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Geriatric Health in KSA

Community Medicine Seminar - Medical College - King Saud University
by

Njoud Faisal

on 7 February 2014

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Transcript of Geriatric Health in KSA

Community Medicine Seminar
3 February - 2014

Geriatric Health in KSA
What do we mean by the word "Geriatrics" ?
Saudi Arabia 2013 Demographics Profile :
Risk Factors in the Geriatric Population
Prevention & Control
any Question?
References
Global Demographic Changes
The world population is rapidly ageing
2 billion people will be aged 60 and older by 2050
Low- and middle-income countries will experience the most rapid and dramatic demographic change
It took more than 100 years for the share of France's population aged 65 or older to double from 7 to 14%. In contrast, it will take countries like Brazil and China less than 25 years to reach the same growth.
The world will have more people who live to see their 80s or 90s than ever before
More children will know their grandparents and even their great-grandparents
Changing Age Structure in Saudi Arabia
Geriatric
Health Problems

What happen to our body ?!
Cell die
No adequate replacing
Decrease the number of cells
Decrease the body function
The most common illnesses
of elderly
1- Arthritis
2- Alzheimer’s disease
3-Parkinson’s disease
4- heart failure
5- Cancer

* Those will cause major effects on their life and health
Every single disease has its own risk factors; if we can avoid them we will avoid the disease itself. However some risk factors are associated with genes, aging, and gender and race, which the human cannot avoid them.
Here are some risk factors that associated with health problem of the geriatric:

"The ageing process is of course a biological reality which has its own dynamic.
In the developed world
,
chronological time plays a paramount role.
The age of 60 or 65 is said to be the beginning of old age.
In the developing world
,
socially constructed meanings of age are more significant
such as when active contribution is no longer possible." (Gorman, 2000)


-
What Is the Age of Geriatric ?
At the moment, there is no United Nations standard numerical criterion, but the UN agreed cutoff is
60+
years to refer to the older population.


Life Expectancy in Saudi Arabia :
Life Expectancy at Birth in Saudi Arabia gained 9.4 years from the period 1980-1985 to the period 2005 - 2010, increasing from

64.9
years to

74.3
years.
It is projected to reach
81.8
years for the period 2045 – 2050.

What is geriatric medicine ?
- Why we need geriatrics?
(Primary, Secondary & Tertiary)
aims to avert the development of disease, By :

-
Immunizations
-
Life style modifications
like : smoking cessation,
promoting physical activity
- For heart disease they may take
aspirin
 as primary
prevention.
1- healthy lifestyle :
may lower the risk of developing disability

2- Physical activity  :
Exercise benefits people of all ages and may decrease all cause morbidity and increase lifespan .

3- Tobacco use :
High-quality evidence demonstrates that smoking cessation significantly reduces the risk for :

1- coronary heart disease
2- various cancers
3- chronic obstructive pulmonary disease

4- Alcohol  :
 Approximately 15 percent of adults over age 65 years experience health problems related to the complications of alcohol consumption in combination with medication or chronic conditions.

5- Aspirin for primary prevention :  
"strongly recommend“ to adults who are at increased risk for cardiovascular disease.  benefits and risks of aspirin for coronary heart disease and stroke may differ in men and women. Aspirin appears to provide :
men
with protection from
first myocardial infarction
women
from
first ischemic stroke.

6- Vaccination :
1- Tetanus vaccine :
is important for adults +65 who have close contact with infants aged younger than one year (such as grandparents, child care providers, and health care providers
2- Influenza vaccine :
More than 90 percent of influenza-related deaths occur among people +60 years of age.
3- Pneumococcal vaccine :
 All adults 65 years of age and older should receive a dose of 23-valent polysaccharide vaccine (PPSV23) even if they were vaccinated when they were younger than 65 years of age.
4- Herpes zoster vaccine

Secondary Prevention
Primary prevention

Geriatric Screening Programs :
Blood Pressure.
Cholesterol.
Diabetes Screening.
Colon Cancer Screening.
Vision Exam.
Hearing Screening.
Women :
Breast Cancer Screening.
Cervical Cancer Screening.
Osteoporosis.

Men :
Prostate Cancer Screening.

