Day of the Elderly & ndash; a reason to give again expert healthy happy living advice.
How many centenarians are there in Moscow, who are geriatricians and what healthy aging is, what food rejuvenates, and also how to age beautifully on the eve of the Day of the Elderly 'Arguments and Facts' said & nbsp; Independent specialist head geriatrician, MD, Professor Nadezhda Runikhina .
When does aging begin?
Maria Egorova, AiF: & nbsp; & mdash; Nadezhda Konstantinovna, at what age does old age begin?
Najda Runikhina: & mdash; There are different ideas about the start of the aging process. There is no medical description of what an old man is. There is a biological process that affects many organs and systems. It is done gradually. There are external signs, physiologists and pathophysiologists have described the aging processes occurring in various organs and tissues. As doctors, we focus on the age and health indicators of the patient, which vary greatly between people of the same age. For example, we looked at patients in the Citizen Centennial Project, in which many centenarians were very active, with a clear mind, a great sense of humor.
& mdash; What problems do Muscovites seek help from a geriatrician?
& mdash; Elderly people almost all seek medical help from doctors of various specialties, as there are certain health issues. Patients see geriatricians for specific geriatric issues related to age. These include the so-called Senile Asthenia Syndrome, which manifests as general weakness, trouble walking, falls, weight loss. It is a pathological variant of aging, a person becomes weak, very vulnerable. Any stress & ndash; acute illness, trauma and mdash; can become a trigger and trigger a process that rapidly degrades health and functional status.
Senile asthenia often develops in a patient who has many chronic diseases. Studies show that more than 40% of all elderly patients with chronic heart failure suffer from this geriatric syndrome. If the patient has diabetes mellitus, joint disease, high blood pressure, then these patients develop signs of senile asthenia more quickly. But senile asthenia can develop in an elderly patient without significant pathologies.
Reception at the geriatrician
& mdash; How to understand that you need a visit to the geriatrician and how is the appointment?
& mdash; Suddenly, an elderly person began to lose weight for no good reason or began to walk slowly, complaining of weakness, rapid fatigue. Physical activity began to decrease noticeably. All of this is a reason to make an appointment with a geriatrician. Geriatrician & ndash; is a doctor who has general therapeutic knowledge, knowledge in the field of neurology, psychiatry, psychotherapy, physiology of the aging process itself, geriatric syndromes. A distinguishing feature of an advisory appointment is that we perform a comprehensive geriatric assessment. This technology does not require any complex equipment, it takes knowledge and time to understand in detail the problems facing the patient. All geriatric syndromes are multifactorial & ndash; There are many reasons why a person has started to weaken and a more rapid type of pathological aging is formed which leads to functional disturbances and people quickly fall into the group of people addicted to it. outside help, lose their autonomy.
Geriatric syndromes & mdash; age-related conditions, the older a person, the more often they occur. Concomitant diseases, previous severe trauma, sensory deficits and ndash; vision or hearing loss, taking a large number of medications, memory impairment, depression & ndash; all of this also contributes to the development of senile asthenia and other geriatric syndromes. In a comprehensive geriatric assessment, we analyze this in detail, assess the physical, functional and cognitive state. Be sure to assess the patient's social status, clarify who the person lives with, who can provide support, what living conditions. Based on a comprehensive geriatric assessment, another treatment plan is developed. The patient is seen for at least an hour.
Loneliness shortens life
& mdash; Is it possible to get advice from relatives who are caring for an elderly person?
& mdash; We always welcome when an elderly person comes to an appointment with a geriatrician, accompanied by their loved ones & ndash; the people who care for him help him live. Many recommendations are addressed not only to the patient himself, but also to the family, relatives. You cannot counsel a family without seeing the patient. Relatives, if necessary, we give recommendations after examining the patient & ndash; how to eat, how to heal a wound, how to give medicine, how to exercise, teach the features of hygiene care. Therefore, we always work with the relatives of the elderly person. This is a common practice for physicians who work in home nursing and interact with families, caregivers and sometimes social workers caring for lonely elderly patients.
& mdash; Can I make an appointment with a geriatrician in a polyclinic?
& mdash; Geriatric clinics are open in several polyclinics. You can register for it on the recommendation of a general practitioner. You may also be referred for a geriatric consultation at hospitals for veterans of wars # 1, # 2 and # 3.
& mdash; Is it true that loneliness shortens life?
& mdash; This is the case, especially in old age, when a person becomes dependent on outside help. Of course, at any age, social support, family support is important, but for a weakened person it becomes vital. So when we do a full geriatric assessment, the social domain is essential.
Along with the relatives of a very debilitated patient, we also discuss the safety of a person's independent living and the possibility of a rapid response in an emergency. For example, if a person falls home and is alone then they should have a panic button, a phone, so they can call for help, which should be provided on as soon as possible. The elderly must not be alone, they must be supervised, supervised above all by their relatives, possibly neighbors, acquaintances, social workers. & nbsp;
& mdash; Why do older people today look younger than their peers, say 20-30 years ago?
& mdash; I think we have learned to age more slowly. On the one hand, there are biological prerequisites associated with advances in medicine. We started to take better care of ourselves. We started to pay more attention to our physical activity, to track our weight. That is, a biological premise based on knowledge of health and the use of the capabilities of modern medicine gives us the opportunity from a point of view physique to be younger and stronger. But it seems to me that the change in our psychology makes a great contribution. We are now seeing examples of successful aging. There was a psychological restructuring & ndash; we want to live long and active. And it significantly contributes to our appearance.
It is a very important time for modern people entering old age to have psychological preparation to be active, to learn, to perceive new things, to show interest and curiosity for life & ndash; this is very important.
