For many elderly people, the joyful perception of life is overshadowed by poor health, hence the well-known saying “old age is not joy.” However, not everything is so scary: experts say that old age does not mean weakness and suffering. Modern medicine can significantly improve the quality of life of the elderly, so now a person at 80 years old can be an active and full-fledged member of society. Of course, this requires some effort and, first of all, to enlist the support of a geriatrician.
It is clear that medicine is unable to abolish old age. Aging is associated with the passage of time, which, alas, cannot be stopped or reversed. But it is quite possible to make elderly people live with comfort, sound mind and firm memory. And this is precisely the task of geriatrics – a science that studies the development, diagnosis, treatment and prevention of diseases characteristic of the elderly.BLOg
It should be noted that old age for ordinary people is a very vague concept. Someone at 80 years old is able to maintain clarity of mind and activity enough to write books and do morning jogging, and someone already at 50 complains of memory, back shots and apathy. Where are the boundaries of aging? Experts use the following age division: up to 45 years old, a person is considered young, from 45 to 60 years old – mature, from 60 to 75 – elderly, and then old age sets in. The patients of a geriatrician are mostly people over 60 years old. It is by these years that a person begins to observe age-related changes associated with the aging of the cardiovascular system, primarily due to violations of the microcirculatory bed due to the compaction of the vascular wall; the musculoskeletal system due to a violation of mineral metabolism; the gastrointestinal tract – due to violations of the motor-evacuation function and the development of atrophy of the mucous membranes; mental performance decreases. These and other changes in the human body are quite natural and, alas, inevitable. Another thing is that they can become fertile ground for the development of so-called age-associated diseases, many of which are chronic.
The primary task of a geriatrician is to be able to distinguish regular age-related shifts from disorders caused by the disease and requiring therapeutic and prophylactic measures.
In addition to “senile” ailments, such as atherosclerosis, osteoporosis, Alzheimer’s disease, in the elderly, non-aging diseases also acquire a certain specificity. For example, the well-known diabetes mellitus in the elderly has its own characteristics of the course and more often gives complications than in young people. It is associated with age-related features of the function of the pancreas, changes in the processes of metabolism and production of insulin, the reaction of tissues to the action of this hormone and, accordingly, requires a completely different approach to treatment. The same applies to oncology: in the fight against cancer in aged patients, doctors choose, if possible, more gentle methods of treatment, because sometimes the consequences of chemotherapy for old people simply cannot be tolerated. Age-related changes also affect the nature of the course of infectious diseases, which are often quite difficult to recognize due to the absence of such pronounced symptoms as a temperature reaction, chills, cough. “Typically, the elderly in the clinical picture are dominated by general symptoms: loss of appetite, weakness, apathy, inadequacy in behavior. Anything can be hidden behind these signs, therefore, examination of aged patients requires knowledge about the specifics of an aging organism, special care and, of course, attentiveness, ”notes Tatyana Valentinovna Kharitonova, Geriatrician at the“ Parade Quarter ”department of the Scandinavia clinic.
During a conversation with a patient, the geriatrician collects data not only on the state of his health, but is also interested in the social conditions of his life, relations in the family. Examination of an elderly patient takes about twice as long as a standard appointment with a therapist. Such a detailed heart-to-heart conversation is necessary when collecting anamnesis: patients sometimes do not attach importance or hesitate to say about such manifestations as nocturia (frequent nighttime urination) and urinary incontinence, hearing and vision impairment, fears or apathy, attributing them to age. Meanwhile, these seemingly insignificant violations may turn out to be manifestations of serious diseases.
Geriatricians pay special attention to the prescription of medicines – and in this regard, their tactics also differ from classical therapy. The effectiveness of most drugs for each age is different: those drugs that are good at a young and mature age may be useless, if not dangerous for an elderly person. “When treating elderly patients, polypharmacy is unacceptable, that is, the appointment of many drugs, which often work out of tune, suppressing the positive effect of each other and aggravating the side effects. As a rule, combined drugs are prescribed, which should be focused on solving several problems at once. It is better to give preference to combined preparations of prolonged action also because that this will improve the patient’s adherence to therapy by reducing the amount of drugs taken. This approach to treatment gives a slow effect, but it is more gentle and therefore more effective in general, ”explains Tatyana Valentinovna.
In the “Scandinavia” clinic, examination and treatment of an elderly person without fail includes consultations of cardiologists, gastroenterologists, rheumatologists, neurologists and other specialized specialists. But it is the geriatrician who develops the examination plan, tactics and coordination of treatment, the implementation of which is perhaps the most important in the management of the patient in old age. Thanks to an integrated approach, the extension of self-service ability and a high quality of life becomes quite real. Older adults can and should strive to improve their quality of life, which implies good health, vigor, positive attitude and performance – all that geriatricians call “active longevity”.