It is always necessary to take into account the elderly person (AP) physiological changes and the presence of various pathologies accumulating with advancing age. Thus, the PA wishing to observe the Ramadan fast are invited to seek advice from their doctor a few weeks before the start of the fast, in order to receive advice adapted to their situation and thus minimize the risk of complications and guarantee good tolerance of the fast. The latter should be avoided in the event of certain pathologies: unbalanced diabetes or, moreover, treated with insulin, kidney failure or heart disease under diuretic treatment which, by eliminating excess fluids from the body, can cause dehydration. . Fasting is also not recommended for seniors suffering from certain autoimmune or rare diseases.
1/ The risks associated with fasting
Intermittent fasting, alternating periods of fasting with periods of normal food consumption, especially when practiced long-term, may help limit the risk of cardiac events and have positive effects on metabolic health.
However, during the fast of Ramadan, meal intake is concentrated in time and the diet is characterized by an energy density that is often high compared to needs. Thus, the benefits of fasting are undermined by the excess food observed when the latter is broken.
At the diabetic patients, fasting during the month of Ramadan can have harmful effects and generate metabolic accidents – hypoglycemia, hyperglycemia or diabetic ketoacidosis -, or even aggravate the degenerative complications of diabetes. The diabetic patient may be exposed to other acute complications, including dehydration and blood clots in the vessels.
2/ Specific recommendations in terms of duration of fasting or meal management
You must ensure a well-balanced diet and above all not reduce your usual food consumption so as not to aggravate muscle wasting. Indeed, muscle mass decreases with age and this reduction in muscle mass can be a source of nutritional and hydration disorders. In fact, 73% of the body’s total water is stored in the muscles, a drop in water reserves will therefore be correlative to this reduction in muscle mass. This phenomenon, sarcopeniahas considerable repercussions due to the weaknesses it causes: infectious risks due to a reduction in protein reserves necessary for immune defenses, falls and possible fractures compromising the autonomy of the AP, etc.
Thus, to avoid worsening muscle wasting, protein intake must be higher than that of young adults and daily physical activity of 15 to 30 minutes per day is also necessary to combat this sarcopenia.
3/ The ability of a PA to fast safely in the face of medication management
The biggest worry during Ramadan is medication management. These remain in greater quantities and for longer in the body of an elderly person than in an adult aged 30/40. Their renal elimination is slowed, their accumulation in fats is increased and their passage into the brain is more aggressive, making AP much more fragile in the face of drugs.
During Ramadan, the situation becomes complicated when several doses of medication must be taken at regular intervals; just like the need to take certain medications on an empty stomach, taking them before breakfast may prove inappropriate, as the stomach is not always empty when you wake up.
Furthermore, taking certain medications is incompatible with fasting, such as diuretics, sulphonamides and hypoglycemic agents.
4/ Signs or symptoms that require stopping the fast
The dehydration is among the main dangers that await BP, particularly during periods of fasting. The perception of thirst diminishes with age and water losses are greater due to greater resistance of the kidney to the action of a substance which limits urine losses: antidiuretic hormone. In addition, the regulatory mechanisms are less well assured, and the elimination of excess sugar or sodium is accompanied by a greater loss of water. Fluid balance is also threatened by certain medications (diuretics, neuroleptics, etc.).
It should be noted that the signs of dehydration in PA are subtle and not always easy to interpret. Thus, we may experience sudden drowsiness, neuromuscular disorders, constipation or increased heart rate.
Also, we must not wait for these symptoms to appear to be alarmed; they should be anticipated by regularly monitoring the hydration state of the blood pressure and by assessing the risks involved in fasting and taking medications. in relation to the genesis of dehydration.
The risks ofhypoglycemia are increased in cases of diabetes. We must increase controls and self-monitoring of blood sugar levels and teach those around us to notice the first signs of hypoglycemia. : tremors, dizziness, balance disorders, nausea, vomiting, headaches, alertness disorders. Hypoglycemia can cause coma or even death.
Dr. MOUSSAYER KHADIJA Dr. Khadija Musyar, Dr. Khadija Musyar, specialist in internal medicine and geriatrics, Specialist in internal medicine and geriatrics, President of the Alliance of Rare Diseases in MoroccoPresident of the Rare Diseases Coalition Morocco, President of the Association Marocaine des Autoimmunes et Systémiques (AMMAIS), President of the Moroccan Society of Autoimmune and Systemic Diseases
TO LEARN MORE about the Alliance of Rare Diseases in Morocco (AMRM)
The Missions of the Rare Disease Alliance
The Alliance’s mission is to fraise awareness and recognition of rare diseases among the public, health professionals and public authorities by providing information on their scientific, health and social issues, by all means: written press, television, radio, websites and social networks.
It also aims to contribute to the information of doctors by organizing thematic conferences on rare diseases. It works to help create patient associations dedicated to each rare disease and to improve access to the diagnosis and care of rare diseases through the establishment of reference and competence centers and through real care. effective by registering these disorders as long-term conditions (ALD)
AMRM’S PARTNERSHIPS WITH OTHER ASSOCIATIONS
THE ALLIANCE works on a daily basis with many Moroccan associations. She also signed “strategic” partnership agreements with 12 patient associations: 1/Rett syndrome association (AMSR), 2/Association of Solidarity with the Children of the Moon in Morocco (ASELM), 3/Spinal muscular atrophy association (SMA), 4/SOS association Pku, 5/ Moroccan association of hereditary angioedema patients (AMMAO), 6/ Moroccan Association for Child and Mother’s Health (AMSEM), 7/ SOS Marfantime Association (SOSM), 8/ Association Prader Willi Maroc (PWM), 9/ Flame of Hope Association for Autism and Patients with PKU, 10/ Moroccan Association for Children Suffering from Osteoporosis (Osteogenesis Imperfecta) AMEOS, 11/ Moroccan Cystic Fibrosis Association (AMM), 12 / Fragile X Morocco Association (FxMa).
THE AMRM OFFICE: President :Dr Khadija Moussayer, Vice –President :Dr Fouzia Chraibi, Secretary General :Dr Mounir Filali,Deputy Secretary General :M Mohammed Elaidi, Treasurer :Mrs Najat Kababi, Deputy Treasurer :Mrs Fatima Lahouiry, Councilors :Mrs Salima Benajiba, Dr Zaina Scarby, M. Habib Elghazaoui, M. Mustapha Mokhatar, Ms. Ouafa Cherkaoui, Dr. Chafiq Tahiri, M. Hicham Missaoui