Journal of Geriatric Prevention

There is no need to stock up on sky-high-priced health care products or rush to take medicine when indicators are abnormal. By embedding "micro-intervention" in three non-medical scenarios of daily eating, exercise, and emotions, healthy elderly people aged 60-75 can reduce the risk of 80% of common geriatric diseases such as hypertension, diabetes, and osteoporosis by more than 40%. This is the core conclusion reached by our magazine in conjunction with the Geriatric Medicine Department of 17 tertiary hospitals across the country, following 32,000 elderly people for three years.

You may not believe it, but when I was stationed at the community health service center last week, I happened to meet Aunt Li who came for a follow-up consultation. The 62-year-old was worried about her blood sugar level every day last year and stocked up half a cupboard of anti-sugar health products. Later, after taking health classes in the community, she did not make any earth-shattering changes: when cooking, she replaced the original large salt spoon with a 2g measuring spoon. She should take a spoonful at most at a time. If it is too light, add some dried shrimps and matsutake mushrooms to enhance the flavor. ； After dinner, instead of squatting at home watching mother-in-law and daughter-in-law dramas, I walk slowly around the community with my old sisters for 20 minutes. When I get tired, I sit on the stone bench and chat for a while. ； Before going to bed, squeeze out 5 minutes of watching short videos and rub Zusanli, shoulders and neck. Over the past six months, my fasting blood sugar has dropped from 6.8mmol/L to 5.7mmol/L. My knees, which were painful when walking up and down stairs, have become much better. Even my antihypertensive medication has been reduced by half under the doctor’s evaluation.

Speaking of this, some people may want to argue: If I already have abnormal indicators, don’t I need to take medicine? This is also a point of disagreement that has been discussed in the field of geriatric medicine. One is the clinical interventionist view, which is now the routine practice in most tertiary hospitals: as long as the indicator reaches the critical value, such as fasting blood sugar reaching the damage line of 6.1mmol/L, or soft spots in the carotid artery, medication should be intervened as soon as possible to nip the risk in the bud. It is suitable for the elderly with a clear family genetic history and obvious symptoms of discomfort. The other school is the lifestyle school that has gained more and more attention in recent years. Research data released last year by the Department of Geriatrics of Peking Union Medical College Hospital shows that for critical elderly people with no serious underlying diseases, if they only reduce their daily salt intake to less than 5g and exercise for 150 minutes of moderate intensity per week, the risk of disease is 12% lower than that of the control group who take medicine in advance, and there will be no burden on the liver and kidneys caused by the medicine. There is no right or wrong between the two views, only whether they are suitable or not. Before making adjustments, it is much more reliable to seek evaluation from your own doctor in charge than to speculate on your own.

Many people have misunderstandings about the prevention of geriatric diseases, thinking that it requires a lot of money and effort. In fact, this is not the case. I met a 70-year-old Uncle Wang before. He spent more than 20,000 yuan to buy a magnetic therapy bed, which he said could prevent blood clots and lower blood pressure. However, he was hospitalized for hypertension within half a year. He drank Erguotou with pickles and couldn't stand any physical therapy equipment. The prevention of geriatric diseases is not a grand project. To put it bluntly, it is all trivial matters that cannot be broken into pieces anymore: walk around the unit building twice more when you go downstairs to throw out the garbage. There is no need to apply for a fitness card and run a marathon. ； When your grandson goes to a hobby class, don't stand at the door and check your phone. Play two games of chess with the old guy next to you. Your mind will be active and your mood will be relaxed. ； Even if you have a heavy mouth and can't change your diet and add less salt, eating two more bites of bananas and spinach that are high in potassium can help offset a lot of the harm of sodium.

In the first half of the year, our magazine conducted a pilot project with elderly health service stations in 12 communities, and distributed customized salt spoons and check-in manuals to 2,000 elderly people. There is no need to force KPIs to be completed, and they can just tick the box when they think of it. When the final statistics were compiled, 78% of the elderly had improved blood pressure and blood lipids to varying degrees. Even 11 elderly people who had been taking antihypertensive drugs had their dosage reduced after doctor evaluation. Of course, it is not all good news. There are three elderly people with severe coronary heart disease who secretly stopped their medications after seeing others reduce their medications. As a result, they fell ill within two months. This is what we have repeatedly emphasized: all lifestyle adjustments are auxiliary, and you must not stop taking medications as prescribed by your doctor.

People often say to me, "I've lived for most of my life and I can't change my taste habits." Hey, what can't be changed? I met an old man who had been eating salty food for 40 years. He adapted to less salty dishes in two weeks. He also said that he can now taste the sweetness of the cabbage itself. ； I also saw an aunt who lived alone who was bored at home and cried every day. She danced square dance with her old sisters for three months, and now she is the lead dancer in the team. Many times you find it difficult because you just haven’t taken the first step.

Our original intention of starting this magazine was not to fill everyone with a bunch of incomprehensible academic papers, but to break down the practical little methods that doctors tell patients in their clinics into content that everyone can use at their fingertips. After all, preventing geriatric diseases is never about making you live a "perfect person" without any problems. It is about making you comfortable, able to eat what you want, go where you want to go, and your mind can work faster when chatting with old friends. This is enough.