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L6 Health promo in Aging population :older_man::skin-tone-2: (PhysicalâĶ
L6 Health promo in
Aging
population :older_man::skin-tone-2:
:white_flower:
Outline
Global burden ds
Clinical tracer of COPD
Falls case
Geriatric clinical assessment
Aging
> 60 y/o
which has Î in body & āļāļīāļāđāļ differ fr younger age causing by deterioration of most body system
progressive & generalized impairment of body func âŊ loss of adaptive responses to stress & :arrow_up: risk of age-related ds
NOT a freaking DISEASE (it's nm & inevitable biological phenomenon)
:three:
pillars
of a policy framework for
Active aging
Participation
Health :star:--āđāļŠāļēāļŦāļĨāļąāļāļāļĩāđāļŠāļģāļāļąāļ
Health determinants include
āļāļąāļāđāļāļāļāļļāļāļāļĨ
āļŠāļ§āļĨ. āļāļļāļĄāļāļ (physical environment, economics)
āļĢāļ°āļāļāļāļĢāļīāļŦāļēāļĢ
Security
Thailand society
:arrow_up:elders, :arrow_down:āļāļģāļĨāļąāļāđāļĢāļāļāļēāļ&āđāļāđāļ
Physical problems
(order āļāļēāļĄ % of occurrence)
Visual complaints (88%)
Cataract, Glaucoma, Retinopathy
Locomotor system disorders (40%)
Fibrositis, OA, RA, Myositis, Neuritis, Gout, Spondylitis of spine
Neurological complaints (18.7%)
Dementia, Parkinson's ds, Alzheimer's ds
CVS (17.4%)
Atherosclerosis, Thrombus formation, MI, HT
Respiratory system (16.1%)
Chronic bronchitis, Asthma, Emphysema
Skin conditions (13.3%)
GI tract (9%)
Peptic ulcer, Constipation, UC, CA of GIT
Psychiatric complaints (8.5%)
Alzheimer's ds, Depression, Anxiety, Delirium(acute confusion), Schizophrenia, Personality disorder, Suicide & deliberate self harm
Hearing loss (8.2%)
Nerve deafness, Conductive hearing loss
Genito-urinary complaints (3.5%)
Enlargement of prostate, Dysuria, Nocturia, Frequency&Urgency of micturation
:arrow_down:no. of nephrons âŊ Impaired excretion âŊ Accu. of toxins in body
:arrow_down:RBF & GFR âŊ Impaired excretion âŊ Accu. of toxins in body
:arrow_down:bladder capacity âŊ Urinary incontinence âŊ UTI
Prostatic hyperplasia in men âŊ BPH âŊ Frequency
based on Report of Independent Commission on Health in India
?. Endocrine system
Impaired glucose tolerance âŊ Hyperglycemia âŊ DM
Impaired thyroid func âŊ Hypo/Hyperthyroidism
Disturbed vitD metabolism âŊ Osteomalacia âŊ Fx
:arrow_down:sex hormone synthesis âŊ Impotence in male & Reproductive organ cancers in female
?. Hematology
:arrow_down:BM reserves âŊ Anemia
:arrow_down:T-cell func** âŊ non-resolving infections âŊ prone to infections
:arrow_up:synthesis of auto-antibodies âŊ autoimmune disorders
Prevention & Mx of Health problems in Geriatrics
How we treat our elderly - **one of the most important measure of how civilised we are
"You don't heal old age, you protect it, you promote it and you extend it."
- Sir James Sterling Ross
Assessment
Components of
Physical
Functional
Psychological
Cognitive
Affective
Socio-economical
Environmental
AIMS :goal_net:
Cost effective uses of services
Maintain elderly active
Provides quality care up to Max satisfaction of user
Multi-disciplinary Geriatric Assessment
(
Geriatric clinic)
Concept: suits best for assessment & mx of ds & disabilities in elderly
Components: Gerontologist/Physician, Physiotherapist (PT), Occupational therapist (OT), Ophthalmologist, Audiologist, Psychiatrist, Dietitian, Nurse, Social worker
Stats
Q. What's
RFs
drive the most death & disability combined?
based on 2016 rankings
1st Tobacco
2nd Alc & drug use
3rd Dietary risks
4th High FBS
5th High blood pressure
Health-related SDG index (sustainable development goals) of ASEAN countries in 188 countries worldwide
Thai got #112
(6/10 in ASEAN)
Q. What
causes
the most death & disability combined?
**Non-communicable disease (NCDs) āđāļāļāđāļĒāļāļ°āļŠāļļāļ
āļāļēāļĒāļļāļāļēāļāđāļāļĨāļĩāđāļĒ...
