Dr Carol Tan on preventive care and wellbeing in the era of longevity

Preventive healthcare begins with understanding our genetics, personal health and life goals. Active ageing specialist Dr Carol Tan tells us more.

Using the analogy of a car to describe our physical health, Dr Carol Tan, a geriatrician and preventive care specialist, asks us to imagine the following: we all inherit one car that we will drive our entire lives — one that cannot be traded in or replaced. Each of our cars varies in make and quality — but, she says, how well we maintain our unique vehicle determines how smooth our drive down the road ahead is going to be.

Why is maintenance more important than ever? Life expectancy in Singapore has increased steadily in recent decades, from 62.9 years in 1960 to the current life expectancy from birth at 84.5 years for women and 80.9 years for men. According to Ready for 100, a report conducted by The Economist Intelligence Unit (EIU) for Prudential, this figure is not only set to rise, but ageing is also expected to accelerate in the coming 15 years.

The report, which was based on a survey of more than 200 healthcare practitioners in Singapore and over 1,200 Singapore residents, revealed uncertainty around structures that are in place to support a rapidly ageing population, especially when it comes to preventive healthcare. According to experts like Dr Tan, this can place unnecessary stress on individuals and their loved ones, affecting physical, mental and financial well-being. Here she shares how we can all equip ourselves for a longer life that we can meaningfully enjoy.

You specialise in preventive healthcare — can you explain why it’s so important?

If our body is like a car and our lifespan is like a certificate of entitlement (COE), in Singapore our “COE” is pretty long — up to 87 years. However, everyone’s car — our inherited genetics — is different. You might have a Mercedes-Benz, or you might not.

The first step to preventive healthcare is knowing what car you have. In other words, what ailments you may be predisposed to. That’s where prevention comes in. Healthcare is not about statistics or national demographics — it’s about knowing your own body and preparing, with your doctor, for what may come.

As they say, prevention is always better than cure. It’s much easier to have prevented a fire than to try to put it out. In Singapore especially, where healthcare costs inflate by about 15 to 20 percent year-on-year, it’s also a lot cheaper, on top of being less painful for patients to go through treatment, which can impact all aspects of life: emotional, mental, physical, financial and professional.

When should preventive healthcare begin, for most of us?

As a geriatrician, I have the benefit of a retrospective view. From what my patients tell me, I would say that preventive healthcare, with all the determining factors involved, starts as early as birth and childhood development. Quality nutrition and education in someone’s developmental years, for example, both play a large part in their propensity to develop osteoporosis or dementia later in life.

Preventive healthcare is really about examining your whole life and taking full ownership and proactive steps, as you anticipate longevity and the years ahead.

What truths do we need to face now about preventive healthcare and active ageing?

We need to talk about dementia prevention. If we’re going to be living to 100, at least 20 percent of the elderly population will have severe dementia. At 70 years old, it’s one in 10. That’s a very high number. Today, when we have endless amounts of information to remember, dementia is the silent killer of our health, well-being and quality of life.

Most people greatly misunderstand what dementia is. Dementia is not an incurable disease. In fact, it’s an umbrella of conditions that could include an imbalanced diet, mental health issues, or sensory impairments, like being hard of hearing. Some of my patients who exhibited dementia symptoms were actually suffering from a vitamin B12 deficiency, high stress or depression.

With early detection and proper medication, mild cognitive impairment, also known as pre-dementia, can be treated, helping patients to lead healthy, independent lives.

From a practical point of view, what must we do to provide ourselves and our loved ones with adequate support down the line?

First, acknowledge the fact that you may live to 100. Now, what are you going to do about it? You need to maintain your car to enjoy the drive. The body can be repaired but you need to take care of the driver — make sure your brain works well for as long as you can.

Draw up a living will, do your financial planning, make an Advance Medical Directive to state your wishes for medical intervention, and appoint people you can fully trust under a Lasting Power of Attorney. Go for regular, customised health screenings, find a Financial Consultant, lawyer and doctors who can get your affairs and succession planning in order — and realistically, who will outlast you in years!