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0:55 Braille In the name of Allah, the Most 1:22 Gracious, the Most Merciful. Peace be 1:23 upon you, and Allah's mercy and 1:24 blessings. Brothers and sisters, may 1:26 you be blessed. Praise be to Allah, we 1:29 are gifted with opportunity, health, 1:32 guidance, support, and the mercy of 1:34 Allah Subhanahu wa ta'ala, which allows 1:37 us to be together in this health 1:39 segment on Radio Silaturahim for one 1:41 Islam. May this make us servants of 1:46 Allah who are adept at caring for 1:49 ourselves, both outwardly and inwardly, 1:51 to optimally serve Him. Let us not 1:55 forget to offer prayers and peace upon 1:57 our beloved leader of the ummah, 1:59 Muhammad Rasulullah sallallahu alaihi 2:01 wasallam. May we be reunited with him 2:05 one day in the moments we long for in 2:08 the hereafter. Brothers and sisters, 2:13 today the health segment again presents 2:16 a doctor from Yarsi. You know, a 2:22 hospital that we often hear about 2:26 through Rasil, with its motto of 2:30 dedication, compassion, and innovation, 2:35 and it is a sharia hospital that truly 2:39 makes us feel very close to it. She is 2:45 the one sent today to be here with us. 2:48 Especially for those of you who feel 2:50 you are stepping into your golden years 2:53 , hopefully, this topic is just right, 2:55 featuring Dr. Aulia Rizka, a specialist 2:58 in internal medicine and geriatrics, 3:00 who is ready here. Peace be upon you, 3:04 Doctor. 3:05 And peace be upon you, and Allah's 3:06 mercy and blessings. 3:07 Are you well? Praise be to Allah. Yeah. 3:10 So, as I mentioned earlier, reaching 3:14 those golden years does not mean it is 3:17 already time for something we must 3:20 avoid: senility. So that is our topic 3:25 today. 3:26 Prevented, yes, prevented. 3:27 Preventing senility in the golden years 3:30 . Yes. Dr. Aulia Rizka received her 3:34 general medical degree from UNAIR and 3:37 her specialization from the University 3:39 of Indonesia. Let us listen. Hopefully, 3:43 you are ready with questions to send 3:46 via WhatsApp should you wish to know 3:49 more. Please, Doctor. 3:51 Thank you. Peace be upon you, and 3:53 Allah's mercy and blessings. Ladies and 3:55 gentlemen, whom I respect. So, this 3:58 afternoon, we will chat and discuss how 4:01 to prevent senility in our senior years 4:04 . Perhaps we shouldn't call it "old," 4:07 but "senior." 4:09 Ladies and gentlemen, in Indonesia, the 4:12 threshold for what is called "advanced 4:15 age" is being over 60 years old. So, if 4:20 you or your parents are 60 years or 4:23 older, that is considered advanced age. 4:28 Abroad, this age threshold is even 4:30 higher. But in Indonesia, we indeed 4:32 still use the 60-year-old threshold. 4:37 Now, we know that approaching 60, 4:40 perhaps from 50 upwards towards 60 and 4:43 beyond, there are many changes in our 4:46 bodies that will naturally occur. 4:52 Starting from perhaps one's appetite, 4:55 which is usually good, becoming 4:57 diminished, and then the feeling of 5:00 fitness or energy to carry out daily 5:03 activities. Sometimes it declines 5:07 because there is a lot of joint pain, 5:09 and the body gets tired easily, among 5:11 other things. And also, what is often 5:15 complained about or experienced is 5:17 being forgetful, which to some extent 5:20 can interfere with our quality of life. 5:25 Yes. 5:26 So, this forgetfulness doesn't actually 5:30 only happen to those over 60 years old. 5:35 People younger than that might also 5:38 start showing signs or symptoms that 5:41 lead toward forgetfulness. However, we 5:46 do realize that as we age, the brain's 5:49 ability to process information and to 5:52 remember slowly declines. So, first, 5:57 perhaps we will talk about our brains. 6:03 God gave us a brain, an extraordinary 6:06 organ because it contains a vast number 6:09 of nerve cells, more than 100 billion, 6:12 woven in such a way that it performs 6:15 many tasks, starting from recognizing 6:18 objects, to remembering, using language 6:21 , making decisions, and many other 6:24 brain functions that, even if we are 6:27 not aware of them, are performed every 6:32 second, every minute, allowing us to be 6:34 humans who can interact with others. 6:39 Now, as we age, the speed at which 6:42 these nerve cells work and their size 6:45 will certainly change. That is what 6:48 will greatly influence why our brain's 6:51 performance is not what it used to be. 6:56 Now, the topic this afternoon is about 7:00 senility. But we need to know that 7:04 there is something called the normal 7:06 aging process in our brain and our 7:08 memory. So, not all forgetfulness means 7:12 senility. Not all seniors will 7:15 experience senility. Because, in fact, 7:19 senility is not part of the normal 7:21 aging process. The normal aging process 7:26 in our brain does involve some decline, 7:29 but the decline that occurs will not be 7:31 too severe. For example, sometimes you 7:36 forget where you put something, 7:40 sometimes you forget the name of a 7:43 friend you just met, or sometimes you 7:47 forget what you were about to get, 7:50 where you put your car keys or a 7:54 certain item; it happens sometimes. 