Comprehensive knowledge on geriatric disease prevention

There is no universal formula that can cure all diseases in the elderly. The core is to focus on four things - eating nutritiously enough, moving without force, controlling chronic diseases, and being relaxed. All kinds of knowledge are ultimately centered on these four points, and must be adjusted based on your own basic diseases and body tolerance. Copying other people's experiences can easily lead to problems.

I have been working in a community health service center for almost 10 years, and I have seen too many elderly people who have taken detours. Not long ago, there was a 67-year-old Uncle Zhang. His physical examination revealed that there was a small plaque in the carotid artery. He was so panicked that he bought more than 20,000 yuan of "Vascular Scavenger" health supplements. After half a year, he checked again and found that the plaque had not gone away. Instead, his transaminase had tripled and his liver had been damaged. Many people always think that the prevention of geriatric diseases depends on various high-tech and expensive products. In fact, it is not necessary. Doing the little daily things right is better than anything else.

At this point, someone may want to ask, then it’s right for me to eat something lighter every day, right? Not necessarily. There are two quite mainstream views now. One is the traditional health saying that "fish produces fire and meat produces phlegm", and the elderly should eat more vegetarians and avoid meat. The other is that the clinical nutrition circle emphasizes that protein intake should be ensured and not blindly vegetarian. Last year, I followed up on 62 elderly people in my area who had insisted on being vegetarian for more than a year. 38 of them had low albumin to varying degrees, and 11 had numbness in their hands and feet and poor memory due to vitamin B12 deficiency. In fact, for most ordinary old people, they do not need to eat cabbage and tofu every day, but eat one egg, palm-sized lean meat or fish and shrimp every day, and avoid fried and pickled processed foods, which is already considered "light". If they are obese and have high blood fat that cannot be controlled by taking medicine, it is not too late to consider appropriately reducing their red meat intake.

After talking about food, let’s talk about mobility. In the past two years, many elderly people have been fooled by the slogan “walk 10,000 steps a day”. In order to control her blood sugar, Aunt Li in the community walked 15,000 steps around the park every morning. After walking for half a year, her knees hurt so much that she couldn't go downstairs. When she went to take a film, she found that one-third of her meniscus had been worn away, and she couldn't even go out. There are two opinions about exercise for the elderly. One group of fitness bloggers say that the elderly should practice more strength to prevent muscle loss and falls. The other group says that the elderly should take a slow walk and stop messing around. In fact, both are correct, but it depends on the person: If you usually have no joint problems, you can indeed reduce falls by practicing squatting against the wall and lifting two mineral water bottles filled with water two days a week. ； If you have knee arthritis or severe osteoporosis, don't insist on walking so much. Find a flat road and walk slowly for 20 minutes, and bask in the sun. By the way, one more thing, don’t go out too early to exercise in autumn and winter. From November to January every year, our emergency department receives 30% more elderly people with myocardial infarction from 6 to 8 a.m. than at other times. When cold air stimulates blood vessels, hard blood vessels are prone to problems. It’s not too late to wait until the sun comes out and warms up before moving.

The most troublesome thing is the management of chronic diseases. Many elderly people feel that "they are dependent on antihypertensive drugs and cannot stop taking them" and "if blood sugar is high and it does not cause discomfort, it is not necessary to take care of it." The views of Chinese and Western medicine are indeed different on this issue: Western medicine believes that chronic diseases such as essential hypertension and type 2 diabetes are lifelong, and long-term medication and stable control of indicators can reduce complications such as myocardial infarction, stroke, and renal failure.； Traditional Chinese medicine believes that if abnormal indicators are just discovered, such as systolic blood pressure just reaching 140, fasting blood sugar just reaching 6.2, and there are no other underlying diseases, you can try to adjust your diet and exercise for three months without rushing to take medicine. Both of these statements are correct, but there is a major premise: you must measure your indicators frequently. If you still have not dropped to the normal range after adjusting for 3 months, don't insist on not taking medicine. The most pitiful old man I have ever seen is a 68-year-old man who refused to take medicine for high blood pressure for three years, saying that "the medicine is 30% poisonous". Last winter, he suddenly suffered a cerebral hemorrhage and became paralyzed. What could have been solved by half a tablet of antihypertensive medicine a day has now made his whole family suffer.

Many people ignore the impact of emotions on geriatric diseases. My neighbor Aunt Wang had no physical problems before. After her grandson went to junior high school without her, she was bored at home every day and didn't even leave the house. In less than half a year, her blood pressure rose to 160 and she took sleeping pills. It’s not alarmist. Studies have shown that elderly people who are chronically anxious and stay at home without going out have a risk of coronary heart disease that is twice as high as those who like to go out and socialize. Don’t think that square dancing, gossiping with old sisters, or playing chess together are not part of your real job. It can make you happy, which is more effective than taking any number of tonics.

Oh, by the way, there is another physical examination issue that everyone is most concerned about. There are two opinions now. One group says that annual physical examinations are necessary to detect problems early and intervene early. The other group says that physical examinations are useless. The detection of nodules will only scare the disease. In fact, it depends on the situation: for elderly people aged 60 to 75, it is really necessary to have a routine physical examination every year. I have seen several elderly people who found lung cancer in the early stage during physical examinations and recovered with minimally invasive surgery. ； If you are over 75 years old, have many underlying diseases, and are very weak, you don’t need to do all the examinations. You can just follow the doctor’s instructions and focus on the examinations, but there is no need to worry.

To put it bluntly, the prevention of geriatric diseases is to get along well with your own body. Don’t compare your physical strength with young people, don’t compare your indicators with your old colleagues, and don’t believe in any “one trick to prevent all diseases” folk prescriptions. Eat well, sleep well, and move well, that’s better than anything else.