-āđāļĢāļāđāļāļīāļ in 2555 = 75
-āļāļāļāļāļēāļĢāļĄāļĩāļŠāļļāļāļ āļēāļāļāļĩ in 2555 = 66
Among ASEAN, Thai got 3 physicians per 10,000 population
Burden of disease
Concept that was deve in 1990s by Harvard School of Public Health, World bank & WHO to describe:
âŊ Death & Loss of health due to ds, injuries, & RFs for all regions of the world
Estimation
Estimation by adding together
Years of Life lived with Disability (YLD)
: the No. of yrs of life a person lives with disability caused by ds.
YLD = I x DW x L
I = āļāļļāļāļąāļāļīāļāļēāļĢāļāđāļāļāļāđāļĢāļāđāļāļāđāļ§āļāđāļ§āļĨāļēāđāļāđāļ§āļĨāļēāļŦāļāļķāđāļ,
DW = āļāđāļēāļāđāļ§āļāļāđāļģāļŦāļāļąāļāļāļāļāļ āļēāļ§āļ°āļāļāļāļĢāđāļāļāļāļēāļāļŠāļļāļāļ āļēāļ,
L = āļĢāļ°āļĒāļ°āđāļ§āļĨāļēāđāļāļĨāļĩāđāļĒāļāļāļāļāļ āļēāļ§āļ°āļāļāļāļĢāđāļāļāļāļēāļāļŠāļļāļāļ āļēāļ (āļāļĩ)
Years of Life Lost (YLL)
: the No. of yrs of life a person loses as a consequence of dying early bcuz of ds
YLL = N x L
N = death no., L = age-specific life expectancy (āļāļēāļĒāļļāļāļēāļāđāļāļĨāļĩāđāļĒāļĢāļēāļĒāļāļēāļĒāļļ)
YLL + YLD =
Disability Adjusted Life Year (DALY)
[DALY = single-figure estimate of ds burden]
1
DALY
= loss of 1 yr of life lived in full health
āļāļĩāļāļĩāđāļŠāļđāļāđāļŠāļĩāļĒāļŠāļļāļāļ āļēāļ§āļ° = āļāļĩāļāļĩāđāļŠāļđāļāđāļŠāļĩāļĒāļāļēāļāļāļēāļĢāļāļēāļĒāļāđāļāļāļ§āļąāļĒāļāļąāļāļāļ§āļĢ + āļāļĩāļāļĩāđāļŠāļđāļāđāļŠāļĩāļĒāļāļēāļāļāļ§āļēāļĄāđāļāđāļāļāđāļ§āļĒāļŦāļĢāļ·āļāļāļīāļāļēāļĢ
Post-2015 Development Agenda (āļ§āļēāļĢāļ°āļāļēāļĢāļāļąāļāļāļēāļ āļēāļĒāļŦāļĨāļąāļāļāļĩ 2558) =
End
of āļāļēāļĢāļāļģāđāļāļīāļāļāļēāļĢāđāļĨāļ°āļāļīāļāļāļēāļĄāļāļēāļĢāļāļąāļāļāļēāđāļāļĢāļ°āļāļąāļāđāļĨāļāļāļēāļĄ 'Millennium Development Goals (MDGs)
âŊ New āļāļĢāļ°āļāļ§āļāļāļąāļĻāļāđāļāļĩāđāđāļāđāļāļŦāļąāļ§āđāļāļŦāļĨāļąāļ =
āļāļēāļĢāļāļąāļāļāļēāļāļĩāđāļĒāļąāđāļāļĒāļ·āļ
UN & stuffs āļāļĢāļ°āļāļļāļĄ âŊ āļāļģāļŦāļāļ āđāļāđāļēāļŦāļĄāļēāļĒāļāļēāļĢāļāļąāļāļāļēāļāļĩāđāļĒāļąāđāļāļĒāļ·āļ or "Sustainable Development Goals (
SDGs
)
SDGs consists of :one::seven: āđāļāđāļēāļŦāļĄāļēāļĒāļāļēāļĢāļāļąāļāļāļē with āđāļāđāļēāļŦāļĄāļēāļĒāļĒāđāļāļĒāđāļĨāļ°āļāļąāļ§āļāļĩāđāļ§āļąāļ to follow the development and result that needed to succeed within yr 2573 (got 230 āļāļąāļ§āļāļĩāđāļ§āļąāļ)
:nine: āđāļāđāļēāļŦāļĄāļēāļĒāļāļāļāļāļēāļĢāļāļ§āļāļāļļāļĄāļāđāļāļāļāļąāļ NCDs āļĢāļ°āļāļąāļāđāļĨāļ for Thailand :grapes: