Preventive medecine: ageing

PREVENTIVE MEDECINE: AGEING

What is it?
Ageing is a normal process that starts in our mid-twenties. It is characterized by a decline in cardiovascular and respiratory fitness, a loss of muscle and bone, a thinning and wrinkling of the skin, a stiffening of the joints, a fall in sexual potency (especially in men) and many other more subtle changes. Many, if not most, of these changes appear simply to accompany the advancing years-there is no solid evidence that they are caused by growing old. For this reason it is at least theoretically possible that they can be slowed down, halted or even, on occasions, reversed.
The elderly and the very young are the greatest consumers of health services and the elderly are becoming very numerous. It is estimated that one third of all the people who have reached the age of 65 in the last 2,000 years are alive today! By the turn of the century one person in three will be over 75 and one in thirteen over 85.
The consequences of survival of the elderly on such a scale are so great that as yet few people have grasped them, but it is certain that the physical, mental and social demands of such a vast number of old people will be great and could even be beyond the ability of a decreasing working-age population to sustain.
All of this makes preventive strategies for the elderly vital for the community at large -not just to make life more pleasant for older people themselves (valuable though this undoubtedly is).
There is evidence that although people's life expectancy is rising actual lifespan is not. On average people are already remaining fitter for longer and have a shorter period of terminal dependency as a result of medical, social and economic changes that have taken place over the last century. The aim of prevention in old age is to prevent illness rather than postpone mortality. As one old lady put it, 'I want to die old, and healthy.'
But preventing the problems of old age does not just involve preventing illness in the commonly accepted sense of the word, because in the elderly, perhaps more than at any other age, social and other less well-defined factors come into play.

What causes it?
No one knows what causes the degeneration that currently goes hand in hand with advancing age, but we are only too aware of the results and it is these that need to be tackled in any preventive regime for the elderly. The most common specific problems are: iatrogenic disease; depression/anxiety; alcoholism; hypothermia; flu; constipation; tetanus; malnutrition; and high blood pressure. These are brought about not just by the degeneration process itself, but also by a general loss of fitness, and the social consequences of old age in our society.

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