Rheumatoid arthritis most often affects older people. It causes inflammation of all joints and surrounding tissues. This significantly affects their function and quality of life. To prevent the disease from developing further and the person not to lose ability to work, it is necessary to slow down the inflammatory process.
Rheumatoid arthritis is a chronic inflammatory disease of the joints and surrounding tissues, as well as other organs. Arthritis develops in the connective tissue and causes erosive changes in it. After the inner lining of the joints becomes inflamed, joint fluid begins to be intensively produced in them. Ultimately, the joint becomes immobile and any movement causes acute pain. Sometimes a thickening appears in the joint, which spreads to other tissues, the articular ligaments are affected and the person may become disabled.
Typically, rheumatoid arthritis affects older people (30%) and middle-aged women. Most often, the disease affects smokers.
The disease rheumatoid arthritis can appear after a cold, after an injury, or when there is a source of infection in the body.
The cause of arthritis in old age is immunological and biochemical changes. Autoimmune changes occur in the connective tissue of the joints. Regular hypothermia can also cause the development of rheumatoid arthritis. There are studies confirming that there is a certain genetic predisposition to this disease. Smoking and viral diseases play a significant role in the development of the disease.
Large physical loads on the joints contribute to rheumatoid arthritis. For example, when there is frequent stress on the knees or other joints. During pregnancy, a woman’s body experiences a double load, and this directly affects the joints.
The development of the disease occurs slowly and therefore often goes unnoticed at the initial stage. The very first symptoms usually appear:
1) slight increase in body temperature;
2) general fatigue;
3) fatigue;
4) loss of appetite;
5) loss of body weight;
In rheumatoid arthritis, entire groups of joints are affected and polyarthritis occurs. Joints are affected symmetrically. Rheumatoid arthritis in older people differs from rheumatoid arthritis in other people in that the disease always begins acutely, and all symptoms are more pronounced. After the inflammatory process develops, pain appears in the joints and they begin to swell. Their function is impaired, they become less mobile, and the temperature at the site of inflammation rises. Stiffness in the joints appears immediately after waking up or at rest. It lasts about an hour - this is a direct sign of arthritis in older people.
Often systemic symptoms occur simultaneously with articular symptoms.
On examination, the inflamed joints are hyperemic, swollen, and hot to the touch. First of all, the metacarpophalangeal joints and wrists are hit, followed by the elbow joints, ankle joints and others. When the median nerve is compressed, carpal tunnel syndrome occurs. In some cases, a Baker's cyst may rupture.
Extra-articular manifestations include vasculitis, mononeuritis, myocarditis, episcleritis, pleural effusion, age spots and others. If the cervical spine is affected, compression of the spinal cord or subluxation of the atlantaxial joint may occur.
In 80% of older people, joint damage develops gradually over 10 years.
A rheumatologist examines and interviews the patient. Examines the joints and skin at the site of the lesion. Very often in older people it is difficult to diagnose and distinguish rheumatoid arthritis from other diseases.
For reliable diagnosis, laboratory diagnostic methods and x-ray methods are used.
Laboratory methods include various blood tests:
1) blood test for citrulline. In rheumatoid arthritis, abnormal antibodies called rheumatoid factor are found in the blood. This test gives the most accurate result, while a regular blood test shows a negative result.
2) a blood test for erythrocyte sedimentation rate supplements the overall picture of the disease. With arthritis, it is over 20 mm in one hour. This indicates the presence of an inflammatory process in the body.
3) a blood test for C-reactive protein helps determine the extent of joint damage from rheumatoid arthritis. With rheumatoid arthritis, anemia will be observed in the blood.
Using the X-ray method, you can see signs of joint inflammation in the very early stages of the development of rheumatoid arthritis. On an x-ray you can see changes in the joints that are characteristic of this particular disease, bone erosions.
Thanks to the images, it is possible to monitor the development of the inflammatory process.
Among additional research methods, the patient may be prescribed joint puncture. This test can help identify the cause of rheumatoid arthritis. It also helps reduce joint swelling and pain.
Treatment of rheumatoid arthritis in older people has its own specifics:
1) timely diagnosis of the disease;
2) determination of a suitable treatment regimen and further prognosis;
3) modifying drugs;
4) taking into account the peculiarities of metabolism in people of geriatric age;
5) relief of inflammation;
6) antidepressants (if necessary);
7) training in proper nutrition, sleep and rest patterns.
The regimen is drawn up taking into account the possible risk of side effects and drug compatibility. In order to relieve a painful attack, NSAIDs (non-steroidal anti-inflammatory drugs) are used in the required dosage. They are combined with antihypertensive drugs, hypoglycemic agents and antiplatelet agents. There may be a risk of developing complications from the gastrointestinal tract. Meloxicam and Celebrex can reduce the risk of nephropathy and gastropathy. Periarticular inflammation is relieved by NSAIDs.
