Preventive methods for geriatric diseases

The first is to adapt your lifestyle habits to your own physique rather than blindly follow the trend of health care. The second is to dynamically monitor basic indicators instead of waiting for symptoms to seek medical treatment. The third is to manage and control basic diseases by taking into account risks and quality of life rather than blindly pursuing perfect indicators.

Last week, I was doing a free health clinic for the elderly in the community. I met 58-year-old Uncle Zhang, who was sweating and holding a physical examination report. He said that he usually drinks two ounces of white wine, eats meat, and doesn't feel any discomfort. Why was it suddenly found that he had carotid artery plaque and that his fasting blood sugar exceeded the critical value? I asked if there is any "special medicine" that can quickly lower the indicator and prevent subsequent problems. This is actually the misunderstanding that most people have about the prevention of geriatric diseases: they always think that they have to wait until the problem is discovered before remedying it, or they just need to find a general "health template" to apply to themselves.

To tell you something interesting, a 70-year-old man once read on the Internet that "walking 10,000 steps a day can help you live longer." He carried a pedometer every day to count his steps. He walked up to 32,000 steps a day. After half a month, he had effusion in his knees and was hospitalized. He originally wanted to prevent age-related diseases, but instead damaged his joints first. In fact, different medical systems have different references on exercise: The evidence-based guideline of Western medicine recommends that 150 minutes of moderate-intensity exercise per week is enough, including brisk walking, Tai Chi, and slow-paced square dancing. There is no need to deliberately pursue the number of steps. Especially for the elderly with poor joints, excessive exercise will increase wear and tear. ； The view of traditional Chinese medicine is more towards "a combination of movement and stillness". Movement should be "physically demanding but not tiring". Don't be tired. It should also be combined with activities such as sitting quietly and taking deep breaths to calm the mind. The mood will be stabilized and the qi and blood will be smooth. It is much more effective than walking tens of thousands of steps.

Diet is even more controversial. Some people say that you need to be vegetarian to be healthy, some people say that you need to eat more meat to have resistance, and some people fill their thermos cups with Panax notoginseng, wolfberry, and chrysanthemum and drink health tea every day. From the perspective of nutritional standards of Western medicine, there are actually three core points: daily salt intake should not exceed 5g, oil should not exceed 25g, sugar should be used as little as possible, and a balanced mix of meat, eggs, vegetables and milk is enough. There is no need to deliberately be vegetarian and there is no need to eat too much fish or meat. ； Traditional Chinese medicine pays more attention to "eating and drinking in moderation". Don't eat things that are too hot or too cold, and eat seasonal ingredients according to the seasons. For example, don't always eat cold watermelon in winter, and don't eat spicy hot pot all the time in summer. No matter how many supplements you take, it will be more effective. Oh yes, there is also the issue of calcium supplementation that has been a hot topic recently. One school of thought holds that the elderly lose bone mass quickly and should supplement calcium regularly every day. ； Another school of thought believes that excessive calcium supplementation will increase the risk of kidney stones and cardiovascular calcification. My experience is, don’t take supplements blindly. Check your blood calcium and bone density first. If you are really deficient, then supplement as needed. If you are not deficient, drink 300ml of milk a day and bask in the sun for half an hour. It is completely enough.

Oh, by the way, don’t think that everything will be fine if you go to bed early and get up early to exercise every day. You really can’t be lazy when it comes to monitoring. Aunt Li, who lives next door to me, is 62 years old. She seems to be very energetic. She goes to the park every morning to do Tai Chi. The last time her blood pressure was measured for free in the community, her high blood pressure had reached 160. She still didn’t believe it, saying she had never had dizziness or headache. After going to the hospital for a detailed examination, she found out that she had high blood pressure for three or four years, but she just had no symptoms. There are now different recommendations regarding the frequency of physical examinations: If you are a healthy elderly person with no underlying diseases and no family history, a routine physical examination once a year is enough. You do not need to follow the trend and check a lot of expensive tumor markers. False positives will only increase anxiety. ； If you have a family history of high blood pressure or diabetes, or if you already have abnormal basic indicators, you need to be checked every six months. Special tests such as carotid artery ultrasound, bone density, and glycosylated hemoglobin are also required. Early detection of problems and early intervention are much better than waiting until symptoms such as chest tightness and dizziness occur before going to the hospital.

If you have been diagnosed with basic diseases such as high blood pressure and diabetes, don’t just focus on whether the indicators are falling or not. I used to take care of a 72-year-old man. After he got diabetes, he was afraid of high blood sugar. He only dared to eat less than half a bowl of multi-grain rice every time, and he didn't even dare to touch fruit. His glycosylated hemoglobin was controlled to 6.2, but he was so hungry every day that he felt dizzy. Once when he got up at home, he fell down due to hypoglycemia and hit his head, which required three stitches. There are actually differences in the academic circles regarding the sugar control standards for elderly diabetic patients: one group believes that strict sugar control is required, and the glycosylated hemoglobin must be reduced to below 6.5 to reduce the risk of complications. ； The other group believes that elderly people over 75 years old have many underlying diseases, and the risk of hypoglycemia is more dangerous than hyperglycemia. It is perfectly fine to relax the glycation limit to 7-8, and there is no need to compare it with the standards for young people. Later, we adjusted the old man's diet plan, allowing him to eat half a piece of apple every day, and adding an appropriate amount of rice. The glycation level stabilized at around 7.3. His overall mental state improved a lot, and he never suffered from hypoglycemia again.

After all, there is no universal formula for preventing geriatric diseases, and there is no need to follow the "health strategies" on the Internet. People drink chrysanthemum tea to relieve internal heat. If you have a weak spleen and stomach and you have diarrhea after drinking it, don’t drink it forcefully. ； People can run five kilometers a day without any problem. If your knees are bad, then take a walk and play Baduanjin. Oh, by the way, there’s another point that’s most easily overlooked: worry less. Many old people can't sit still after retirement. They worry about their children's work and their grandchildren's studies every day. They get sulky when something goes wrong, and their blood pressure suddenly rises. There was an aunt who had a quarrel with her daughter-in-law before and was sent to the hospital with a cerebral infarction. The gain outweighed the loss.

You see, there are many precautions. In fact, the last word is "comfortable". Don't compete with your body, and don't be obsessed with the indicators. Living a comfortable life is more effective than taking many expensive tonics.