7:59 That is normal forgetfulness or 8:02 forgetfulness that can be part of the 8:05 natural process of aging. But we also 8:12 need to know that there is a severe 8:15 type of forgetfulness that leads to 8:18 senility, which is an abnormal process 8:21 or not part of the normal aging process 8:24 . So, we need to be aware of certain 8:31 signs, perhaps in our fathers, mothers, 8:35 or even yourselves, to know if it is 8:39 truly leading toward a process of 8:42 forgetfulness or senility that is 8:45 actually a disease. Some of the signs 8:51 that occur if this memory decline or 8:55 brain function decline leads to 8:58 senility are that we become forgetful 9:01 or unable to remember short-term things 9:05 anymore. So, the signs that we can see 9:11 or observe are, for example, if we see 9:14 our parents or people around us 9:17 frequently repeating questions. For 9:22 instance, they just asked question A 9:24 earlier. Then, two minutes later, they 9:28 will repeat the same question. Two 9:30 minutes later, they repeat the same 9:32 question again. Now, that is a sign 9:34 that our ability to store short-term 9:38 memory is impaired. Often, this becomes 9:43 an early sign that we must be wary of 9:46 regarding the decline in brain capacity 9:49 associated with senility. At first, 9:55 perhaps that is what is found. So, 9:59 repeating words or repeating activities 10:01 . For example, they already prayed, 10:04 then they want to pray again. They 10:06 already ate, then five minutes later, 10:07 they want to eat again. Because they 10:09 forgot that they had already done so. 10:12 Now, this decline is accompanied by 10:15 other declines. Because we remember 10:18 earlier that brain functions are 10:20 numerous, not just memory. For example, 10:24 making appropriate decisions; for 10:26 instance, it is natural that when we 10:29 leave the house, we should be fully 10:32 dressed, but then they leave the house 10:35 in somewhat inappropriate clothing. Now 10:39 , that is actually one of the signs 10:42 that there is a change in our brain 10:44 function in determining what is right 10:47 and what is not. Besides that, for 10:51 example, it is usually not difficult to 10:53 shop at the market or to calculate 10:55 simple money matters; there is no 10:57 problem. But now, they become confused 11:00 when they want to pay, thinking how 11:02 much money they should take out. So, it 11:05 takes a long time to think about how 11:08 much money they actually need to pay. 11:11 Now, those are signs pointing towards 11:15 senility that we must be wary of, and 11:18 also, these things—if one is senile 11:21 —will interfere with that person's 11:24 ability to perform daily activities. 11:28 For example, if we recall earlier, what 11:31 was it? They are no longer skilled at 11:34 using money; for example, they used to 11:36 be able to tend to a shop, but then it 11:39 becomes difficult, and with these 11:41 difficulties, it becomes hard to 11:42 perform daily activities that were 11:44 usually easy to do. Usually at home, 11:47 they could still do everything 11:49 themselves, like getting dressed or 11:50 eating. But then, with declining brain 11:54 capacity, they get confused when 11:56 wanting to cook, such as whether to 11:59 turn on the stove first or what to turn 12:01 on first. Those sequences are no longer 12:05 easy or spontaneous to think about. Now 12:09 , that will eventually interfere with 12:11 activities that are usually done. So, 12:15 those were some signs that we must 12:18 observe or be wary of as part of the 12:21 senility process, or in medical terms, 12:24 often called dementia, which is 12:27 actually not a normal process but a 12:30 process that we need to pay attention 12:33 to and look for ways to prevent. Today, 12:37 we will talk about prevention. That is 12:42 roughly a little bit of an introduction 12:46 about what senility actually is. 12:50 Yes. It seems we tend to think it's 12:54 normal if it's like this or like that. 12:58 But it turns out, if we look closely, 13:00 there are many things we can try to 13:02 prevent, Doctor. That's correct. 13:06 Certain things that will make our 13:08 future steps more steady. Among the 13:13 many watching, Doctor. Someone is 13:16 asking, if you just forget which rakaat 13:18 you are in during prayer, is that 13:20 normal or not? How do we fix it? I am 13:23 only 61 years old. Uh-huh. 13:25 Okay. Yes. Yes. Ma'am. So sometimes, 13:30 well not just sometimes, when we are 13:33 doing something we need to concentrate 13:36 or be, what is it, mindful or focused. 13:41 Besides that, to be able to remember, 13:44 our brain must truly be in a state of 13:47 readiness. Meaning if we are sleepy, 13:50 our memory will also decline. Now, 13:53 those things are normal occurrences. 13:55 For example, if we are not 13:56 concentrating or find it hard to 13:58 concentrate, then we don't remember 14:00 something, or if we are very sleepy 14:02 because we had trouble sleeping last 14:04 night, today we become forgetful. That 14:06 is also something understandable. 14:07 Because the brain indeed needs optimal 14:11 conditions to function. So, not being 14:14 sleepy and having good concentration. 14:16 Now, those are the requirements that 14:18 must be met if we want our brain to be, 14:21 what? Maximal. However, if someone is 14:23 senile, even if they aren't sleepy and 14:25 are concentrating, that memory just 14:27 cannot be retrieved. So it will just 14:29 disappear like that. Now, that is what 14:33 we need to distinguish between normal 14:35 forgetfulness, in quotes, and 14:37 illness-related forgetfulness, or 14:39 senility. 14:42 Like that. 14:42 Yes. So for some things, if the 14:46 forgetting is due to sleepiness, that's 14:49 possible. But if it's like the case 14:53 from the lady—I don't have her name 14:55 —who asked how to overcome it, 14:57 perhaps as I once heard from a 14:59 religious teacher, just recite the same 15:02 surah every second rakaat so you 15:04 remember, or other things. Okay, Doctor 15:07 , there is a question. I heard this 15:10 from Mrs. Ina. I heard that consuming 15:15 too much sugar will also cause 15:17 interference, not just physical illness 15:19 , but also make you forgetful; is there 15:22 really a connection? Thank you. Yes. 15:28 Okay. Right. So this is a very 15:30 excellent question and we need to 15:33 relate it to what we call risk factors 15:36 or things that increase the likelihood 15:39 of us becoming senile later in life 15:42 when we are elderly. There are several 15:46 risk factors that cannot be changed. 