Lecture on geriatric disease prevention and health care knowledge

There is no universal prevention formula for geriatric diseases. The most effective way is to conduct personalized daily intervention based on your age, underlying diseases, and physical tolerance. The so-called "tonics can cure all diseases" and "one trick to prevent premature aging" are all lies.

I just met the 72-year-old Aunt Wang at a community free clinic last week. She has a three-year history of grade 2 hypertension. She listened to a free health class in the community and said that nattokinase can "dissolve thrombosis and open blood vessels." She secretly stopped her antihypertensive medicine and replaced her with three boxes of health supplements costing 1,980 yuan. She became dizzy and unable to stand within half a month of taking her. When she was sent to the emergency room, her blood pressure soared to 180/110. Fortunately, she was delivered in time and no serious problems occurred. I have seen no less than 20 such cases in the past six months. Many elderly people always want to find a once-and-for-all health care method, but instead they fall into a trap.

One of the most controversial issues nowadays is whether the elderly should rest or exercise more. Both schools of thought are well-founded and reasonable. Most of the people who advocate recuperation are younger people, who are always afraid that the elderly will fall and bump into them, especially the elderly who have suffered from cerebral infarction or joint replacement. Their families can't wait to let them sit on the sofa every day without moving. But to be honest, old people have more than 30% less muscle mass than young people. If they lie still every day, their muscles will lose faster. The next time they stand up, their legs will become weak, which will make them more likely to fall. I used to manage an 80-year-old man who lay at home for 3 months after a fracture. He did not fall a second time, but he was hospitalized with pneumonia first. On the other hand, old people who say "the more you move, the longer you live" are also prone to going to extremes. They go hiking before dawn and do high-intensity square dancing for two hours. Last winter, there was an old man in our district who ran 5 kilometers at minus 3 degrees Celsius. The cold wind caused vasoconstriction and directly caused a myocardial infarction. Fortunately, he was rescued. In fact, there is no standard answer. The core is just one: it is not uncomfortable and can be tolerated. It is perfectly fine for the elderly with good basic skills to walk 6,000 steps a day and do Tai Chi. If you have severe heart failure and have just undergone surgery, there is no need to do hard exercises. Doing a few sets of ankle pump exercises in bed every day to move your wrists and ankles is also an effective exercise. If you are not sure about the intensity, just remember a simple formula: the heart rate after exercise does not exceed 170 minus your age, and there is no chest tightness and dizziness, then you will be fine.

After talking about moving, let’s talk about eating. There are more different ideas in this regard. Chronic disease management in Western medicine emphasizes priority on indicators. Salt should not exceed 5 grams per day and added sugar should not exceed 25 grams. Diabetic patients should control fasting blood sugar between 4.4-7.0mmol/L. The standard is very clear, but it is easy to go to extremes. I met a 75-year-old man before. In order to control sugar, he did not even dare to eat rice. He only ate cucumbers and boiled vegetables every day. In the end, he fainted in the vegetable market due to low blood sugar. When he was delivered, his blood sugar was only 2.8mmol/L. Traditional Chinese medicine's approach to treating disease is more flexible and emphasizes "grains as nourishment". There is no need to completely cut off staple food, just adjust according to the body constitution. For example, an elderly person with a weak constitution who is usually afraid of cold and has cold hands and feet can eat more ginger stewed mutton in winter. If a person with a damp-heat constitution usually suffers from bitter mouth, bad breath and dry stool, drink more winter melon soup and make some chrysanthemum tea. The two ideas do not conflict at all and are best used together. Many elderly people always buy it after hearing others say "this is good". In fact, what is suitable for others may not be suitable for you. The reason why Lao Zhang's waist does not hurt after taking calcium tablets is because he has osteoporosis. If you have a herniated intervertebral disc, it will be useless to take more calcium tablets.

I have been a geriatrician for 12 years, and none of the long-lived elderly people I have met lived past 90 years old by taking health supplements. Instead, most of them have one thing in common: they don’t get entangled. There used to be an 87-year-old Grandma Chen who has been suffering from hypertension and diabetes for more than 30 years. She should take medicine every day and take a walk every day. She doesn’t worry about whether today’s blood pressure is 1mmHg higher than it is going to be a big problem. She doesn’t follow the trend and buy a health care bed worth several thousand yuan. Now she can cook her own meals and take care of her hemiplegic wife. She is in much better spirits than those old people who compare their symptoms with health books every day and always suspect that they are seriously ill.

What I’m talking about today is not to make you remember some rules, but to remind you that you know your own body best, don’t follow the trend blindly, and if you feel uncomfortable, go to a community doctor or go to a regular hospital as soon as possible. It is more effective than any health products. If you have any questions now, you can raise your hands and ask, and I will answer them one by one.