements may be microscopic, which are not immediately visible to the patient. This is why it is important to actively help patients recognize and understand their progress.

To help the patient understand, we document the patient’s condition from the beginning and show them the difference with the help of functional scores. We record videos to show the patient’s movement and compare it over the weeks of treatment. We also use functional assessment scores and balance testing equipment that convert progress into measurable numerical values. This can help patients see how much they have improved over time.

Setting weekly or fortnightly milestones. Smaller milestones are more realistic and achievable. Patients see progress after certain milestones. This helps rebuild their confidence and belief in the process.

Long-term risks of skipping rehabilitation

In case of neurological conditions like stroke or spinal cord injury, there is a golden period for rehabilitation. This is the time for spontaneous recovery, where the brain starts to relearn. The brain keeps making new connections with repetition. If the patient is not actively participating or completing rehabilitation during that time, they may lose the opportunity to achieve the results.

Even if the patient resumes rehabilitation after a period of time, benefits might not be as significant as envisioned. Discontinuing rehabilitation can lead to stiffness, reduced mobility, and functional limitations. In such cases, if the surgery may be technically successful, the outcome may not be satisfactory.

Beyond physical complications, incomplete or skipping rehabilitation can result in loss of independence. The ultimate goal of rehabilitation is to help patients restore their maximum potential and help them perform everyday activities with ease. Thus, completing rehabilitation is necessary, especially at the right time.

Motivated And Consistent During The Rehabilitation

Motivation is the fuel for rehabilitation. Motivation should not depend only on the patient’s willpower; it should be supported and guided throughout the journey.

Set Realistic goals

For example, in a high spinal cord injury, independent walking with an orthosis may be unrealistic, resulting in loss of motivation. Instead, rehabilitation should focus on short-term goals that can be achieved gradually. If goals are realistic, patients stay encouraged and committed to the process.

Importance of Family Involvement

Recovery is never limited to the patient alone; it should involve the entire support system to see desirable results. Families should be educated about the goals and be updated on the patient’s progress. Documenting the improvements can also help both patients and families stay positive and motivated during rehabilitation.

Communication

Tracking progress

Celebrating small victories, such as a slight improvement in balance or movement, should be acknowledged. This can significantly boost the patient’s confidence and motivation in the journey.

At times, we as rehabilitation professionals do much more than provide clinical treatment. We also become motivators, coaches, educators, and emotional support systems for our patients throughout their recovery journey.

We work with the patients during the most vulnerable phase of their lives, when they are not only struggling with the disease but also with their identity, confidence, and independence. So our responsibility is not just to improve muscle strength or to correct gait. We have to help restore their independence, daily functional movements, and help restore dignity, which makes it more meaningful.

Epilepsy is one of the most common neurological disorders and a leading cause of disability worldwide. Research has suggested that associated conditions, such as stigma, anxiety, and depression, can sometimes be more debilitating than the seizures themselves.

Stigma related to epilepsy can exist at both societal and individual levels, with many patients experiencing feelings of shame, fear, discrimination, and social isolation.

Now, research led by AIIMS New Delhi has suggested that yoga may help reduce epilepsy-related stigma while also improving seizure control. The 2023 study, published in Neurology, found that yoga-based interventions may offer benefits for both mental well-being and disease management.

“Yoga has been clinically proven to reduce the ‘felt stigma’ associated with epilepsy. By alleviating anxiety and improving both mindfulness and overall quality of life, mind-body interventions empower individuals to feel more in control and less socially isolated,” lead author Dr. Manjari Tripathi, Head of the Department of Neurology at AIIMS, told HealthandMe.

What Did the Study Find?

According to Dr. Manjari, the study identified three key benefits of yoga for people living with epilepsy:

• Stigma Reduction: Patients who participated in a six-month yoga and psychoeducation program reported a significant reduction in perceived stigma compared with the control group.

• Improved Seizure Control: The yoga intervention was associated with a higher rate of seizure reduction. "Participants were more than four times as likely to experience a greater than 50% reduction in seizures and were significantly more likely to achieve complete seizure remission," Dr. Manjari told HealthandMe.

• Better Mental Health: Yoga practice was linked to lower anxiety levels, improved emotional regulation, and reduced cognitive impairment.

Also read: Yoga's Increasing Role As Great Soft Power And Preventive Healthcare: Ayush Secretary

Dr. Rajesh Sagar, Professor of Psychiatry at AIIMS, told HealthandMe that yoga reduced the burden of epilepsy and improved the overall quality of life in epilepsy patients by reducing the perceived stigma. The overall quality of life was also improved in the yoga group.

How Was the Study Conducted?

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Researchers conducted a randomized clinical trial involving 160 adults with epilepsy who were followed for six months. Participants were assigned either a structured yoga program or a sham yoga intervention, while both groups also received epilepsy-related psychoeducation.

The yoga program included loosening exercises , breathing techniques, meditation, and positive affirmations.

While the impact on seizure frequency was reduced compared with the control group, the researchers cautioned that larger studies are needed to conclusively determine the effect of yoga on seizure control.

Yoga For Mental Health

Further, mood disturbances have been common among people with epilepsy and often remain inadequately addressed, particularly in developing countries.

According to the researchers, yoga may offer a scalable and accessible option for helping patients manage these challenges alongside conventional treatment.

Dr. Rajesh further told HealthandMe that yoga has well-established benefits for mental health.

“Yoga is important in mental health care, and it has been found that the three important things, which are pranayama, that is, breathing techniques, asanas, that is, physical posture, and dhyana, that is, meditation, have a positive effect on anxiety and even depression, and also improve sleep".

He added that yoga can help reduce stress, improve mood, lower anxiety levels, and enhance sleep quality.

“There is substantial evidence from around the world showing that yoga can benefit people living with certain mental health disorders,” he said.