Comprehensive knowledge on geriatric disease prevention

The core logic of geriatric disease prevention has never been to "treat the disease after you get it", but to seize the four keys of "early screening and screening for the right items, finding suitable lifestyle habits, stabilizing basic diseases and not stopping medication casually, and not neglecting the mental state." By achieving these points, more than 80% of common geriatric diseases can be effectively delayed or even avoided.

Last week, I met 62-year-old Uncle Zhang at a community health clinic. He frowned and asked with the newly issued physical examination report. He said that he could eat and sleep normally, and he rarely caught colds. How come it was found that there were small plaques in the carotid arteries and that his fasting blood sugar reached the critical line of 6.1mmol/L? After further questioning, I found out that in the past three years, he thought it was too troublesome to wait in line for physical examinations and worried about minor problems after being found out, so he simply didn't do it. If he had discovered abnormal blood sugar a year or two earlier and adjusted his diet, he would never have reached the critical value.

Currently, there are two extreme views on physical examinations for the elderly. One group says that "physical examinations are all about IQ taxation and can detect illnesses even if they don't exist." The other group says that "the more expensive the program, the better. It is best to do a full set of tumor screenings every year." In fact, both of these are untenable.

Most of the former have not seen the benefits of early intervention. For example, early gastrointestinal cancer and lung cancer have basically no specific symptoms. They wait until they feel pain or cough up blood before checking again. Most of them are already in the middle and late stages. If they had done a gastrointestinal endoscopy or low-dose lung CT three to five years earlier, the lesions would be removed and they would be fine. Even chemotherapy would not be needed. The latter is excessive anxiety. Items like PET-CT, which have high radiation and cost several thousand per time, do not need to be done every year without high risk factors for tumors. After the age of 60, ordinary elderly people, in addition to the basic physical examination, can do carotid artery ultrasound, bone density, low-dose lung CT, and gastrointestinal endoscopy. If there are no polyps or ulcers after the gastrointestinal endoscopy, it can be done once every three to five years. There is no need to suffer that fate every year.

After talking about screening, let’s talk about the living habits that are most likely to get into trouble.

Many elderly people are used to saving their lives and are reluctant to throw away leftovers after reheating them for three or four meals. Aunt Wang, who I know, was hospitalized for nitrite poisoning last month after eating three-day-old leftover vegetables. She spent a small amount of two thousand, enough to buy three months' worth of fresh vegetables. There are also misunderstandings about eating. Many elderly people go to extremes after listening to popular science. They heard that high blood fat is bad and simply don’t eat a bite of meat. Last month, I met a 70-year-old grandmother in the outpatient clinic. Her albumin was only 32g/L and her muscle mass was 20% less than the standard value. She was out of breath after taking two steps and fell down frequently. When I asked, I found out that she hadn’t touched meat in half a year. In fact, eating two ounces of lean pork, fish or shrimp every day, or even a few pieces of greasy braised pork occasionally, as long as it is not eaten every day, will not have a big impact on blood lipids. On the contrary, it can supplement enough protein to prevent sarcopenia, which is better than anything else.

Nowadays, there is a lot of noise on the Internet about exercise for the elderly. Some people say that you must walk 10,000 steps a day to be healthy. Some people say that it is completely unnecessary to hurt your knees if you walk too much. In fact, there is no unified standard. If you have degenerative disease in your knees and force yourself to walk 10,000 steps, isn't that just looking for trouble? Doing Tai Chi, swimming, or even standing at home holding the dining table for 20 minutes every day to bask in the sun is better than lying still. I’ve seen a 75-year-old man climb five floors a day without any problems, and I’ve also seen a 60-year-old man’s knees swell up after walking 5,000 steps. The one that suits you is the best. Don’t compete with the old guys in terms of step count.

The control of basic diseases is the area where I see the elderly making the most mistakes.

I met Uncle Li at a free clinic before. He had been taking medicine for high blood pressure for three years. His blood pressure was normal after half a month, so he secretly stopped taking the medicine. As a result, he suffered a cerebral hemorrhage and was sent to the ICU within ten days. His life was saved, but the left side of his body was paralyzed. Now he has to be taken care of by his wife every day. Every time he talks about it, he claps his thigh with regret. There are also many old people who are superstitious about health care products, saying that "purely natural and without side effects" can cure high blood pressure and diabetes. Let's be honest. If this miracle drug really existed, the Nobel Prize would have been awarded to him long ago. Regular dietary supplements such as calcium tablets and vitamin D can be taken. Anyone who claims that they can replace antihypertensive and hypoglycemic drugs are all liars. Don't believe them. If you are not sure, just take a photo and show it to the community doctor. It only takes two minutes.

Finally, let’s talk about the most easily overlooked point: mental state.

Many people think that as long as the elderly have no physical problems, they will be fine. In fact, this is not the case at all. Grandma Liu, who lives downstairs in my house, has children who work in other places. She usually lives alone. She used to sit in front of her apartment building in a daze every day. Her blood pressure fluctuated for three months in a row. She tried several antihypertensive drugs but nothing worked. Later, she went to a large hospital for a checkup and found that she had no organic problems. She was just too lonely. Later, her children enrolled her in a paper-cutting class in the community, and she met a few old sisters. They made appointments to go to the park and cut paper together every day. When I saw her last month, her face brightened, her blood pressure stabilized, and she even reduced her antihypertensive medication by half. Nowadays, there are still many elderly people who think that psychological problems are "hypocrisy" and are embarrassed to look at them. In fact, the incidence rate of depression in the elderly is much higher than everyone thinks. If you can't be energetic, sleep well, and don't want to eat for half a month, don't bear it. Go to a psychological department for a check-up. There is no shame in it.

In fact, after all, the prevention of geriatric diseases really doesn’t have to be so fancy. You don’t have to blindly try out those “magic health recipes” on the Internet, and you don’t have to be so anxious about the slightest problem that you can’t sleep. Occasionally, I'm craving for hot pot, or I just want to lie at home for a day on a cloudy day. It's no big deal. After all, as we get older, living comfortably is more important than anything else. As long as you do the key things mentioned above, you will suffer less and cause less trouble to your children, which is better than taking many health supplements.