Health Promotion Guidelines for Adults and the Elderly
Health Promotion in Adults and the Elderly
Adult Program (25-64 Years Old)
1A. Health Problems
Adult Health: Leading causes of death include violence, cancer, cardiovascular diseases, and digestive diseases.
Morbidity: Common health issues include digestive diseases, trauma, musculoskeletal disorders, mental health disorders, and more. Chronic diseases and accidents are significant concerns for adults.
Levels of Prevention
- Primary
- Secondary
- Tertiary
1B. Program Objectives
- Reduce the number of people with low functional reserve (FR).
- Increase the identification of asymptomatic carriers.
- Increase the number of hypertensive patients who are properly controlled.
- Reduce complications and consequences of health conditions.
- Raise the overall health standard of the population.
- Empower patients and families to take control of their health through active participation.
- Contribute to increasing the level of healthcare coverage.
1C. Cancer Prevention
Cancer is prevalent in Western countries, with frequency increasing with age. It is the second leading cause of death (after cardiovascular disease) for individuals aged 35-64.
Primary Prevention
Focuses on reducing cancer incidence by addressing risk factors.
Secondary Prevention
Aims to detect cancer in its early stages before symptoms appear.
Colorectal Cancer Screening
- Fecal occult blood test
- Digital rectal examination
- Sigmoidoscopy
Recommendations vary based on individual risk factors and age.
Other Cancers
- Prostate Cancer: No evidence-based screening recommendations currently exist.
- Skin Cancer: Encourage sun exposure awareness and sunscreen use. Community campaigns can promote prevention strategies, and individuals with risk factors should receive counseling and regular skin examinations.
Health Promotion in Aging
High-Risk Individuals
- Living alone
- Recently discharged from the hospital
- Over 80 years old
- Homebound
- Experiencing disabling organic pathology
Objectives
- Provide home healthcare services to maintain an acceptable quality of life.
- Prevent or delay institutionalization.
Activities
- Comprehensive assessment of living conditions
- Immunizations
- Targeted care for identified problems
Geriatric Health Promotion: Specific Recommendations for the Elderly
1. Fall Prevention
- Physical exercise, including balance and strength training
- Educate caregivers and family members on fall prevention measures, such as exercise, home safety modifications, and medication monitoring
- For high-risk individuals, implement a multifactorial intervention plan, including physical exercise, medication review, psychological support, and environmental modifications
2. Vision Changes
- Annual eye exams for all elderly individuals
- Diabetic patients and those with high intraocular pressure (IOP) should receive more frequent eye care
3. Hearing Loss
- Conduct regular hearing screenings, especially for those with a family history of hearing loss
- Advise on the use of hearing aids when appropriate
4. Dementia
- Be alert for symptoms such as memory loss, impaired functioning, or behavioral changes reported by the patient or family members
5. Inappropriate Medication Use
- Utilize computer systems for medication tracking and management
- Provide patient education on medications
- Conduct periodic medication reviews
- Offer training for healthcare professionals on appropriate prescribing practices
6. Urinary Incontinence
- Inquire about urine leakage during routine checkups
- Initiate appropriate investigations for urinary incontinence (UI)
7. Malnutrition
- Regularly monitor weight and height
- Weight loss is a significant indicator of potential malnutrition and requires further assessment
Detection and Prevention of Risk Factors
1. High Blood Pressure (HBP)
- Defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg
- Diagnosis requires at least three separate readings on different occasions, with blood pressure taken at least twice, one minute apart, during each visit
- Screening frequency varies by age
2. High Cholesterol
- Hypercholesterolemia is defined as total cholesterol ≥ 250 mg/dL, confirmed on two separate occasions
- Screening frequency varies by age and gender
3. Smoking Prevention
- Smoking is defined as having smoked any amount of cigarettes daily in the past month
- Provide counseling, support, and monitoring to individuals who smoke
- Assess their readiness to quit and address nicotine dependence
- Offer follow-up support for at least one year after quitting
4. Physical Activity
- An active person engages in more than 30 minutes of physical activity most days of the week, with a total daily energy expenditure of approximately 3000 kcal
- Encourage physical activity through questioning, information sharing, advice, and monitoring
- Follow-up on physical activity levels regularly
5. Obesity
- Obesity is defined as a body mass index (BMI) ≥ 30 kg/m²
- Overweight is defined as a BMI between 25 and 30 kg/m²
- Measure weight and height to calculate BMI
- The goal is to achieve a BMI below 30 through diet, exercise, and psychological support
- Monitor BMI regularly
Calculating Total Coronary Risk
1. Patients with Cardiovascular Disease
- Address risk factors such as smoking, high blood pressure, high cholesterol, and low HDL cholesterol
- Smoking cessation is crucial
2. Patients at High Cardiovascular Risk
- Defined as having a 20% or greater risk of developing cardiovascular disease in the next 10 years
- Address smoking, high blood pressure, and high cholesterol
3. Patients with Moderate Cardiovascular Risk
- Defined as having one or more cardiovascular risk factors and a less than 20% risk of developing cardiovascular disease in the next 10 years
- Address high blood pressure and high cholesterol
4. People with Low Cardiovascular Risk
- No cardiovascular risk factors present
- Maintain regular monitoring of cardiovascular risk factors
Infectious Diseases
: PPD is recommended for: persons
HIV positive, users of intravenous drugs, close contacts with
TB case smear-positive immunocompromised, chronic illness anergy –
zante; destitute ethnic minorities in low-income, immigrant
from countries with high endecimidad, residents in institutions
closed, prison inmates in situ; professionals who can
trasmisitir TB to the community.