Preventive methods for geriatric diseases

The core logic of geriatric disease prevention is to conduct layered intervention based on the pattern of physical decline starting from the age of 40, rather than improvising after the age of 60. Prioritizing controllable living habits and adjusting them in place, coupled with early control of chronic diseases and targeted screening, can reduce the risk of common geriatric diseases by more than 70%. This is a solid conclusion that we have been working on for more than ten years in community elderly health services.

I was particularly impressed by Uncle Zhang, whom I met at a community free clinic two years ago. When he was 52 years old, his blood pressure was measured at 145/95, which is borderline high blood pressure. He refused to intervene at any cost, saying that his father only had high blood pressure when he was 70 years old. Many people’s misunderstanding about geriatric diseases is that they “can only be acquired when you are old.” However, in fact, common geriatric diseases such as hypertension, diabetes, osteoporosis, and degenerative joint disease generally have an incubation period of 10 to 20 years. I met a 38-year-old young man a while ago. His physical examination showed that uric acid was 580. He casually said that he was young and just took a painkiller when he was in pain. If he does not wait until he is 50 years old, problems such as gout, kidneys, and joint deformation will have to be found.

The most controllable part of prevention is definitely daily living habits, but this is also the most controversial part. For example, do you want to take health supplements? Western medicine generally recommends supplementing whatever is lacking. For example, if you don’t get enough sunlight, take some vitamin D. If you already have osteoporosis, take some calcium. There is really no need to take other multivitamins and anti-aging preparations. Excessive supplementation will increase the burden on the liver and kidneys. ； But the view of traditional Chinese medicine is also reasonable. It pays attention to the origin of medicine and food. For example, if you always feel tired and short of breath, you can drink some astragalus water. If you have heavy moisture and thick tongue coating, you can occasionally cook some poria porridge. As long as you don’t supplement the symptoms, it can indeed have a conditioning effect. You don’t have to stand on one side and step on the other. There is also the issue of exercise. I have seen many people either walk more than 10,000 steps a day until their knees hurt, or they slump on the sofa every day, saying that exercise hurts their knees and they simply don’t move. I was talking to a doctor in the sports medicine department a while ago and he said that the average middle-aged and elderly people walk 6,000-8,000 steps a day. Just walking slowly will not hurt the knees at all, but it can delay bone loss. As for whether you should exercise to the point of sweating, different schools of thought have different opinions. Exercise rehabilitation practitioners believe that you need to exercise at a moderate intensity 1-2 times a week, with a heart rate above 100 and a slight panting and sweating, in order to exercise your cardiopulmonary function. ； But people who practice traditional health-preserving practices prefer mild ones like Baduanjin and Tai Chi. They think that not sweating will not damage Yang Qi. In fact, there is really no need to worry about it. Just choose something you can persist in. Even if you go downstairs for a half-hour walk after meals every day, it is better than lying down.

If you have been found to have basic diseases such as high blood pressure and high uric acid, don't believe in any "dietary cure" folk remedies. This is the place where I have seen the most mistakes. There was an Aunt Li who had a fasting blood sugar of 7.8 when she was 55 years old. She heard from people in the community that anti-diabetic drugs hurt her kidneys, so she refused to take them. She ate bitter melon and boiled corn silk water every day. As a result, just over a year later, she began to see blurry things. When she went to the hospital, she was already in the early stages of diabetic retinopathy. If she hadn't been delivered in time, she would have almost lost her sight. This is not to say that diet therapy is useless, but that diet therapy can only be used as an auxiliary. Taking medicine according to the doctor's instructions and keeping the indicators within the normal range is the core of preventing serious elderly complications such as myocardial infarction, cerebral infarction, and renal failure. If the follow-up diet and exercise are adjusted well, there are examples of reducing or even stopping the medication after seeking evaluation from a doctor, but you must not stop it on your own.

Another point that is easily overlooked is targeted screening. Don’t think everything will be fine just because your employer does a general physical examination every year. After the age of 50, you have to add items according to your own situation: if you have a long-term smoking history, you should have a low-dose chest CT every year. Don’t just take a chest X-ray. Chest X-rays cannot capture early-stage lung cancer at all. ； If you have a family history of gastric or intestinal cancer, have a gastrointestinal endoscopy every two to three years ； It is best for women after menopause to have their bone density checked every year. I have seen too many aunts who feel nothing but fracture their femoral neck after a fall. They just have osteoporosis and they don’t know it. Of course, there is also a saying now that "over-screening can be harmful." For example, if a full set of tumor markers are checked at every turn, a slightly higher indicator will scare you to sleep, causing anxiety and trouble. This statement is also quite objective. It is best to find a doctor to customize the screening program based on your family history and past medical history. There is no need to check whatever is expensive.

Oh, by the way, many people have missed the impact of emotions on geriatric diseases. We have done research in nursing homes in the jurisdiction before. Those elderly people who play cards, dance square dances, and like to join in the fun every day have a 32% higher blood pressure control rate than those who stay at home every day. Don't think that "good mood" is false. Long-term anxiety and depression will directly affect endocrine and immunity. Not only are the three highs easy to control, but the risk of cancer is higher than ordinary people.

In fact, after having worked on elderly health for so many years, I feel that there is nothing mysterious about the prevention of geriatric diseases. To put it bluntly, don’t “do it”. When you are young, don’t rely on your good health to eat and drink and stay up late every day. When you find out the problem, you will mess around with folk remedies. Don’t be too anxious and stock up on health products every day. Do the little things in your daily life, don't eat too greasy or salty, go for a walk when you have nothing to do, and follow the doctor's advice when you are sick, it will be more effective than any sky-high-priced health products or health secrets.