15:49 For example, being female. Women have a 15:52 higher risk of experiencing senility 15:54 than men. 15:55 Wow. 15:56 Second, genetics. Meaning if one or 16:00 both of your parents were senile, we 16:03 have a higher risk of experiencing 16:05 senility ourselves. Now, those are 16:09 things that cannot be changed. Meaning 16:11 if you are a woman and your parents 16:13 were senile, there is nothing we can do 16:15 about that. Well, but there is some 16:17 good news. So, there are risk factors 16:19 that can actually still be managed. It 16:23 means if we really want to make an 16:25 effort to reduce those risk factors, 16:28 hopefully, God willing, the dementia 16:30 won't appear, or if it does, it won't 16:32 appear too soon. One of them is smoking 16:36 , for example. Smoking is a known risk 16:39 factor, and it's actually something we 16:42 can try not to do. Then there is 16:45 uncontrolled high blood pressure, high 16:48 blood sugar, or uncontrolled diabetes. 16:51 Then, these things also increase the 16:53 risk of a heart attack or stroke. Both 16:56 of which also increase the risk of 16:58 dementia. So, actually, the link 17:02 between eating sweets or frequently 17:04 eating sweets is that the blood vessels 17:07 , including those in the brain, have 17:10 walls that change to become more 17:12 fragile, stiffer, and it becomes harder 17:15 for blood flow to be smooth. Now, that 17:20 is one of the reasons why eating sweets 17:23 or having diabetes...... 17:26 if it becomes diabetes, it turns into a 17:28 risk factor for dementia. So, those 17:32 risk factors that can still be 17:34 addressed are exactly what we must 17:36 prevent so that dementia doesn't appear 17:39 , or if it does, the hope is that it 17:41 appears at a very old age, not too 17:44 early, like that. Okay, I'll go to 17:49 someone who has responded on Rasil 17:52 YouTube, this is from Mr. Amin. I am 29 17:56 years old and experiencing a lack of 17:59 focus. So, when I'm working on 18:03 something, in the middle of it, I often 18:05 do other things for a long time until I 18:07 forget the original task. Even though 18:11 I'm only 29, so it's probably not 18:12 because of age, right, Doc? Why is this 18:15 , Doc? Okay, Mr. Amin. Right. So, 18:18 perhaps regarding the previous question 18:21 , for us to be able to concentrate, 18:24 many things certainly need to be 18:27 maintained. First, for example, having 18:31 good motivation, not being in a sleepy 18:34 state, and having no distractions. 18:37 Meaning things that easily make us 18:39 shift our focus, and we end up getting 18:41 absorbed in doing that instead. Now, 18:44 those are the things that will reduce 18:46 our ability to complete a task. At that 18:51 age, I think the brain should still be 18:54 in prime condition. Meaning there 18:58 should be no problems in terms of 19:00 remembering information, planning, and 19:02 so on. So, those things can be managed 19:07 by trying to focus on one task at a 19:09 time, because this is actually 19:12 something that can be trained, so we 19:15 aren't easily distracted by other 19:17 things, allowing us to complete tasks 19:20 well. Something else that can actually 19:25 reduce memory capacity or make us more 19:28 forgetful is feeling sad, or feeling 19:31 anxious, or depressed. Now, that makes 19:35 it harder for us to remember and makes 19:38 it harder for us to focus on a task or 19:41 job. So, we really must try to keep our 19:46 mood or our state of mind in a good 19:48 condition so that the brain doesn't 19:51 have trouble performing its tasks. 19:54 Something like that. So, the brain 19:57 plays a vital role in the matters we 19:59 are discussing, like this question from 20:05 um, there is no name here, but it's 20:07 from YouTube. Uh-huh. "Doc, I have a 20:11 parent who is senile.""How do I handle 20:13 them?""Because they get emotional.""My 20:16 parent is the one who forgets, but I 20:18 get blamed." Yes. Yeah. Yes. Indeed, 20:24 this is often the complaint or 20:26 something expressed by family members 20:29 or children of patients whose parents 20:33 are starting to experience memory 20:35 decline. This decline can start from 20:39 being mild. Meaning, they can still 20:41 actually perform their usual activities 20:44 , up to being very severe. Meaning, 20:47 their ability to perform daily 20:49 activities is completely gone, so they 20:52 eventually need help with everything, 20:54 because senility or dementia is usually 20:57 a process that gets worse over time. So 21:00 , it's progressive. As time goes on, 21:04 the degree becomes more severe until 21:06 they eventually have difficulty 21:08 performing activities that they could 21:10 usually do. Now, in some types of 21:14 senility or dementia, this can also be 21:17 accompanied by behavioral disturbances. 21:21 Which means the patient becomes more 21:24 easily angered, offended, or in some 21:26 cases can become aggressive, for 21:28 example, hitting others and so on. It's 21:33 not because they are fierce or cruel, 21:36 but because the process inside their 21:39 brain causes these changes to occur. 21:43 Now, as children or family members who 21:46 live with them and who are experiencing 21:48 memory decline, we can try several 21:51 things. First, of course, if the parent 21:55 has diseases that can still be 21:57 controlled, for example, hypertension, 21:59 diabetes, heart disease, or stroke. We 22:02 must ensure regular treatment so that 22:05 the decline does not become 22:07 increasingly severe. So, regular 22:10 check-ups with the doctor and taking 22:12 medication regularly are very important 22:15 because they prevent the decline from 22:17 being too sharp. Secondly, we can also 22:21 encourage them to learn many new things 22:24 . For example, would they like to learn 22:28 to memorize the Quran, learn something 22:32 new that they might enjoy, because that 22:36 is one way to maintain memory or train 22:39 the memory. For example, learning 22:42 gardening and so on. New things that 22:45 can be learned at any age are