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

The liver and heart are two of the most vital organs of the body, and although they perform very different functions, they are closely connected. When the liver is not functioning properly, it can place significant stress on the heart and circulatory system of the body.

Liver disease not only affects the digestion process, metabolism, and detoxification but can also trigger serious cardiovascular changes that may go unnoticed in the early stages. Understanding this particular connection is significant for timely diagnosis and better overall care.

The Liver-Heart Connection

The liver helps to regulate the flow of blood, fluid balance, cholesterol metabolism, and inflammation as well. When liver disease develops—whether due to fatty liver, hepatitis, cirrhosis, or alcohol-related damage—all these processes become disturbed.

As a result of the same, the heart may have to work harder to maintain circulation, while blood vessels may also undergo certain changes that impact blood pressure and delivery of oxygen as well.

Changes In Blood Circulation

In well-advanced liver disease, especially cirrhosis, the flow of blood through the liver becomes restricted. This can also increase pressure in the portal vein, a condition known as portal hypertension. At the same point in time, blood vessels in the rest of the body may also widen, causing a drop in effective blood pressure.

To compensate, the heart pumps faster and harder. With the passage of time, this constant strain can weaken cardiac function and even lead to a condition sometimes referred to as cirrhotic cardiomyopathy, where the heart does not respond normally under stress.

Fluid Retention And Heart Stress

Liver disease often causes the body to retain both salt and water. This can also lead to swelling in the legs, abdomen, and surrounding tissues as well. Extra fluid in the body increases the workload on the heart, making it more difficult for it to pump blood in an efficient way. In severe cases, this may also contribute to shortness of breath, fatigue, and worsening cardiovascular strain.

Inflammation And Metabolic Impact

Some of the conditions, such as non-alcoholic fatty liver disease, are also linked with diabetes, obesity, high levels of cholesterol, and high blood pressure – all of which are the major risk factors for heart disease. Chronic inflammation, well-associated with liver damage, may further increase the risk of atherosclerosis and other cardiac complications.

GLP-1 receptor agonist drugs such as Ozempic and Wegovy have shown significant benefits for people with diabetes and obesity. However, not everyone experiences the same results.

Now, a study suggests that this variation may be due to genetic resistance, which means that some people are biologically less responsive to these medications, making these drugs less effective.

The new study by scientists at Stanford University in the US showed that about 10 per cent of the general population carry genetic variants that lead to what the researchers called “GLP-1 resistance”.

The GLP-1- receptor agonist drugs typically work by mimicking the hormone GLP-1 (glucagon-like peptide-1), which naturally helps regulate blood sugar by stimulating insulin release. The process slows the emptying of the stomach and reduces appetite.

However, in individuals with certain genetic variants, the team found that higher levels of GLP-1 did not regulate blood sugar better.

The researchers noted that the findings, published in the journal Genome Medicine, may be key to developing new therapies for people with GLP-1 resistance.

“There are a whole class of medications that are insulin sensitizers, so perhaps we can develop medications that will allow people to be sensitized to GLP-1s or find formulations of GLP-1, like the longer-acting versions, that avoid the GLP-1 resistance,” said Anna Gloyn, professor of pediatrics and of genetics at Stanford Medicine.

The Gene Linked to GLP-1 Resistance

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To zero in on the gene resistant to GLP-1 drugs, the team conducted experiments in humans. They traced this resistance to a PAM variant known as p.S539W.

PAM (peptidyl-glycine alpha-amidating monooxygenase) is an enzyme that is uniquely capable of activating many hormones in the body, including GLP-1.

While the researchers suspected that people with the PAM variant would have lower levels of GLP-1 in their blood, it actually increased levels of GLP-1. Although the exact mechanism is still unclear, experiments in both humans and mice confirmed signs of reduced response to GLP-1.

Analyzing diabetes drug trial data, they found that individuals with these variants were less able to lower their blood sugar levels even after six months of treatment. This suggests that despite having more circulating GLP-1, their bodies are less responsive to it.

“When I treat patients in the diabetes clinic, I see a huge variation in response to these GLP-1-based medications and it is difficult to predict this response clinically,” said Mahesh Umapathysivam, an endocrinologist and clinical researcher at Adelaide University in Australia.

“This is the first step in being able to use someone’s genetic make-up to help us improve that decision-making process,” he added.

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Importantly, participants with the PAM variants did not respond differently to other common diabetes treatments, including sulfonylureas, metformin, and DPP-4i.

