Hike sentence

Stroke, dementia, others not on death row — Ogunniyi

Professor Sola Ogunniyi, Neurologist, in this interview with SADE OGUNTOLA says that neurological diseases like stroke and dementia are not necessarily a death sentence, and Nigerian hospitals are generally not suitable for the elderly.

TALK to us about your work over your decades of medical practice and the contributions to medicine that individuals can harness for better health.

The medical code of conduct does not allow individuals to sing their own praises. But, without being shameless, I trained as a neurologist, with a particular interest in the epidemiology of neurological diseases. This is to examine how neurological disorders affect people in communities, their distribution and their determinants.

Although I started out working on epilepsy, over time I evolved and eventually ended up focusing on neurodegenerative diseases, an area in which I made a significant contribution in dementia. We have shown that dementia is a big problem in some communities in Nigeria. We compared the burden of dementia in Nigeria with the rest of the world and showed that it is relatively lower than in other parts of the world.

By looking for the reasons why this is so, we have shown that social isolation is not good for older people. When left alone, they are forced to think about other things that don’t really matter and their brain function generally tends to deteriorate. It also tends to predispose them to other diseases that can affect the brain.

Over time, we have shown that hypertension increases the risk of dementia, especially in older people whose blood pressure is not controlled. They risk having more forgetfulness, reduced brain function and a subsequent predisposition to dementia, which is bad.

We have also shown over time that when older people lose weight unintentionally, it can also be an indicator of the development of certain degenerative brain diseases like dementia. And so these are things that we can pay attention to. Our goal has always been to prevent neurological diseases by educating people about predisposing factors and how the disease can be treated. And besides, those who have neurological disorders should seek help because people thought that once you have a neurological disease, it’s almost like a death sentence.

Why aren’t neurological diseases really a death sentence?

Previously, very few treatments were available for neurological disorders; but now many neurological disorders can be treated. Apart from the use of medication, there are other treatment modalities that can be used like palliative care, psychotherapy, physiotherapy, occupational therapy to help individuals. Before, doctors were like gods, but now, if you make people aware of their problem, they also go back to read about it and they are better informed, indirectly ensuring an improvement in their own health.

What is your group’s conclusion on the benefits of cognitive stimulation therapy in the management of dementia?

Cognitive stimulation therapy is a form of group therapy, reminding older people who may have some forgetfulness of things that happened in the past. We have shown that it is very beneficial; it tends to awaken their memory. The study took place over seven weeks; two sessions per week. All the results showed that people who went through it benefited immensely.

What has been your contribution as a teacher and researcher to human capacity building?

Over a period of 20 to 30 years, I helped train over 60 neurologists at University College Hospital, Ibadan. Some of them are now teachers, so I feel accomplished as a teacher.

As part of a group of researchers, we have also obtained grants to conduct many studies and help people obtain grants themselves. At the time, as chair of the Research Innovation Management Unit of the College of Medicine, support was given to promoting research ideas among young people so that research grants were not won only by professors, but also by young colleagues and lecturers. It has improved the webometric ranking of the College of Medicine and I am proud of it.

Looking back, if you had a choice, would you still have chosen medicine?

I will do medicine every day. This is the most exciting specialty. I will not only do medicine but also neurology because it is perhaps the pinnacle of human intelligence and the most difficult part of medical care that finds it very interesting.

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In your last 68 years on earth, you certainly have a thing or two to say to people about aging. How can an individual age well, gracefully and end up strong?

It’s a constant challenge because our lives are in God’s hands, but there’s nothing worse than having a very terrible life in old age. So, it’s important that we live well and live strong so that we can finish strong. This means living well, doing things in moderation, keeping friends, seeing a doctor when needed, and being grateful to God for what he has given you.

Eating well will help stave off diseases, especially diseases that weaken the brain, such as dementia and stroke, which can cripple individuals. And the best way is to be careful in researching your risk factors like hypertension, diabetes and to be moderate in the things we do socially.

Avoid smoking. If you must drink alcohol, do so in moderation and eat modestly so you don’t become obese, and exercise as you age. Exercise helps improve brain activity and also brings life to muscles and the rest of the body.

Get involved with your colleagues; you need to have friends you can talk to. By doing so, you help stimulate each other, you encourage each other, and you have people to discuss issues with. It is important that as people age, they must have identified physicians who can deal with their medical issues; people who know their medical history and who are willing to help them get better when they are sick, because that is something that can get people down. As we get older, we can no longer fight diseases like when we were younger; the immune system has become less active and insects and all other infectious agents become more vicious and can cause more damage. If you don’t treat a disease in time, it can end up hurting you, leading to a more complicated disease. So we have to be careful.

How friendly are Nigerian hospitals for the elderly and disabled? How can we improve them?

Most of our hospitals are not suitable for the elderly, but things are changing. For example, at University College Hospital, where we practice, we now have a geriatric center and that has made a big difference. You see old people who otherwise would have hated hospitals, all wanting to come there. They see their colleagues, they sit together; they receive special treatment. They also receive subsidized care. But this is not the case in all hospitals in Nigeria. It is something that should be advocated that at least all regional centers have geriatric care facilities. There should be ramps for older people to move from place to place. There should be places where the cars of people with disabilities and the elderly can park so that they can easily get from their car to the places in the clinic where they are going.

What advice would you give to children and relatives on caring for the elderly, as well as on preventing stigma?

Families have a big role to play in ensuring that seniors maintain their state of happiness and a good quality of life. They must help them. Pension systems are not very good and do not cover everyone. Health insurance is also not universal at the moment. So much depends on the family members who provide the necessary support for the elderly. They must therefore identify the problems that the elderly may have and think of easy but inexpensive solutions to address them.

Take them to the hospital if necessary and make sure they

take their medications as regularly as possible if they have a medical condition. They should be encouraged to use walking aids if they have walking problems. Those with vision problems should be helped to see an eye doctor and get the right glasses prescribed, or even if it is glaucoma to treat it before the eye is damaged. The appetite decreases as one ages, the requirement is also less. But the one or two meals that the elderly eat must be sufficiently rich and beneficial for their health.

What should Nigeria prioritize in the health system: providing equipment, financing and human capital for health or revitalizing and reorienting the health system?

All this is equally important. If you don’t have the right equipment, you can’t perform well. So you feel inadequate. As a researcher, the availability of the right research equipment that will be on par with what is happening in the rest of the world is also important. But at the same time, the reorientation of the system and its redesign are also important.

The general attitude of health workers needs to be changed to make them more responsive and helpful to people seeking care. In a few hospitals overseas, we have volunteers who help direct people, especially older people who come to the hospital, where they should see a doctor or which clinic they should go to. We need more stuff like that here.

These are people who do it because they have free time and don’t need the money. These volunteers can help direct people around hospitals, ensure that people who come to the hospital receive timely attention and are not misdirected between labs and payment points and locations. services such as physiotherapy, occupational therapy, etc.