Focus on healthspan as Singapore turns ‘super aged’

LONGEVITY means different things to different people. Some years ago, I wrote in a column that I found the prospect of a 100-year life daunting. More recently my colleague Leslie Yee wrote on the “curse” of longevity.

Decades ago, age seemed to just creep along. But since my 50s, I’d say it snowballs. Just this weekend my husband had a health scare: He fainted while jogging in the park. The impact left him in shock. Fainting of course is only a symptom of what may be more serious physical issues. He’s in his early 70s.

So, is longevity a blessing or a curse? As Singapore becomes “super aged”, defined by the United Nations as the threshold when 21 per cent of the population is 65 and older, the question turns on how well we manage ageing, as a population and as individuals.

I’m currently reading Dr Peter Attia’s bestseller Outlive: The Science and Art of Longevity. Longevity, he writes, can be very simplistically defined as how long you live. In this respect, genes play a role.

The second dimension is how well you live, or the quality of your years. Hence the concepts of lifespan and healthspan, respectively. Clearly, if we’re to live longer, we’d want to be in optimal health and not suffer severe disabilities from chronic illnesses.

The key, he argues, is to engineer a fundamental shift from the type of medicine that prevails today – which he calls Medicine 2.0, or the treatment of acute illnesses and injuries – towards medicine that anticipates and prevents chronic disease.

There is too much to detail in this column, but essentially Medicine 3.0 emphases prevention, rather than treatment. It considers the patient as a unique individual, and, most pointedly, focuses on healthspan rather than lifespan. As he sees it, a focus on healthspan has three pillars – physical, cognitive and emotional health.

Singapore in its Healthier SG initiative has made a start. Healthier SG assigns individuals to a doctor who ideally becomes a family doctor, able to design a health plan and advise on healthy habits and preventive care. In this respect, ActiveSG is a core feature as it offers a slew of facilities and physical activities for participants of any age.

But in healthcare there are still gaps, and that’s not surprising.

Emotional health, for instance, may be barely discussed, even though that can have knock-on impacts on physical and cognitive health. In my own health journey, now that I do have a chronic condition – osteopenia and osteoporosis – doctors tend to insist on medication, and barely discuss strength training, nutrition and supplements, apart from the low-hanging fruit which is calcium and vitamin D. Even with vitamin D, a relatively low reading – albeit still within the recommended range – was deemed “okay”. I disagree.

Singapore’s efforts through Healthier SG and ActiveSG are a good start in the quest towards an optimum healthspan. A good family doctor ideally can address the three major pillars of physical, cognitive and emotional health.

Committing to a health plan from a young age builds up a store of tangible and intangible health habits, which can serve as credits that we can hopefully draw on in times when we fall ill or become frail, which is inevitable.

These efforts should go a long way towards sustaining an optimum healthspan – a boon in a rapidly ageing society.