Regular medical examinations: why are they needed in old age

Regular medical examinations: why are they needed in old age

I. Introduction: aging and its physiological changes

Acting is an inevitable biological process, characterized by a progressive decrease in the functional reserves of the body and increased susceptibility to diseases. With age, numerous physiological changes occur, affecting almost all organs and systems. Understanding these changes is crucial for the development of effective strategies for maintaining health and preventing diseases in old age.

A. Cardiovascular system:

• Reducing the elasticity of the arteries: The walls of arteries become more rigid and less elastic due to the accumulation of collagen and calcium. This leads to an increase in blood pressure (especially systolic) and an increase in the load on the heart.
• Thickening of the walls of the heart: The left ventricle of the heart can thicken (hypertrophy) in response to increased pressure, which reduces its ability to effectively pump blood.
• Reduced heart rate (heart rate): The maximum heart rate that can be achieved during physical activity decreases with age, which limits physical activity.
• Heart rhythm disturbances (arrhythmias): The risk of developing arrhythmias, such as atrial fibrillation, increases with age.
• Reducing sensitivity to barooreceptors: Barooreceptors that control blood pressure become less sensitive, which can lead to orthostatic hypotension (reduction of pressure when rising).

B. Respiratory system:

• Reduced elasticity of the lungs: The lungs become less elastic, which complicates the complete expansion and contraction of the chest.
• Weakening of the respiratory muscles: The respiratory muscles, such as the diaphragm, weaken, which reduces exhalation and complicates the jerking.
• Increase in the residual volume of the lungs: In the lungs, more air remains after exhalation (residual volume), which reduces the volume of fresh air entering with each inhalation.
• Reduced diffusion ability of the lungs: The ability of the lungs to transfer oxygen to the blood is reduced.
• Increased susceptibility to infections: A decrease in the effectiveness of mucociliary clearance (removal of mucus and foreign particles from the respiratory tract) increases the risk of respiratory infections.

C. Nervous system:

• Reducing the volume of the brain: The volume of the brain gradually decreases with age, especially in frontal lobes and hippocampus.
• Reducing the velocity of nervous conduction: Nervous pulses are transmitted more slowly, which affects the reaction rate and coordination.
• Reducing the number of neurotransmitters: The level of neurotransmitters, such as dopamine and serotonin, decreases, which can affect mood, sleep and cognitive functions.
• Memory disorders and cognitive functions: A short -term memory, the ability to teach and concentration of attention is deteriorated.
• Increased risk of developing neurodegenerative diseases: The risk of developing diseases of Alzheimer and Parkinson is increasing.

D. The musculoskeletal system:

• Reduced bone density (osteoporosis): The bones become more fragile and subject to fractures.
• Reducing muscle mass (sarcopenia): The muscle mass and strength are reduced, which leads to weakness, a decrease in mobility and increased risk of falls.
• Degenerative changes in the joints (osteoarthrosis): The cartilage covering the joints wears out, which causes pain, stiffness and limitation of mobility.
• Violation of equilibrium: A decrease in propriocasculation (feelings of body position in space) and deterioration of the function of the vestibular apparatus increase the risk of falls.

E. Endocrine system:

• Reducing the production of hormones: The production of many hormones, such as growth hormone, testosterone (in men) and estrogen (in women), is reduced.
• Violation of regulation of glucose levels in the blood: The risk of developing type 2 diabetes increases due to a decrease in insulin sensitivity.
• Reduced thyroid function (hypothyroidism): The thyroid gland produces less hormones, which can lead to fatigue, a slowdown in metabolism and other symptoms.
• Reduced level of vitamin D: The ability of the skin to produce vitamin D is reduced under the influence of sunlight, which can lead to osteoporosis and other problems.

F. Immune system:

• Reduced immune function (immunostation): The immune system becomes less effective in the fight against infections and cancer cells.
• Increased susceptibility to infections: The risk of developing and the severity of infectious diseases, such as flu and pneumonia, increases.
• Reducing the effectiveness of vaccination: Vaccines can be less effective in the elderly.
• Increased risk of developing autoimmune diseases: The risk of developing autoimmune diseases is increasing when the immune system attacks the body’s own tissues.

