Lecture content on geriatric disease prevention and health care knowledge

In today’s lecture on the prevention and health care of geriatric diseases, I will first give you the most basic information: the prevention of geriatric diseases can never be achieved by hoarding a bunch of expensive health care products and following the trend of 10,000 steps. The three most effective things are actually Lifestyle adjustments that suit your own situation, targeted screening once or twice a year, and long-term standardized management of chronic diseases , if you do these three things right, you can avoid more than 80% of the risks of emergencies in the elderly.

Last week, I treated 72-year-old Aunt Zhang in the community. She was carrying a bag full of health care products. She said she had been feeling dizzy and flustered recently. When I asked, she only took 7 kinds of products to soften blood vessels, supplement calcium, and improve immunity every day. She only took antihypertensive medicines when she thought about it. When she measured her blood pressure, it was 170/95. This is a typical example of using her energy in the wrong place.

Many people are now struggling with the appropriate number of steps to take every day. When I attended an academic conference before, the orthopedic doctor said that for elderly people over 70 years old with degenerative knee disease, walking more than 5,000 steps a day will put a burden on the joints. It is best to switch to swimming, Tai Chi and other exercises that put less pressure on the joints.； But the cardiology doctor also said that elderly people with coronary heart disease and high blood lipids must do at least 150 minutes of moderate-intensity exercise every week, otherwise their blood lipids will not be lowered. In fact, both of these statements are correct. There is no unified standard at all. If your knees are good, you can walk seven or eight thousand steps a day. If it hurts to go up and down stairs, don't force the KPI of 10,000 steps. The one that suits you is the best.

Another detail that everyone tends to overlook is not to go out for a walk too early in the winter. Last winter, I met three elderly people who suffered cerebral infarction after going out for morning exercise at around 5 a.m. in winter. When the temperature is low in the early morning in winter, when the blood vessels shrink, elderly people with arteriosclerosis are prone to accidents. It is better to wait for the sun to come out and the temperature to rise above 10 degrees before going out, which is within half an hour.

Let’s talk about eating. In the past, many people said, “You can’t buy a lot of money to lose weight in old age.” However, in the past two years, the nutritional community has reversed the trend again, saying that it is best not to have a BMI lower than 22 for people over 65 years old. If you are too thin, your immunity will be weak and you will not be able to withstand minor illnesses. I once had an old patient who was afraid of high blood sugar. He only ate half a bowl of rice and barely touched the meat. He lost 10 pounds in half a year. Later, he got herpes zoster, which took two months to recover. It was because his immunity was too low. In fact, you don’t have to quit everything. For example, if you have stable blood sugar control, it’s okay to eat a small piece of cake or half an orange occasionally. It’s better than malnutrition. Oh, by the way, there is also the saying that drinking red wine softens blood vessels. There is still a debate in the academic world. Some say that a small amount of resveratrol does have antioxidant effects, and some say that even a sip of wine can increase the risk of liver cancer and cardiovascular disease. The current mainstream advice is not to rely on drinking to nourish blood vessels, but to eat deep-sea fish two or three times a week and use some olive oil for cooking. It is more reliable than anything else.

Let’s talk about physical examinations. Many old people say that I do physical examinations at work every year, so why did I suddenly get cancer? Chest X-rays of routine physical examinations cannot detect early lung cancer, and abdominal B-ultrasound cannot detect early gastrointestinal tumors. For those over 60 years old, it is best to have a gastrointestinal endoscopy every 2-3 years, a low-dose lung CT and a bone density test every year, homocysteine ​​for those with high blood pressure, and glycated hemoglobin every 3 months for those with diabetes. Only these targeted screenings are useful. My former patient, Aunt Wang, had normal chest X-rays every year. Last year, she followed my advice and had a low-dose CT scan, which detected ground glass nodules and removed early-stage lung cancer. She is fine now. If she waits for the chest X-ray to reveal it, it will be too late.

Finally, I would like to mention chronic disease management. This is really a cliché but many people still don’t do it correctly. Many elderly people think that they can stop taking medication when their blood pressure and blood sugar are normal, or they can reduce the dosage themselves. This is the most dangerous thing. I just met an uncle Li last month. He had diabetes and stopped taking anti-diabetic drugs. He took so-called "pure natural anti-diabetic health products". As a result, he had ketoacidosis and was hospitalized in the ICU. It cost him tens of thousands to save him. Those health products that say they can cure diabetes and high blood pressure are all lies. Currently, there is no cure for these two diseases. Taking medicine honestly and following the doctor's instructions and monitoring regularly is better than anything else.

What I’m talking about today are all real examples I’ve encountered in the past six or seven years as a community health practitioner. There is nothing imaginary, and there is no unified standard answer. If you are not sure about your situation, come to us at the community health service center, and we will give you individualized advice. Don’t believe those scammers who deliver eggs or sell health care products on the street. Your body is your own, and being comfortable is more important than anything else.