Significance of geriatric disease prevention

The core significance of geriatric disease prevention is never to prevent the elderly from getting sick at all, but to postpone the time of disability per capita by 5-10 years through early intervention and early control, improve the quality of life in the elderly by more than three times, and at the same time reduce more than 60% of the family's pension medical expenses and save at least 40% of related expenses for the public health insurance system. This is not what I say. It is a statistical result obtained by the National Center for Disease Control and Prevention after tracking 300,000 elderly people in the past 10 years.

When I was volunteering at a community elderly health education site two years ago, I met two Uncle Zhangs of the same age, which is the most intuitive example. Both of them were diagnosed with high blood pressure and high blood lipids during physical examinations at the age of 62. One of them listened to the doctor and gave up the habit of drinking two taels a day, adding less salt in cooking, walking around the community for 40 minutes every day after dinner, and taking antihypertensive medicine on time. Now he is 78, and he can still ride a tricycle to carry his grandson to the elementary school two kilometers away every morning. After school, he buys half a rack of ribs and makes soup for his wife. Another person felt that he was not dizzy, but taking antihypertensive drugs had side effects, and continued to eat soybean meat and drink white wine. He suffered a cerebral infarction at the age of 70, and the left side of his body was completely paralyzed. He has been lying in bed for eight years. The nursing fee plus monthly rehabilitation and medical expenses cost more than 4,000. His wife has a bad waist, so she helps him turn and rub himself every day. Last year, he was so tired that he was hospitalized for lumbar spine surgery. The family's life is tight.

In fact, there have been two different voices in the industry regarding the scale of geriatric disease prevention. One group is the "radical preventive group", which advocates that special screenings for carotid artery ultrasound, bone density, glucose metabolism and other geriatric diseases should be carried out every year starting from the age of 40, and blood pressure, blood lipids, blood sugar and other indicators should be strictly controlled within the standard line for young and middle-aged people, so as to delay the aging rate of blood vessels and organs as much as possible. The core basis of this group is that "the damage of aging is irreversible, and only by early control can the damage be minimized." The other school is the "moderate prevention school" that has become more and more recognized in recent years. It believes that people over 75 years old do not need to excessively pursue perfect indicators. For example, even if the fasting blood sugar reaches 7mmol/L, as long as there is no obvious discomfort, there is no need to forcibly lower blood sugar. On the contrary, it can avoid the risk of falling and myocardial infarction caused by hypoglycemia. After all, for the elderly, the risk of fractures and bed rest caused by falling is much greater than that of mild hyperglycemia. No one is right or wrong between the two groups. Essentially, they both focus on the core of "improving the quality of life of the elderly", but they are suitable for different groups of people.

Many people have a misunderstanding. They think that geriatric diseases are diseases that only occur when you are old, and you have to wait until you retire to prevent them. This is not true. Last week, I helped my 36-year-old cousin get the physical examination report. She found early-stage plaques in her carotid arteries. She stayed up late with milk tea every day and said with a smile, "Old age diseases are far away from me." In fact, the pathological basis of geriatric diseases such as atherosclerosis and bone loss begin to develop slowly at the age of 30. By the time you develop symptoms of dizziness and joint pain at the age of 60, it will be too late to take care of them.

Some people have told me before that life and death are determined by fate, and there is no point in taking precautions. I generally don’t argue with people about this. It is true that there are a few chosen ones who smoke and drink all their lives and still live to be over 90 and can climb stairs, but that is a genetic advantage with a very small probability. What do we ordinary people bet on? Take the most common form of osteoporosis, for example. If you start drinking a glass of milk and spending 10 minutes in the sun every day at the age of 40, the risk of fractures can be reduced by 40% by the age of 70. It’s such a simple thing, why not do it?

Dr. Wang, who worked with me on a missionary mission for half a year, has been practicing geriatrics in the community for almost 20 years. He said that he has seen too many elderly people who have taken detours. In fact, the most effective preventive measures are not health products or physical therapy devices that cost thousands of dollars, but just three small things: eating enough green leafy vegetables every day, walking slowly for 30 minutes, and checking blood biochemistry and blood pressure once a year. 70% of common geriatric diseases can be prevented. Unfortunately, many people just don’t believe it and have to pay the IQ tax.

Last year, our district conducted statistics and found that among the three streets that insist on standardizing geriatric disease prevention, the average annual hospital stay for the elderly was 12 days less than that of other streets, and the per capita expenditure on medical insurance was nearly 40% less. The money saved was used to install 20 more sets of fitness equipment for the elderly in the community, open three affordable canteens for the elderly, and provide two more mobile vehicles for free door-to-door physical examinations, which is equivalent to a virtuous circle.

To put it bluntly, the prevention of geriatric diseases is worth it no matter how you calculate it: you should pay more attention when you are young. When you are old, you can go to the park by yourself, play chess with the old man, and eat delicious food. You don’t have to lie in bed and look at other people’s faces, and you don’t have to ask your children to quit their jobs and come back to take care of you. On a larger scale, the saved resources can benefit more elderly people. This is not a grand public issue, but a real good old age that you can hold in your own hands.