an effort 22:49 to train the brain. Besides that, 22:53 interaction with other people, with 22:56 family, and with peers is also 22:57 something we need to encourage. Now, if 23:02 there are indeed behavioral 23:03 disturbances or what you call it? A 23:07 change, right. We feel that their 23:10 personality or behavior has changed. We 23:13 need to immediately take our parents or 23:16 our family members to the doctor to see 23:20 if medication or other assistance is 23:23 truly needed so that their behavior 23:26 does not endanger themselves or others 23:29 around them. Medication is often needed 23:35 to control this, so that their quality 23:37 of life can then be improved. Perhaps 23:40 something like that. 23:41 Yes. To those who care for parents who 23:45 are already over 60, thank you very 23:47 much because your care is an 23:49 extraordinary form of love. This one is 23:52 from Mr. Arman. Doc, my mother has 23:56 vascular dementia and was referred to 24:01 cardiology, neurology, and psychiatry. 24:03 At the psychiatry clinic, I'm not sure 24:06 if it was a psychiatrist or not, they 24:09 gave my mom 1 mg of risperidone and 0.5 24:12 mg of lorazepam. My mother seems to 24:17 have hallucinations, gets angry 24:19 suddenly, cries, then wants to wander 24:21 off, and is difficult to calm down. 24:25 When the medication ran out and we 24:27 hadn't had a check-up at the clinic yet 24:28 , I looked for the same medicine but 24:30 with a different dosage. Um, to make it 24:35 the same, I gave my mother one and a 24:38 half tablets at night. The effect was 24:41 that my mother had trouble sleeping, 24:43 but actually slept more until the next 24:45 morning. Oh no. And during the day, she 24:48 was also quieter or more obedient; 24:50 because of that effect, I stopped 24:52 giving her the medicine. Is that safe, 24:56 Doc? Please provide some enlightenment. 24:59 Yes. 25:00 Yes. All right. Uh, thank you for the 25:02 question. So, for medications like this 25:07 that can manage or attempt to ensure 25:11 that their behavior or activities are 25:15 stable for the majority of the time. 25:20 Indeed, the selection process must be 25:23 done very carefully. We must understand 25:27 that there are many changes in an 25:29 elderly person, so the choice of 25:31 medication must not be wrong. Because 25:36 usually their kidney function and liver 25:38 function have started to decline, and 25:41 then their muscles have also started to 25:44 shrink, because most of the metabolism 25:46 and the drug will be bound to the fatty 25:49 tissue that is usually present. Well, 25:53 those changes will cause the drug's 25:56 properties to change. Whether it stays 26:00 longer in the body and takes longer to 26:02 be excreted, so the effect becomes 26:04 prolonged, which can lead to side 26:06 effects that we sometimes do not expect 26:08 . Therefore, the use of such 26:12 medications must be chosen by the 26:14 doctor in accordance with other 26:17 illnesses experienced by the patient in 26:19 question. For example, choosing 26:22 medication for a patient with declining 26:24 kidney function is specific, and if 26:27 there are other comorbidities, the 26:29 medication is also specific. So the 26:31 selection must indeed be very careful 26:33 and usually starts with a small dose 26:35 first, then is increased slowly 26:37 according to the response shown. So I 26:41 think it is easier and safer if the 26:44 doctor chooses which one is most 26:47 suitable for your parent. And yes, for 26:52 medications like this, when at home as 26:54 a family, we really need to observe the 26:57 side effects that occur after 26:59 administration and then discuss them 27:01 further with the doctor. Because the 27:04 response can indeed be different for 27:06 each person, so the process of choosing 27:09 which medicine is suitable often takes 27:11 time and requires discussion with the 27:13 doctor, which one is actually the most 27:16 appropriate or fitting for our parents, 27:18 perhaps like that. Yes. And if asked 27:22 which hospital to go to, there are 27:24 indeed many choices. But I want to 27:27 convey that this IRC Hospital is a 27:30 sharia-compliant hospital which of 27:34 course hopes that the patients served 27:38 also receive high-quality service, both 27:42 Muslim and non-Muslim. And as a 27:45 sharia-based hospital. Hopefully, this 27:49 hospital is friendly and comfortable 27:51 for anyone who visits. I will provide 27:54 the address at the end, Doctor. Let's 27:57 continue with one question before we 27:59 move on to what was mentioned about 28:01 what the aging process is like. This is 28:04 from Ms. Riza. Peace be upon you, 28:07 Doctor. My father is 50 years old, 28:13 suddenly lost a bit of his memory and 28:15 has difficulty understanding 28:17 conversations. He has also been lost 28:20 and didn't know the way home, Doctor. 28:23 Is the illness my father is suffering 28:25 from actually a neurological disorder 28:27 or a psychological one? If we have to 28:30 take him to the hospital, should we see 28:32 a neurologist, a psychologist, or how, 28:35 Doctor? Please respond. Thank you. Yes. 28:38 Alright, thank you. So, regarding the 28:42 previous complaint where memory 28:45 suddenly declined and then... 28:48 getting lost and not being able to find 28:49 the way home, 28:49 not being able to find the way home 28:51 means there is a memory disturbance 28:53 that...is something that I think needs 28:59 to be checked immediately because 29:01 remembering home, home is something we 29:04 usually head to, meaning it is 29:07 something very natural for us to 29:09 memorize. Now, suddenly not knowing it. 29:12 So, this is something that needs to be 29:13 investigated immediately. Because 29:15 usually, if it is sudden like this, we 29:18 must ensure there are no problems in 29:21 the brain causing this to happen. Now, 29:25 if there are complaints like this, 29:28 there are several doctors