phiconEmergency Contact Number: +65 6535 8833

Successful Aging

Normal aging is accompanied by a number of catabolic effects, including a decrease in lean mass, increase in fat mass, and decrease in bone density. Associated with these physiologic changes is a clinical picture often referred to as the somatopause: frailty, muscle atrophy, relative obesity, increased frequency of fractures and disordered sleep.

Growth Hormone

Growth hormone is produced by the pituitary gland — a pea-sized structure at the base of the brain — to fuel childhood growth and help maintain tissues and organs throughout life. Beginning in middle age, however, the pituitary gland slowly reduces the amount of growth hormone it produces.

Growth hormone deficiency in adults is rare and may be caused by pituitary adenoma — a tumor on the pituitary gland — or treatment of the adenoma with surgery or radiotherapy. For adults who have a growth hormone deficiency, injections of human growth hormone can:

  • Increase bone density
  • Increase muscle mass
  • Decrease body fat
  • Increase exercise capacity

Human growth hormone may cause a number of side effects for healthy adults, including:

  • Carpal tunnel syndrome
  • Swelling in the arms and legs
  • Joint pain
  • Muscle pain
  • For men, enlargement of breast tissue (gynecomastia)

Human growth hormone may also contribute to conditions such as diabetes and heart disease.

Some research suggests that side effects of human growth hormone treatments may be more likely in older adults than in younger adults.

Steroid Hormone


Dehydroepiandrosterone (DHEA; brand name Fidelin, Ovomax), also known as androstenolone or prasterone (INN), as well as 3β-hydroxyandrost-5-en-17-one or 5-androsten-3β-ol-17-one, is an important endogenous steroid hormone. Age-related decline in DHEA levels is thought to result in frailty, Osteopenia, cognitive impairment and Atherosclerosis.

Possible side-effects of Dehydroepiandrosterone include:

  • Nausea
  • Abdominal discomfort
  • Nasal congestion
  • Acne
  • Irregular menses
  • Irregular heartbeats
  • Headache
  • Facial hair (in women)
  • Gynaecomastia (in men)
  • Testicular wasting


Testosterone is a steroid hormone from the androgen group. Testosterone plays a key role in the development of male reproductive tissues such as the testis and prostate as well as promoting secondary sexual characteristics such as increased muscle, bone mass, and the growth of body hair. In addition, testosterone is essential for health and well-being as well as the prevention of osteoporosis and so is used in testosterone replacement therapy.

However, it leads to some minor side effects such as acne and oily skin, and more significant complications such as increased hematocrit which can require venipuncture in order to treat, exacerbation of sleep apnea and acceleration of pre-existing prostate cancer growth in individuals who have undergone androgen deprivation. Another adverse effect may be significant hair loss and/or thinning of the hair.

Caloric Restriction

Another approach is to restrict calorie intake in elderly without malnutrition. It may be associated with increased life span. The postulated mechanisms include:

  • Lower blood pressure
  • Lower Triodothyronine levels
  • Increased insulin sensitivity
  • Lower inflammatory markers

However, Caloric restriction is not without problems. There have been cases of delayed menstruation, low body fat and decreased bone density. Also, there are as yet no definitive studies to prove that Caloric restriction can prolong life span in humans as Okinawan studies do not take into account genetic and psycho-social factors. Thus, caloric restriction cannot be recommended as a means of prolonging life in humans.

Active aging

The process of optimizing opportunities for health, participation, and security in order to enhance quality of life as people age comprises of personal decisions for lifestyles coupled with facilitation by society and government. It involves taking charge of one’s health and treating primary physician as doctor, mentor and life-coach in order to minimize disabilities.

Read more about Comprehensive Health Screening for Older Persons
Make an Enquiry

Care of the Older Person


About Our Doctor


Dr Sitoh Yih Yiow is a consultant geriatrician who graduated from the National University of Singapore in 1991. He obtained his Membership of the Royal College of Physicians of the United Kingdom in 1996 and was awarded a Higher Manpower Development Programme (HMDP) fellowship by the Ministry of Health... Read more about our doctor