Tertiary Prevention
First:
Home care program
Second: Social care homes
These homes receives elderly - from both sexes – who are unable to work, service themselves or patients who have reached 60 years of living with a physical or mental defect so they lost their ability to work or take care for themselves. Social care home provide for them full social and health care, psychological services, physical therapy programs and personal care.
Home care program and social care home are available in major cities like Riyadh, Dammam, Makkah, Madinah, etc

Furthermore, there are some
private charity centers
for geriatrics like:

-"
Charity group to take care of human
" in Jeddah.
-"
Brotherhood
" for the care of the elderly in Rass.
-"
Home of happiness
" or the elderly care in Madinah.
-
Sayhat charity group for Social Services
in Dammam.
-
Elderly Care Center
in Qassim.

Geriatric Medicine
Geriatrics is the
subspecialty
of
internal medicine
concerned with the health and well-being of elderly .
Who is geriatrician?
A physician specialized in management & care of elderly people. Treating the medical disorders that frequently affect them, including :

Falls and Immobility
Osteoporosis and arthritis
Memory loss and dementia
Hypertension and diabetes
Heart disease
Urinary incontinence
when does it start?
The first book to offer instruction for the care of the elderly people is
The Canon of Medicine
, written by
Avicenna
in 1025.

The word “geriatrics” was invented by an American physician
Ignatz Nascher
at 1909.

However,
clinical geriatrics
really started in Great Britain in 1910, 1920.

Later, in 1950 the first geriatric program was officially established in US.
American invented the word “Geriatrics”.

However, the English invented the specialty :)
How to be a geriatrician?
In USA :
Specialized in
internal medicine
or
family medicine
complete a 1 or 2 year fellowship in geriatric medicine.

In Sweden :
Geriatric medicine started 1969. Then in 2005 it was decided that geriatrics could remain as a

specialty of its own
and

not to be a subspecialty of Internal Medicine
. After graduating, you have to complete 5 years on geriatrics.

In Saudi Arabia :
Not found in Saudi Commission for Health specialties.
However, we have
Geriatric Medicine clinic
in

King Abdulaziz Medical City in Riyadh
. It was established in January 2006.



As a health care provider, you will be dealing with elderly people
no matter what specialty you choose
, even pediatricians deal with grandparents raising grandchildren.
The Demographic changes :
The demographics of the United States are changing. Between 2010 and 2030, the
population over 65 will increase by 72% in 2030!
Seventy million people will be over 65 (
One out of every five Americans
).


increase life expectancy:
Improvement of living conditions
Improvement in healthcare facilities
Reduce mortality

* Average lifespan is increasing,
but maximum lifespan is the same!


* Elderly have multiple
Chronic Conditions.
They may suffer from common
errors
including iatrogenic problems by
poly-pharmacy
or by prescribing normal adult doses to elderly patients.
So

they need a special care.
Good geriatric healthcare
, will result in :
Improvement in quality of life
Low morbidity, and mortality
Maintenance of independence

1- Who.int. WHO | Interesting facts about ageing. [Online] Available from: http://www.who.int/ageing/about/facts/en/index.html [Accessed 27 Jan 2014].

2- UN-ESCWA. The Demographic Profile of Saudi Arabia. [e-book] United Nations Economic and Social Commission for Western Asia.; 2011. Available from: http://www.escwa.un.org/popin/members/SaudiArabia.pdf

3- who.int. 2013. who | definition of an older or elderly person. [online] available at: http://www.who.int/healthinfo/survey/ageingdefnolder/en/ [accessed: 23 dec 2013].

from: http://www.mayoclinic.org/diseases-conditions/osteoarthritis/basics/risk-factors/CON-20014749.

9- Mayo Clinic Staff MC. Mayo Clinic, [homepage on the Internet]. Jun. 21, 2013 [cited 2013 Dec 21]. Available from: http://www.mayoclinic.org/diseases-conditions/osteoporosis/basics/risk-factors/CON-20019924.

10- Mayo Clinic Staff MC. Mayo Clinic, [homepage on the Internet]. Jan. 25, 2013 [cited 2013 Dec 21]. Available from: http://www.mayoclinic.org/diseases-conditions/type-2-diabetes/basics/risk-factors/CON-20031902.
Source: UN-ESCWA
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