S.

RATHIPRIYA

PREVENTIVE GERIATRICS

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

GERENTOLOGY: study of the physical and psycological changes which are incident to old age

CLINICAL GERENTOLOGY OR GERIATRICS: The care for the aged. SOCIAL GERENTOLOGY: humanitarian and social attitude towards the old people EXPERIMENTAL GERENTOLOGY: research into basic biological problems of the ageing. GERIATRIC GYNAECOLOGY: repair of prolapse of varying degrees, nonspecific vaginitis, ovarian tumours, psychic aberrations, sexual problems

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.

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

SIZE OF THE PROBLEM

Improved medical scince and social conditions Developed countries no. of old people is on the increase. Expectation of life at birth over 70 years. 2002, 605 million old people 400 million lower socioeconomic groups Italy and Japan have highest no. of old persons of about 16.7 and 16% respectively. In India, in 2003 SRS estimates 1.2% of total population above age 60 years. 1980- 5.3% 2000- 7.7% 2025- 13.3% ( 1.2 billion ) 71% - Developing World 70 million population in India-2001 177 million population -2025 40% below poverty line 73% illiterate

HEALTH STATUS OF THE AGED IN INDIA

88

40 18.7

17.4 16.7 13.3 9 8.5

8.2

3.5

90 80 70 60 50 40 30 20 10 0

REPORTED %

Health problems of the aged

PROBLEMS DUE TO AGEING PROCESS PROBLEMS ASSOCIATED WITH LONG TERM ILLNESS

PSYCHOLOGICAL PROBLEMS

 is not identical with The biological age of a person

his chronological age. Ageing stands for growing old ,senescence is an expression for deterioration of vitality or lowering of biological efficiency that accompanies ageing. These deleterious lead to the death of the person Disabilities incident to ageing process: Senile cataract , glaucoma, nerve deafness, failure of special senses, osteoporosis

1) Problems due to ageing process

2) Problems associated with long term illness

DEGERATIVE CONDITIONS OF HEART & BLOOD VESSELS CANCER
ACCIDENTS

DIABETES
DISEASES OF LOCOMOTOR SYSTEM
RESPIRATORY ILLNESS GENITOURINARY SYSTEM

a)Degenerative diseases of heart and blood vessels

CVD are major causes of death in developed countries Inner arterial wall breakdown lipoid deposition replaced by calcium narrowing of blood vessels atherosclerosis diminished blood supply, thrombus formation, rupture of blood vessels, high blood pressure. No single factor , diet, overweight, hereditory, nervous and emotional strain have been implicated Reduction in body weight and modification of life style habits

b) Cancer
Incidence rises rapidly after age 40 Cancer of prostate common after age of 65

c) Accidents
fragile bones and decalcification household accidents common fracture of neck and femur very common geriatric problem

d) Diabetes
long term illness due to faulty carbohydrate metabolism. 75% of diabetics are over 50 years of age

e) Diseases of locomotor system

range of articular and non articular disorders affect the aged fibrositis, myositis, neuritis, gout, rheumatoid arthritis, osteoarthritis, spondylitis of spine, etc. these cause more discomfort and disability than any other chronic disease in the elderly

f) Respiratory illness
chronic bronchitis, asthma, emphysema are of major importance

g) Genitourinory system
enlargement of prostate, dysuria, nocturia, frequent and urgency of micturition are common complaints

3) Psycological problems
A) MENTAL CHANGES: Impaired memory, rigidity of outlook, dislike of change , reduced income mental and social consequences B) SEXUAL ADJUSTMENT : diminution of sexual activity, cessation of reproduction lead to physical and emotional disturbance , irritability, jealousy, and despondency are frequent. C) EMOTIONAL DISORDERS : social maladjustment, failure to adapt result in bitterness, inner withdrawal , depression, weariness of life, and even suicide.

Lifestyle and healthy ageing

Diet and nutrition Exercise Weight Smoking Alcohol Social activities

a)Diet and nutrition

In developed countries, overnutrition replacing undernutrition Diet should be balanced with Less saturated fats and oils , salt and sugar More fruits and vegetables Calcium and fibre rich diet

b) Exercise maintain good health

control weight improves emotional well being and relieves stress improves blood circulation increases flexibility lowers BP increases energy levels improves balance & reduces dangers of falls lowers blood sugar helps in diabetes improves bone density & prevent osteoporosis

c) Weight
Overweight and obesity major problem worldwide Obesity is important factor in Heart disease Stroke Hypertension Diabetes Arthritis Breast cancer

d) smoking
In developed countries, 22% of men and 18% of women aged 65 to 74 yrs are smokers Former smokers live longer than continuing smokers

e) alcohol
Sensitivity to effect of alcohol increases with age Compared to younger people , older people hj Blood concentration due to body water diluting alcohol Ability to develop tolerance to amount of alcohol

f) Social actvities

NATIONAL POLICY ON OLDER PERSONS

NATIONAL COUNCIL FOR OLDER PERSONS

OASIS

INDIRA GANDHI NATIONAL OLD AGE PENTION SCHEME

HELP AGE INDIA

MODERN PHILOSOPHY

DISEASE PREVENTION IN ELDERLY

CARE FOR THE OLD PEOPLE