In cases where modifying drugs are prescribed to an elderly person, the risks and benefits are weighed and a drug with a lower dose of toxicity is selected. The most common side effects in older people are cataracts and retinopathy.
Antiosteoporotic drugs can quickly restore loss of bone tissue (mineral) density.
1) Surgical method. It is used only in cases where it is not possible to restore normal functions to the joint or if cartilage tissue is destroyed. In this case, the patient undergoes removal of the joint capsule (synovectomy) - this method helps to ensure stable remission and make the future prognosis more favorable. Sometimes it is necessary to undergo total joint replacement. This is especially true for all large joints, such as the hip, knee and others.
2) X-ray irradiation: it is carried out when small joints of the hands and feet are affected by arthritis. X-ray irradiation relieves inflammation and pain.
3) Physiotherapy: paraffin applications, applications with therapeutic mud, hydrocortisone, analgin, electrophoresis and other methods are most often used.
4) Therapeutic exercises: physical therapy helps, with the help of properly selected exercises, to increase the range of movements and return the damaged joint to functionality.
In each case, the further prognosis after rheumatoid arthritis depends on the severity and extent of the inflammatory process and will be strictly individual. If the treatment is chosen correctly, the patient remains competent and can return to normal life. But approximately 15% of patients with rheumatoid arthritis completely lose normal joint function and become disabled.
Arthritis in older adults is a major health concern. The disease cannot be cured, therefore, if you suspect and have characteristic symptoms, you should not expect results and start the disease. It is better to consult a doctor to find out an accurate diagnosis and begin treatment.
The disease is found in 1% of the world's people - 70 million people, with 1 million in our country. Rheumatoid arthritis is more common in older people.
Recently, it occurs more often at a younger age. You shouldn’t look at your age and try to independently determine the cause of your symptoms; a doctor will help.
Research is being conducted to identify the causes that serve as a trigger for the development of arthritis. Scientists do not understand why human immunity recedes when a disease occurs. The occurrence of rheumatoid arthritis is associated with the autoimmune system. The body's lymphocytes begin to work against it.
Arthritis is more common in mentally unstable people. Emotional distress can cause arthritis.
The main types of rheumatoid arthritis:
If arthritis is detected quickly, it can be cured sooner. At severe levels, when the heart muscles are affected, treatment will be difficult or impossible. Doctors can help eliminate the disease if you recognize it at the first sign. Complications of advanced forms lead to disastrous consequences.
To eliminate arthritis in older people while maintaining joint mobility, you need to seek help in time. If a person works, he needs to be more careful about his own body. You can prolong life and increase its activity. Treat comprehensively, based on the doctor’s recommendations. Rheumatoid arthritis is characterized by a chronic condition; treatment will take a long time.
The disease is treated with medications that prevent complications of joint destruction. Physiotherapeutic and rehabilitation measures are needed. If the form of arthritis is severe, surgery will help.
Osteoporosis in rheumatoid arthritis is a secondary disease based on chronic immune inflammation. Refers to a severe degree of development of RA. They compare early osteoporosis with atherosclerosis, focusing on their interdependence. Osteoporosis is accompanied by a decrease in bone mass, affecting the autoimmune system. Inflammatory processes occur, causing destruction of joints and bone resorption locally or systemically.
Osteoporosis occurs as complications of rheumatoid arthritis. One second of patients suffering from RA develops osteoporosis as a consequence of the disease. Develops from antirheumatic therapies administered incorrectly or without a doctor.
Characteristic signs of osteoporosis that increase the risk of developing the disease:
To identify osteoporosis, contact a medical center. After the medical examination, the doctor will prescribe the necessary treatment. Living with such a diagnosis is not easy, negative factors can be reduced. Treatment of osteoporosis is carried out under the supervision of a doctor who monitors the development of osteoporosis. Dispensary treatment will be required.
Arthritis due to influenza, a viral disease, is accompanied by inflammatory processes in muscle tissue and joints. The disease will manifest itself at the initial stage of the spread of influenza; it does not occur in advanced disease. After the crisis moment, at least 10 days will pass, and arthritis will take root.
Joint stiffness, pain, muscle spasms, fever and weakness are noticeable. Arthritis with influenza exhibits all the symptoms, depending on the degree of damage to the joints.
To prevent complications, it is necessary to take measures. By contacting a medical center for help in time, you can stop the spread of the disease and completely cure it.
People who are diagnosed with RA as a consequence of influenza should be careful with their immune system. Vaccinations must be carried out with the permission of the attending physician. You should contact the center for help, especially if there are complications. By following all the doctor's recommendations, you can cure the disease.
