What Really Fades First as We Age — And the Screenings That Can Help Us Stay Sharp

Ageing affects everyone differently. Some notice changes in eyesight, others in hearing or memory. While there’s no single sense that fades first, regular health screenings can make all the difference. Professor Dr Tan Maw Pin offers advice and recommendations to help you stay ahead of potential problems and keep your body and mind in good shape as the years go by.

WORDS LIM TECK CHOON

FEATURED EXPERT PROFESSOR DR TAN MAW PIN Head of Geriatric Medicine and Senior Consultant Faculty of Medicine Universiti Malaya

AS WE GROW OLDER, WHICH ONE OF OUR SENSES WILL GO FIRST?

“There is no clear- cut answer to that question,” Professor Dr Tan Maw Pin says when we ask her this question. “There are many factors to consider.”

Existing Health Conditions

• For one thing, the answer depends on whether the person has any existing health conditions.
• Someone with type 2 diabetes, for example, may find their sense of touch being affected by the condition over time, especially if their diabetes is not properly controlled.

Other Factors

Other factors may include physical geography and cultural elements.

• People in the Himalayan region, for example, have a high prevalence of eye problems such as cataract.
• In Nepal, glaucoma (an eye condition that can lead to blindness) is prevalent as the people in that country age – a survey from the World Health Organization and the Nepal Blindness Survey estimated that the rate could range from 3.2% to as high as 9%.
• It is thought that the prevalence of these problems could be due to a combination of poor nutrition, lack of proper sanitation, the climate, and other issues.

“There are many variables, and therefore which sense will be affected first by ageing can differ from person to person,” Professor Dr Tan says. “There is no ‘secret formula’, sadly, as everyone is a unique individual! It may be more worthwhile to focus on how we can go for certain screenings as we age to detect potential problems early.”

BLOOD PRESSURE

• Have our blood pressure checked every year or two.
• This is because age is a risk factor for high blood pressure. The older we are, the more likely we develop this condition.
• Earlier detection will allow for better management and reduced risk of heart problems in the future.

EYESIGHT

• When we are 40 or older, we should go for an eye screening every 1 to 2 years at an optometrist’s clinic.
• This is to check for eye problems such as glaucoma and cataract.
• Glaucoma is a leading cause of blindness, and our risk of developing this condition increases the older we are.

GUMS AND TEETH

• Contrary to popular belief, we lose our teeth as we grow older because of gum disease (periodontitis), not age!
• “It’s possible to have a full set of teeth no matter how old you are!” says Professor Dr Tan.
• She recommends going to the dentist once every 6 months, so that gum diseases and other tooth issues can be detected and treated early.

TYPE 2 DIABETES

• Age (45 years or older) is a risk factor for type 2 diabetes.
• The risk increases if we are also sedentary, overweight and/or have high blood pressure and other risk factors.
• The test consists of taking our urine sample and using a dipstick to detect the presence of glucose. If the results are normal, the doctor may recommend repeating the screening every few years.
• An added advantage of this test is that we can also detect the presence of problems in the bladder or kidneys by analyzing the presence of blood, nitrites, protein and white blood cells in the urine sample.

HIGH BLOOD PRESSURE AND HEART DISEASE

• Discuss screening with the doctor if you have a family history.

HEARING

• Routine hearing screening is not viable due to the low pick-up rate, but Professor Dr Tan says that the test is actually quite simple.
• The doctor will run some simple activities, such as whispering near our ears and asking us to repeat what has been said.
• If we have difficulties hearing normal conversations, we should consult an audiologist for further examination.

CERVICAL CANCER

• Women should routinely get a Pap smear every 3 years from the time they turn 21 years old to the time they hit 65.
• This test is useful to detect cervical cancer and other abnormal conditions of the cervix.

BREAST CANCER

• Women are advised to go for a mammogram every 2 to 3 years from the time they turn 45 or 55 (different guidelines offer different age suggestions), earlier if they have a family history. We can discuss this further with our doctor.
• After the age of 70, the benefits of breast cancer screening are not clearly defined, but some people choose to continue going for it.

PROSTATE CANCER

While there is a screening test for prostate cancer in men, called the prostate- specific antigen (PSA) test, Professor Dr Tan says that a more effective screening method is to have a physical rectal exam performed by a healthcare provider.

This method also allows for detection of haemorrhoids, lumps and other unusual growths in the rectal area.

MEMORY AND BRAIN FUNCTION

• Perhaps lesser known compared to other screenings, the memory test (also called a neuropsychological test) allows for the measuring of the capacity of our brain to function in areas such as memory and language skills.
• It can help detect early issues such as memory loss, dementia, Alzheimer’s disease and other often age-related brain function issues.
• This test consists of simple question-and-answer sessions, and the results will be measured against a standardized model.
• Most government health clinics offer memory screening.