The elderly population is increasing rapidly in our country, as in the rest of the world, due to the increase in average life expectancy. This brings with it diseases. In fact, the biggest danger awaiting the elderly is not diseases but inactivity. The destructive effects of diseases are much greater in the inactive elderly.
In a person who exercises regularly every day, cholesterol decreases, blood pressure decreases, atherosclerosis slows down, muscle mass increases, bones become stronger, cardiovascular vessels are not clogged, and endurance increases. , body resistance increases, fewer infections occur. Exercise does not mean exercising at the gym every day. Regular walking every day is also an exercise. The benefits of exercise in older people increase exponentially. However, the tendency to move in the elderly decreases due to diseases or other reasons. For example, it is difficult for a patient with arthritis in his knees to walk. Or an elderly person with imbalance may be afraid of walking or exercising. An elderly patient living in a house without an elevator on the fourth floor may also remain immobile due to necessity. Many elderly people have many diseases together. They may be hospitalized from time to time due to these diseases. There are many other reasons for inactivity in the elderly. One way or another, most of the elderly population is less active due to the damage caused by diseases to their bodies, and some of them are less active due to the laziness that comes with age. The most important danger of this is the decrease in muscle mass. The natural decrease in muscle mass with age, or sarcopenia as it is known in medicine, is much more common in an inactive elderly person. The main consequence of decreased muscle mass is weakness. This weakness is usually followed by imbalance, walking difficulty and falls due to the effects of other diseases that most elderly people have. As a doctor dealing with rehabilitation, the most common sentence we hear from elderly relatives is "Before my doctor got sick, he could walk at home and more or less do his own business." But after he was hospitalized and discharged, we could not get him back on his feet.” In fact, the statement "he was more or less doing his own business" shows that the patient's walking capacity was at the limit. If such a patient were to stay in the hospital for, say, 10 days due to pneumonia, he would already lose another 10-20% of his muscle mass. this d It renders the patient, who can walk at the border, unable to walk. Another sentence we often hear from elderly relatives is, "Sir, after his fall, he stopped leaving the house, he doesn't want to walk anymore, he sits in front of the TV all day." This so-called actually refers to another phenomenon in the elderly, the fear of falling. Elderly patients may hesitate to walk for fear of breaking something, especially after falling several times, and may not want to go out. However, this does not protect them from falling because as they become weaker due to inactivity, they begin to fall at home. An even more disastrous scenario that we often see is that a patient who was operated on due to a hip fracture due to a fall and had to stay in the hospital cannot get up again, even if the operation is successful.
However, it is possible to rewind the aging movie to some extent. The only cure for this is exercise, that is, an active life. The elderly patient's knee-hip joint or waist-related musculoskeletal problems must be resolved and all necessary treatments must be carried out for diseases that will prevent him from walking. These patients should be rehabilitated at home or in a clinical setting. The ideal thing for patients is to have their treatments done by physiotherapists in physical therapy and rehabilitation centers. Rehabilitation centers can provide highly effective treatment for such elderly patients with the facilities they have. Computer-assisted balance rehabilitation and strengthening exercise programs are the basis of treatment for balance problems common in the elderly. The patient is initially rehabilitated 3-4 times a week in a clinical setting. Depending on the response to the treatment, treatment intervals are extended and the patient also completes the additional home exercise program given to him. After a while, these patients see that their balance improves, their muscle mass increases, their self-confidence returns, and their falls do not reoccur. When they are hospitalized for any reason, they do not have problems getting up after hospitalization because they have reserve muscle strength.
The importance of elderly patient rehabilitation (geriatric rehabilitation), which is very common abroad, is just now being understood in our country. Elderly people should be encouraged to exercise instead of sitting in a corner of the house. Otherwise, both they and their relatives will pay a heavy price for their inaction.
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