G. Sensory organs:

• Visual impairment: Age -related changes are developing, such as presbyopia (age -related farsightedness), cataracts (clouding of the lens) and glaucoma (damage to the optic nerve).
• Hearing deterioration (Presbiacusis): The ability to hear high frequencies is reduced.
• Reducing taste and smell: The number of taste receptors and olfactory cells is reduced, which affects appetite and food behavior.

II. The goals and objectives of regular medical examinations in old age

Regular medical examinations play a crucial role in maintaining health and improving the quality of life of older people. They allow you to identify diseases in the early stages, when treatment is most effective, as well as carry out preventive measures aimed at preventing diseases and maintaining functional activity.

A. Early detection of diseases:

• Cardiovascular diseases: The identification of arterial hypertension, coronary heart disease, heart failure and arrhythmias in the early stages allows you to start treatment and prevent serious complications, such as myocardial infarction and stroke.
• Oncological diseases: Screening for breast cancer, cervical cancer, colon cancer, prostate cancer and lung cancer allows you to detect tumors in the early stages when they are most treated.
• Diabetes sugar: The identification of type 2 diabetes in the early stages allows you to prevent the development of complications, such as damage to the kidneys, eyes, nerves and cardiovascular system.
• Osteoporosis: The identification of osteoporosis allows you to start treatment and reduce the risk of fractures.
• Dementia: The identification of cognitive disorders in the early stages allows you to begin treatment and slow down the progression of dementia.
• Depression: Identification of depression allows you to start treatment and improve the quality of life.
• Thyroid diseases: The identification of hypothyroidism and hyperthyroidism allows you to start treatment in a timely manner and prevent the development of complications.
• Kidney diseases: The identification of chronic kidney disease allows you to slow down its progression and prevent the development of renal failure.

B. Prevention of diseases:

• Vaccination: Regular vaccination against influenza, pneumococcal infection, encircling deprivation and other infectious diseases helps to reduce the risk of developing these diseases and their complications.
• Screening for risk factors: Assessment of risk factors for the development of cardiovascular diseases (high blood pressure, high cholesterol, smoking, obesity, diabetes mellitus) allows you to develop an individual prevention plan.
• Recommendations on a healthy lifestyle: Providing recommendations for proper nutrition, physical activity, rejection of smoking and moderate alcohol consumption helps reduce the risk of developing many diseases and improve the general health of health.
• Downs prevention: Assessment of the risk of falls and the development of measures to prevent them (equilibrium exercises, vision correction, elimination of risk factors in the house) help reduce the risk of fractures and other injuries.
• Prevention of pressure sores: In bedridden patients, it is necessary to carry out the prevention of pressure sores, including regular skin examination, a change in body position and the use of special mattresses and pillows.

C. Assessment of the functional status:

• Mobility assessment: Assessment of the ability to move independently, climb the stairs and perform other physical actions helps to identify restrictions and develop a rehabilitation plan.
• Assessment of cognitive functions: Assessment of memory, attention and other cognitive functions helps to identify cognitive impairment and determine the need for further examination.
• Evaluation of the emotional state: Assessment of mood and identifying symptoms of depression or anxiety help to begin treatment and improve the quality of life.
• Assessment of social functioning: Assessment of social activity and support helps to identify social isolation and develop measures to overcome it.

D. Correction of drug therapy:

• Assessment of polypragmasia: In the elderly, polypragmasis (simultaneous use of several drugs) is often observed, which increases the risk of side effects and drug interactions. Regular medical examinations allow you to assess the need for each drug and optimize drug therapy.
• Identification of side effects: Regular medical examinations allow you to identify side effects of drugs and take measures to eliminate them.
• Assessment of adherence to treatment: Regular medical examinations allow you to evaluate how much the patient complies with the doctor’s recommendations for taking drugs, and if necessary, conduct treatment correction.

E. Support for independence and quality of life:

• Identification of care needs: Regular medical examinations allow you to identify care and provide information about available resources and services.
• Assessment of the quality of life: Assessment of the quality of life allows us to identify factors affecting the well -being of the patient, and developing a plan of measures to improve it.
• Providing information and consultations: Regular medical examinations allow to provide patients and their families with information about diseases, methods of treatment and prevention, as well as answer their questions.
• Increased treatment: Regular medical examinations help increase patients adherence to treatment, which leads to an improvement in treatment and quality of life.