The finding may help develop precision medicine, the researchers said. Knowing ahead of time who is likely to respond would help patients get on the right drugs faster, Gloyn said.

Reasons Why Ozempic May Not Help All People Lose Weight

Ozempic is primarily indicated for type 2 diabetes management. But some doctors may prescribe it for weight loss in appropriate patients without diabetes.

Previous research has shown that medical conditions such as sleep apnea, along with certain common medications, such as antidepressants, steroids, and contraceptives, can hamper the process of shedding extra pounds.

Another major reason that can hamper weight loss is the side-effects of these drugs that can prompt a person to halt their prescription mid-way.

Once widely known as non-alcoholic fatty liver disease (NAFLD), the common and dangerous fatty liver condition was rephrased as Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) due to its strong link to metabolic health issues like obesity and diabetes.

MASLD now includes patients with fatty liver disease linked to metabolic risk factors such as obesity, diabetes, and hypertension.

MASLD: So What Prompted The Change?

Globally, it was observed that all patients who have non-alcoholic fatty liver disease also have some associated form of metabolic dysfunction. The patients reported having either obesity, diabetes, metabolic syndrome, hypertension, or cholesterol problems.

And all these problems eventually lead to significant comorbidities later, like some people developed heart disease, while others developed complications of diabetes.

In view of these, a global consensus process in 2023 involving hundreds of experts from different countries adopted MASLD as it better reflected these underlying causes of the condition.

What Does MASLD Mean?

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MASLD is an umbrella term for liver conditions that develop in the presence of 1 or more cardiometabolic risk factors—including high blood sugar, elevated body mass index (BMI), and hypertension—but in the absence of other causes of liver fat accumulation.

The condition can be defined by excess liver fat accumulation (more than 5 per cent of liver weight) in the presence of metabolic dysfunction, independent of alcohol intake.

It encompasses a spectrum from simple steatosis to steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma.

“Initially, it was thought that having fatty liver disease without alcohol was a benign condition, but now it is recognized that, since it is associated with lots of metabolic comorbidities, it's no longer benign,” Dr. Ashish Kumar, Professor of gastroenterology and hepatology at Sir Ganga Ram Hospital in New Delhi, told HealthandMe.

He stated that whenever a diagnosis of fatty liver is present, "we should actually include other comorbidities, like obesity, dyslipidemia, which means cholesterol problem, diabetes, sugar problem, pre-diabetes, and hypertension. At least 50–70–80 percent of these patients will have one or more of these comorbidities".

Why Alcohol Is Not The Only Culprit For Fatty Liver

Although alcohol has remained the number one risk for liver disease, MASLD seems to be rising globally, including among people who do not drink. Why?

The reasons include:

a sedentary lifestyle,

increased consumption of fast and processed food,

lack of exercise,

lack of sleep,

stressful life.

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The experts noted that food, especially the increasingly accessible junk food or processed food, is a major culprit.

“So even if the person is not drinking alcohol, people are developing addiction to processed food, and this is causing an epidemic level of obesity and diabetes. Consequently, MASLD is also increasing, and now it is becoming the number one cause of liver disease,” Dr Kumar said.

How To Prevent MASLD?

According to Dr. Sanjay Goja, Director, Liver Transplant & HPB Surgery, Narayana Hospital, Gurugram, prevention must focus on following a healthy lifestyle like maintaining a healthy BMI, engaging in regular physical activity, and eating a balanced diet.

Controlling diabetes, cholesterol, and blood pressure is also important to prevent the risk of MASLD.

Dr Siddharth Badola, Manipal Hospital, Ghaziabad, suggested sustainable lifestyle changes such as:

Maintaining an adequate body weight: Even slight weight loss (5–10 percent) has been shown to significantly reduce liver fat and inflammation.

Follow a balanced and nutrient-rich diet: People should focus on consuming whole grains, fresh fruits and vegetables, lean proteins, and healthy fats, while limiting refined carbohydrates and processed foods.

Avoid foods with added sugar: Excess consumption of fructose, commonly found in packaged foods and sugary beverages, is a key contributor to fat accumulation in the liver.

Engage in regular physical activity: At least 150 minutes of moderate-intensity exercise per week is recommended to improve insulin sensitivity and liver health.

Manage associated metabolic conditions: Effective control of diabetes, hypertension, and dyslipidemia is essential in reducing the risk of MASLD progression.

Ensure adequate sleep and stress management: Poor sleep quality and chronic stress can negatively impact metabolic balance and liver function.

Keep your body hydrated with ample water intake and follow structured meal timings.