TABLE 6-3 Areas Potentially Amenable to Preventive Health Care in the Elderly

Primary

Secondary

Tertiary

Health habits

Screening for

Rehabilitation

Smoking

Hypertension

Physical deficits

Alcohol abuse

Diabetes

Cognitive deficits

Obesity

Periodontal disease

Functional deficits

Nutrition

Dental caries

 

Physical activity

Sensory impairment

 

Sleep

Medication side effects

Caretaker support

 

Colorectal cancer

Introduction of

Coronary heart disease risk

Breast cancer

support necessary

factors

Cervical cancer

to prevent loss

 

Prostatic cancer

of autonomy

Immunization

Nutritionally induced

 

Influenza

anemia

 

Pneumovax

Depression, stress

 

Tetanus

Urinary incontinence

 

 

Podiatric problems

 

Injury prevention

Fall risk

 

Iatrogenesis prevention

Tuberculosis (high risk)

 

Osteoporosis prevention

Syphilis (high risk)

 

 

Stroke prevention

 

 

Myocardial infarction

 

 

SOURCE: German and Fried, 1989. Reproduced with permission from the Annual Review of Public Health, Vol. 10. Copyright, 1989, by Annual Reviews, Inc.

targets for disability prevention. For example, inappropriate prescribing of medications by physicians and improper use of drugs among the elderly pose serious risks to physical and mental health. Certain medications can cause drowsiness or impair coordination, increasing the likelihood of falls and injuries; they can also reduce appetite, resulting in nutritional deficiencies. Thus improved education and training of physicians that places greater emphasis on prescribing and drug-monitoring practices that are tailored to the elderly would be beneficial in preventing these conditions. Also needed are public education programs and drug labeling practices that foster greater awareness of proper use of medications, particularly when multiple drugs are involved (Montamat et al., 1989).

Injury prevention is especially important for the elderly. The incidence of falls increases greatly after age 65. Combined with the high prevalence of osteoporosis among the elderly, falls are responsible for a large portion



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