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Important health conditions to look out for |
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In addition to checking for high blood pressure, high cholesterol and high sugar level, the following are some health conditions that you can look out for. |
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Cataracts |
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Cataract describes any lens opacity. The symptoms depend on the degree and the site of opacity. Cataract causes gradual visual loss with normal direct pupillary light reflex. Prevalence of cataracts increases with age: 65% at age 50 to 59, and all people aged over 80 have opacities.
Usual causes of cataracts:
- Age
- Diabetes mellitus
- Prolonged usage of steroids
- Radiation: long exposure to UV light
- Infection: Uveitis
Typical symptoms:
- Reading difficulty
- Difficulty in recognizing faces
- Problems with driving, especially at night
- Difficulty with television viewing
- Reduced ability to see in bright light
- Haloes around lights
Management Unfortunately, there is no effective medical treatment for established cataracts. Usually, the patient is advised to undergo lens replacement when the patient can’t cope. Cataracts are usually removed in two ways, depending on the advice of the eye professional: Phacoemulsification or extracapsular surgery.
Postoperative management
- Avoiding bending for a few weeks
- Avoid strenuous exercise
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Osteoporosis |
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Osteoporosis is a condition in which the bones become weak and brittle, resulting in a greater likelihood of breaking after minor trauma.
Should you be screened for osteoporosis?
If you are adult around age 50 and have the following risk factors:
- Personal history of past fracture as an adult
- History of fracture in an immediate relative (especially mother)
- Low body weight
- Smoker
- Heavy alcohol drinker
- Early menopause / Artificial menopause (surgical removal of the ovaries before the age of 45)
- Long term medications, eg: steroids, thyroid medications
- Prolong period of immobility
- Low calcium intake for most of your life (< 500mg/day)
- Lack of regular exercise
What are the screening tests available?
Osteoporosis self assessment tool for Asians (OSTA). For those who have not suffered fractures, OSTA is a quick and effective test to determine your risk of osteoporosis. OSTA, which is based on age and weight, groups Asian women who have reached menopause into high, moderate or low risk of having osteoporosis. If your risk is moderate or high, consult your doctor for sceening.
Osteoporosis can be easily detected through a simple procedure called dual energy x-ray absorptiometry (DXA) and the tests scans your lower back, hip region or wrist. This test measures the density of your bones (Bone mineral density – BMD), indicating your risk of fracture at the most common sites affected.
You could measure BMD annually if you are being followed up for osteoporosis. Frequency of screening varies from 1 – 5 years if you have mild decrease in your bone mass / osteopenia & once in 5 years if your bone mass is normal. Why? For elderly patients, there is a high morbidity and mortality rate for patients who suffer from fractures.
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Osteoarthritis |
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OA is the most common type of arthritis, occurring in about 10% of the adult population and in 50% of those aged above 60. It is a degenerative disease of cartilage and may be primary (idiopathic) or secondary to causes such as previous trauma, sepsis.
OA presents mainly as pain – worse at the end of the day, worsen with activity, relieved with rest, and worse in cold weather. At the affected joints, the patient may notice some physical deformity - hard and bony swellings with crepitus. However, there should not be any systemic manifestations, which characterizes other arthritis, eg: inflammatory arthritis
Diagnosis of this condition is clinical and radiological, but the degree of Xray changes do not always correspond to the levels of symptoms.
Management of OA always starts with lifestyle modifications before more invasive treatment options are considered.
Lifestyle modifications
- Education: provide patient with information and reassurances that arthritis is not crippling disease perceived by most patients.
- Exercise: A low intensity graduated exercise programme is essential to maintain joint function.
- Rest: Prolonged bed rest is not advised; however short period of rest is advised only if there is acute episode of joint pain.
- Diet: If a patient is overweight, it is advisable to reduce weight to reduce the stress placed on the joint. Obesity increases the risk of OA of the knee about 4 times, and weight loss may slow progression.
- Physiotherapy might be useful to educate patients about the various strengthening exercises, eg: for the neck , back, quadriceps etc.
- Supplements: Glucosamine might be useful in reducing pain
Medications
- Simple analgesias, eg: paracetamol are useful in controlling mild to occasional moderate pain. However, if the pain increases to moderate in severity, NSAIDs can be used carefully, as the significant risks of NSAIDs are:
- Gastric erosions with bleeding
- Worsening of kidney function
- Hepatotoxicity
- Intra-articular corticosteroids or hylans should be used judiciously in selected cases.
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