Core information for senior health

The core of elderly health has never been to pursue a perfect physical examination report with "zero disease", but to maximize the integrity of physiological, cognitive, and social functions, reduce the risk of disability as much as possible, and achieve a life of independent choice in old age. This is the consensus gradually reached by the domestic geriatrics academic community in the past 10 years. It is also the most practical truth I have learned from working in elderly health services in the community for 6 years.

Many elderly people stare at the arrows and worry as soon as they get the physical examination report. Their high blood pressure needs to be reduced to 120, and their blood sugar needs to be stuck below 6. If there is a slight fluctuation, they can't sleep all night, and they even add medicine randomly. Last year, the 73-year-old Uncle Wang in the community was like this. He secretly added half a tablet of anti-diabetic medicine and dropped it in the living room due to hypoglycemia in the middle of the night. If his wife hadn't woken up at night and discovered it, a big accident would have almost happened. In fact, his fasting blood sugar was stable at 7.2. He could carry a hoe to the roof of the building to plant vegetables every day, and he could also take his granddaughter to and from school. His condition was completely fine. However, he insisted on keeping the indicator to the standard of a young person, but he got into trouble.

Regarding the scale of management and control of chronic diseases in the elderly, there are actually two voices in the academic community. One group advocates "indicators first" and believes that as long as blood pressure, blood sugar, blood lipids and other indicators are controlled within the standard range, the risk of complications can be reduced to the greatest extent. This idea is more suitable for young people under the age of 70, with few underlying diseases and strong physical condition. ； The other group advocates "function first" and believes that there is no need to pursue absolute perfection in the indicators for the elderly who are over 75 years old and have more than three chronic diseases. For example, fasting blood sugar can be relaxed to 8-9mmol/L, and blood pressure can be relaxed to about 140/90mmHg to avoid the risks of hypoglycemia, hypotension and other risks caused by over-medication. On the contrary, it is more likely to induce more serious problems such as falls and organ hypoperfusion. There is no absolute right or wrong between these two views. The core point is to match the actual physical condition of the elderly and cannot be one size fits all.

Last month, I met a 78-year-old grandma at a free clinic. I heard that eating whole grains is healthy. She eats corn, sweet potato and oatmeal every day, and does not touch any polished rice or white flour. In three months, she lost 8 pounds. Her albumin was very low, and she felt shaky when she walked. I told her that your teeth are not good to begin with. You eat too much whole grains and can’t digest them. You can’t keep up with protein. You can fall down when the wind blows. How can you talk about health? Later, she was asked to add an egg a day and eat steamed fish or lean braised pork twice a week. Whole grains accounted for up to one-third of the staple food. After a follow-up check this month, she found that her weight had increased by 4 pounds, and her overall mental state was different. In fact, there are really not so many taboos on nutritional supplements for the elderly. As long as there are no serious liver and kidney problems, eating enough meat, eggs and milk is the priority, which is more effective than any "health secret recipe".

Many people think that if an elderly person forgets something, it is a sign of Alzheimer's disease, which scares them. In fact, it is not the case. I have seen an 82-year-old man who usually doesn’t like to read, but hangs out at the gate of his community every day to play chess and cards with his old friends. His memory is better than that of many 60-year-olds. ； I have also seen a 65-year-old man who stayed at home watching TV every day after retirement and never left the house. He showed obvious cognitive deterioration in just two years. There are different opinions on cognitive maintenance. Some people say that you should read more books and use your brain more, while others say that you should socialize more and go out more. In fact, the core is not to let your brain be "idle". Whether it is learning to shoot short videos, raising grandchildren, playing chess or dancing with others, as long as it allows you to use your brain and have social connections, it will be useful.

To be honest, for the elderly, falls are really the "number one killer". At least 6 out of 10 disabled elderly people have chain problems caused by being bedridden after falling. I have seen too many elderly people whose families were reluctant to spend hundreds of dollars to install bathroom handrails or change to non-slip slippers. When they got up in the middle of the night, their foot slipped and fell and fractured their bones. After lying down for three months, they could go to the park by themselves before, but later they had to be helped out of bed. Don't listen to the old saying that "it's unlucky to have handrails in your home". If you fall down once, the hospital bills will be enough to buy a whole room of handrails. No matter how you calculate it, it's a good deal.

In fact, is there any unified standard answer to elderly health? If you like to eat something sweet, as long as your blood sugar doesn’t spike, it’s okay to eat a piece of cake once in a while. ； If you don't like to exercise, don't lie down every day, just walk around the neighborhood twice a day. ； If you just like to stay at home and don't like to join in the fun, then you can grow flowers and watch TV at home, as long as you don't use your brain, that's totally fine. After all, being able to decide by yourself what to eat today and where to go tomorrow without having to rely on others for everything is the best state of health.