Comprehensive knowledge on geriatric disease prevention

The core logic of geriatric disease prevention has never been to rely on eating sky-high-priced health products and doing high-intensity exercise to solve the problem once and for all. The most effective solution is actually a combination of "prioritizing early screening, controlling basic diseases, and adapting lifestyle to individual conditions." There is no unified standard that suits everyone. All measures must be combined with one's own basic diseases and tolerance adjustments to be effective.

I have been doing free clinics in the community geriatric department for almost 8 years, and I have seen too many elderly people who have fallen into trouble. Last week, I met 62-year-old Aunt Li. She saved half a year's pension and bought more than 30,000 health capsules that are said to "clear blood vessel plaques." Really, don’t believe in the “magic medicine” that can cure all diseases. The prevention of geriatric diseases is not that mysterious.

Let’s talk about the early screening that everyone is most concerned about. In the past two years, there has been a lot of controversy about whether to check tumor markers every year. One group of people believes that annual testing can detect early cancer earlier, while the other group believes that annual testing for ordinary healthy elderly people can easily lead to excessive testing. Medical - I met 70-year-old Uncle Wang last year. A routine physical examination showed that his CA199 level was twice as high as the normal value. He was so frightened that he lost 7 pounds in half a month. After having his whole body examined three times, it was finally discovered that he was suffering from an attack of chronic cholecystitis. His suffering for half a month was in vain. The current general consensus in the industry is that it is enough for ordinary elderly people to undergo basic screening every 1 to 2 years: blood pressure, blood sugar, blood lipids, electrocardiogram, abdominal ultrasound, and low-dose chest CT. If there is a family history or past medical history, corresponding special items can be added. For example, those with a family history of lung cancer should have an additional low-dose CT every year, and those with a history of gastrointestinal polyps should have a gastrointestinal endoscopy every year. There is no need to add all items to the physical examination sheet.

Then there is the control of basic diseases where people are most likely to go to extremes. Many elderly people think that blood pressure must be reduced to 120/80 to be considered normal, and blood sugar must be stuck at the young people's standard of 6.1mmol/L to be considered qualified. In fact, this is not the case. In the past two years, academic circles have had different opinions on the goals of controlling basic diseases of the elderly. For example, for elderly people over 80 years old with severe carotid artery stenosis, many studies believe that it is safer to maintain blood pressure at 130-140/80-90. If it is lowered too low, blood supply to the brain will be insufficient, and a fall is no joke. There used to be a 78-year-old Uncle Liu. He heard from his neighbors that a certain antihypertensive drug was effective, so he increased the dosage privately, and his blood pressure dropped to 110/60. He went to the vegetable market to buy vegetables in the morning and fainted on the side of the road. He suffered a concussion and was hospitalized for a week. The same is true for blood sugar. For people over 70 years old, it is perfectly fine to control fasting blood sugar at 7-8mmol/L. A low standard can easily induce hypoglycemia, which can kill people in minutes and is much more dangerous than short-term high blood sugar. Remember, your basic disease control goals are set for you by your attending doctor. Don’t just follow the trend and adjust medicines blindly. Everyone’s situation is different.

As for lifestyle adjustments, there is no standard answer. I have seen too many elderly people walk 20,000 steps a day in order to count the number of steps on WeChat. In the end, they ended up with effusion in their knees and Achilles tendonitis, and they came for follow-up consultation on crutches. I have also seen aunts twisting their waists and lying down for half a month in order to compete for the C position in the square dance. Really, the most important thing is to exercise that is suitable for you. If you have joint problems, go swimming or sit Baduanjin. If you have a heart condition, walk slowly for 20 minutes every day and stop when you are slightly sweaty. There is no need to make up the number of 10,000 steps.

There is no need to be overly strict in terms of food. Elderly people with gout should eat less seafood and beer, and those with diabetes should control their refined sugar intake. But if an 85-year-old man likes to eat a bite of soy elbow all his life, you have to stop him from eating it. If he eats vegetables and rice every day, he will be more likely to have problems if he is depressed. Previously, our department followed up a 92-year-old man who ate half a piece of soy pork elbow and drank a small glass of white wine every day. His blood pressure and blood sugar were under stable control, and he had a very open mind. He was more energetic than the old man who dared not eat or touch anything every day, and was anxious every day that he would get sick. Nowadays, the nutritional community is also mentioning that the diet of the elderly should first ensure balanced nutrition and a happy mood, and there is no need to deprive oneself of the joy of life for the sake of so-called "health standards."

Oh, by the way, there is another point that most people ignore: fall prevention. Hip fractures in the elderly are known as "the last fractures in life". The mortality rate one year after surgery can reach 30%. Many elderly people never recover after a fall. Instead of spending a lot of money to buy various calcium supplements, it is better to throw away the slippery polished carpet at home, install handrails in the bathroom, wear suitable non-slip shoes, and try to go out as little as possible on rainy and snowy days. It will work better than anything else. Don’t take your mental health seriously. After retirement, many elderly people stay at home every day with no one to talk to. Anxiety and depression can directly induce high blood pressure and coronary heart disease. Go out to play chess and chat with old friends when you have nothing to do. Even having a few words with others is better than staying at home.

After all, there really is no universal formula for the prevention of geriatric diseases. Don’t listen to the random health rumors on the Internet, and don’t copy other people’s health care experiences. Pay more attention to your own body’s small signals, see your own doctor for follow-up regularly, eat well, sleep well, and have a bright mood. This is more effective than any high-priced supplement. If there are elderly people at home, don’t chase after them every day to care about them. Happy elderly people are the most effective preventive agent.