Elderly health knowledge

The core of elderly health has never been “to cure all diseases and adjust all indicators to the standards of young people”, but to maximize the ability to take care of oneself and obtain a high-quality life experience in the coexistence of chronic diseases. This is the current general consensus in the global geriatric medicine community.

Not long ago, I met 68-year-old Uncle Zhang at a community free clinic. He has been taking medication for high blood pressure and high blood lipids for five or six years as prescribed by the doctor. He is normally well under control. He can ride his bike to buy groceries and pick up his grandson from school. However, after browsing a short video, he saw someone saying, "If there is plaque in the carotid artery, it will explode on time." "Bomb", I had to go to a private hospital to inject the so-called "blood vessel opening nutrient solution". On the third day of the infusion, I squatted down to tie my shoelaces and when I stood up, I suddenly suffered from low blood pressure and fractured my femoral neck. I lay down for two months before I could barely walk with a crutch. My originally good quality of life was directly compromised. To be honest, I have seen many examples of this kind of "pursuing perfect health" that actually compromises the quality of life in the seven or eight years I have been doing community health missionary work.

Many elderly people always like to compete with the arrows on the physical examination report. In fact, even as for the control standards of indicators, the academic community has not yet completely unified. Taking the most common form of high blood pressure as an example, one school of thought believes that if people over 65 years old do not have symptoms such as dizziness or amaurosis, maintaining systolic blood pressure at 130-140mmHg is enough. Lowering it too low can easily lead to cerebral hypoperfusion and increase the risk of falling. ； The other group believes that as long as the body tolerates it, lowering it below 130mmHg can further reduce the probability of cardiovascular and cerebrovascular events. Both sides are supported by large sample research data. There is never an absolutely correct answer. The core criterion is actually whether you are comfortable or not.

Speaking of this, I have to mention the dietary issue that many elderly people have the most trouble with. Don't listen to those extreme health accounts that say "the elderly should be vegetarian and avoid meat and fish." Last year, I met a 72-year-old aunt who was afraid of having high blood lipids and did not dare to touch a bite of braised pork for a whole year. She finally fainted and was sent to the hospital due to hypoalbuminemia. After she was rescued, the doctor asked her to eat lean pork and an egg at least twice a week. However, her blood lipids did not increase, and her spirits improved more than a little. Of course, this does not mean that you can just eat a lot of fish and meat. The "Dietary Guidelines for the Elderly in China 2023" clearly recommends that the elderly eat an average of 12 kinds of food every day and 25 kinds of food every week, which is higher than the requirements of young people. After all, the elderly have weak digestion and absorption functions and must ensure balanced nutrition. As for whether the health care products that everyone is arguing about are IQ taxes, we can’t beat them to death with a stick: the elderly who are vegetarians all year round should take appropriate supplements of B12, those who seldom get out of the sun should take supplements of vitamin D, and those diagnosed with osteoporosis should follow the doctor’s advice to take calcium supplements. These all have clear benefits. ； But for those sky-high-priced health care products that boast of "anti-cancer", "thrombolytic" and "longevity", I advise you that it is better to save your money and buy more fresh fish, shrimp and seasonal fruits.

In addition to eating, there are also many pitfalls for moving. Don't believe in the saying that "10,000 steps a day will keep you healthy for a lifetime". I have seen too many examples of elderly people with bad knees who had to walk 20,000 steps and eventually wore out their meniscus and needed surgery. There is really no standardized plan for exercise. If your knees are not good, go swimming, sit on a chair and stretch your limbs. If your waist is bad, do Tai Chi and take more walks. Even if you carry a vegetable basket and visit the market for half an hour every day, it is better than doing high-intensity exercise. Aunt Li, whom I know, has an old knee injury, so she learns to make handmade beads from the older sisters in the community every day. She stands up and moves for ten minutes after sitting for a long time. Over the past year, her weight has stabilized, and her blood pressure is much more normal than before when she walked 10,000 steps a day.

There are two other minor problems that are easily regarded as "normal for old age", but in fact they have a particularly great impact on health. One is the oral cavity. Many people think that it is normal for the elderly to lose teeth. If two or three missing teeth do not delay eating, they can ignore it. In fact, research data shows that the probability of indigestion for the elderly who are missing more than three teeth is 2.3 times that of those with complete teeth, and the risk of cognitive decline is 30% higher. If you need to get dentures, you can eat apples and ribs, which is better than anything else. The other is hearing. If you are deaf, don't force yourself to do it. You can't always hear what others are saying, and you will gradually become unwilling to communicate with others. The risk of depression and cognitive deterioration will increase accordingly. If you wear a suitable hearing aid, you can chat with your old sisters and hear the lyrics of the opera clearly, and your life will be much more interesting.

Many elderly people panic when they forget things and think they are going to suffer from Alzheimer's disease. In fact, there is really no need to be overly anxious. In many cases, it is just a temporary decline in memory caused by not sleeping well recently and thinking too much. Even if mild cognitive impairment is indeed diagnosed, there is no unified standard for intervention ideas: some doctors will recommend taking drugs such as donepezil as soon as possible to delay the progression. Many studies have confirmed that playing mahjong for half an hour a day, learning new skills such as making short videos, and reciting ancient poems with your grandson, the intervention effect is no worse than taking medicine. The one that suits you is the best.

In fact, the elderly's body is like an old home appliance that has been used for fifty or sixty years. As long as the core components are not faulty, a little noise or a bit of paint peeling off the outer shell is not a problem. There is no need to insist on the parameters being exactly the same as the new one shipped from the factory. I have seen too many old people competing with the indicators every day, not daring to eat this or do that, and living a tight life. On the contrary, they are not as happy as those who are happy every day, eat two bites of sauce elbow when they want, and go downstairs to play two games of chess with their old friends. Live a long and comfortable life. To put it bluntly, being able to eat well, sleep well, go out for a walk by yourself, and have a good chat with your family is the best state of health.