Chronic joint inflammation can be prevented if you seek help in time. Living after the discovery of RA is difficult; it is necessary to regularly visit specialists, carry out procedures and constantly do tests.
To avoid negative factors that develop the disease, you need to get flu shots. After vaccination, 12 months must pass, after which the procedure is repeated. Not all vaccines have a positive effect. For the effectiveness to be noticeable, you need to get vaccinations that do not reduce the effect of taking medications, or vice versa. Vaccination is carried out before taking basic medications, after which it has a positive effect, and life will be safer and easier.
Some vaccines have no effect. In some cases, vaccination is not allowed; instead, the patient receives recommendations: a change in diet, environmental influences, protection from stress.
Medicines suitable for the treatment of rheumatoid arthritis will help with eczema. It helps if actions are carried out under the supervision of specialists and after examination.
Eczema is a chronic inflammatory process of the skin. Characterized by rashes, itching and burning, confused with an allergic reaction. Eczema manifests itself in weeping and dry forms. There are many reasons for its occurrence: allergenic skin contact, nervous system disorders, pathology of the endocrine system, abnormal metabolism.
Eczema occurs in chronic or acute forms. The development is cyclical, there may be periods of decline in the disease process, then a relapse occurs. Living with this problem in an uncomfortable situation, the medical center is developing the causes of the disease and ways to eliminate the disease processes.
For treatment, special steroid ointments are prescribed, which do not always help solve the problem. The drug for the treatment of rheumatoid arthritis showed the best results. Eczema responds to tofacitinib.
During the experiment, 6 people were admitted whose eczema was highly developed. The itching effect disappeared in every patient. People talked about improvements in the condition of their skin after taking the drug.
It is believed that eczema occurs due to a failure of the autoimmune system. The likelihood of the drug helping is possible if eczema is associated with immune processes. Tofacitinib is used to treat rheumatoid arthritis and eczema.
Arthritis is common in older people. Occurs more often in those who consume alcohol. When alcohol is consumed regularly, it contributes to chronic disease, which is not easy to get rid of. Starting to take alcohol at a young age, to old age, after several decades of consumption, this leads to changes in bone tissue. The rehabilitation center helps eliminate alcohol addiction, and as a result, arthritis can be cured.
When alcohol is consumed in moderation, the opposite occurs - strengthening bone tissue. The lower the quality level (elite) of alcohol products, the higher the risk of developing the disease. To live a long healthy life, you need to completely stop consuming.
Alcohol is a cause of physical and mental destruction. If you have an addiction to the drink, it is better to contact a rehabilitation center. Alcohol thickens the blood and flushes calcium from the body. Joints and knees that begin to hurt signal the start of the inflammatory process. Dopamine and adrenaline, which are rich in alcohol, inflame joint tissue.
Alcohol consumed in large quantities contributes to the development of rheumatoid arthritis. Accompanied by characteristic symptoms: pain, swelling, vitamin deficiency, bone tissue destruction. Loads on joints lead to damage. Alcohol is a catalyst for triggering arthritic disease, accelerating the process of its development.
Rheumatoid arthritis (RA) is one of the most common diseases in older people. Its causes are still not exactly clear from a medical point of view, but the autoimmune nature of the inflammation has been established. It is chronic and manifests itself primarily as arthritis with erosive changes in the joints. Articular syndrome is accompanied by damage to many internal organs.
The list of possible causes of arthritis includes complications from infectious diseases, injuries, hypothermia, hereditary predisposition, etc.
As a result of numerous medical studies on the study of arthritis, we can conclude that this disease primarily affects mentally unstable people who are in a stressful state most of the time.
Currently, to establish the diagnosis of rheumatoid arthritis of the joints, the ACR/EULAR 2010 criteria are used. They attach great importance to physical examination (inspection, palpation, percussion) and laboratory diagnosis. Using them, the doctor needs to:
When calculating points, the following indicators are taken into account:
It should be noted that some joints, such as the distal interphalangeal joints, are never affected by RA (exceptions).
There are also groups of patients in whom symptoms of rheumatoid arthritis of the joints can be diagnosed even if the clinic does not meet the classification criteria. The first group includes patients with erosive changes in joints typical of RA on radiographs. The second group includes patients whose long-term process previously met the criteria.
There are many classifications of rheumatoid arthritis. It is classified according to stages as follows: very early (duration less than six months); early (from six months to 12 months); extensive (with a duration of more than 1 year and the presence of typical clinical manifestations); late (from 2 years of onset of the disease; accompanied by severe destruction of joints and complications).
The main goal of drug therapy for rheumatoid arthritis is to achieve remission. Treatment is usually carried out by a rheumatologist (much less often by a general practitioner) with the involvement of other specialists.
