“The health conditions of the elderly include improving lifestyle habits, regular checkups, and medication management”: Busan’s leading political opinion paper, Kukje Newspaper

-On General Hospital Geriatric Internal Medicine Clinic publishes Q&A data book

Last September, On General Hospital opened and operates the first geriatric internal medicine clinic in Busan, which efficiently treats and manages various diseases in the elderly. Eunmyeong, director of this clinic, recently published a resource book (‘Geriatric Internal Medicine and Geriatric Medicine to Respond to the Change to a Super-Aging Society’, page 43), gathering together the questions and curiosities frequently asked by patients who have visited the geriatric internal medicine clinic. Introducing the main Q&A included in the resource book.

Q: How do you manage common diseases in the elderly?

A: Diseases that occur frequently in the elderly require a systematic and individualized approach considering the patient’s health and vulnerability. The first is improving lifestyle habits. Regular physical activity, balanced nutrition, smoking cessation, and moderate alcohol consumption are important in preventing and managing cardiovascular disease, diabetes, and osteoporosis. In addition, we must pay attention to early detection and diagnosis of diseases through regular checkups and also pay attention to appropriate medication management. Drug management considers drug interactions, side effects, changes in drug metabolism, etc., and minimizes the risk of polypharmacy (using multiple types of drugs at the same time for one patient) through periodic drug reviews.

Q: What is the most important factor in mental health care in old age?

A: As with other diseases, early detection and appropriate treatment are key factors. Older people can face a variety of mental health problems, such as depression, anxiety disorders, and dementia, which require a multifaceted approach. Accordingly, the focus is on improving the patient’s mental health status, including drug and psychological treatment. Drug treatment can help relieve symptoms and improve function, and psychological therapy can help patients understand and adapt to their condition. Social support cannot be left out. This helps patients connect with local communities and facilitate social activities, which is important for reducing feelings of isolation and maintaining mental health.

Q: What is the prevention and management of osteoporosis?

A: Osteoporosis, which occurs frequently in the elderly, reduces bone density and strength, increasing the risk of fractures. To prevent this, it is good to consume enough calcium and vitamin D. Regular exercise, especially weight-bearing exercise and strength training, helps maintain and strengthen bone density. These activities promote bone health, improve balance and flexibility, and reduce the risk of falls. Smoking and excessive alcohol consumption have a negative effect on bone health and should be avoided.

Q: How should medication management and drug interaction issues be handled?

A: As we age, changes occur in drug metabolism and excretion processes, and this is because elderly patients are more sensitive to drug reactions. This may increase or decrease the effectiveness of the drug and increase the risk of side effects. Therefore, regular drug review and management is essential. Medication review evaluates all medications a patient is taking and reduces unnecessary ones. During this process, it is important to apply the ‘stop before you start’ principle to reduce the risk of drug interactions. This principle means starting the drug at a low dose and slowly adjusting the dose while observing the response. Careful monitoring of drug side effects is also necessary. Elderly patients often take multiple medications simultaneously, increasing the likelihood of side effects or drug interactions. Therefore, medical staff must be aware of all side effects that patients may experience and monitor them.

Q: What about the management and prevention of cardiovascular diseases related to aging?

A: It is important to effectively manage major risk factors for cardiovascular disease such as high blood pressure, high cholesterol, and diabetes. For example, high blood pressure can be managed with medication and lifestyle changes. This can reduce the risk of heart attack or stroke. Smoking cessation, a healthy diet, and regular exercise are key factors in preventing cardiovascular disease. Mediterranean and low-fat diets lower the risk of cardiovascular disease, and regular aerobic exercise helps improve heart health and manage weight.

Q: What is important in diagnosing and treating depression in old age?

A: Depression in old age can often be mistaken for or overlooked as a symptom of another illness. Accurate diagnosis requires a careful clinical evaluation of the patient’s emotional and behavioral symptoms, as well as physical health, history of drug use, or changes in daily life. To achieve this, standardized assessment tools should be used or the patient’s individual circumstances and medical history should be taken into account. Drug treatment for elderly patients with depression must be particularly cautious. Elderly patients metabolize drugs more slowly, are more likely to interact with other drugs, and may be more sensitive to side effects. Pharmacological/psychological therapy and cognitive behavioral therapy (CBT) are important in treating depression in old age. CBT can relieve symptoms of depression by helping you identify and change negative thinking patterns. Support from family and friends, participation in social activities, and professional counseling also help patients achieve emotional stability and recover from depression.