you can visit 29:31 who are experts, for example, a 29:34 neurologist, a psychiatrist, or an 29:37 internist who is a geriatric consultant 29:40 if the age is over 60 years. So later 29:45 the doctor will perform an evaluation 29:47 on whether the problem is due to a 29:49 decline in brain function that results 29:52 in complaints like this or if there are 29:54 other factors. It was mentioned earlier 29:57 , is this a psychological problem? Well 30:00 , it is very possible or it could be 30:03 that a state of deep sadness or 30:05 depression then reduces our ability to 30:08 remember. Because of that, the doctor 30:10 will later distinguish which process it 30:12 actually is. Because that will later 30:15 determine what therapy or treatment 30:17 will be given, depending on what the 30:20 main cause actually is. 30:22 Yes. 30:23 Thank you, Ma'am. 30:24 Erm, many are waiting, Doctor. How we 30:27 should be aware of the aging process. 30:29 Perhaps you could give us a little clue 30:31 about what the process is like. 30:34 Okay. All right. So, ladies and 30:37 gentlemen, we all certainly know that 30:40 everyone actually has a chronological 30:43 age. Chronological age is our age as 30:47 stated on our respective ID cards. So, 30:50 it means if someone was born in, say, 30:54 1950, their chronological age is 73. As 30:58 of this year, that is the chronological 31:00 age. 31:01 Everyone can calculate it easily. But 31:04 there is also what is called biological 31:06 age. Age. Sorry. So, we can see the 31:09 chronological age on our ID, and 31:11 actually, by what? By definition, if 31:13 you are over 60, you are definitely 31:15 considered elderly. That is because it 31:18 was established by the WHO and the 31:20 government. But there is also something 31:22 called biological age. Biological age 31:25 is the age of our body or our body's 31:27 organs, which is not necessarily the 31:29 same as our chronological age. This 31:33 means it is possible for someone who is 31:35 80 years old, with a chronological age 31:37 of 80 on their ID, to actually have a 31:39 biological age of 55, for example. So, 31:43 their organs are much younger compared 31:45 to their chronological age, their ID 31:47 age. Conversely, it could also be that 31:52 they are still young on their ID, say 31:54 45, but biologically, their organs are 31:57 already like those of someone who is 70 32:00 years old, for instance. So, 32:03 chronological age is not the same as 32:06 biological age. Because of that, we can 32:09 realize that we don't have to wait 32:12 until we are 60 to feel the aging 32:14 process happening in our organs. And 32:18 conversely, if we can take good care of 32:21 our body with good nutrition and lots 32:24 of activities—staying active, meaning 32:27 not just sitting around or lacking 32:30 exercise—we can strive to ensure that 32:33 the aging process, in quotation marks, 32:36 appears much later after 60. So it is 32:39 only felt when one is at a very 32:41 advanced age, for example. That is 32:43 something that can be strived for. Now, 32:46 the aging process itself occurs in all 32:50 organs from head to toe, and the rate 32:54 of decline of our organs as we age is 32:57 different. There are organs that, 33:00 starting from age 40, have already 33:02 begun a slow decline in their ability, 33:04 for example, kidney function. There are 33:07 also organs with a very, very slow 33:09 aging process. Now, the brain is one 33:13 that will begin to decline slowly after 33:16 about age 60. So, the rate for each 33:21 organ to decline is different, as is 33:25 the time it starts. We can strive for 33:29 this with good nutrition and physical 33:31 activity from a young age. Because, 33:34 indeed, if you want to be healthy in 33:37 old age, you cannot start when you are 33:39 already elderly, or the results will 33:41 not be as good compared to if we had 33:43 strived for it from the beginning, for 33:46 example, from age 30 and up. Because if 33:50 we take those efforts from the start, 33:53 we hope that the biological aging 33:55 process can be slowed down. Now, this 34:00 aging process greatly affects our 34:03 bodies and our organ functions. Perhaps 34:07 we have discussed the brain quite a bit 34:09 earlier. Another aging process, for 34:12 example, in the digestive tract, makes 34:15 our stomach capacity smaller and slows 34:17 down bowel movements. That is why 34:22 elderly patients or people get full 34:26 very easily and do not often or rarely 34:30 ask for food. Because their stomach 34:34 capacity is indeed smaller and emptying 34:36 will be delayed. So, to maintain good 34:41 nutrition, we must ensure that our 34:44 parents eat in small but frequent 34:47 portions because their stomach capacity 34:50 naturally decreases. Now, another aging 34:55 process also occurs in the lungs. For 34:58 instance, the ability to clear the 35:00 lungs if germs enter is reduced because 35:03 the cough reflex also usually decreases 35:06 with age. This makes elderly people 35:10 more prone to lung infections. To 35:14 prevent this, there are many things we 35:17 must strive for. For example, dental 35:19 and oral health must be properly 35:21 maintained. Brushing teeth and rinsing 35:24 must be done consistently and well. 35:27 Then we can also pursue vaccination, 35:30 because vaccinations for the elderly 35:32 reduce the risk of severe lung 35:34 infections. Then we must also pay 35:38 attention to whether there are any 35:40 swallowing disorders. Because as we age 35:43 , swallowing disorders often start to 35:45 occur, which causes, what is it? The 35:50 ability to send food to the esophagus 35:53 is disrupted, and if food goes down the 35:55 wrong pipe into the lungs, lung 35:58 infections can easily occur. Those were 36:03 some examples of things that change as 36:05 we age, and many organs are affected by 36:08 the aging process, but it is actually a 36:11 process we can work on to prevent it 36:14 from appearing too quickly, even as our 36:17 chronological age increases. Okay, 36:22 before we continue, let's look at 36:25 another question sent in, maybe there 36:28 is a name below, Doc. I am 78 years and 36:32 2 months old. Thank God, I still always 36:36 remember to pray Tahajud. But please 36:39 give some insight on how not to become 36:42 senile; at 78, that is already very 36:45 cool, Doc. But they still want to get 36:49 some insight. How not to become senile. 