Patients should get rid of the influence of factors that provoke an exacerbation of the process (secondary prevention): lose weight (with overweight and obesity), quit smoking, avoid hypothermia, treat infectious diseases under the supervision of a doctor, use vitamin-mineral complexes during periods of acute vitamin deficiency.
General prevention of rheumatoid arthritis of the joints in older people involves providing them with appropriate living conditions and constant monitoring of their well-being, which is exactly what we do in our boarding house for the elderly.
Older people are more likely to develop arthritis. This is due to degenerative changes in bone tissue and metabolic disorders. Arthritis is an autoimmune disease and is characterized by symmetrical damage to the joints of the limbs. Patients complain of stiffness of movement in the first half of the day and the occurrence of deformities.
The development of arthritis is based on the inflammatory process in the cartilage tissues of the joint, caused by the influence of the body’s own immune defense mechanisms. The trigger mechanism in the autoimmune process is the introduction into the body of a virus, bacteria or fungus that disrupts the reactivity of the immune system. In this regard, it begins to produce antibodies against the cells of its own body.
The disease is more common among women.
Arthritis in older people develops quite often, which is associated with the influence of such factors:
Arthritis, which affects older people, develops as a result of physiological wear and tear on the joints. There are several types of pathology:
The juvenile form of pathology manifests itself even in old age.
Forms of arthritis are also classified depending on radiological signs:
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Arthritis in older people is characterized by slow progression of the pathological process. In this case, the pain is slightly expressed, since the destruction of nerve endings occurs due to metabolic disorders. Rheumatoid arthritis affects symmetrical joints. The most commonly affected joints are the knee and wrist joints. Sometimes the location of the disease is determined by the patient’s occupation.
Elderly patients with arthritis are bothered by the symptoms of malaise, they sleep poorly and feel constant fatigue. Sometimes patients have difficulty getting out of bed and moving around, which is associated with stiffness and pain. Muscle atrophy causes weight loss. A constant low body temperature causes nausea and lack of appetite.
Damage to the joints is accompanied by severe aching pain. It is permanent and causes significant stiffness of movement in patients. Painful joints constantly become inflamed, the soft tissue around them swells, and the skin becomes red and hot to the touch. With a prolonged course, deformities of the limbs occur. They are especially pronounced in older people. In addition, rheumatoid arthritis causes damage to other organs by an autoimmune process. Pigment spots appear on the skin, muscle inflammation (myocarditis), and vascular changes (vasculitis) develop. The pleura is involved in the process with the appearance of pleural effusion and the heart muscle - this is fraught with myocarditis.
Arthritis in older people affects almost all joints. Often the location of the diseased joint depends on the patient’s type of activity or is determined by significant trauma suffered in the past. More often, the knee, elbow and wrist joints are involved in the pathological process. The disease is symmetrical in nature, as it is caused by autoimmune inflammatory damage to one’s own tissues.
Arthritis in older people can be detected using x-rays. To obtain a detailed picture of the damage to soft and bone tissues, magnetic resonance imaging is used. A puncture of the diseased joint is also performed. In addition, an immunological blood test is performed to check for the presence of autoimmune complexes that damage joint tissue. A general blood and urine test is mandatory.
Treatment of the disease is symptomatic.
Treatment for rheumatoid arthritis involves taking non-steroidal anti-inflammatory drugs. Therapeutic gymnastics, massage and various physical procedures can slow down the pathological process. Drugs that destroy immune complexes are also used experimentally. Treatment in old age often includes surgery, which involves removing the affected tissue and partial or complete joint replacement.
Diabetes in older adults: This page tells you everything you need to know. Learn the causes, symptoms and signs of this disease, and most importantly, ways to effectively treat it. Find out in detail what complications diabetes can cause in old age. After this, you will be motivated to stick to the regime and keep your blood glucose levels normal. Dr. Bernstein and Endocrin-Patient.Com teach how to keep your blood sugar between 3.9 and 5.5 mmol/L 24 hours a day. This is the level of healthy people. To achieve it, you don’t have to starve, exercise painfully, drink expensive and harmful pills, or inject massive doses of insulin.
Diabetes in the elderly: detailed article
Diabetes mellitus affects at least 20% of people over 65 years of age. These are tens of millions of patients. They provide employment to doctors who treat cardiovascular diseases, leg problems, eye problems and kidney problems. Find out below about effective methods for controlling impaired glucose metabolism. Use them so that you do not have to suffer from complications. A step-by-step treatment plan for type 2 diabetes suitable for older patients. Dr. Bernstein's recommendations can be followed even by people who are overloaded with work, and even more so by retirees.
