PREVENTIVE GERIATRICS

PREVENTIVE GERIATRICS
Dr.I.Selvaraj,I.R.M.S
B.Sc., M.B.B.S.,(M.D Community medicine).,
D.P.H.,D.I.H.,P.G.C.H&FW (NIHFW, New Delhi)
Sr.D.M.O (Selection Grade Officer)
INDIAN RAILWAYS MEDICAL SERVICE

It is the art and science of preventing disease in the geriatric population and promoting their health and efficiency

* Hippocrates noted conditions common in later life
* Aristotle offered theory of ageing based on loss of heat
* The word geriatrics was invented by Ignatz L. Nascher, a vienna born immigrant to the united states
* Geriatric medicine was a product of the British NHS
* Nascher was the father of geriatrics and Majory Warren was its Mother
* The 1st Geriatric service was started in U.K in 1947.
* Geriatric department at GH, Chennai was established in 1978.
* Post Graduate course in Geriatric medicine has been started in 1996 at Madras medical college.
* Prof. V.S. Natarajan was the first Geriatric professor in India
* The study of physical and psychological changes that occur in old age is called “gerontology”.
* Geriatrics is the branch of general medicine concerned with clinical, preventive, medical and social aspects of illness in the elderly.
* The old age is defined as the age of retirement. In our country it is fixed at 60 years and above.

Present scenario in INDIA
* Cataract &Visual impairment- 88%
* Arthritis &locomotion disorder-40%
* CVD &HT – 18%
* Neurological problems- 18%
* Respiratory problems including Chronic bronchitis- 16%
* GIT problems- 9%
* Psychiatric problems- 9%
* Loss of Hearing – 8%

Theory of aging
* Somatic mutation theory
* Autoimmune theory
* Hayflick’s theory of aging

Geriatrics
* Senility
* Decline in sexual prowess
* Diminution in endocrine activity
* Loss of elasticity of blood vessels
* Rise in B.P

RISK OF GERIATRICS
* PRONE FOR INFECTIONS
* PRONE FOR INJURIES
* NEED SPECIAL ASSISTANCE
* PRONE FOR PSYCHOLOGICAL PROBLEMS
* PRONE FOR DEGENERATIVE DISORDERS
* INCREASED RISK FOR DISEASE
* INCREASED RISK OF DISABILITY
* INCRASED RISK OF DEATH

AIM OF GERIATRIC MEDICINE
* Maintenance of health in old age by high levels of engagement and avoidance of disease
* Early detection and appropriate treatment of disease
* Maintenance of maximum independence consistent with irreversible disease and disability
* Sympathetic care and support during terminal illness

GERIATRIC PEOPLE PROBLEMS
* HEALTH PROBLEMS

1.Joint problems
2.Impairment of special senses
3. Cardio vascular disease
4.Hypothermia
5.Cancer, Prostate enlargement, Diabetes& Accidental falls

* Psychological problems
1. Emotional problems
2. Suicidal tendency
3. Senile dementia, Alzheimer’disease

* Social problems
* Poverty, Loneliness, Dependency, Isolation, Elder abuse, Generation Gap

GERIATRIC TEAM
* Geriatricians
* Nurses
* Physiotherapist
* Social worker
* And Health worker
* Investigation is an essential tool in the diagnosis of elderly patients.
* Under or over investigations to be avoided.
* Know the age related variables while interpreting the results.
* Non-invasive tests are preferred than invasive.
* The objective of the investigations is to improve the quality of life.
* One must try to get the diagnosis right, as wrong diagnosis is harbinger of wrong treatment
* Polypharmacy should be avoided whenever possible
* Regular review of medication is a must
* Poor drug compliance could be due to poor advice
* Proper nutrition is vital for healthy living
* A well balanced nutritious diet is ideal for older age
* It is not the quantity but the quality

Indicators of health status of aged
* Age proportional mortality rate
* Age specific death rate persons over 55 years
* Age specific prevalence rates for cvd, cancers and accidents.
* % elders taking three or more drugs/day
* Cumulative percentage of elders undergone cataract surgery
* Proportion of elders admitted to the hospital in the past one year

PREVENTION
* Primordial prevention
* Pre geriatric care
* Primary prevention
* Health education
* Exercise
* Secondary prevention
* Annual medical check-up
* Early detection ( Universal approach, Selective approach)
* Treatment
* Tertiary prevention
* Counseling and Rehabilitation
* Welfare activities (Sanjay Niradhar Yojana, Vridhashrama)
* Chiropody services
* Improving quality of life
* Cultural programme
* Old age club
* Meals-on wheel service
* Home help
* Old age home

PREVENTIVE GERIATRICS.ppt