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Zhou Yan
Geriatrics
About me
Member of the 7th Rehabilitation Professional Committee of the Chinese Society of Rehabilitation Medicine, and Chairman of the 1st Youth Committee of the Geriatric Health Medical Professional Committee of the Hunan Provincial Women Physicians Association.
Proficient in diseases
Specializes in geriatric internal medicine diseases, particularly in the rescue of cardiovascular critical illnesses such as acute coronary syndrome, hypertensive crisis, malignant arrhythmia, acute heart failure, etc.
Voices
How to treat geriatric depression effectively?
Elderly depression should be treated comprehensively. Firstly, it is important to enhance the diet and supplement nutrition. Secondly, through psychotherapy, mainly to alleviate or relieve symptoms, improve patients' compliance with drug treatment, and reduce or eliminate the adverse consequences of the disease. Thirdly, pharmacotherapy can involve the use of selective serotonin reuptake inhibitors, selective serotonin, and norepinephrine reuptake inhibitors, which are widely used in the treatment of elderly patients with depression. Fourth, modified electroconvulsive therapy is an option. Through the aforementioned comprehensive treatment, the clinical symptoms of depression can be improved. (Medication should be used under the guidance of a physician.)
Early symptoms of Parkinson's disease
The clinical manifestations of Parkinson's disease are divided into two major categories. One category includes motor symptoms related to damage to the dopaminergic system. The other category includes non-motor symptoms related to damage to non-dopaminergic systems. The non-motor symptoms of Parkinson's disease can appear at various stages, especially before the onset of motor symptoms, such as loss of smell, rapid eye movement sleep behavior disorder, constipation, and depression, which are often early symptoms of the disease. However, because the onset of the disease in patients is relatively hidden, the initial symptoms are often tremors, but can also be bradykinesia or stiffness, with the majority of these cases being diagnosed based on these symptoms. Therefore, when a patient has loss of smell, constipation, depression, or sleep behavior disorder, the possibility of Parkinson's tremor paralysis should be considered.
Can arteriosclerosis be cured?
There are currently many data to prove that the progression of arteriosclerotic lesions is not irreversible. Through angiography or intravascular ultrasound, it has been confirmed that early arteriosclerotic lesions can partially recede after controlling and treating risk factors for a period of time. This demonstrates that arteriosclerosis can be actively managed by controlling its risk factors, such as abnormal blood lipids, hypertension, smoking, diabetes, reduced glucose tolerance, obesity, Type A personality, and dietary patterns, and it can be treated. However, there are three aspects that are still uncontrollable: age, gender, and family history. This indicates that it is not possible to completely cure the condition; it can only alleviate the progression of the disease.
Is the elderly person's diabetes severe?
Elderly diabetes often begins in a concealed manner, lacking the typical symptoms of excessive drinking, eating, urination, and weight loss. At the same time, it has many complications, such as diabetic peripheral neuropathy, diabetic retinopathy, diabetic nephropathy, and diabetic cardiopathy, making its manifestations more diverse and extensive. In addition, it can be complicated by infections, ketoacidosis, and hyperosmolar hyperglycemic syndrome, both of which have very high mortality rates. Fourthly, diabetes often coexists with multiple chronic diseases in the elderly, including angina, hyperlipidemia, hypertension, and heart failure, thus increasing the risk associated with polypharmacy. Fifthly, hypoglycemia can easily occur and is difficult to diagnose and treat promptly, often leading to severe adverse events such as falls and cardiovascular incidents. Therefore, we should pay more attention to diabetes in elderly individuals, managing it more thoroughly to enable a happier life in their later years.
Can acupuncture be used for Parkinson's disease?
The treatment of Parkinson’s disease is comprehensive, where pharmacotherapy is the core method, supplemented by surgical treatments. Additionally, physical rehabilitation and psychotherapy can also be performed. For Parkinson's patients, acupuncture is an option. Since elderly Parkinson's patients may suffer from other illnesses, acupuncture can help alleviate symptoms of these additional ailments. If patients wish to use acupuncture to improve symptoms of Parkinson’s disease, it is feasible. However, it cannot cure the disease or solve the fundamental problem; it can only alleviate symptoms and enhance the quality of life.
