In my career as a doctor, I have come across countless impressive cases, but some are a special reminder that illness does not wait for anyone, especially in the elderly. The physical fitness of the elderly is relatively weak, and once they suffer from illness, the difficulty and complexity of recovery are higher than that of young people. Therefore, it is important to understand these common, potentially life-threatening conditions, and how to diagnose and treat them in a timely manner.
I remember one time when a 75-year-old retired teacher was rushed to our hospital with a sudden chest pain. The old gentleman had always been physically strong and rarely fell ill, but the sudden illness made him and his family feel very sudden and frightened. After a detailed examination, we found that he had severe coronary heart disease, but fortunately he was sent to the hospital in time and received the right treatment, which did not lead to more serious consequences such as myocardial infarction.
Cardiovascular and cerebrovascular diseases
1. Overview of the disease
Cardiovascular and cerebrovascular diseases mainly include hypertension, coronary heart disease, myocardial infarction, stroke (stroke), etc., which are the leading causes of death and disability worldwide. Older people are more susceptible to these diseases due to the gradual deterioration of their physical functions.
High-risk factors include:
Aging: Natural aging of blood vessels and loss of elasticity.
Bad lifestyle habits: such as smoking, eating a diet high in salt and fat, and long-term lack of exercise.
Genetic factors: If there is a history of cardiovascular and cerebrovascular diseases in the family, the risk is correspondingly increased.
2. Diagnostic methods
Early diagnosis is the key to preventing cardiovascular and cerebrovascular diseases. Include:
Blood pressure monitoring: Check your blood pressure regularly to detect signs of high blood pressure.
Electrocardiogram (ECG): Monitors heart activity to identify problems such as irregular heartbeats.
Arteriosclerosis test: A medical technique such as ultrasound is used to assess the degree of hardening of the arteries.
3. Practical treatment recommendations
For cardiovascular and cerebrovascular diseases, we adopt a comprehensive treatment approach:
drug therapy
Antihypertensive drugs: such as ACE inhibitors and ARBs, which are used to control high blood pressure.
Lipid-lowering drugs, such as statins, help lower blood cholesterol levels.
Anticoagulants: such as aspirin, to prevent thrombosis.
Lifestyle adjustments
Eat a reasonable diet: increase the intake of vegetables and fruits, and reduce greasy and high-salt foods.
Regular exercise: At least 150 minutes of moderate-intensity exercise, such as brisk walking, per week.
Quit smoking and limit alcohol: Smoking and excessive alcohol consumption can aggravate cardiovascular and cerebrovascular diseases.
4. Daily management skills
In order to effectively manage cardiovascular and cerebrovascular diseases, the following daily measures are recommended:
Regular check-ups: Have a comprehensive check-up at least once a year, including blood pressure, electrocardiogram and cholesterol levels.
Monitor blood pressure: Use a home blood pressure monitor to monitor blood pressure changes daily and adjust medications in a timely manner.
Record symptoms: Record any unusual physical changes or symptoms, such as chest pain, difficulty breathing, etc., and communicate with your doctor in a timely manner.
diabetes
Overview of the disease
Diabetes is a chronic disease that affects hundreds of millions of people worldwide, especially among the elderly. The disease is due to prolonged abnormalities in blood glucose due to improper use of insulin or hypofunction of pancreatic β islet cells. The elderly are more susceptible to its effects due to the general decline in physical function, leading to aggravation of the disease and even complications.
High-risk factors
Obesity: Being overweight is a major risk factor for diabetes, especially abdominal obesity.
Poor eating habits: Long-term intake of high-sugar, high-fat foods directly affects blood sugar and insulin sensitivity.
Lack of exercise: Exercise can increase insulin sensitivity and improve blood sugar control.
Family history: Older people who have diabetes in their family are more likely to develop the disease.
Diagnostic methods
Blood glucose monitoring: Fasting blood glucose and postprandial blood glucose are routine tests used to monitor daily blood glucose levels.
Glycosylated hemoglobin A1c test: reflects the average blood sugar level over the past 2 to 3 months and is the gold standard for diagnosing diabetes.
Practical treatment recommendations
Drug therapy:
Insulin: Depending on your patient's condition, your doctor may recommend long-acting or short-acting insulin to control your blood sugar.
Oral hypoglycemic drugs: such as metformin and sulfonylureas, which are often used in patients with type 2 diabetes.
Dietary modifications:
Low-sugar diet: Limit your intake of foods high in sugar, such as sweets and certain fruits.
Balanced nutrition: Proper mix of protein, fat and low GI (glycemic index) carbohydrates.
Day-to-day management skills
Self-glucose monitoring: Educate patients on how to self-monitor their blood glucose and adjust their diet and medications based on the results.
Record diet and exercise: Patients are advised to keep a food diary and activity diary to help doctors evaluate the effectiveness of treatment.
Regular check-up: Glycosylated hemoglobin A1c should be rechecked every 3 to 6 months, and the treatment regimen should be adjusted in time.
慢性阻塞性肺病（COPD）
Overview of the disease
Chronic obstructive pulmonary disease, or COPD for short, is a respiratory disease that is common in older people and is characterized by dyspnea and persistent productive cough. The disease is mainly due to permanent damage to the airways and/or alveoli due to long-term smoking or long-term exposure to harmful substances such as industrial dust and air pollution.
High-risk factors
Long-term smoking: both active and passive smoking significantly increase the risk.
Air pollution: Prolonged exposure to indoor and outdoor air pollution.
Occupational factors: such as working in a miner, construction and organic chemical industry.
Diagnostic methods
pulmonary function tests:
Forced expiratory rate per second (FEV1) and one-second rate (FEV1/FVC ratio) are mainly used to assess respiratory function.
Normally, the FEV1/FVC ratio should be greater than 0.7. Patients with COPD are usually below this criterion.
chest x-ray:
May show for other possible structural abnormalities in the lungs, such as typical findings of emphysema.
blood gas analysis:
Oxygen and carbon dioxide levels in the blood are measured to assess the gas exchange function of the lungs.
Practical treatment recommendations
Stop smoking:
Smoking is the main cause of COPD, and stopping smoking immediately is the most effective measure to slow the progression of the disease.
Drug therapy:
Bronchodilators, such as SABA (short-acting beta-2 agonists) or LABA (long-acting beta-2 agonists), are used to relieve dyspnea.
In severe cases, inhaled or oral steroids may be needed to reduce airway inflammation.
Pulmonary Rehabilitation:
These include physical training, breathing exercises, and more designed to enhance lung function and overall endurance.
Day-to-day management skills
Avoid smog and polluting the environment:
Try to minimize going out to polluted places or on days with poor air quality.
Regular pulmonary function tests:
Monitor changes in the condition and adjust the treatment plan in time.
Healthy Lifestyle:
Eat a balanced diet, exercise moderately, maintain a healthy weight, and avoid the effects of other respiratory diseases.
Through these specific diagnostic methods, treatment strategies, and daily management recommendations, older patients can effectively control and manage COPD and improve their quality of life. Early diagnosis and aggressive treatment are essential to slow disease progression, reduce exacerbations, and improve survival.