III. Recommendations for the frequency and content of medical examinations

The frequency and content of medical examinations in old age should be individualized taking into account the age, gender, state of health, the presence of chronic diseases and risk factors. However, there are general recommendations that can serve as the basis for the development of an individual medical examination plan.

A. General recommendations on frequency:

• 65-74 years: Annual medical examinations are recommended to all people aged 65-74 years.
• 75 years and older: People aged 75 years and older are recommended to conduct medical examinations every 6 months or more often, especially in the presence of chronic diseases or functional restrictions.
• In the presence of chronic diseases: People with chronic diseases, such as cardiovascular diseases, diabetes mellitus, chronic obstructive lung disease (COPD), etc., may require more frequent observation.

B. Recommendations for the content of medical examinations:

1. A history of anamnesis:

   • A history of life: Collection of information about the diseases, operations, injuries, allergies, vaccination, bad habits (smoking, alcohol consumption), family history (the presence of diseases in relatives).
   • History collection of this disease: Collection of information about complaints, symptoms, the time of their appearance, factors that enhance them or weaken, previously treated and its effectiveness.
   • Medication anamnesis: The transfer of all drugs taken, including prescription, over -the -counter, vitamins and food additives, indicating the dosage, receiving frequency and the causes of administration.
   • Social history: Information on social status, housing conditions, financial situation, social support, level of education, kind of classes.
   • Psychological history: Assessment of mood, the presence of symptoms of depression or anxiety, stress level, sleep quality.
   • Power history: Evaluation of food habits, diet, appetite, weight, availability of problems with chewing or swallowing.

2. Physical examination:

   • Measurement of blood pressure: Measurement of blood pressure on both hands to detect arterial hypertension or hypotension.
   • Pulse measurement: Assessment of the frequency and rhythm of the pulse to detect arrhythmias.
   • Measurement of body temperature: Measurement of body temperature to identify fever.
   • Skin examination: Inspection of the skin for rashes, ulcers, neoplasms, and more.
   • Eye examination: Inspection of eyes for cataracts, glaucoma, macular degeneration.
   • Examination of the ears: Inspection of ears for the presence of sulfur plugs, inflammation, hearing loss.
   • Office of the oral cavity: Inspection of the oral cavity for caries, gum diseases, neoplasms.
   • Operation of the neck: Palpation of the thyroid gland, lymph nodes.
   • Chest examination: Auscultation of the lungs and heart to detect pathological noise.
   • Summary of the abdomen: Palpation of the abdomen to detect pain, increase organs.
   • Examination of the limbs: Inspection of the limbs for the presence of edema, varicose veins, trophic ulcers.
   • Neurological examination: Assessment of mental status, traumatic brain nerves, motor function, sensitivity, reflexes.

3. Laboratory research:

   • General blood test: Assessment of the level of hemoglobin, red blood cells, white blood cells, platelets to detect anemia, infections, inflammatory processes, blood coagulation disorders.
   • General urine analysis: Assessment of the presence of protein, glucose, ketones, blood, leukocytes, bacteria for detecting kidney diseases, diabetes mellitus, urinary tract infections.
   • Biochemical blood test: Assessment of glucose levels, cholesterol, triglycerides, high density lipoproteins (HDLs), low density lipoproteins (LDL), creatinine, urea, electrolytes (potassium, sodium, chlorine), hepatic enzymes (Alt, AST), bilirubin to detect diabetes, dyslipidemia, diseases, diseases, diseases, diseases, diseases, diseases, diseases, diseases, diseases liver.
   • Determination of the level of thyroidropic hormone (TSH): Assessment of thyroid function to detect hypothyroidism or hyperthyroidism.
   • Determination of vitamin D level: Assessment of vitamin D levels to detect vitamin D deficiency and risk of osteoporosis.
   • Hidden blood analysis: Screening for colon cancer.
   • Determination of glomerular filtration rate (SKF): Assessment of kidney function.