What is the best treatment for cerebral infarction?
In the treatment of cerebral infarction, there is no best option, only the most suitable one based on the different conditions at the time. Generally speaking, there are several major aspects. First, it is necessary to improve cerebral circulation. One method is thrombolysis, and another is interventional treatment. One of these two approaches is chosen depending on the specific conditions, including corresponding contraindications and indications. Next, treatments can include antiplatelet aggregation, anticoagulation, fibrinolytic therapy, volume expansion, vasodilation, and improving cerebral blood circulation. Furthermore, there is neuroprotective treatment and other therapies like hyperbaric oxygen and hypothermia. Another major category is general management, which, in addition to symptomatic treatment, includes life support such as oxygenation, cardiac monitoring, managing cardiac complications, temperature control, blood pressure control, blood sugar control, and nutritional support. Additionally, there is treatment for acute-phase complications such as cerebral edema, epilepsy, swallowing difficulties, pneumonia, urinary retention and infection, and deep vein thrombosis. Finally, there is early rehabilitation therapy. After a stroke, in a stable condition, it is important to engage in activities such as sitting, standing, and walking as much as possible, and to focus on rehabilitation training in speech, movement, psychology, and other aspects, aiming to quickly restore the ability to perform daily activities independently.
Is elderly depression easy to treat?
Depression in the elderly is difficult to treat because compared to younger patients, depression in the elderly tends to last longer with an average duration often exceeding one year, and episodes occur more frequently, often becoming chronic. Additionally, the prognosis for elderly depression is worse compared to other age groups, primarily due to the coexistence of cerebrovascular diseases and other physical comorbidities, recent acute illnesses, long-term ongoing diseases, as well as the presence of delusions and a lack of social support systems. Thus, depression in the elderly is quite challenging to treat.
Symptoms of diabetes in the elderly
Elderly diabetes often begins inconspicuously, lacking the typical symptoms of excessive thirst, urination, hunger, and weight loss. It can present with various complications such as diarrhea, constipation, urinary retention, limb numbness, skin itching, and shoulder joint pain. Elderly diabetics often have concurrent infections, particularly in the respiratory and urinary systems, as well as cholecystitis and skin infections. They may also suffer from ketoacidosis, hyperosmolar hyperglycemia syndrome, and coexist with multiple chronic diseases of old age such as heart failure, coronary heart disease, hypertension, and hyperlipidemia. They require different types of medications and are susceptible to hypoglycemia, making timely diagnosis and treatment challenging. These are the symptoms of diabetes in the elderly.
Parkinson's disease skin symptoms
In Parkinson's disease, there are two main types of clinical manifestations. One is motor symptoms associated with damage to the dopaminergic system, and the other is non-motor symptoms related to damage of non-dopaminergic systems. The non-motor symptoms include olfactory dysfunction, sleep disorders, mood disorders, as well as cognitive and psychiatric behavioral disturbances. Additionally, there are dysfunctions of the autonomic nervous system, which manifest in the gastrointestinal tract mainly as constipation, and in the urinary system as urinary incontinence, urinary frequency, urinary retention, and sexual dysfunction. There also occurs orthostatic hypotension, along with changes in the skin. Some patients may experience abnormal increases or decreases in sweating and abnormal secretion of sebum in the facial area, which are specific skin symptoms of Parkinson's disease.
Initial symptoms of Parkinson's disease
The early symptoms of Parkinson's disease are divided into motor symptoms and non-motor symptoms. The onset of Parkinson's disease is relatively concealed and progresses gradually. The initial symptoms can be tremors, bradykinesia, or rigidity, occurring asymmetrically. It often starts in one upper limb and can initially appear in the lower limbs in a few cases, gradually extending to the limbs on the other side. Non-motor symptoms can occur at any stage of Parkinson's disease, including before motor symptoms arise, such as loss of smell, rapid eye movement sleep behavior disorder, constipation, and depression. These are often precursory symptoms of Parkinson’s disease, but such non-motor symptoms can also appear in other diseases, which can make them difficult to clearly distinguish.