& mdash; What do you think of the Moscow Longevity project? in terms of geriatrics?
& mdash; This is an amazing project that provides seniors with incredible opportunities to be active by participating in athletic, creative, intellectual and cultural programs. This helps prevent many geriatric problems associated with deficits in physical and cognitive activity. “Longevity of Moscow” & mdash; prevents loneliness. Because a person is involved in various social activities. He forms a circle of friends and acquaintances who support and control each other. We conducted research & ndash; assessment of the health status of older people participating in the Moscow Longevity project. And they found that when a person participates in two or more activities, for example, Scandinavian walking, painting, swimming, and something else, then their health indicators objectively improve. People improved their walking speed and cognitive status indicators: & ndash; memory, reflection. From the point of view of geriatrics, Moscow Longevity & mdash; it's just a brilliant project.
& mdash; How many long livers are there in Moscow?
& mdash; People 85 and over are considered centenarians, and there are many of them. There are more than 3 million elderly people in Moscow, and long livers & mdash; about 270 thousand
& mdash; What is healthy aging?
& mdash; There is debate as to whether aging can be considered a disease and whether it should be treated. But it is clear that there is physiology and there is a biological aging process, which has not been reversed. And there is the concept of age-associated diseases that occur in the elderly. These include hypertension, osteoporosis, atherosclerosis, and type 2 diabetes mellitus – on the one hand, they are brought on by age. On the other hand, these diseases cause rapid and pathological aging, when the syndrome of senile asthenia is formed. The issues related to healthy aging are more related to prevention programs. Knowing geriatrics, studying the problems of people linked to pathological aging, we give recommendations to people to avoid these complications and to age in good health. These are programs aimed at supporting the elderly and senile in order to prevent the development of complications, senile asthenia and the progression of functional disorders.
Rejuvenating apples or living water?
& mdash; It would be naïve to wonder about the existence of old age pills, but are there ways to delay its approach medically, physiotherapy or by other means? Is it possible for the elderly to have a glass of wine or a glass of vodka?
& mdash; A glass of vodka, of course, is a strong drink & ndash; Better not. An occasional glass of wine can be drunk by a senior and a senior. I want to stress that the most important thing is & ndash; not to lose the meaning of life in old age. It is important that a person is not afraid to go on living. Anxiety and depression & ndash; these are some of the powerful factors that contribute to premature aging. It is therefore important to provide psychological, social support and to teach the elderly person to cope with this anxiety or depression. To be able to live, enjoy life in the company of friends with a glass of wine & mdash; everything is very well shown. & nbsp;
& mdash; What food prolongs the youth of the body?
& mdash; Food for young people & ndash; this is called the Mediterranean diet, balanced in protein, fat and fiber. We always focus on getting enough protein in the diet of the elderly. Because for people who age normally, one gram of protein per kilogram of weight is worth -; this is the norm. It is very important to maintain muscle mass. If a person has suffered from any disease, after injury or surgery, this rate increases to one and a half grams per kilogram of weight. These are meat, poultry, fish, dairy products. We always focus on vitamin D, as its deficiency increases with age.
& mdash; Where do we teach geriatrics? Only doctors, but nurses?
& mdash; In 2016, the Procedure for the provision of medical care in the “Geriatrics” profile was adopted and the standards for the provision of medical personnel were determined. Active staff training has started. Training is conducted at the Department of Diseases of Aging of the Faculty of Continuing Professional Education of the Russian National Medical Research University. OR. Pirogov. Additional training programs for Moscow doctors are also being implemented for Moscow. And it's not just further training. At the exit, they are doctors who, in addition to being certified as therapists, are also geriatricians.
And, of course, the doctors who work in patronage. They also receive training in the specialty “Geriatrics”. In addition, geriatric doctors are regularly trained, who work in outpatient clinics in consultation rooms. Geriatricians also work in geriatric wards, located in three veterans hospitals. (# 1, # 2, and # 3).
Of course, a doctor needs a nurse who must have additional geriatric training to perform a full geriatric assessment. And now a number of medical schools in Moscow have opened additional courses in geriatrics.
Therapists, endocrinologists and neurologists now receive additional training in geriatrics. Such courses are in great demand among surgeons, oncologists, orthopedists, since doctors of many specialties work with the elderly. Many questions in the field of geriatrics are asked by doctors of other specialties, so short targeted courses are also being implemented for them now.
In Moscow, an elderly person can receive geriatric consultation on an outpatient basis and inpatient care in three hospitals.
& mdash; On October 1, 2021, the United Nations International Day of Older Persons will be celebrated under the slogan Digital Equality for All Ages. Why is it important that older people also benefit from digitization?
& mdash; The world is changing and modern reality is such that digital technologies surround us very closely. And for a modern elderly person, it is very important to maintain the will to learn, to accept new technologies and not to be afraid. Be sure he will master anything new. And in the times to come, digital technologies will be even more numerous and they will have even more meaning for us. Until the end of their days, people will learn and master them. On the other hand, all digital technologies are needed to simplify people's lives and make them more comfortable. After all, when a senior comes to MFC, they only take one piece of ID, and all the rest are in electronic form. A unique system in the Moscow health care EMIAS & ndash; doctors can transfer information about a patient to each other, and the patient in their electronic medical record sees what has been assigned to them, what has been done. You can make an appointment online with a doctor and do some research. Everything is done to make life easier for people. Therefore, being progressive, energetic, light-hearted, open to learning and mastering digital technologies is very important for people entering old age. It is also psychological attitudes & ndash; don't get tired of learning and being curious & mdash; aging well is very important.