36:52 Okay. 36:53 Okay. Yes. I think if at 78 you can 36:58 still worship well and still perform 37:03 light activities well, that is very 37:08 good. So that is something we should be 37:11 grateful for. Now, you asked about how 37:15 to avoid becoming senile. Of course, we 37:18 want it not to appear at all, or as I 37:21 said before, if it does appear, let it 37:24 not be too early. The first thing that 37:28 can be done is, if there are diseases 37:31 that increase the risk of dementia, for 37:34 example hypertension, diabetes, high 37:37 cholesterol, or perhaps a history of 37:40 stroke or heart attack. Well, we must 37:44 seek regular treatment so that it does 37:47 not degrade our current memory or 37:49 existing brain function, ensuring the 37:52 decline is not too rapid. The second 37:55 thing, we must learn many new things. 37:58 As I mentioned earlier, for example, 37:59 memorizing the Quran or learning 38:01 something new that we like, but the 38:02 condition is that it must be something 38:04 we enjoy. This means I cannot be the 38:07 one choosing it for you, Sir or Madam. 38:10 Because it is not certain that what I 38:12 choose is something you would actually 38:13 like. So, what is it that you actually 38:15 enjoy? Do you like gardening, for 38:17 instance? Learning to plant a new plant 38:21 requires a learning process that 38:23 actually trains our brain, or perhaps 38:26 learning to cook new dishes if you like 38:28 cooking. So, indeed, we should choose 38:32 activities that involve learning 38:34 something new but something we like; it 38:36 should not be something forced upon us. 38:39 Because if we are not happy, the brain 38:42 will not be stimulated either. The 38:44 third thing, social interaction with 38:46 other people must be done as much as 38:48 possible. Because without realizing it, 38:51 meeting people is actually an exercise 38:53 in choosing words, practicing memory, 38:55 and feeling happy. Happiness also 38:58 greatly influences memory and our 38:59 brain's capabilities. So, by 39:02 interacting as much as possible with 39:04 friends or family, it is essentially an 39:06 effort to train our brain. Then, simple 39:10 and light exercise, which is 39:12 appropriate for any underlying 39:14 conditions, can also be done. So, these 39:19 things that seem simple, if done 39:22 routinely, can reduce the risk of 39:24 dementia, so that, God willing, the 39:27 dementia will not occur. Like that. Um, 39:33 brothers and sisters may have also 39:36 heard regarding Gitasav. Public because 39:42 of her comments about staying young. 39:44 There is someone asking here without a 39:47 name. Um, Doc, I want to know about the 39:52 comment that became a public spotlight 39:56 regarding staying young, which sparked 39:59 controversy because it was said that 40:02 not having children or being " 40:05 child-free" is an anti-aging or natural 40:08 youth solution. Is that true, Doc? 40:13 Yes. 40:14 Alright, yes. So, from a medical 40:17 science perspective, I think back to 40:19 the idea that if you want to be 40:20 naturally youthful, chronological age 40:22 certainly cannot be changed, because as 40:25 time goes by, our chronological age 40:27 will definitely get older and keep 40:29 increasing. However, biological age is 40:34 something that can be managed, and one 40:37 of the things that greatly influences 40:41 biological age is our mindset, or 40:43 feelings of joy, being free from 40:46 anxiety, and free from sadness, which 40:49 are things that must be pursued. I 40:54 think when it comes to, uh, children, 40:57 that will, uh, be different. Perhaps 41:00 I’m not in the context to discuss 41:03 that, but clearly, uh, having children 41:06 if it makes you happy, and there are no 41:09 issues, and you see them as a gift from 41:13 God that we truly, uh, look after, that 41:16 I think is also one of the good things 41:19 we can strive for so that our 41:21 biological age can stay young even as 41:24 we grow older. So, uh, that’s 41:28 actually how it is, and, uh, aging 41:30 isn’t just seen from the skin, but 41:33 also these organs. Then, uh, fitness is 41:36 also, uh, something that we often, uh, 41:39 say is easy, in quotes. Well, that can 41:43 actually be achieved in many ways, like 41:46 I mentioned, uh, food, then, uh, a 41:48 lifestyle we can maintain, exercise, 41:51 and so on, and feeling happy, thinking 41:53 positively. Now, those are the things 41:57 that can keep us forever young or keep 42:00 our biological age young, right? 42:02 Although, for chronological age, it 42:04 can’t be stopped; it definitely 42:05 increases. 