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【社会人文】婴儿潮面临晚年：10项最普遍的医疗
婴儿潮面临晚年：10项最普遍的医疗挑战
链接： http://www.medicalnewstoday.com/articles/160773.php
In the year 2030, the youngest members of the baby boomer generation will hit 65, making up nearly a quarter of the country's population, according to the U.S. Census Bureau. If current elderly Americans are a precursor of what is to come, they will experience health challenges such as diabetes, dementia, depression and functional disability in record numbers.
But their huge presence may also open up specialized emergency rooms and critical care units, encourage more research into the mysteries of the aging body and place a focus on specialized geriatric and end-of-life care.
According to researchers and clinicians in the Division of Geriatric and Palliative Medicine at The University of Texas Medical School at Houston, here is a snapshot of 10 of the challenges that may be staring back at baby boomers:
1. Functional decline: According to the U.S. Department of Agriculture, the body loses 1 percent of muscle mass a year beginning at age 45, which can result in sarcopenia as skeletal muscle is eventually replaced with fat and the body becomes weaker. Some research has linked protein deficiency with sarcopenia. For every week spent in the hospital, it takes an aging body a month to recover muscle strength with daily rehabilitation, says geriatrician Liliana Andrade, M.D., assistant professor of internal medicine at the UT Medical School at Houston. Exercise, including resistance and strength training, is absolutely essential for retaining muscle mass and strength. "For balance, tai chi is good," she says. "We also encourage patients to rent 'sit and be fit' videos that use hand and leg weights." A study published recently in Diabetes Care, a journal of the American Diabetes Association, found that older adults especially women with diagnosed or undiagnosed type 2 diabetes had a higher rate of skeletal muscle loss.
2. Depression: Considered as prevalent as the common cold in the elderly, depression can be the result of major life changes, including retirement, losing loved ones and loss of mobility and independence. It can show up differently in older people, says geriatrician Nasiya Ahmed, M.D., assistant professor of internal medicine at the UT Medical School at Houston. "There's not as much of a tendency toward tearfulness or feelings of hopelessness," she says. "Instead they have vague somatic complaints, increased pain, not sleeping or eating well or general apathy."
3. Disease: Chronic diseases associated with the aging process, including high blood pressure, stroke, cardiovascular disease, osteoporosis, chronic obstructive pulmonary disease, hypothyroidism, constipation, incontinence and arthritis, can take their toll. Preventive measures taken now such as quitting smoking, eating healthy food and exercising are all important steps toward a better quality of life. "Even quitting smoking at age 60 is better than not quitting at all," Andrade says.
4. Polypharmacy: A term geriatricians are using for the number of prescription and over-the-counter medications that elderly people are taking in alarming numbers is polypharmacy. "People go to five different doctors and none of the others know what is going on," Ahmed says. In some cases, seniors who wind up in the hospital may be prescribed a different medication for an existing condition such as high blood pressure because the hospital doesn't stock the particular one they've been taking in the past. The patient returns home with a new prescription from the hospital physician and continues taking the other medication as well, which can be deadly. "I've had patients come in who are taking 20 different medications," Andrade says. "A lot of them also take vitamins and herbal supplements that they don't need and that can interfere with medications." The solution, they say, is to have a written record of all prescriptions, supplements and vitamins that they can bring to their appointments and have a family practitioner or geriatrician who can be the lead physician in managing their care.
5. Falls: Low blood pressure, which can be a result of poorly managed hypertension or dehydration, can lead to dizziness. That dizziness, combined with a decreased ability of the vascular system to compensate for changes in position such as standing up, is the largest cause of falls, they say. "So many patients have told me that they take blood pressure medication when they feel like it's high instead of taking it as it is prescribed," Ahmed says. "I ask them how they know it's high and they give vague signs such as their nose tingles or their tremor worsening." Taking medications for sleep can also be dangerous. "Some take Benadryl to help them sleep and as people get older, that's not such a good thing because it causes confusion and they can fall because they're sleepy," Andrade says.
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作者:admin@医学,生命科学 2010-10-24 05:11
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