Please enable JavaScript.
Coggle requires JavaScript to display documents.
L6 Health promo in Aging population 3 :older_man::skin-tone-3: (GeriatricâĶ
L6 Health promo in
Aging population
3 :older_man::skin-tone-3:
Infections
Importance cuz āđāļāđāļāļŠāļēāđāļŦāļāļļāļāļāļ acute āļāļēāļĢāđāļāđāļāļāđāļ§āļĒ & āļāļģāđāļŦāđāđāļāļīāļ death āđāļāđāļāđāļāļĒ
Most dangerous infection in elderly = :three:āđāļĢāļ āđāļāđāđāļāđ
āđāļāđāļŦāļ§āļąāļāđāļŦāļāđ, āļāļāļāļāļ§āļĄ!!!, āđāļĢāļāļāļđāļŠāļ§āļąāļ
:syringe:
Vaccine
āļāđāļāļāļāļąāļāđ
āļāđāļŦāļ§āļąāļāđāļŦāļāđ
with
Pneumococcus
vaccine âŊ :arrow_down:āļāļēāļĢāđāļāļīāļpneumonia&severe infection, :arrow_down:āļāļāļāļĢāļ., :arrow_down:death rate
Clinical tracer
/ āļāļąāļ§āļāļēāļĄāļĢāļāļĒāļāļēāļāļāļĨāļīāļāļīāļ
Def: āļŠāļ āļēāļ§āļ°āļāļēāļāļāļĨāļīāļāļīāļāļāļĩāđāđāļāđ āļāļīāļāļāļēāļĄāļāļĢāļ°āđāļĄāļīāļāļāļļāļāļ āļēāļ āđāļāđāļāđāļĄāļļāļĄāļāđāļēāļāđ
(āļŠāļ āļēāļ§āļ°āļāļēāļāļāļĨāļīāļāļīāļ--āļāļēāļāđāļāđāļāđāļĢāļ āļŦāļąāļāļāļāļēāļĢ āļāļąāļāļŦāļēāļŠāļļāļāļ āļēāļ āļŦāļĢāļ·āļāļāļĨāļļāđāļĄāđāļāđāļēāļŦāļĄāļēāļĒāļāđāđāļāđ)
āļāļēāļĢāļāļēāļĄāļĢāļāļĒāđāļŦāđ
āļāļĢāļāļāļāļĨāļļāļĄ
must look at
āļāđāļēāļāļāļĢāļ°āļāļ§āļāļāļēāļĢāļāļđāđāļĨāļāļ. āļŦāļĢāļ·āļāļāļĢāļ°āļāļ§āļāļāļēāļĢāļāļģāļāļēāļāđāļĢāļ·āđāļāļāļāļąāđāļ
āļāļĢāļ°āļāļ§āļāļāļēāļĢāļāļąāļāļāļēāļāļļāļāļ āļēāļ
āļāļāļāđāļāļĢāļ°āļāļāļāļāļ·āđāļāđāļāļĩāđāļāļ.āļāļąāļāļāļļāļāļ āļēāļ eg āļāļēāļĢāļāļąāļāļāļēāļāļļāļāļĨāļēāļāļĢ āļĢāļ°āļāļāļŠāļēāļĢāļŠāļāđāļāļĻ āđāļāļĢāļ·āđāļāļāļĄāļ·āļ āļŠāļ§āļĨ. āļĢāļ°āļāļāļĒāļē āļāļēāļĢāļāļģāļāļēāļāļāļąāļāļāļļāļĄāļāļ
āļŠāļĢāļļāļ = āļŠāļēāļĄāļēāļĢāļāļāļēāļĄāļĢāļāļĒāđāļāđāđāļ āļāļļāļāļāļāļāđāļāļĢāļ°āļāļāļāļāļāļāļĄāļēāļāļĢāļāļēāļāđāļĢāļāļāļĒāļēāļāļēāļĨ
Geriatric Giants
:birthday:
:candle:
Falls
āļĨāđāļĄāđāļĨāđāļ§āļĄāļąāļāđāļāđāļāđāļĢāļ·āđāļāļ āđāļāļīāļ
*Geriatric Syndrome
âŊ āļāļĢāļ°āļāļđāļāļāļĢāļļāļ āļāļĢāļ°āļāļđāļāļŦāļąāļ
Consequences after fall
Death
Injury
Bone Fx
Cartilage injury
Head injuries
Joint dislocation
Lack of confidence - āļāļĨāļąāļ§āļāļēāļĢāļŦāļāļĨāđāļĄ
Limit of movement
Risk factors
Internal
RFs
External
RFs
Prevention
Risk evaluation
:mans_shoe:
āļāļāļŠāļāļ "āļĨāļļāļāđāļĨāđāļ§āđāļāļīāļ"
Review
chronic conditions, drug uses, seeing-hearing ability, foot abnormality
Evaluation
of āļŠāļ āļēāļāđāļ§āļāļĨāđāļāļĄ
āļāļąāļāļāļĢāļēāļĒ āļ āļēāļĒāđāļ āļāđāļēāļ
:candle:
Confusion
:candle:
Incontinence
:candle:
Impaired homeostasis
:candle:
Iatrogenic disorders
Changes in the Future
Aged Society in 2023?