4. Instrumental research:

   • Electrocardodiography (ECG): Assessment of heart rhythm and identifying signs of coronary heart disease, arrhythmias, myocardial hypertrophy.
   • X -ray of the chest organs: Identification of diseases of the lungs and heart.
   • Ultrasound examination (ultrasound) of the abdominal organs: Identification of diseases of the liver, gall bladder, pancreas, spleen, kidneys.
   • Dencitometry: Measurement of bone density to detect osteoporosis.
   • Mammography: Breast cancer screening in women.
   • Cytological study of smear from the cervix (papa test): Screening for cervical cancer in women.
   • Colonoscopy: Screening for colon cancer.
   • Ophthalmological examination: Assessment of visual acuity, intraocular pressure, the state of the fundus to detect cataracts, glaucoma, macular degeneration.
   • Audiometry: Hearing assessment to identify the presbyacus.

5. Functional status assessment:

   • Mobility assessment: The test “Get and go” (Timed Up and Go Test), test for walking speed.
   • Assessment of cognitive functions: Brief scale of mental assessment (MMSE), watch drawing (Clock Drawing Test).
   • Evaluation of the emotional state: Gerriatatic scale of depression (GDS).
   • Assessment of social functioning: Assessment of social support and social activity.

6. Vaccination:

   • Influenzation against influenza: Annual vaccination against influenza.
   • Vaccination against pneumococcal infection: Vaccination against pneumococcal infection.
   • Vaccination against encircling lichen: Vaccination against enclosing lichen.
   • Vaccination against tetanus and diphtheria: Revaccination is every 10 years.

7. Consulting:

   • Recommendations on a healthy lifestyle: Proper nutrition, physical activity, rejection of smoking, moderate use of alcohol.
   • Recommendations for the prevention of falls: Equilibrium exercises, vision correction, elimination of risk factors in the house.
   • Recommendations for taking drugs: Instructions for the correct use of drugs, identification of side effects.
   • Care recommendations: Information about available resources and care services.

IV. Screening programs for the elderly

In addition to regular medical examinations, older people are recommended to participate in screening programs aimed at identifying specific diseases in the early stages.

A. Cancer screening:

• Breast cancer (women): Annual mammography for women aged 50-74 years.
• Cervical cancer (women): A cytological study of a smear from a cervix (papa test) every 3 years for women aged 21-65 years.
• Tolstoy Cancer: Colonoscopy every 10 years or analysis of feces for hidden blood annually for people aged 50-75 years.
• Prostate cancer (men): Determination of the level of prostatic specific antigen (PSA) and a finger rectal examination of the prostate gland for men aged 50-75 years (the decision on screening is made individually taking into account the risk factors and preferences of the patient).
• Lung cancer: Low-like computed tomography of the lungs for people aged 55-80 years with a high risk of developing lung cancer (smokers with an experience of more than 30 paches or who rushed to smoke less than 15 years ago).

B. Screening for osteoporosis:

• Densitometry for women aged 65 and older, as well as for women under 65 years with risk factors for the development of osteoporosis (history fractures, low body weight, family history of osteoporosis, prolonged use of glucocorticoids).
• Densitometry for men aged 70 and older, as well as for men younger than 70 years with risk factors for osteoporosis.

C. Screening to the aneurysm of the abdominal aorta:

• A single ultrasound study of the abdominal aorta for men aged 65-75 years that have ever been smoked.

D. Screening to dementia:

• Assessment of cognitive functions (for example, using a brief scale of mental assessment – MMSE) for all elderly people, especially if there are complaints about memory deterioration or other cognitive functions.

E. Depression screening:

• Assessment of the emotional state (for example, using a geriatric depression scale – GDS) for all elderly people.

V. The role of a general practitioner in conducting medical examinations

A general practitioner (family doctor) plays a key role in conducting medical examinations in old age. It is the first link in the healthcare system and provides primary medical care.

A. Coordination of medical care:

• A general practitioner coordinates medical care provided to the patient with various specialists, and provides an integrated approach to the treatment and prevention of diseases.

B. Individual approach:

• A general practitioner knows the history of the patient’s disease, his social and psychological characteristics, which allows him to develop an individual plan of medical examinations and preventive measures.

C. Accessibility and continuity:

• A general practitioner is the most affordable and permanent medical worker for the patient, which ensures the continuity of medical care and increases the commitment of treatment.

D. Conducting medical examinations:

• A general practitioner conducts medical examinations, including the history of the anamnesis, a physics examination, laboratory and instrumental studies, a functional status assessment and vaccination.

E. Direction to specialists:

• A general practice doctor directs the patient to narrow specialists for additional examinations and consultations if necessary.

F. Monitoring and treatment correction:

• A general practice doctor monitors the patient’s health status, corrects drug therapy and gives recommendations on a healthy lifestyle.

G. Educational work:

• A general practitioner is conducting educational work among patients and their families on health issues, the prevention of diseases and care for elderly people.

VI. Advantages of regular medical examinations for older people

Regular medical examinations have many advantages for the elderly:

• Improving the quality of life: Early detection and treatment of diseases, prevention of complications, maintaining the functional status and quality of life.
• Increase in life expectancy: Timely identification and treatment of diseases, the prevention of complications and maintaining a healthy lifestyle can help increase life expectancy.
• Reducing treatment costs: Early detection of diseases allows you to begin treatment in the early stages, which can be less expensive than the treatment of advanced forms of diseases.
• Increased treatment: Regular medical examinations help increase patients adherence to treatment, which leads to an improvement in treatment results.
• Improving the relationship between the doctor and the patient: Regular medical examinations contribute to the establishment of trusting relations between the doctor and the patient, which facilitates communication and increases the effectiveness of treatment.
• Prevention of hospitalizations: Early detection and treatment of diseases, as well as the prevention of complications, can help prevent hospitalization.
• Maintaining independence: Maintaining functional status and independence allows the elderly to remain independent and live in their home.
• Improving mental health: Early identification and treatment of depression and other mental disorders can improve mental health and quality of life.
• Reducing the risk of falls and fractures: The risk assessment of falls and the development of measures to prevent them can reduce the risk of fractures and other injuries.
• Improvement: Evaluation of food habits and providing recommendations on proper nutrition can improve nutrition and health.
• Prevention of pressure sores: In bedridden patients, it is necessary to carry out the prevention of pressure sores, which improves the quality of life and prevents complications.

VII. Barriers to undergo medical examinations and ways to overcome them

Despite all the advantages, many elderly people do not undergo regular medical examinations due to various barriers.

A. Financial barriers:

• Lack of medical insurance: The lack of medical insurance or insufficient coating can be a serious financial barrier for medical examinations.
  • Methods of overcoming: Appeal to state social services to obtain medical insurance or benefits, search for free or preferential medical care programs, and appeal to charitable organizations.
• High expenses for medical services: Even if there is medical insurance, the costs of medical services (for example, payment for taking a doctor, tests, examinations) can be unbearable for the elderly with low income.
  • Methods of overcoming: Searching for programs offering discounts on medical services for the elderly, contacting charitable organizations for financial assistance, discussing the doctor with the possibility of reducing the cost of treatment or using cheaper alternative drugs.

B. Transport barriers:

• Lack of transport: The lack of own transport or the inaccessibility of public transport may make it difficult to visit a doctor.
  • Methods of overcoming: The use of social taxis services, seeking help from relatives, friends or volunteers, the search for doctors taking patients at home.
• Physical restrictions: Physical restrictions (for example, problems with movement, weakness) can make it difficult to travel to a doctor.
  • Methods of overcoming: The use of a wheelchair or other auxiliary tools, seeking help to the accompanying person, the search for doctors taking patients at home.

C. Information barriers:

• Lack of information about the need for medical examinations: Many elderly people do not know about the need for regular medical examinations and their advantages.
  • Methods of overcoming: Conducting educational campaigns, disseminating information about medical examinations through the media, medical institutions, social services, public organizations.
• Lack of information about available medical services: Many elderly people do not know about available medical services and programs that can help them get the necessary medical care.
  • Methods of overcoming: Providing information on available medical services and programs through medical institutions, social services, public organizations, Internet portals.

