It is wonderful that the average expectation of life is increasing. And this requires us to take good care of our body and mind. It may sound corny if somebody tells you health is the most important thing. If you have ever been seriously ill you will understand the value of being healthy. When getting older the body changes and that is completely normal. We have less strength, our bones are less strong, joints and tendons wear off. We have to listen to our bodies and our mind. With this article, we intend to make you aware of health issues that may occur when you are older and we want to encourage you to consult medical professionals and make use of the services which are offered in Malta.
We thank Dr. Mark Grech for his very valuable contribution to this article.
HEALTHY LIFESTYLE
Leading a healthy lifestyle is important at any age. Changing habits may seem difficult and we have to recognize that it is also a cultural issue, considering that Malta had again an obesity rate above the European average in 2019.
Regular exercise (which can be a brisk daily walk and does not mean going to the gym to get a six-pack), healthy eating, limited consumption of alcohol, if at all, and stopping smoking are some recommendations that can prevent or delay health issues. Healthy eating boosts your immune system, provides energy, improves your power of concentration and makes you feel better, and it also contributes to a healthy BMI (Body Mass Index). It does not mean less enjoyment. While aging the body changes and one should adopt eating habits and lifestyle. The body burns fewer calories and therefore it is important to follow a diet that is rich in nutrients and lower in calories. A healthy diet can reduce the risks of cardiovascular diseases and certain types of cancer. If you think you need help with your diet ask your doctor if you are eligible to make use of the services of the nutrition and dietetic department.
CARDIOVASCULAR DISEASES
In 2017 cardiovascular diseases were the main cause of deaths in Malta.[1] The US National Council on Ageing (NCOA) refers to smoking and alcohol consumption as key factors for heart diseases and underlines that these are, at least in the US, popular amongst gay men. In relation to lesbians, it considers obesity, smoking and a lack of physical activity as main risk factors.[2] The best way to avoid cardiovascular diseases is to live a healthy lifestyle. It may also benefit you to have your lipids (cholesterol) checked, especially if you are a cis man or trans man on testosterone. For transgender, it is important to know that the effects of long-term hormone treatment have to be studied more in order to establish if they are increasing the risk of a stroke or a heart attack. Here it has to be emphasized that in general hormone treatment should only be done under professional medical supervision. This is even more important if other medications are taken.
CANCER
NCOA refers to a study of 2011 which established that 19% of senior LGBT have at least one type of cancer. NCOA also states that[3] lesbian, gay, and bisexual older adults are more likely to have risk factors associated with breast, cervical, testicular, prostate, and colon cancer. The human papillomavirus (HPV) for example which is transmitted by having unprotected sex can cause cervical and colon cancer. The earlier cancer is detected the higher are the chances that it can be cured. Hence it is important to have regular check-ups. According to NCOA gay and bisexual men should ask their doctor for tests of HPV and anal cancer. In general, after the age of 50 the risk of for example collateral cancer increases. In Malta screening is offered to people between 56 – 70 years old. More info: Colorectal Screening (gov.mt)
Cervical screening is offered to women at first when they are between 27 – 39 years of age. After the age of 50 women are invited every five years for screening. Extensive information about cervical cancer, HPV, and screening can be found here:
The risk of prostate cancer increases heavily with age. If for example, you have to frequently urinate, urinate frequently at night, cannot empty your bladder completely or the flow of urine is weak ask your doctor for advice. Up until now, the state is not offering regular prostate screenings. A blood test can give a first indication if somebody has developed prostate cancer.
Both women and men can get breast cancer, although the latter cases are rarer. Estrogen treatment for example of transwomen can increase the risk as compared to cisgender men. However, some studies suggest it is still lower than in cisgender women. You should regularly check your breasts and armpits for any lumps. In Malta breast screening is offered to all women between 50 – 69 years of age. Check here for more details:
Testicular cancer is more frequent amongst the younger age group. A type of testicular cancer called seminoma is found in men in their 40’s and 50’s. However, even when you are older consult your doctor if for example, you feel that your testicles or one testicle feel different, that there is a painless lump or a certain heaviness in the scrotum. Although in general, the cure rate of testicular cancer is high the earlier it is detected the lesser the chances it spreads. Examine yourself regularly.
MENTAL HEALTH
In recent years mental health has been picked up by mainstream media and at least the stigma has been slightly lessened, although stigma remains an issue among many. Mental health issues can occur at any age. It seems that members of the LGBTI community are at higher risk to suffer from mental health issues than heterosexual people.[4] The cause can for example be the experience of discrimination or even homo-, bi-, trans- and interphobia. Additional stress can occur when getting older, for example, because of illnesses, limited mobility and the loss of partners and friends, and widespread loneliness in the elderly LGBTIQ community. And a move into a care home can be particularly frightening when the question can arise if one has to go into the closet again or not.
If you have issues with mental health you can contact the Rainbow Support Service (RSS) of the Malta LGBTIQ Rights Movement (MGRM) (+356 – 79 43 00 06) or the government general mental health services
DEMENTIA
Just last month the film „Supernova“ with Stanley Tucci and Colin Firth, was released. It's about a couple of two gay men of which one suffers from dementia (watch the trailer here:
According to the Dementia Strategy 2015-2023, dementia is a syndrome due to the illness of the brain. Affected persons can for example experience loss of memory, confusion, behavioral changes and language problems.[5]
With an aging population, the number of people with dementia will increase, according to government estimates from 1.5% of the population in 2015 to 3.5% by 2050.[6]
The dementia helpline 1771 offers information for persons affected, their family members, friends, etc. Within the community care services, the government provides dementia activity centers and has set up a dementia intervention team. Information can be found here:
The Alzheimers Society UK offers information for LGBTI living with dementia
and Dementia Australia published a guide for LGBTI people and their family, friends, etc. which can be downloaded here:
Make use of all the services offered. And take care of yourself!
[1] Health-Profile-Malta-Eng.pdf (who.int) [2] Top 3 Health Issues in LGBT Seniors - Healthy Aging Blog | NCOA [3] Top 3 Health Issues in LGBT Seniors - Healthy Aging Blog | NCOA [4] Mental health issues and discrimination among older LGBTI people | International Psychogeriatrics | Cambridge Core [5] book_english_book.pdf (gov.mt) [6] National Dementia Strategy (gov.mt)