Geriatric disease prevention and care

For the prevention and care of geriatric diseases, the core logic is by no means "symptomatic treatment after illness", but a combination of "early screening + personalized intervention + full-scenario adaptive care". According to research data released by the Chinese Society of Geriatrics in 2024, this program can delay the onset of common geriatric diseases such as hypertension, stroke, and cognitive impairment by an average of 6-10 years, and reduce the incidence of disability by about 68%.

I spent a whole year in the elderly care team of the neighborhood community health service center in the past two years, and I have seen too many regrets that could have been completely avoided. For example, I met Aunt Zhang last year. She was 63 years old. She could dance for two hours straight without gasping for breath. She would occasionally get dizzy in the morning. She always said, "People are like this when they get old." Originally, if I had had a 20-yuan carotid artery B-ultrasound six months earlier, taken a low-dose statin, and put less salt in my diet, I would never have reached this stage.

There are actually different opinions in the industry about the frequency and items of elderly screening. One group thinks that routine annual physical examinations are enough. More examinations will easily lead to excessive medical treatment and put a psychological burden on the elderly.； The other group insists on adding elderly-specific items to routine physical examinations. I personally prefer the latter - last year we conducted free exclusive screenings for 117 elderly people over the age of 60 who had not been diagnosed with underlying diseases in our jurisdiction. 24 cases were found to have mild cognitive decline alone, and 19 cases had bone density that reached the osteoporosis warning value. These items are not actively covered by routine physical examinations. If you wait for obvious symptoms to be checked again, it has often reached an irreversible stage. Of course, this does not mean that the more frequent the examination, the better. For example, for the elderly without a family history of gastrointestinal cancer, a gastrointestinal endoscopy once every 3-5 years is enough. There is no need to bother with it every year, which will only cause suffering.

When many people hear about preventing geriatric diseases, their first reaction is to buy various health products. I have seen many elderly people spend most of their retirement funds on "blood vessel scavengers" and "brain gold". Last month, a 72-year-old Uncle Li came to me with a box of health products that were claimed to "lower blood sugar." When I looked at the ingredient list, the first three ingredients were maltodextrin, sucrose, and honey. After taking it for three months, his blood sugar rose from 6.2 to 7.8. Do you think it was unfair? If we really talk about daily prevention, eating two less spoons of salt, smoking two less cigarettes, and going out for a walk for half an hour every day are more effective than any sky-high-priced health products.

There are even different opinions on exercise for the elderly. Some people say that 10,000 steps a day is enough, while others say that the elderly should move less to avoid hurting their knees. In fact, there is really no standard answer. Uncle Wang, whom I met before, had heard the saying "walk 10,000 steps a day". He walked 15,000 steps around the park every day. After walking for three months, fluid accumulated in his knees and he was in so much pain that he couldn't go downstairs. Later, we adjusted the plan for him, walking briskly for 25 minutes every day, plus two 5-minute silent squats against the wall, which can train muscles without hurting joints. Now he can walk for half an hour without pain, and his blood fat has dropped from 5.8 to 4.7. He is very happy. To put it bluntly, you have to follow your own body when exercising. If you have joint problems, don’t force yourself to walk. If you have high blood pressure, don’t do strenuous exercises like weight lifting and holding your breath. Only those that suit you will be useful.

Many people think that nursing is something that happens after getting sick. In fact, it is not the case. Nursing is a part of daily life. For example, many toilets in the homes of the elderly have no handrails, high thresholds, and beds that are too short. These seemingly inconspicuous details are often the causes of falls and fractures for the elderly. There are currently two mainstream views on the care of disabled elderly people. One believes that family members must take care of themselves to feel at ease, and the other advocates seeking the intervention of a professional care team. I don’t think it is really necessary to do so. There used to be a grandma Liu who had left hemiplegia after a stroke. Her daughter quit her job and took care of her at home for half a year. She had a herniated disc and was hospitalized. Later, we came to her home and made aging-friendly modifications. We installed handrails in the bathroom and raised the bed by 12 centimeters. We came to her home twice a week for rehabilitation training. In less than half a year, grandma Liu was able to walk to the door of the community to buy groceries on her own with a walker. Her daughter also went back to work, taking care of both ends.

I have been working in the geriatric care industry for almost 8 years, and my biggest feeling is that the prevention and care of geriatric diseases has never been a difficult task, and there is no one-size-fits-all standard. There is no need to rely on the "health tips" on the Internet. Pay more attention to the small changes in the elderly - for example, he suddenly forgets things very much recently, or his legs always hurt when walking. Don't take it seriously. Take the time to take it to the community hospital for a check-up. It will be more effective than any number of supplements you buy. After all, what we want is never that the elderly are "completely disease-free", but that they can live the life they want to live comfortably and happily, right?