D. Psychological barriers:

• Fear of examination and identification of diseases: Many elderly people are afraid to undergo medical examinations due to fear of identifying serious diseases.
  • Methods of overcoming: Providing patients with detailed information about upcoming examinations and their goals, emphasizing the importance of early detection of diseases for successful treatment, creating a trusting atmosphere between a doctor and a patient, and the provision of psychological support.
• Depression and apathy: Depression and apathy can reduce the motivation of the elderly to undergo medical examinations.
  • Methods of overcoming: Identification and treatment of depression, providing patients with support and motivation, involving relatives and friends in the patient care process.
• Distrust of doctors and healthcare system: Distrust of doctors and healthcare system can be a serious barrier for medical examinations.
  • Methods of overcoming: The establishment of trust relations between a doctor and a patient, providing patients with the opportunity to ask questions and receive detailed answers, ensuring the transparency and openness of the healthcare system.

E. Organizational barriers:

• For a long time waiting for a doctor: For a long time for waiting for a doctor may be an obstacle to medical examinations.
  • Methods of overcoming: Optimization of the work of medical institutions, an increase in the number of doctors and medical personnel, the use of a preliminary appointment, organization of field medical examinations.
• Unsuitable schedule of the work of medical institutions: An inconvenient schedule for the work of medical institutions may make it difficult to visit a doctor.
  • Methods of overcoming: Expansion of the work schedule of medical institutions, organization of work on weekends and holidays, organization of field medical examinations.
• The complexity of the recording: The difficulty of appointing an appointment with a doctor may be an obstacle to medical examinations.
  • Methods of overcoming: Simplification of the reception procedure, the use of online reception, providing an appointment with an appointment by phone.

VIII. Using technologies to improve access to medical examinations

Modern technologies can significantly improve older people’s access to medical examinations and increase their effectiveness.

A. Telemedicine:

• Online consultations with a doctor: Online consultations allow patients to receive a doctor’s consultations without leaving their home, which is especially convenient for people with limited mobility or living in remote areas.
• Remote health monitoring: Remote health monitoring using wearable devices (for example, fitness scraps, smart watches) allows you to track the patient’s health (for example, blood pressure, pulse, blood glucose level) and detect deviations in a timely manner.
• Telereabilitation: Telebalization allows patients to undergo rehabilitation under the guidance of a specialist, without visiting a medical institution.

B. Mobile applications:

• Reminders of medication: Mobile applications can remind patients about the need to take drugs, which increases the commitment of treatment.
• Tracking health indicators: Mobile applications can help patients track health indicators (for example, weight, blood pressure, blood glucose levels) and share this information with their doctor.
• Obtaining health information: Mobile applications can provide patients with information about health, prevention of diseases and a healthy lifestyle.

C. Artificial intelligence (AI):

• Help in diagnostics: AI can be used to analyze medical data (for example, test results, x -rays) and helping doctors in the diagnosis of diseases.
• Personalized recommendations: AI can be used to develop personalized recommendations for the treatment and prevention of diseases, taking into account the individual characteristics of the patient.
• Chat bots for answers to questions: Chat bots can answer patient questions about health, medical services and programs, which reduces the load on doctors and medical personnel.

D. Electronic medical cards (EMK):

• Convenient access to medical information: EMC allow doctors and patients conveniently and safely gain access to medical information, which increases the effectiveness of treatment and coordination of medical care.
• Exchange of medical information between doctors: EMC allow doctors to exchange medical information about the patient, which improves medical care coordination and prevents the duplication of examinations.
• Automatic reminder of the need to undergo medical examinations: EMK can automatically remind patients of the need to undergo medical examinations and vaccination.

IX. The role of the family and Caregivers in ensuring medical examinations

Family and Caregivers play an important role in ensuring the passage of regular medical examinations by elderly.

A. Support and motivation:

• Family and Caregivers can support and motivate the elderly to undergo medical examinations, explaining to them the importance of these measures to maintain health and quality of life.

B. Help in the organization:

• Family and Caregivers can help older people organize a doctor’s visit, make an appointment, organize transport and escort.

C. Support for reception:

• Family and Caregivers can accompany elderly people to see a doctor, help them ask questions and understand the received