Comprehensive knowledge on geriatric disease prevention

Early screening is more important than supplements, and fitness is more important than standards. If you feel uncomfortable, go to a doctor first instead of searching for folk remedies.

I have been doing health education for the elderly in the community for almost 6 years, and I have seen too many elderly people who make health care a burden. Downstairs, Aunt Zhang followed the "teacher" in the health care group and stocked up more than 30,000 yuan of "vasopurifiers" and "joint regeneration pills", and set three alarm clocks to eat them on time. At the end of the year, the low-density lipoprotein was still over the standard, and the old problem of knee pain was not relieved. Later, she heard from her family doctor. I suggested that I stop all those bottles and cans, take my wife for a 40-minute walk around the neighborhood every day after dinner, and deliberately add half a spoonful of salt less when cooking. I went for a follow-up check-up in six months and found that my blood lipids were normal, and my knees didn’t hurt much when I walked up and down the stairs. When I met everyone, I told everyone that the 30,000 yuan I spent before was wasted. Don’t think this is an exception. Too many people really think about the prevention of geriatric diseases in a complicated way. They always think that they have to spend a lot of money to buy expensive things to be effective. In fact, most of the most effective methods cost nothing.

Take the most commonly debated exercise as an example. You must have heard two completely opposite opinions: one says that the elderly cannot climb stairs and climb mountains, which will wear down the knees; the other says that climbing stairs more can build leg strength and prevent osteoporosis. There is actually nothing wrong with both of these statements, but they are applicable to different groups of people: Western orthopedics usually recommends that elderly people who already have knee joint degeneration and meniscus damage should try to avoid climbing stairs as much as possible to reduce the weight on their joints. ； However, many schools of traditional Chinese medicine for orthopedic injuries recommend that elderly people without underlying joint diseases climb a low building or a gently sloping hill 1-2 times a week. This can stimulate the growth of muscles and ligaments around the knee joint, and in turn protect the joints. The premise is that the posture is correct, do not climb two steps at a time, and do not carry heavy things while climbing. Uncle Li from our community is 73 years old and in great health. He and his old friend go hiking in the hills in the suburbs every week. There is no problem with his knees. However, Aunt Chen from the same community was diagnosed with meniscus wear before and followed the trend to climb stairs. Within half a month, the pain was so bad that she couldn't walk. She went to the hospital and received three injections of sodium hyaluronate before she recovered.

Don't always listen to the stereotype that "elderly people need to eat 70% full and eat a vegetarian diet to be healthy." It's really not true. An old man once listened to a health class and said that eating meat would raise blood lipids. He didn't touch a bite of meat for three years and ate vegetables and white rice every day. As a result, he was hospitalized last year due to hypoalbuminemia and his whole body was swollen like a steamed bun. Later, he adjusted his diet and ate one or two lean pork or steamed fish with half a pound of green leafy vegetables every day. Now he is in good spirits and his blood lipids have not increased. There is currently no unified conclusion in the academic community regarding whether or not to go vegan. One school of thought believes that a long-term vegan diet can reduce cardiovascular burden and reduce the risk of hyperlipidemia and coronary heart disease. ； Another school of thought believes that the digestion and absorption capacity of the elderly is inherently weak, and that a vegetarian diet can easily lead to a lack of vitamin B12 and iron, which can lead to anemia, cognitive decline and other problems. Elderly people who really want to be vegetarian must remember to supplement with multivitamins and check their hemoglobin regularly.

Let me talk about a point that many people overlook: early screening is really more effective than any supplements. I met a 72-year-old Uncle Wang before. He was usually in good health and could carry 20 kilograms of meters up to the fourth floor without gasping for breath. The chest X-ray taken during the annual physical examination at the work unit was also normal. But last year, he suddenly developed a severe cough and went for a CT scan to detect late-stage lung cancer. Later I found out that he had a history of smoking for more than 30 years and was in the high-risk group for lung cancer. He should have been screened by low-dose spiral CT every year. However, he thought "if the chest X-ray is normal, it will be fine", so he never did it. When he found out, he had already missed the best time for surgery. It was really a pity. There are also many elderly people with high blood pressure who always think that once their blood pressure is normal in the morning, everything will be fine. In fact, clinically, nearly 30% of the elderly have "occult nocturnal hypertension". Their blood pressure is normal when measured during the day, but their blood pressure will soar very high between 1 and 3 in the morning without them feeling it at all. This is more likely to cause cerebral infarction and myocardial infarction. Elderly people with high blood pressure are best to do 24-hour ambulatory blood pressure monitoring once every six months, which is much more reliable than blindly measuring blood pressure at home.

Many elderly people have heard the saying "take aspirin to prevent cerebral infarction", so they go to the pharmacy to buy it and take it every day. This is actually very risky. Now the American Heart Association's guidelines clearly state that people over 70 years old without a clear history of cardiovascular disease are not recommended to take aspirin regularly to prevent diseases. On the contrary, it will increase the risk of gastric bleeding and cerebral hemorrhage. ； However, many domestic clinicians will also make adjustments based on the specific conditions of the patients. For example, elderly people with carotid plaques and long-term high blood lipids will recommend taking a small dose if the risk of bleeding is low. Therefore, you should not take this kind of prescription drug blindly. See a doctor for evaluation first.

By the way, there is another prevention point that is easily overlooked: oral health. Many people think that "it is normal to lose teeth as we age," but this is not the case. If periodontal disease is not treated for a long time, the bacteria in it will spread throughout the body along the bloodstream, increasing the risk of diabetes, endocarditis, and even Alzheimer's disease. I have met several elderly people who have been unable to control their blood sugar. After the periodontal disease was cured, their blood sugar became much more stable. Therefore, the elderly should have their teeth cleaned at least once a year, and any missing teeth should be replaced promptly without being too troublesome or expensive.

In fact, this is a "big picture", but there really is no standard answer that suits everyone. Our bodies are like old cars that have been driven for decades. The condition of each car is different. Others run smoothly with 92 mph, but you may have to add 95. Others can drive 120 mph, but you may drive 80 mph to be the most stable. Don't always follow other people's health methods. Drink this tea today, take that medicine tomorrow. Talk to your family doctor if nothing happens. Get regular targeted physical examinations every year. Eat well, sleep well, and feel comfortable. This is more effective than any universal health prescription.