Common knowledge about geriatric disease prevention and health care

There has never been a "universal health care formula" that applies to everyone. The most effective prevention logic is always "prioritizing early screening, focusing on life intervention, and supporting emotional health." All unified health care recommendations that are divorced from individual basic diseases and living habits are essentially irresponsible.

I have been doing community health education for the elderly for almost 7 years, and I have seen countless examples. Let me tell you something that happened last week: 63-year-old Aunt Zhang usually feels that she can climb stairs without breathing and eat more deliciously. She even refuses to go to the community's free two-cancer screening and elderly physical examination because of the trouble of queuing. Last month, her daughter forced herself to have a physical examination and found breast nodule 4a. Fortunately, the puncture result was carcinoma in situ, which can be cured after surgery. If it had been delayed for another six months and a year, I really can't imagine the consequences. There are actually different views on early screening in the industry: the public health school recommends that people over 65 years old should undergo low-dose spiral CT, gastrointestinal endoscopy, and basic tumor marker screening once a year. Those with a family history of cancer should shorten the screening cycle to 1-2 years. The core is to avoid excessive medical treatment. ； The clinical group recommends flexible adjustments. If symptoms such as long-term cough with blood, changes in stool properties, or inexplicable weight loss occur, there is no need to wait for the annual physical examination. Just go to the hospital for investigation at any time. The core logic of the two groups is actually the same: Don’t waste money by doing random examinations, and don’t miss early lesions in the screening cycle. Oh, by the way, the radiation dose of low-dose spiral CT is only 1/5 of that of conventional CT. There will be no health effects at all if done once a year. There is really no need to worry about this.

When many elderly people hear about "health care", their first reaction is to ask if they should buy protein powder, deep-sea fish oil, or follow Douyin to eat health meals. I have seen too many elderly people who spent most of their retirement funds on health products. It is really unnecessary. Uncle Li, who used to live in our community, had type 2 diabetes. In the past two years, he listened to the scams of MLM and spent more than 8,000 on the so-called "hypoglycemic Ganoderma powder". He secretly stopped the hypoglycemic medicine and almost went to the emergency room for ketoacidosis. Later, as recommended by the nutritionist, he drank half a catty of pure milk every morning, ate a fistful of multi-grain rice, and walked slowly for 20 minutes after meals. Now his blood sugar is more stable than before when he took medicine randomly. Nowadays, there is a lot of debate on the Internet about "Should the elderly be vegetarians?" ； Elderly people with bad joints and degenerative bone disease do not need to force a KPI of 10,000 steps. They can walk slowly for half an hour every day, play Baduanjin, and be active. I have seen too many elderly people who have to have surgery in order to top the WeChat step list. They really cannot do this. There is also controversy about vitamin supplementation. Some studies say that vitamin D supplementation can prevent osteoporosis, while others say that excessive supplementation will increase the risk of stones. The current consensus in the industry is to do a serum vitamin D test first, and then supplement if you are deficient. If you are not deficient, 15 minutes of sunshine a day is enough, and there is no need to eat blindly.

To be honest, many family members take the elderly to check the physical examination report and just focus on the numbers of blood sugar, blood pressure, and blood lipids. Few people ask whether they slept well recently or whether they were too bored to talk. This is the most easily missed health killer. Last year there was a 72-year-old Uncle Wang in our community. After his wife passed away, he sat at home every day and lost 20 pounds in half a year. His children took him to Beijing and Shanghai to check his body and found nothing wrong with him. Later, we persuaded him to join the community's elderly choir, where he sang and chatted with the old man every day. He regained his weight in three months, and his blood pressure, which had been high and low before, was stabilized. In the past, some family members complained to me that the elderly just "have nothing to do and think wildly" and just give them enough money to spend. In fact, the field of geriatric medicine has long included "social support" as a core indicator of elderly health assessment. The incidence of cardiovascular and cerebrovascular diseases for elderly people who live alone for a long time and have no social interaction is 1.6 times that of elderly people with partners and social interaction. This is supported by clear epidemiological data, and it is really not hypocritical.

Oh, by the way, there is another pitfall that many elderly people fall into: they always think that "the medicine is only three parts poisonous". When blood pressure and blood sugar are stable, they secretly reduce the medicine or even stop the medicine. This is really not allowed. You must go to your own doctor to adjust the medicine. Don't change it by yourself, and don't follow the neighbor's prescription to buy medicine. Everyone's basic situation is different. Someone else is taking a good medicine, but you may have problems if you take it.

In fact, there is no standard answer for the prevention of geriatric diseases. Every elderly person's situation is different. You don't have to follow the "health tips" on the Internet. Pay more attention to your own physical feelings and go to the hospital promptly if you feel uncomfortable. This is more effective than any fancy health care common sense.