42:05 Yes. 42:07 Well, next is Mr. Sigit in Pamulang 42:09 asking, "Assalamualaikum, Doc. Uh, what 42:13 is the standard for someone to be said 42:15 to suffer from Alzheimer's? Is 42:19 forgetting something occasionally also 42:22 considered being senile? Thank you. Yes 42:27 . Alright. So, indeed, to say, uh, 42:30 Alzheimer's—Alzheimer's is a type of 42:32 dementia and it is among the most 42:34 common—it requires a careful 42:35 examination by a doctor. Because the 42:39 doctor will ensure that the decline in 42:41 brain function is not just limited to 42:44 memory, but also involves a decline in 42:46 other brain functions. So, there are 42:50 examinations conducted by the doctor 42:53 with, uh, questions and follow-up tests 42:57 , including, uh, blood tests, and 43:00 sometimes it is also necessary to have, 43:03 uh, brain imaging to determine whether 43:06 it is indeed Alzheimer's dementia or 43:10 not. So, it is not easy to state that 43:14 you are senile or that you have 43:15 Alzheimer's. Because, uh, there are 43:19 stages of examination that need to be 43:22 gone through, and that can be done by a 43:24 doctor to establish whether this is 43:26 indeed Alzheimer's or not, like that. 43:30 Alright, this one is from Ms. Maya. Doc 43:33 , if vascular dementia disorder and 43:35 Alzheimer's disorder happen at the same 43:37 time, is that possible, Doc? Can it be 43:41 cured or not? 43:42 Okay. 43:43 Yes. Alright. So, regarding this 43:45 vascular dementia, uh, perhaps it is 43:47 already very specific about what type 43:49 of dementia it is. Vascular dementia is 43:53 caused by a process related to blood 43:56 vessels in the brain, for example, 43:59 after a stroke or other issues, blood 44:03 vessel problems that eventually lead to 44:07 memory decline. Usually, it's sudden 44:12 because events like a stroke or heart 44:15 attack appear suddenly. So, the decline 44:19 usually happens suddenly. Meanwhile, 44:21 with Alzheimer's, the decline is more 44:23 gradual, very gradual. It cannot really 44:27 be pinpointed to a specific date or 44:29 week, but the decline happens slowly. 44:33 And also, what changes in vascular and 44:36 Alzheimer's is different; the brain 44:38 abilities that decline are different 44:40 between these two types of dementia. 44:45 Well, if it has occurred or is 44:48 diagnosed as dementia, we can try to 44:51 ensure the decline is not that fast. So 44:57 , a cure that can truly restore memory 44:59 to its previous state has not been 45:01 found yet. Because nerve cells are 45:04 among the most difficult cells. Once 45:07 they have declined, it is hard to 45:09 improve, but we can try to ensure the 45:12 decline is not as fast as it would be 45:14 if untreated. So, actually, the goal of 45:19 medication for dementia is to reduce 45:21 the speed so that the decline is not 45:24 too sharp. 45:26 Right, the next one is from Mbak M or 45:29 Ibu. Oh, Ibu, right. Ibu Ana Syarif. 45:32 Doctor, peace be upon you. I feel like 45:35 I'm starting to show symptoms of 45:37 senility, Doc. I often forget the way 45:40 home to my house. And in the end, I get 45:43 confused on the road even though I'm 45:45 only 47. Yeah. What is happening? 45:50 Yes, indeed the degree of senility or 45:53 the degree of cognitive impairment, 45:55 which is the term for the decline of 45:58 our brain function, can can have many 46:04 degrees. Meaning it starts from mild to 46:06 very severe. But it could also be 46:10 normal, for example, it is normal if we 46:12 are not concentrating, we are sad, we 46:15 are sleepy, that is normal. But if we 46:19 are in an optimal state and yet we 46:21 cannot remember something, we must be 46:23 certain. So, to ensure whether this is 46:28 something normal or if you are actually 46:31 in a stage, an early stage of a disease 46:34 . Perhaps you need to seek treatment, 46:39 come to a doctor, for a detailed 46:41 examination to know if this is 46:43 something normal, or something that 46:46 needs to be watched, or we... 46:49 we try to make sure it doesn't get 46:52 worse. 46:53 So, a special examination is needed to 46:55 ensure that, Ma'am. 46:57 Yes. Forgetting is indeed a middle name 46:59 for all of us, right? But if you're 47:01 forgetting the way home at only 47 47:03 years old, we have to look into it. All 47:06 right. Next, I'll go to Mbak Fitri in 47:09 Bekasi. Doctor, my mother has undergone 47:13 radiotherapy 25 times. Now, my mother 47:17 has become forgetful and slow. Is that 47:20 one of the side effects of radiotherapy 47:22 ? Yes, Doc. Please help me with an 47:24 answer. I 47:25 yes. Thank you. Well, actually 47:28 radiotherapy itself is not directly 47:31 related to a decline in brain function. 47:35 However, we need to check if there are 47:37 other factors causing it. For instance, 47:42 are there other underlying illnesses, 47:44 or has her social interaction decreased 47:47 during treatment or throughout this 47:49 pandemic, as many people complain that 47:51 their parents become forgetful during 47:54 this time? Because we really limit 47:58 social interaction with others, the 48:01 opportunity to train communication or 48:05 to be happy with friends and family has 48:08 decreased significantly in frequency. 48:12 So, the brain becomes less trained to 48:16 do the things it usually does. So, my 48:21 advice is, if you see changes like this 48:25 , I think you should immediately take 48:29 your mother to the doctor to see if 48:33 this is something like dementia or 48:36 another cause that can be identified 48:40 and treated. I think that seems to be a 48:45 question for many of us watching this 48:48 program. Mrs. Oki asks," Doc, I'm 48:51 confused because this has happened many 48:54 times and it's become very dangerous; I 48:56 often forget things, especially turning 48:58 off the stove. "" Oh my, when heating 49:02 or boiling water, I let it dry up until 49:04 it burns. "What should I do, Doc? What 49:08 is wrong with me and what should I do? 49:13 I'm worried, Doc, I don't want my house 49:15 to burn down because I forgot. But Mrs. 49:17 Oki didn't mention her age, did she? 49:20 Okay, Doc, please go ahead. 49:21 Yes, yes, yes. Yes, so indeed, memory 49:26 issues or brain capacity are things we 49:29 might not always realize. However, 49:33 sometimes at a certain degree, it can 49:36 become dangerous as mentioned. For 49:39 example, frequently or repeatedly 49:42 forgetting to turn off the stove or, 49:45 what is it, going out and not knowing 49:47 where to go home. Now, that is 49:51 something dangerous. Because of that, 49:55 you need to communicate it with your 49:57 family. So that there is always someone 50:00 ensuring that such things do not happen 50:03 again. Meaning, you cannot be alone; 50:07 there must always be someone there to 50:09 ensure it doesn't happen again. Then, 50:14 as previously suggested, if it happens 50:16 often or repeatedly, I think it would 50:19 be very good for you to see a doctor to 50:21 check whether this is a normal process 50:24 or a specific medical condition. 