Comprehensive knowledge on geriatric disease prevention

The core answer to the prevention of geriatric diseases has never been achieved by taking sky-high-priced health products and regularly infusing “blood vessel opening fluid”. The essence is Maintaining healthy habits throughout the life cycle + personalized risk stratification intervention + early screening and diagnosis of high-risk diseases The combination of the three covers the five most common elderly diseases, cardiovascular and cerebrovascular diseases, metabolic diseases, bone and joint degeneration, cognitive impairment, and malignant tumors, and can reduce the risk of severe elderly diseases by more than 80%.

Don’t believe it, I have been doing health education for the elderly in the community for almost 9 years, and I have seen too many elderly people fall into the trap of “unified formula”: in the community, aunts and uncles form groups to go to small clinics to inject “blood circulation and blood stasis removal” liquid in the spring and autumn, thinking that it can prevent cerebral infarction and myocardial infarction. Regarding this controversial point, the consensus in different fields is actually very clear: Western medicine evidence-based medicine clearly points out that routine infusion of such liquids for people without a clear history of cardiovascular and cerebrovascular diseases has no preventive effect. Instead, it will increase the burden of liver and kidney metabolism and the risk of allergies. Elderly people with poor coagulation function may even induce bleeding. ； Traditional Chinese medicine does not advocate indiscriminate infusion. Only the elderly who are clearly diagnosed with severe blood stasis syndrome, often dizzy, chest tightness, and purple lips need to be evaluated by a professional doctor and then choose appropriate drug intervention. Indiscriminate infusion on your own is simply a waste of money. Blood vessels are actually like old water pipes at home. Regular cleaning of oil stains and not throwing debris into them is the key to preventing blockage. If you have to pour in strong acid and alkali every two months, it will corrode the pipe wall, which is not worth the gain.

Speaking of cardiovascular and cerebrovascular prevention, there is another question that people often ask: Should I take aspirin regularly when I get older? On this point, there are actually differences in the opinions of domestic and foreign guidelines. Some domestic guidelines recommend that elderly people with more than three high-risk factors such as high blood pressure, hyperlipidemia, and smoking can take low-dose aspirin, while the latest European and American guidelines clearly state that elderly people over 70 years old who have no clear history of myocardial infarction or cerebral infarction are not recommended to take aspirin regularly to avoid increasing the risk of bleeding. Uncle Zhang, who I met last year, is a typical example. He heard from an old colleague that taking aspirin can prevent stroke. After buying aspirin and taking it for half a year, he developed stomach bleeding and had to be sent to the hospital for a week before he recovered. If you really want to take it, you must first see a doctor for a bleeding risk assessment. Don't follow the trend and buy medicine on your own.

Speaking of following the trend, many elderly people particularly believe in "eating whole grains to lower blood sugar" and "vegetarian food is healthier". In fact, there are many misunderstandings here. Last month, I met a 70-year-old Aunt Wang at a free clinic. After she was diagnosed with diabetes, she ate two large bowls of corn rice and sweet potatoes as her staple food. As a result, her fasting blood sugar still soared to 8.7. She even felt very aggrieved and said, "I haven't even touched a morsel of white rice." In fact, the glycemic index of whole grains is only lower than that of polished rice and white flour. If you eat too much, it will still raise blood sugar. Moreover, whole grain products made of glutinous rice and multigrain biscuits with added sugar will raise blood sugar faster than white rice. As for whether a vegetarian diet is good or not, the nutrition community has been arguing for many years: one group believes that the elderly have slow metabolism and a vegetarian diet can reduce the burden of blood lipids. ； Another school of thought believes that the elderly have poor digestion and absorption functions, and a vegan diet can easily lead to iron deficiency anemia and hypoalbuminemia, which in turn may lead to reduced immunity. I have come into contact with several elderly people who have been vegetarians all year round. They look thin, but their albumin levels are ridiculously low when tested, and they get colds and fevers when the seasons change. In fact, there is no need to go to extremes. Eating one or two lean beef and one egg every day is more effective than any supplement. If your kidney function is not good, you can just reduce your protein intake appropriately. What suits you is the right one.

Many old people can't sit still and think that the more they exercise, the healthier they will be. They climb stairs and walk ten thousand steps every day, and eventually wear out their knees. Uncle Li from the opposite door used to climb the 6th floor five times a day to exercise. After half a year of climbing, his knees hurt so much that he couldn't walk. He went to check for third-degree meniscus wear and underwent arthroscopic surgery before he recovered. Regarding the appropriate number of steps to take every day, the views of the sports medicine community and the Department of Orthopedics of Traditional Chinese Medicine are somewhat different: Sports medicine recommends that ordinary elderly people should take 6,000-8,000 steps a day. It is best to wear soft-soled sports shoes and walk on asphalt roads or plastic tracks. Do not walk hard on cement floors. ； The Department of Orthopedics and Traumatology recommends static exercises such as Baduanjin and Tai Chi for the elderly, which can not only train core strength, put less pressure on joints, adjust breathing, and are also good for the heart and lungs. There is really no need to pursue the KPI of "walking 10,000 steps a day". If you keep walking until your knees hurt, that's not called exercise, it's called self-mutilation.

There are also many people who think that "it's normal for old people to be confused". In fact, this is an early sign of cognitive impairment. If the elderly often can't find things after putting them away, ask the same questions repeatedly, or can't even remember familiar roads, don't take it seriously. Early intervention can delay the development of the disease for 5-10 years. Some people have said before that playing mahjong can prevent Alzheimer's disease. This is true from both sides: playing mahjong properly can indeed exercise the brain's response, but if you sit still for four or five hours and get excited about winning or losing, it can easily cause blood pressure to rise and blood clots to fall off, which is dangerous. Usually, if you keep more flowers, write, and chat with old neighbors, the effect is no worse than playing mahjong, and there are no risks.

Finally, let’s talk about the tumors that everyone is most afraid of. In fact, more than 60% of malignant tumors in the elderly can be discovered through early screening, and the early cure rate can reach more than 90%. I met a 72-year-old patient last year. He had blood in his stool for half a year and was unwilling to undergo a colonoscopy because he felt it was too uncomfortable. In the end, he was diagnosed with mid-stage intestinal cancer. If he had had a colonoscopy two years earlier, he could have been resected endoscopically without even an operation. You don’t need to listen to other people’s lies about the frequency of early screening. For ordinary risk groups, colonoscopy every 10 years and low-dose chest CT every 2 years for people over 50 years old are enough. People with family history can go to 40 years old earlier and get tested every 3-5 years. Over-screening can be harmful to the body.

After working on elderly health for so many years, my deepest feeling is that there is never a universal formula for preventing geriatric diseases. No matter how good other people’s experience is, it must be suitable for your own physical condition to be useful. There is really no need to pursue perfection in everything. Smoking less cigarettes, adding less salt when cooking, and walking downstairs for 10 minutes after meals every day. Fixing a small problem will be much more effective than buying health care products worth thousands of dollars.