Geriatric disease prevention and precautions

The core of geriatric disease prevention has never been to rely on taking supplements and waiting for symptoms to appear before intervening. Instead, it is "prioritizing full-cycle lifestyle adjustment, supporting individualized risk screening, and personalized management and control without following the trend or blindly following the trend." There is no universal "universal prevention formula", and the most effective one is what suits you.

I met 62-year-old Uncle Zhang at a community free clinic last week. He was carrying a bag full of fish oil, ammonia sugar, and liver-protecting tablets that he had just bought. He said that he spent more than 3,000 on health supplements every month. His blood pressure was 165/95mmHg. When he asked about it, he found out that he drank two ounces of white wine every meal and put twice as much salt in cooking as his younger generation. He also always thought that "you won't get sick if you take supplements." To be honest, this is the most common misunderstanding I have encountered in my three years of community chronic disease management: many elderly people equate prevention with nourishment. If it really works, first reduce the amount of salt on the table by half, which is more effective than eating any amount of imported fish oil. Data from the National Center for Disease Control and Prevention is here: the prevalence of hypertension among people over 60 years old exceeds 50%, and nearly half of them do not know they have the disease. Excessive sodium intake is the primary cause of hypertension among the elderly in my country.

Of course, eating is only one aspect. I have met several elderly people who have very strict dietary control, but their blood lipids are still high. When I asked them, I found out that they sit at home and watch TV every day and are too lazy to go downstairs because they are afraid of falling. What’s interesting is that doctors in different fields have different opinions on exercise for the elderly: Most cardiovascular doctors recommend maintaining moderate intensity activities for 30 minutes a day, including brisk walking and jogging, which can promote blood circulation and reduce the risk of myocardial infarction. ； However, colleagues in the Department of Orthopedics always say that elderly people with degenerative knee disease should not force themselves to take "10,000 steps a day". Walking 3,000 steps is enough. Swimming and Tai Chi put much less pressure on the joints and are more suitable. You really don’t have to follow the health standards on the Internet. If your knees hurt after walking a few steps, don’t force yourself to walk. As long as you can move, even if you wipe the table at home for half an hour every day, it will be fine.

There is another particularly controversial point: Do middle-aged and elderly people need regular calcium supplements? The mainstream view in the nutrition community is that daily supplementation of 1000 mg of calcium + 400 IU of vitamin D can effectively reduce the risk of osteoporosis. ； However, when doctors in the nephrology department encounter elderly people with a family history of kidney stones or high blood calcium levels, they will specifically advise not to take supplements blindly. Taking too much supplements can easily aggravate the risk of stones. The same goes for whether to drink milk every day. One group says that 300ml of milk a day is very cost-effective to supplement calcium and protein. The other group says that elderly people with lactose intolerance will suffer from diarrhea and bloating after drinking it. It is better to switch to sugar-free yogurt or eat half a pound of soy products. The effect is not much different. There is no need to force yourself to drink uncomfortable things just to "supplement nutrition".

Don’t believe it, many fatal risks are hidden in the most inconspicuous little habits. The 70-year-old Uncle Li who had a follow-up visit last month usually has his blood pressure and blood lipids under good control. However, when he woke up in the morning, he sat up and opened the window. He fainted in the living room and was sent to the hospital to be diagnosed with orthostatic hypotension. In fact, as long as he lay down for 30 seconds after waking up, sat up for 30 seconds, and dangled his legs for 30 seconds before standing up, he could avoid 90% of this unnecessary disaster. Some elderly people like to turn their heads quickly to reach for things. If they have carotid artery plaque, this action may cause the plaque to fall off and cause cerebral infarction. I am not alarmist. I have met 3 cases of elderly people with this situation in the past two years.

Many old people always say, "If I don't feel well, I'm not sick." This really deceives a lot of people. Aunt Wang in the community usually dances square dances with more energy than anyone else. Last year, her fasting blood sugar was 8.2mmol/L. She was already in the pre-diabetes stage and she didn’t feel anything. She went home and controlled her intake of polished rice and white flour for three months. After another checkup, she was back to the normal range. If she delayed for another two or three years, she would most likely have to take antidiabetic drugs for the rest of her life. There is really no need to be afraid of physical examinations. Two tubes of blood are drawn every year to check blood pressure, blood sugar, blood lipids, thyroid function, carotid artery ultrasound, and bone density. It does not cost much. If the problem is detected and intervened early, it is much better than delaying the hospitalization for severe illness and spending hundreds of thousands.

After all, the prevention of geriatric diseases is really not a profound knowledge. There is no need to stock up on a bunch of health products that cost thousands of dollars, and there is no need to follow the online health bloggers to practice "longevity exercises" blindly. Pay more attention to your body’s little signals, eat comfortably, move freely, and have a basic physical examination on time every year. If you are unsure about anything, ask your family doctor in the community, which is more reliable than any folk prescription. After all, you live your life comfortably, which is more practical than any standard "longevity index".