Rich or poor, we all have the same physical body

Billionaire Kwek Leng Beng is on the news for trying to get his son Sherman Kwek fired from City Developments Limited (CDL). It does sound pretty exciting cos Kwek Leng Beng is accusing his son of staging a boardroom ‘coup’, which BBC has referred to as Succession-like feud. The post today, however, will not be about that. It will be to discuss Kwek Leng Beng’s approach to health as he aged. This is based on an interview he gave the Peak magazine in 2016.

Everyone grows old

Rich or poor, ageing is an issue we all have to face. It is true that there are social determinants to health. Your network, income, education, working life conditions, access to healthcare services, will all come together to influence your health status.

However, being rich doesn’t always mean healthy or a life expectancy. For example, Kwek Leng Joo, the brother of Kwek Leng Beng, passed away in 2015 at the age of 62. He died of a heart attack.

My point is, rich or poor, we have to take ownership of our own health. It is true that some may have more resources than us, and it is also true that that can have an impact on our health. What is more important, however, is the lifestyle we choose to adopt (within our available resources).

Keeping active as we age

One of the things Kwek Leng Beng mentioned in his interview was that he still keeps active. He plays tennis once a week. On top of that, he does qigong with a master from Shanghai. As part of his qigong training, he works on strengthening his legs.

As a chiropractor, I emphasise a lot on exercise. Muscle strengthening exercises is definitely something seniors would need to consider as they age. We may not have access to exclusive masters to help us but fret not! We have Gym Tonic in Singapore!

I love Gym Tonic because they cater to seniors to help seniors with resistance training or muscle strengthening exercises. They are sometimes affectionately referred to as the uncle auntie gym. Gym Tonic fees are, in my opinion, extremely affordable at only $5 to $12. Unfortunately, ActiveSG credits cannot be used to pay for the sessions.

By the way, Gym Tonic is an initiative by Lien Foundation. They are a billionaire family who invests tons of research into senior health care (e.g., fragility, dementia, palliative care).

Singapore Physical Activity Guidelines for seniors above 65

If you are above 65 years old, you need to exercise more, not less, than people younger than you! According to the latest exercise guidelines, seniors are recommended to:

– At least 150-300 minutes of moderate-intensity aerobic exercises a week
– Engage in muscle-strengthening activities two or more days a week
– Include moderate-intensity activities that emphasise on strength and functional balance at least three days a week
– For adults with chronic conditions (e.g. Type 2 diabetes) the recommendations are still applicable. If unsure how to begin, consult a healthcare professional.

In my opinion, Kwek Leng Beng’s qigong would count towards functional balance activities than muscle strengthening activities. That’s just my opinion. This is very contentious topic as some do consider tai chi to be as strength training, which I unequivocally with.

Strength training, by definition, aims to increase strength. If you are already reasonable fit as a person (e.g., regular tennis sessions), it will be unlikely that qigong is going to increase your muscle strength any further.

That is not to say qigong or tai chi is not good exercise. They are great exercises to help with sense of balance, mobility, and even flexibility. I would not belittle their benefits. But, strength, in my opinion, is not one of them.

Going for walks is good aerobic exercise

Kwek Leng Beng does both tennis and going for walks. In my opinion, this is a great balance of aerobic exercises. Tennis is definitely under the vigorous side of exercising. For vigorous activities (e.g., tennis, cycling, swimming, running), the weekly recommendation is at least 75 minutes. If the exercises are less exertional (e.g., walking), the recommendation is at least 150 minutes.

By the way, there is research to suggest that the more you exercise, the more benefits you enjoy. Provided you don’t get injured.

If you just turned 65 years old, and has no contraindications to exercising, I will argue that walking alone is not exertional enough. I think walking can be part of your aerobic routine. But it will be much better if we include one or more aerobic activities that is slightly more exertional.

Cutting back on physical activities as required

If you are exercising a lot, and you see you need more time between exercise sessions to recover, there is no harm in taking things easier. In Kwek Leng Beng’s example, he went from playing tennis almost daily to just once a week. This is not at all a bad idea!

Remember, he still keeps active. Cutting back on physical activity as your start to see age-related changes in your body is totally reasonable.

It is not recommended for you to cut out exercises completely cos a sedentary lifestyle benefits no one. Exercise promote muscle mass, which can help prevent sarcopenia. Having enough muscles and exercising also have a protective effect against osteoporosis.

Being sedentary also contributes to fragility, which can increase risk of falling. The mortality rate (i.e., changes of dying) one year after a hip fracture among seniors has been reported to be as high as 58%!

We cannot belittle the benefits of exercising.

Dementia in Singapore

Of course we can’t talk about growing old without mentioning dementia. Afterall, Singapore is expected to become a super-aged society by 2026, where 21% of the population will be aged 65 and above. As the population ages, the number of dementia cases is expected to go up.

Thankfully, we have great government initiatives and resources in Singapore to help with that. Admittedly, it is not perfect and brunt of the effects of dementia is still borne by family members of people with dementia.

Some of the initiatives we have in Singapore include demarcating residential areas by colour for easier recognition. Kebun Baru even implemented wayfinding murals to help people with dementia find their way home.

There are also dementia day care centres in Singapore. These centres provide services from nursing and medical care to recreational and exercise programmes. The fees for dementia day care range from $1,260 to $1,575 per month before subsidy.

How can dementia be prevented?

Gardening can help with preventing dementia. Mind Science Centre, that is part of NUS Yong Loo Lin School of Medicine, found that gardening could help with memory and psychological well-being. The benefits also extended to improved immune response and social connectedness.

Music-making has also been reported to help people with dementia. In fact, a twin study found that musicians were 64% less likely to develop dementia. Twin studies are often used in research to isolate the influence of genetics. By comparing twin to twin, we can say that the observed differences are far more likely to be the result of the variable-of-interest than their innate traits.

St Luke’s Hospital launched a Therapist-led Community Inclusive Choir for dementia patients and their carers. In 2022, Jason Lai, the Principal Conductor of the Yong Siew Toh Conservatory, did a Sing to Remember concert. At the end of the three month project, participants with dementia had better cognition, social connectedness, and anxiety!

Focus on doing the best we can, with what we have

It is so easy to be overwhelmed by the news and social media about people who are better off than us. They can be richer, better looking, more healthy, etc. But it really all doesn’t matter.

At the end of the day, our health is what is unique to us. What is most important is not how much we have but what we choose to do with what we already have.

Rich or poor, we all die some more. Rich or poor, we can experience pain and diseases.