Old people with multiple chronic diseases must pay attention to these things.
The elderly need to receive continuous treatment or diseases that affect the function of daily life, such as decreased body function, low immune function, destruction of metabolic balance, decline of cognitive function and disturbance of physical activity. It not only includes common diseases in the elderly, such as diabetes, hypertension, dyslipidemia, coronary heart disease, anxiety, depression, etc., but also includes Alzheimer's disease, Parkinson's disease, osteoarthritis, osteoporosis, cataract and other specific chronic diseases with the increasing incidence of age, geriatric syndrome and other problems such as falls, weakness, sleep disorders, malnutrition, urinary incontinence, delirium and drug addiction. Second, the prevalence of common diseases in the elderly aggravates with the aging of the society, and third, the harm of common diseases in the elderly. 1. It affects the health and quality of life of the elderly. The elderly with comorbid diseases will show varying degrees of functional decline and aging of the whole body tissues and organs. 2. Increase the hospitalization rate and risk of death of elderly patients.
Author expert: Liu Shiping, Clinical Nutrition Department, Chief physician, Department Director, Xiangya second Hospital, Central South University
With the rapid development of economy and the continuous improvement of the level of medical and health services, people's life expectancy is gradually prolonged, the problem of aging population is also aggravated, and the health problems of the elderly have been widely concerned and paid attention to. In particular, the co-disease phenomenon, which generally exists in the elderly with chronic diseases, has become the main hidden danger threatening the health of the elderly. Many elderly people suffer from more than two kinds of chronic diseases at the same time, and most of them are accompanied by nutritional problems, which seriously affect the quality of life and disease control.
1. What is geriatric comorbidity?
An elderly person suffers from two or more chronic diseases at the same time, which is referred to as co-disease, coexistence of multiple chronic diseases or coexistence of multiple diseases. In the elderly, there are many diseases, such as decreased body function, low immune function, destruction of metabolic balance, decline of cognitive function and disturbance of limb movement, and even several diseases exist in one organ at the same time. The elderly, especially the elderly, have a high incidence of common diseases.
Chronic disease refers to a disease that lasts for more than 1 year and requires continuous treatment or affects the function of daily life. It not only includes common diseases in the elderly, such as diabetes, hypertension, dyslipidemia, coronary heart disease, anxiety, depression, etc., but also includes Alzheimer's disease, Parkinson's disease, osteoarthritis, osteoporosis, cataract and other specific chronic diseases with the increasing incidence of age, geriatric syndrome and other problems such as falls, weakness, sleep disorders, malnutrition, urinary incontinence, delirium and drug addiction.
Second, the current situation of common diseases in the elderly.
With the aggravation of the aging of the society, the co-disease of the elderly shows an obvious upward trend. It is reported that the prevalence rate of common diseases in the elderly in China is about 76.5%.[1]In the United States, 65% of the elderly have a common disease[2]Among people over 65 years old worldwide, the prevalence rate of common diseases is 40% to 56%.[3]With the increase of age, the number of comorbidities also increases, and the prevalence rate of comorbidities is as high as 80% in patients aged 80 years and above.[4]; and for every increase of 19 years, the prevalence of comorbidities increases by 10%[5]. To this end, care for the elderly, we need to pay attention to the co-disease of the elderly.
III. The harm of common diseases in the elderly
1. Affect the health and quality of life of the elderly. The elderly with comorbid diseases will show varying degrees of functional decline and aging of the whole body tissues and organs, resulting in a relatively low quality of life.
2. Increase the hospitalization rate and death risk of elderly patients. Chronic disease has become the main cause of death of urban and rural residents in China. According to the report on Nutrition and chronic Diseases of Chinese residents (2020), chronic diseases accounted for 88.5% of the total deaths in 2019, with 80.7% of deaths from central cerebrovascular diseases, cancer and chronic respiratory diseases.
3. It makes medical decision-making more complicated and difficult. Under the existing specialist diagnosis and treatment mode, the elderly with co-disease often have to go to multiple specialties, resulting in multi-reuse drugs, the interaction between drugs and drugs, and the interaction between drugs and diseases lead to poor treatment effect, poor prognosis and adverse reactions.
Nutrition is very important to the elderly with common diseases.
1. Comorbidity and malnutrition-many chronic diseases have problems such as excessive energy consumption, poor nutrition absorption or inadequate intake, which eventually lead to malnutrition. Comorbidities further increase the risk of malnutrition and are not easy to detect, making people weaker and weaker in the process of "boiling frogs in warm water" and finally vulnerable. Malnutrition is also a "chronic disease" in essence. The World Health Organization has made it clear that malnutrition was, is and will continue to be the leading cause of death worldwide.
2. The harm of malnutrition in the elderly with comorbid diseases-malnutrition will lead to muscle loss, decreased mobility, easy to fall, fracture, cognitive decline and other problems in the elderly. At the same time, malnutrition can also affect disease control, aggravate the disease and promote the decline of functional status (disability, difficulty in daily activities) and other complications.
3. Nutrition management guidance for the elderly with comorbid diseases-- "Clinical Nutrition Management guidance of Geriatrics (Diseases) Department" points out: 1) early screening found the risk of malnutrition (such as insufficient nutrition intake, inadvertent weight loss of 5% within 3 months or 10% of 6 months, body mass index & lt; 20 kg/m2), and effective intervention. 2) Oral nutritional supplementation (ONS) can maintain the integrity of intestinal mucosal barrier function, reduce immune dysfunction and pulmonary infection caused by intestinal microbial disorders, and enhance the awareness of early oral nutritional supplementation.[6]. "Adult Oral Nutrition Supplement expert consensus" recommends: 1) elderly patients with malnutrition or the risk of malnutrition, chronic disease patients, should be given ONS nutritional supplement. 2) ONS can increase body mass, reduce the loss of lean tissue and fat content, and improve the nutritional status of the body.[7].
Tips: oral nutritional supplement (Oral Nutritional Supplements,ONS), which aims to increase the intake of oral nutrition, will provide a variety of macronutrients and micronutrients for oral use. ONS has many advantages, such as balanced nutrition, scientific formula, safe and effective, convenient and fast and so on.
Click to learn more useful knowledge about ONS
In view of the importance of nutrition to the elderly with common diseases, it is suggested that we should pay attention to the nutritional status of the elderly with common diseases in our daily life, improve the quality of life of the elderly with common diseases by improving nutrition and prevent the deterioration of their condition.
References:
Lin Hong, et al. Prevention and control of chronic diseases in China. 2002Bing 10 (6): 270-272.
[2] Wolff JL, et al. Arch Inter Med. 2002 Tsac 162 (20): 2269-2276.
[3] TINETTI M E, et al. N Engl J Med. 2011 TX 364 (26): 2478-2481.
[4] Van den Akker M, et al. J Clin Epidemiol. 1998 Bing 51 (5): 367-375.
[5] Fortin M, et al. BMC Health Serv Res. 2010.
[6] Geriatrics Branch of Chinese Medical Association. Chinese Journal of Geriatrics. 2015. 34 (12): 1388-1395.
[7] Adult oral supplementary nutrition experts agree. Chinese Journal of Gastrointestinal surgery. 2017 Ting 20 (4): 361-365.
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Source: Guangming Network