Disruptive technologies
Sustainable health system
Urbanization
Medical services disruption
will transform
Hospital
based medical services (Dx & Rx) âŊ
Personal
based medical services (Prevention & Mx)
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
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° = āļāļĩāļāļĩāđāļŠāļđāļāđāļŠāļĩāļĒāļāļēāļāļāļēāļĢāļāļēāļĒ
āļāđāļāļāļ§āļąāļĒāļāļąāļāļāļ§āļĢ
+ āļāļĩāļāļĩāđāļŠāļđāļāđāļŠāļĩāļĒāļāļēāļ
āļāļ§āļēāļĄāđāļāđāļāļāđāļ§āļĒāļŦāļĢāļ·āļāļāļīāļāļēāļĢ
Q. What
RFs
drive the most death & disability combined?
based on 2016 ranking
1st = Tobacco :no_smoking:
2nd = Alc & drug use :wine_glass:
3rd = Dietary risks
4th = High FBG
5th = High blood pressure
Estimation by adding together
Years of Life Lost due to premature mortality (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)
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)
āļāļąāļ§āļ§āļąāļāļŠāļāļēāļāļ°āļŠāļļāļāļ āļēāļāļāļāļāļāļāļ.āļāļāļāđāļĢāļ§āļĄ
āļāļĩāđāļ§āļąāļāļāļēāļĢāļŠāļđāļāđāļŠāļĩāļĒāļāđāļēāļāļŠāļļāļāļ āļēāļāļāļēāļāļŠāļ āļēāļ§āļ°āļŠāļļāļāļ āļēāļāļāļĩāđāļŠāļĄāļāļđāļĢāļāđāļŦāļĢāļ·āļāđāļŠāļāļāļāđāļāļāļ§āđāļēāļāļāļēāļāļŠāļļāļāļ āļēāļ
Risk factors
:beer:
Theoretical minimum = āļāđāļēāļāđāļģāļŠāļļāļāļāļāļāļĢāļ°āļāļąāļ RF āļāļķāđāļāđāļĄāļ·āđāļāļāļļāļāļāļĨāļŦāļāļķāđāļāđāđāļāđāļŠāļąāļĄāļāļąāļŠāđāļĨāđāļ§ āđāļĄāđāļĄāļĩāļāļ§āļēāļĄāđāļŠāļĩāđāļĒāļāļāđāļāļāļēāļĢāđāļāļīāļāđāļĢāļ
Outcome = āļāļĨāļĨāļąāļāļāđāļāļēāļāļŠāļļāļāļ āļēāļ
Prevention
:grapes:
Accident (Falling)
Screening for Fall
Time Up and Go Test (
TUGT
)
If took
âĨ 30 secs
âŊ
got risk for fall
Test āđāļŦāđāđāļāļīāļāļāļēāļĄāļ§āļīāļāļĩāļāļĩāđāļāļģāļŦāļāļ by āļŠāļąāļāđāļāļāļāđāļēāđāļāļīāļĄ, āļāļąāļāđāļĨāļēāļāļĩāđāđāļāđāđāļāļāļēāļĢāđāļāļīāļ
: āđāļŦāđāđāļāļīāļāđāļāđāļāđāļŠāđāļāļāļĢāļ 3 m then āļŦāļĄāļļāļāļāļąāļ§āđāļĨāđāļ§āđāļāļīāļāļāļĨāļąāļāļĄāļēāļāļąāđāļāļāļĩāđāđāļāļīāļĄ
Berg Balance Scale
got 14 āļāđāļ (Total max score = 56 points)
If
< 45
pts âŊ got abnormality in balancing & high risk for fall
Ischemic heart ds
Primary prevention
Avoid the
risk factors for Heart n vss ds
evaluate Thai CV risk score -- āđāļŠāļāļāļ.āđāļŠāļĩāđāļĒāļāļāđāļ death or being ill from āđāļĢāļāđāļŠāđāļāđāļĨāļ·āļāļāļŦāļąāļ§āđāļāļāļĩāļāļāļąāļ āđāļĨāļ°āđāļĢāļāđāļŠāđāļāđāļĨāļ·āļāļāļŠāļĄāļāļāļāļĩāļāļāļąāļāđāļāļĢāļ°āļĒāļ° 10 āļāļĩāļāđāļēāļāļŦāļāđāļē
Secondary prevention
Screening in suspected of āđāļĢāļāļŦāļąāļ§āđāļāļāļēāļāđāļĨāļ·āļāļ
Hx specific chest pain with EKG
Exercise stress test (check heart fuc during exercise)
Cardiac imaging
Cardiac markers + Lab āļāļĩāđāļāļģāđāļāđāļ
Tertiary prevention
Change behavior
Rx RF
ASA 75-325 mg/day
Anti-lipidemia
ACE inhibitor
Low back & neck pain
Cerebrovascular ds
Sense organ ds
Hearing impairment
Screening by using Questionnaire
Hearing Handicap Inventory for Elderly Screening Version (HHIES)
Vision impairment
Screening by checking VA, VF
Lower Respiratory Infection
Skin ds
DM
Tertiary prevention
Complications
Acute
Hypoglycemia
DKA
HHS
Chronic
Eye, Kidney, Neuro system
Diabetic foot ulcer
COPD
Frequent cause of death in elderly
Primary prevention
Smoking cessation program
Counseling & Pharmacological Rx
Advice (nicotine replacement)
Lifestyle modification
Diet
Exercise
Secondary prevention
Assess symptoms indicative of COPD
Smoking cessation
Refer to physician for confirm Dx
Education on recognition & exacerbations' Rx
Tertiary prevention
Smoking cessation
Pulmonary rehabilitation
Physical activity
Good nutrition
Immunization (Influenza vaccine)
Liver cancer
Secondary prevention
screen by U/S upper abdomen
or by check serum AFP q 6-12 mo.
COPD clinical tracer
Assessment
Symptoms
Modified Medical Research Council Dyspnea Score (mMRC)
COPD Assessment test (CAT)
Airflow limitation severity
GOLD
guideline 2018 (based on post-bronchodilator FEV1)
A, B, C, D Rx