Symptoms of diabetes in older adults are often muted, similar to the general signs of aging. Because of this, at least half of diabetics of retirement age do not know about their disease. Being in the dark, they have no control over their glucose metabolism at all. Treatment of diabetes mellitus in elderly patients is considered more difficult than the control of impaired glucose metabolism in middle-aged people. Treatment methods are discussed in detail below on this page.
After retirement, food quality often declines due to poverty. The diet of low-income pensioners may shift towards cheap “junk” food, overloaded with refined carbohydrates. This is the main reason for the development of type 2 diabetes in old age. However, genetic predisposition plays a role. Because not all people who are severely obese develop diabetes.
Additional possible reasons:
With age, the number and strength of muscles inevitably decreases. If an elderly person leads an unhealthy lifestyle, adipose tissue replaces the lost muscles. Susceptibility to diabetes increases, although weight may remain normal. Therefore, body mass index (BMI) is a poor indicator for assessing the risk of type 2 diabetes in people over 65 years of age. The risk of developing impaired glucose metabolism also increases in cases of social isolation.
In most cases, symptoms of diabetes in older people are mistaken for natural signs of aging. In such cases, neither patients nor their relatives realize that they need to check their blood sugar. A diabetic may experience fatigue, increased scandalousness, depression, and weakened mental abilities. There may be problems with blood pressure, most often hypertension. Some patients experience orthostatic hypotension. This is frequent dizziness and even fainting when getting up from a lying or sitting position.
A characteristic symptom of diabetes is extreme thirst. It occurs because the kidneys try to remove excess glucose in the urine. However, in older diabetics, the brain center that controls fluid balance often malfunctions. Because of this, the feeling of thirst disappears even with severe dehydration. Patients gradually get used to dry mouth. They often have dry, wrinkled skin. Typically, a doctor is consulted only in the last stages of dehydration, when excitability, confusion, delirium develops, or the elderly diabetic falls into a coma.
Diabetic neuropathy (damage to the nervous system) can cause dozens of different symptoms. Read more about them here. The most common symptom is numbness in the legs, loss of sensation. Less often there is not numbness, but pain in the legs. Numbness and loss of sensation are called passive symptoms, and pain is called active. Diabetics are more likely to report pain, although numbness is more dangerous because it increases the risk of amputation of the foot or entire leg.
Diabetes is the #6 most common cause of death in older adults. However, statistics on deaths from diabetes complications do not include people who die from heart attacks and strokes. But these diseases are often caused by impaired glucose metabolism, which was treated incorrectly or was not diagnosed at all during the patient’s lifetime.
If we adjust for heart attack and stroke, it turns out that diabetes causes at least? of all deaths among older people. Correct and timely treatment of this disease can prolong life by 5-10 years, as well as improve its quality and prevent disability.
Diabetes can cause blindness, leg problems including amputation, and dozens of other complications. For example, the inability to move the right or left shoulder due to paralysis of the nerves that control the shoulder muscles.
Diabetics are most afraid of gangrene and leg amputation. Perhaps kidney failure is an even more dire complication. People whose kidneys have failed need to undergo dialysis or seek a donor organ for transplantation.
Poorly controlled diabetes accelerates the development of systemic atherosclerosis. Atherosclerotic plaques affect the vessels supplying the legs, heart and brain. In most patients, latent or improperly treated diabetes leads to early death from heart attack or stroke. Because of this, not everyone experiences complications with their kidneys, eyesight, or legs.
In Western countries, elderly diabetics who have become disabled are placed in special medical institutions. This places a heavy financial burden on the health care system. In Russian-speaking countries, such patients are often left to their fate.
An acute complication of type 2 diabetes in older adults is called hyperosmolar coma. Impaired consciousness may develop if blood glucose levels become 4-7 times higher than normal. The main cause of diabetic hyperosmolar coma is severe dehydration. Older diabetics often have a dulled feeling of thirst. Because of this, they do not replenish fluid reserves in their body on time.
It is believed that treatment goals for diabetes in older adults should be individualized for each patient. They say that if a person doesn’t have long to live, then there is no need to try to normalize his blood sugar. For example, in the case of an incurable and aggressive cancer, complications of diabetes simply do not have time to develop. In such situations, simplified treatment regimens are prescribed. A glycated hemoglobin level of 7.5% and above is considered satisfactory. Doctors only care about making sure that an elderly diabetic does not fall into a coma due to too high glucose levels.
Consider the opposite case - a relatively healthy person aged 65 who is accidentally diagnosed with type 2 diabetes. This patient did not have a heart attack or stroke, and no cancer was detected. Despite diabetes, the body still works well. Such a person can live 10 or more years. He should be treated carefully so that these years do not turn into a nightmare due to blindness, kidney failure or amputation of a leg. Official medicine recommends maintaining glycated hemoglobin no higher than 6.0-6.5%. In fact, this figure can be kept in the range of 4.6-5.5%, as in healthy people. Read more about the step-by-step treatment plan for type 2 diabetes.
