Medical Requisites in the Geriatric Age Group [above 60]
Our motto in David Geriatric Solutions (DGS) is to make an elderly feel good about him/herself. As per our tagline “adding life to time” we aim at improving the quality of life of the elderly and making them independent, healthy (physically and mentally) and vital. Someone once said, “Live your life and forget your age, it’s just a number anyway”. This is what we intend at DGS.
So how to persuade our seniors to stay healthy and feel good about themselves. They require a balanced diet, good sleep, and moderate physical activity in any scenario apart from regular medical checkups and tests. But of course, not everyone has that privilege, especially in developing countries, where economic and emotional abuse of the elderly is routine. That is a different issue altogether which needs attention and discussion - maybe in my next post! Here let me focus on the medical needs of our senior citizens.
The following are some recommendations on early or regular screening to prevent complications and keep our parents/grandparents safe and healthy.
Fall prevention facilities at home: Elderly are prone to sustain fractures, or head injuries very easily even with trivial falls due to decreasing bone mineral density. A few changes made at home to ensure safety, especially in bathrooms, bedrooms or to stairways, can prevent falls. https://www.nia.nih.gov/health/preventing-falls-home-room-room provides some useful tips.
To have a check on weight gain. Due to age related decreased metabolism and muscles getting converted into fat due to hormonal changes, putting on weight could be a trigger for many health issues.
Hypertension (high Blood Pressure-BP) is one of the risk factors for cardiac/brain stroke, kidney disease, eye (retinal) issues. So, blood pressure has to be monitored on a regular basis especially among the elderly and people with family history of hypertension/heart disease/stroke. It is recommended that BP to be checked by a health care provider every year, even if the blood pressure is normal. Our elders may need screening more often if BP is higher than normal or have other risk factors.
Eye check at regular intervals (at least annually) for issues that are common with age such as vision issues, cataract, glaucoma, diabetic or hypertensive retinal complications is very important to restore and maximize vision. Ask an eye doctor how often we need to have our parent’s/grandparent’s eyes checked.
Hearing gets impaired in at least 25-50% of elderly people as age advances and is mostly treatable if screened and sought help promptly. So please help our seniors to overcome the stigma and have the hearing tests (audiogram, etc.) done by an audiologist or ENT doctor if they have trouble in hearing.
With old age comes weak bones (osteoporosis) and need prompt attention to avoid fractures (especially hip fractures with simple falls) and in turn, unnecessary disability years. It is better to have a baseline bone density test done as it will affect the treatment, especially among the elderly women (as post-menopausal are at risk). However, irrespective of this screening, it is advisable to consult the doctor for calcium supplements and Vitamin D levels testing and supplementation.
Regular Dental Check ups are also advisable to maintain proper oral hygiene and dentition. Dental caries could be foci of infection in the elderly. Gum disease and loss of teeth may intervene with proper eating and nutrition.
Blood Tests:
Complete Blood Count/Hemogram: to Know the Hemoglobin level that is an indicator of anemia and may indicate if the lack of hemoglobin is nutritional or loss.
Blood Sugars/HbA1c testing is advisable once a year or at least once in 2-3 years if no prior history/family history. However, frequent testing (once in 3 to 4 months) is required if known diabetic and on treatment or have risk factors.
Cholesterol Levels (Lipids: total cholesterol, triglycerides, HDL/good cholesterol, and LDL/bad cholesterol) screening is recommended to all the elderly as high cholesterol and triglyceride/LDL levels are major risk factors for heart attack and can be easily treated with diet restrictions and medications.
Thyroid Hormone Tests: Thyroid hormone problems can be a cause for fatigue, hair loss, weight gain, bowel disturbances, depression or anxiety, sleep disturbance, etc. So, screening for thyroid hormones is advised at least once in 5 years, especially in women.
9. Cancer Screening:
Colon or Rectal (large intestine) Cancer: risk is high after the age of 45 years. Yearly fecal occult blood testing (to test any blood in the stools which is not evident) is advised between 45 to 75 years of age.
Prostate Cancer: Screening for Prostate Specific Antigen (PSA) is advised in Men after the age of 55.
Breast and Ovarian Cancer: Regular breast examination including manual exam, breast ultrasound or mammogram, Pelvic/lower abdominal ultrasound is advised every 1-2 years or as advised by the treating doctor. Screening for serum ovarian cancer markers and breast cancer genes especially with strong family history is advised in women above 40 years as the risk of these cancers increase with age.
Cervical or Vaginal Cancer (women’s private parts): Pap smears are recommended for women every 3 years, an Human Papilloma Virus (HPV) test every 5 years, or both, up to the age 65.
Additionally, vaccination is as important in the elderly as in the children. People above 65 years old must get pneumococcal vaccine to protect against pneumonia. Also advised is the shingles (Herpes Zoster) vaccine for those over age 50 and almost all elderly should get an annual flu shot.
Most importantly, always be in touch and have regular follow up with your parents’/grandparents’ family physician who will holistically approach them and refer promptly to higher specialties if need arises. Remember, “PREVENTION IS ALWAYS BETTER THAN CURE”.
Yours,
Dr. Seema
MD, DGS
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