50:28 Yes. Brothers and sisters, among the 50:31 many who have asked, perhaps the same 50:33 question arises in our hearts. This is 50:36 from Putri's father," Doc, may I ask a 50:39 question? Aside from senility in one's 50:43 senior years, my daughter is only 20, a 50:45 fourth-semester student. She is often 50:48 forgetful. Forgetting to pull out the 50:50 motorcycle key, often forgetting her 50:52 wallet left on the bike. Has she ever 50:54 forgotten she brought the bike to 50:55 school? Leaving it at school. Doctor, 50:58 what is the scientific way to overcome 51:00 such forgetfulness? 51:03 I 51:03 only 20 years old, right. 51:05 Yes. Yes, indeed. Well, regarding 51:08 memory, there are actually many things 51:10 that cause it, you see. For instance, a 51:13 lack of concentration, being in a hurry 51:15 , like rushing to the office or campus 51:17 and then leaving immediately, 51:19 forgetting, so the key is forgotten or 51:21 where it was placed is forgotten, so 51:23 that can happen repeatedly even though 51:25 the brain function is actually normal. 51:28 But because of rushing, lack of focus, 51:30 being sleepy, or being sad, that leads 51:33 to being forgetful. Those are the 51:36 things that often happen in, in, what 51:38 we call "normal" forgetfulness in 51:40 quotes. Now, it certainly must be 51:43 managed so that this does not happen 51:45 repeatedly. Does one need to, for 51:48 example, what do you call it? Get 51:51 accustomed to, well, if it's too rushed 51:55 like that, it means you really need, 51:58 you need time or to set aside time so 52:02 that in every task you are not in a 52:05 rush. Then keep records or do things 52:09 routinely so they are repeated. That 52:12 also helps; if we are used to parking 52:14 in a certain spot, we should try to 52:16 keep doing it there. Now, that is also 52:19 one of the things that helps us by 52:21 doing the same thing so we don't forget 52:23 easily. Those are perhaps a few things 52:26 that can be attempted. 52:28 Yes. This gentleman, Mr. Imroni, says, 52:31 "Doc, my mother is 66 years old; when 52:34 she's cooking, she thinks about getting 52:36 chilies from the fridge. Suddenly, upon 52:39 reaching the fridge, she forgets what 52:40 she wanted to get. So she gets confused 52:42 for a few seconds. Then she remembers 52:44 she wanted to get chilies. Are those 52:47 signs of senility, Doc? Thank you. 52:49 Before answering, since our time is 52:52 almost at an end. Emm where is it? 52:57 Earlier I heard in the health segment 53:01 this morning that there is a sharia 53:03 hospital. Where is that? I will mention 53:06 it later. The hospital is called Yarsi 53:08 Hospital. At the end, we will provide 53:12 the address and phone number. Okay, Doc 53:15 . Perhaps you could also summarize 53:18 today's discussion. 53:19 Yes, maybe to answer the last question 53:21 earlier. So, if we sometimes forget 53:24 what we wanted to do, or sometimes 53:26 forget where we put things. Well, that 53:30 is actually normal forgetfulness. But 53:32 if that forgetfulness happens more and 53:34 more often. Then, especially with the 53:36 short-term memories that we forgot 53:38 earlier, right. Like what I mentioned 53:41 earlier, for example, asking questions 53:43 repeatedly or doing things repeatedly. 53:45 Well, until it disrupts our ability to 53:47 perform daily activities. Now, that is 53:50 the type of forgetfulness that we need 53:52 to be wary of and find out what the 53:54 cause actually is. So, I think if it's 53:58 what was experienced earlier, for 54:00 example, forgetting to get chilies. If 54:04 it's only sometimes, it's fine, but if 54:06 it happens very often so that a lot of 54:08 things are forgotten, well, I think 54:10 it's necessary to investigate whether 54:12 this is leading to a certain disease or 54:14 not. 54:15 What about 20-year-olds who are already 54:17 forgetful, like leaving their 54:18 motorcycles behind? 54:19 Yes. So that means we have to find ways 54:22 so that, uh... 54:24 Whether by taking notes, or by 54:26 repeating things over and over, you 54:28 know, the same routine? Those are 54:31 things that can be done because it's 54:33 certainly not because of a manual 54:35 process in the brain, but rather the 54:37 way of working or other factors that 54:39 make it difficult to concentrate or 54:41 remember. 54:44 Okay, Doc. If there's nothing else to 54:47 add regarding the person who asked 54:49 about the sharia hospital earlier. Yes, 54:51 that's right. That is Yarsi Hospital, a 54:55 hospital that applies Islamic teachings 54:58 in its service to patients with a 55:01 commitment to applying sharia 55:03 principles in every aspect of the care 55:06 provided. And as mentioned earlier, 55:11 based on sharia, we want to make it a 55:13 friendly and comfortable hospital for 55:15 all visitors. Where is it located? 55:19 Yarsi Hospital is on Jalan Letjen 55:23 Suprapto Kavling 13, RT 10 RW 5, 55:26 Cempaka Putih Timur, Cempaka Putih, 55:29 Central Jakarta, and the phone number 55:33 is 806 1818. Put 021 in front if you're 55:41 calling normally. 80618618. Once again, 55:50 thank you Dr. Aulia Rizka, an internal 55:53 medicine specialist as well as a 55:55 geriatrician, who has enlightened us on 55:57 how to prevent senility at a, not 55:59 twilight age, what was it called? 56:02 Senior. 56:03 Senior, right. Preventing senility at a 56:05 senior age. Doc, thank you once again, 56:08 and to all our friends, hopefully this 56:10 can be a new understanding not only for 56:13 those of us who are elder, I mean, 56:15 senior, but also for their children. 56:18 Billahi taufik walhidayah. 56:19 Wasalamualaikum warahmatullahi 56:21 wabarakatuh. 