The above describes, as it were, two poles. Every older diabetic's situation falls somewhere in between. You need to decide how much you are willing to try to live long and fully. Effective treatment of diabetes requires strict adherence to diet. Insulin injections in flexible, well-calculated doses may be needed. You also need to take pills. However, they will be of little use if you do not combine them with diet, insulin and physical activity. Let us remind you that “if a person truly wants to live, then medicine is powerless” :).
A miracle cure that allows you to quickly and easily cure diabetes does not yet exist. However, there is some good news. The treatment methods promoted by the Endocrin-Patient.Com website give excellent results and allow you to lead a normal life.
You will not have to:
The actions described on this site treat impaired glucose metabolism, and at the same time hypertension. They will protect you not only from kidney, leg and eye problems, but also from heart attack and stroke.
Treating diabetes in older people is considered more challenging than working with other categories of patients. The following factors make it difficult to achieve good blood sugar levels:
It often happens that older people take several types of medications at the same time for various age-related diseases. Adding diabetes pills to this mix significantly increases the risk of side effects. Because many drugs interact with each other in complex ways in the human body. Officially, this problem has no solution. It is believed that no medications for chronic diseases can be canceled. However, switching to a low-carb diet simultaneously improves the following:
Usually it becomes possible to reduce the dose and number of medications taken by 2-3 times.
Ingesting herbal infusions and decoctions helps no better than drinking clean water. When you drink liquid, your blood becomes diluted. Due to this, the glucose level decreases slightly. Only water helps a little. All other components of folk recipes are usually useless, and in the worst case, even harmful. Traditional treatment for diabetes does not help patients, but only their relatives who want to receive an inheritance faster.
You will find the answer in the article “Diet for diabetes.” This way of eating is not hungry, but nourishing and tasty. Therefore, it is popular with elderly diabetics, as well as with all other categories of patients. After switching to a healthy diet, your sugar levels and cheerful well-being will cause the envy of all your friends who have impaired glucose metabolism, and even doctors.
You want to know what medications you should take for diabetes. And it is right. However, it is even more important to know which popular pills are harmful so that you can avoid using them.
Kidney function often deteriorates with age. Before taking any medications for diabetes or other diseases, review a list of tests that check your kidney function. Get blood and urine tests. Compare your results with the norms. The instructions for use of all medicines tell you whether they are suitable for people with reduced kidney function. Understand this issue for each of your medications.
You may be taking medications for high blood pressure. After switching to a low-carb diet, their doses will need to be reduced. Otherwise, hypotension may occur. You may need to stop taking some medications completely. This is unlikely to upset you.
First of all, you need to slow down the development of kidney failure. Try to avoid having to undergo dialysis or go to surgeons for a kidney transplant. To achieve this goal, keep your blood sugar consistently within normal limits using a step-by-step treatment plan for type 2 diabetes. You may also need to take blood pressure pills as prescribed by your doctor.
Some hypertension medications are better at protecting the kidneys than others. Read more in the article on the prevention and treatment of diabetic nephropathy. Periodically take the blood and urine tests listed in it. The steps you take to prevent kidney failure will also reduce your risk of heart attack and stroke.
In addition to diabetes, kidney problems can be caused by the presence of stones in them, as well as infections. The topic of treatment of these diseases is beyond the scope of this site. Many patients manage to recover from pyelonephritis if effective antibiotics are selected individually. To do this, you need to find a competent doctor, and not contact the first one you come across. Also, to help your kidneys, you need to take the time to drink enough fluids. Even if it means you have to visit the toilet more often.
Until the early 2000s, it was believed that almost all older people needed to take aspirin to prevent heart attacks. However, later large studies refuted this idea. Taking low-dose aspirin slightly reduces the risk of another heart attack, but not a first one. This drug can cause stomach problems and even hemorrhagic stroke. Don't take it every day. Do not expect to use it to protect yourself from the formation of blood clots in your blood vessels.
Anemia is a common phenomenon that affects mortality and health status of people after 60 years of age. The disease is often underestimated due to the lack of clear criteria. The diagnosis is established when a hemoglobin level is detected below 130 g/l in men, below 120 g/l in non-pregnant women and 110 g/l in pregnant women. However, rates decline with aging, so anemia in older people is often not treated.
Mortality in the older age group increases when hemoglobin is below 137 g/l for men and 126 g/l for women, and optimal values should be 140–170 g/l and 130–150 g/l, respectively.
Anemia in older people has a number of serious consequences:
The presence of anemia increases the length of hospitalization and the possibility of death from cardiovascular diseases, and may also be an early sign of undiagnosed malignant pathology.
