“Prevention is more important than treatment, and treatment is not a disease.” Regular physical examination and professional health management are the main means to ensure health and prevent disease. With the aging of the population, the popularity of healthy old-age care is increasing, and health check-up programs for the elderly are emerging one after another.
However, when the elderly choose physical examination items, they often ignore their own physical characteristics, blindly follow the trend or only choose basic physical examination items, resulting in little effect on the physical examination results.
After the age of 30, the body mass and muscle strength decline year by year, resulting in decreased skeletal muscle function and even sarcopenia. In healthy adults, after the age of 50, muscle mass decreases by 1% to 2% per year, and muscle strength decreases by 1.5% to 5% per year; compared with 80 years old and 30 years old, the decline of skeletal muscle can reach 50% of total muscle mass , leaving hidden dangers for falls and chronic diseases.
Some elderly people need less calories because they do not have much activity, but they do not eat less, resulting in overnutrition and obesity and other metabolic syndrome. Some elderly people eat less due to chewing problems, digestive problems or conscious control, leading to nutritional deficiencies or nutritional imbalances, decreased immunity, accelerating tissues and organs Aging.
Several chronic diseases
The incidence of chronic diseases in the elderly population is as high as 63.3%~76.4%, of which more than half of the elderly suffer from two or more diseases, such as cardiovascular disease, diabetes, chronic obstructive pulmonary disease, osteoporosis, osteoarthritis, benign Prostate hyperplasia, tumors, etc. Some chronic diseases can be life-threatening once they become acute. Moreover, most chronic diseases in the elderly are degenerative diseases, and sometimes it is difficult to distinguish physiological and pathological diseases.
In addition, the decline of various bodily functions of the elderly, or the side effects of taking multiple drugs may lead to insensitivity, insidious onset, atypical clinical manifestations, and even inability to fully describe the symptoms, which is very likely to cause symptoms during physical examination. Misdiagnosis and missed diagnosis. Therefore, the design of physical examination items should be targeted and personalized.
In addition to regular projects, what other projects should seniors do?
This is “General Check”. Personal information, such as past history, family history, life behavior, etc.; general examination, such as height, weight, waist circumference, etc.; various examinations, such as internal medicine, surgery, neurology, ophthalmology, otolaryngology, stomatology, dermatology, etc.
Including blood pressure, blood biochemistry (liver and kidney function, blood lipids, blood sugar), glycosylated hemoglobin, carotid plaque, electrocardiogram, echocardiography, blood routine, urine routine, stool routine, lung function and other tests. For the complications of chronic diseases, it is recommended that the elderly have targeted examination of liver, kidney, retina and blood vessels of limbs.
Early attention to skeletal muscle status can effectively prevent and delay the development of sarcopenia. Therefore, muscle content and muscle strength should be included in the routine physical examination items for elderly health, and dynamic assessment should be done.
Indices such as prealbumin and transferrin can be increased to reflect the protein metabolism in the human body and the effect of nutritional support in the short term. At the same time, due to the decline of gastrointestinal function and the reduced absorption of calcium and iron, the elderly are prone to osteoporosis and iron-deficiency anemia. Therefore, the detection of vitamins and trace elements should not be ignored.
Including thoracic CT, abdominal ultrasound, thyroid ultrasound, male B-ultrasound (prostate), female B-ultrasound (breast, uterus and accessories) and other imaging examinations. For the elderly with familial gastrointestinal cancer or associated gastrointestinal diseases, Helicobacter pylori and gastrointestinal endoscopy may be added. In general, tumor markers are not routinely used for tumor screening.
Taking the general elderly as an example, a comprehensive health checkup is required once a year, and then according to the recommendations of regular hospital doctors, key items are reviewed once every six months, and individual items are reviewed once every 2-3 months . It should be noted that the physical examination cycle for people over 90 years old depends on individual differences.
Article Department of General Medicine Wang Zhong Wang Ziwen Liver ICU Guo Zhe