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PREVENTIVE GERIATRICS

Dr.I.Selvaraj,I.R.M.SB.Sc., M.B.B.S.,(M.D Community medicine).,

D.P.H.,D.I.H.,P.G.C.H&FW (NIHFW, New Delhi)

Sr.D.M.O (Selection Grade Officer)

INDIAN RAILWAYS MEDICAL SERVICE

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It is the art and science of preventing

disease in the geriatric population andpromoting their health and efficiency

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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 unitedstates

Geriatric medicine was a product of the British NHS

Nascher was the father of geriatrics and MajoryWarren was its Mother

The 1stGeriatric service was started in U.K in 1947.

Geriatric department at GH, Chennai was establishedin 1978.

Post Graduate course in Geriatric medicine has beenstarted in 1996 at Madras medical college.

Prof. V.S. Natarajan was the first Geriatric professorin India

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The study of physical andpsychological changes that occur in

old age is called gerontology. Geriatrics is the branch of general

medicine concerned with clinical,preventive, medical and social

aspects of illness in the elderly.

The old age is defined as the age ofretirement. In our country it is fixed

at 60 years and above.

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Geriatric population

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

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Present scenario in INDIA

Cataract &Visual impairment- 88%

Arthritis &locomotion disorder-40%

CVD &HT 18%

Neurological problems- 18%

Respiratory problems including Chronic

bronchitis- 16% GIT problems- 9%

Psychiatric problems- 9%

Loss of Hearing 8%

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Theory of aging

Somatic mutation theory

Autoimmune theory Hayflicks theory of aging

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RISK OF GERIATRICS

PRONE FOR INFECTIONS PRONE FOR INJURIES

NEED SPECIAL ASSISTANCE

PRONE FOR PSYCHOLOGICAL PROBLEMS

PRONE FOR DEGENERATIVE DISORDERS

INCREASED RISK FOR DISEASE

INCREASED RISK OF DISABILITY

INCRASED RISK OF DEATH

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AIM OF GERIATRIC MEDICINE

Maintenance of health in old age byhigh levels of engagement andavoidance of disease

Early detection and appropriatetreatment of disease

Maintenance of maximumindependence consistent withirreversible disease and disability

Sympathetic care and support duringterminal illness

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GERIATRIC PEOPLE PROBLEMS

HEALTH PROBLEMS

1.Joint problems2.Impairment of special senses3. Cardio vascular disease4.Hypothermia5.Cancer, Prostate enlargement, Diabetes&

Accidental falls Psychological problems

1. Emotional problems2. Suicidal tendency3.& Senile dementia, Alzheimerdisease

Social problems Poverty, Loneliness, Dependency, Isolation, Elder

abuse, Generation Gap

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GERIATRIC TEAM

Geriatricians

Nurses

Physiotherapist Social worker

And Health worker

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Investigation is an essential tool in the diagnosis ofelderly patients.

Under or over investigations to be avoided.

Know the age related variables while interpreting theresults.

Non-invasive tests are preferred than invasive.

The objective of the investigations is to improve thequality of life.

One must try to get the diagnosis right, as wrongdiagnosis is harbinger of wrong treatment

Polypharmacy should be avoided whenever possible

Regular review of medication is a must

Poor drug compliance could be due to poor advice

Proper nutrition is vital for healthy living

A well balanced nutritious diet is ideal for older age

It is not the quantity but the quality

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Indicators of health status of aged

Age proportional mortality rate

Age specific death rate persons over 55years

Age specific prevalence rates for cvd,cancers and accidents.

% elders taking three or more drugs/day

Cumulative percentage of elders undergone

cataract surgery Proportion of elders admitted to the hospital

in the past one year

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PREVENTION

Primordial prevention Pre geriatric care

Primary prevention Health education Exercise

Secondary prevention Annual medical check-up Early detection ( Universal approach, Selective approach)

Treatment Tertiary prevention Counseling and Rehabilitation Welfare activities (Sanjay Niradhar Yojana, Vridhashrama) Chiropody services

Improving quality of life Cultural programme Old age club Meals-on wheel service Home help Old age home

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THANK YOU