The causes of anemia in the elderly are divided into three large groups:
Iron deficiency anemia is determined by low serum ferritin levels and transferrin saturation coefficient. But even with a normal amount of protein, iron deficiency can occur. Ferritin is an element of the acute phase; it is elevated during inflammatory processes and in old age. Therefore, you should focus on transferrin saturation. The diagnosis of anemia is not final. It is necessary to discover the cause, find possible blood loss or malignant tissue degeneration.
Anemia due to inflammation impairs the efficiency of iron recycling from erythrocytes in case of its functional deficiency. Apoptosis (natural loss) of erythroid progenitor cells in the bone marrow increases, and erythropoietin production decreases. An increase in inflammatory molecules in people with chronic diseases of the joints, stomach, and heart leads to the synthesis of hepcidin. It is this oligopeptide that impairs the absorption of iron in the intestine, as well as the receipt of processed substances from macrophages, which leads to deficiency.
Anemia of unknown origin accounts for a third of all cases of anemia in old age. Undiagnosed malignancies, including myelodysplasia, chronic kidney dysfunction and other rare causes, can cause pathology, but their percentage is quite low.
The diagnosis of anemia is complicated by the high frequency of concomitant diseases in older people and an increase in the concentration of anti-inflammatory cytokines, which affects hematopoiesis.
Hepcidin plays a central role in the pathophysiology of anemia in the elderly, and many drugs are being developed for this purpose.
The most common form of the disease occurs when, although there is sufficient iron, the bone marrow is unable to introduce it into red blood cells. This type of disease is associated with cancer, chronic renal failure, collagen vascular pathologies or latent infection.
The problem arises due to the suppression of bone marrow by drugs: ACE inhibitors, sulfa antibiotics and anticonvulsants.
Iron deficiency anemia is observed in young women during heavy menstruation or after childbirth. But with age, nutrient absorption deteriorates or microbleeding occurs in the intestines. Anemia due to B12 deficiency is malignant because it requires taking large doses of the vitamin (1000 mcg per day) or injections.
Therapy consists of correcting the underlying disease, transfusion of red blood cells, administration of recombinant human erythropoietin, as well as taking the following drugs:
Treatment of anemia in older people should begin by eliminating the cause that caused the lack of iron: remove tumors, stop peptic ulcers, adjust diet, relieve intestinal inflammation.
Taking medications is the main method, since radical treatment options are limited by the patient's health condition. The daily dose should be 150–300 mg of ferrous sulfate or fumarate, 1–2 tablets.
The substance is taken with food. Tetracycline antibiotics, calcium and Almagel reduce the effectiveness of the drugs. For enteritis or preparation for surgery, they are administered intravenously or intramuscularly (Ektofer, FerrumLek).
The diet is saturated with foods high in iron: liver, beef, fish, eggs, herbs, legumes. Avoid alcohol and smoking, which provoke inflammatory reactions.
Simultaneously with the treatment of enteritis and the removal of helminths in case of B12 deficiency, the vitamin is administered intramuscularly every day to increase hemoglobin. If the deficiency is combined with a lack of iron, then complex therapy is indicated. When treated with cyanocobalamin, the need for iron increases.
Folic acid deficiency is eliminated by taking the drug at a dose of 5 mg per day. If the tumor and the cause of destruction of red blood cells cannot be cured, then vitamin B9 is prescribed over a long course. The diet is rich in buckwheat porridge, oatmeal, cauliflower, liver, and wholemeal products.
Pneumonia in older people is significantly different in nature from that in young people. This is mainly due to age-related changes in body tissues and decreased immunity. Timely diagnosis and competent therapy are of great importance in the survival of such patients.
A predisposing factor to the occurrence of senile pneumonia are irreversible degenerative processes in the tissues of the respiratory organs associated with age. Among them are the following:
The above and other processes lead to gas exchange disorders, tissue hypoxia, and high CO2 content in the bloodstream.
The development of pneumonia in older women and men is closely related to concomitant diseases. So, if a patient has a history of coronary heart disease or other cardiovascular disorders, then, in most cases, a focal type of disease is observed. In this case, patients over 85 years of age are diagnosed with macrofocal pneumonia.
Diseases of the respiratory system provoke the occurrence of an inflammatory process in segments of the lungs. In older people it is mainly segmental pneumonia, and in old age it is polysegmental. Bilateral pneumonia in older people develops with the simultaneous presence of diseases of the respiratory and cardiovascular systems, and is of a bilateral focal and lobar nature.
There are community-acquired and nosocomial (hospital) forms of pneumonia.
It should be noted that a third of cases of extensive pneumonia in elderly patients are caused by the action of several strains of bacteria, both gram (+) and gram (-).
Among the risk factors for developing pneumonia in elderly and geriatric patients are the following:
If more than two factors are present in older people, the prognosis for pneumonia cannot be considered favorable.
It is difficult to identify specific symptoms suitable for describing senile pneumonia. This is due to the fact that the clinical picture of the disease is not entirely clear. The inflammatory process in the lungs can be greatly “lubricated” due to the use of medications by patients needed to treat other diseases. In addition, due to reduced immunity in elderly and elderly people, inflammation of the lung tissue can be accompanied by a sharp exacerbation of chronic pathologies that are in remission, which also complicates a quick diagnosis.
Be sure to pay attention to the following symptoms:
Body temperature depends on the severity of the inflammatory process, so it can range from low-grade fever to 40 degrees or higher.
Among other extrapulmonary signs of pneumonia in the elderly are:
To prevent negative consequences, it is necessary to consult a doctor as early as possible and conduct a thorough differential diagnosis.
If pneumonia is suspected in older people, diagnostic measures, in addition to identifying the pathogen, are carried out to exclude diseases such as: malignant tumor, tuberculosis, collagenosis, heart failure and others. For this use:
The need for additional diagnostics is determined by a specialist based on the data obtained, the characteristics of the course of pneumonia in elderly patients, and their well-being.
If the diagnosis of pneumonia is confirmed, the elderly person is not necessarily immediately sent to hospital treatment. The decision to hospitalize is based on a combination of factors such as:
In addition, the doctor also takes into account the social status - the absence of relatives or close people in the elderly person.
Treatment of pneumonia in older people is multidirectional. Pneumonia occurs against the background of concomitant diseases (most of which worsen), which must be taken into account when drawing up a plan of therapeutic measures. In the acute period, treatment is aimed at:
In this case, replacement immunotherapy is required, as well as elimination of the symptoms of concomitant diseases. Only after the infection has been eliminated and the risk of complications has been significantly reduced, efforts are directed towards eliminating the inflammatory process, normalizing the functional activity of the lungs, and treating underlying pathologies.
Antibiotics constitute the main group of drugs in the treatment of pneumonia in old age. The choice of drug at the initial stages of therapy is carried out empirically, since the doctor does not yet have laboratory data on which pathogen caused the disease. Upon receipt of diagnostic results, treatment can be adjusted.
The following antibacterial agents are used for treatment:
The duration of treatment for pneumonia in the elderly and senile, just like in other patients, depends on the infectious agent. If the disease proceeds without complications, therapy does not exceed 10 days. For mycoplasma and chlamydia, antibiotics are used for about two weeks, and legionella requires 21 days. During the treatment process, a step-by-step approach is used: in the first days, the antibacterial drug is given intravenously or intramuscularly, then (subject to the improvement of the patient’s condition, confirmed by tests), the medication is taken orally.
In addition to antibiotics in old age, the use of:
As the condition stabilizes, the use of NSAIDs, bronchodilators, mucolytics and expectorants, and medicinal herbs is indicated. If necessary, it is possible to prescribe medications that have an antihistamine effect.
The consequences of pneumonia in a person aged 80 years and older largely depend on his care. It is especially difficult for older people to endure the need for bed rest, so loved ones should provide maximum psychological support, stimulate a positive mood, and promote activity.
The diet of older people with pneumonia should be small, light, rich in vitamins (especially antioxidants) and minerals. Preference should be given to dishes that help improve the functioning of the digestive tract. This applies to a greater extent to bedridden patients. The drinking regime is also aimed at detoxifying the body, so the volume of plain water should not be less than 1.5 liters per day.
With proper treatment, laboratory and clinical indicators can return to normal after 3-4 weeks. It should be noted that therapy after pneumonia in elderly patients does not end there. In the future, for a long time, they are prescribed physiotherapeutic procedures, courses of taking vitamins, exercise therapy, breathing exercises, alternative methods of treatment, rehabilitation measures, and sanatorium-resort treatment.
Why is lower lobe (extensive and other forms) pneumonia dangerous in old age? The main danger is that the treatment is not completed completely. In old age, complications can be fatal.
The consequences of late treatment and improper treatment may include:
Sometimes several complications develop at once.
Many patients are concerned about the question: what is the prognosis for lower lobe (or other) pneumonia, say, at 82 years old? To assess the degree of risk and predict recovery, the specialist uses a special scale of indicators, in which the patient’s age and condition (presence of underlying diseases) have significant weight. The prognosis is considered favorable if the patient is in good health, has normal diagnostic results and has a minimal number of chronic pathologies.
Prevention of pneumonia in elderly and senile patients is as follows:
If an elderly person is on constant bed rest, then loved ones should take care of timely and competent care, providing regular exercises, massage and a positive mood.
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