The Warren Alpert Medical School of Brown University, Providence, RI 02912, USA.
Aging Clin Exp Res. 2010 Jun;22(3):219-30. doi: 10.1007/BF03324800.
Across the world, there are substantial but missed opportunities for promoting health of older persons and extending the healthy life span. Current approaches to health care rely on late detection and treatment of disease, and some of the most expensive systems of care have population health outcomes that are poor to mediocre. A majority of deaths and disability result from progression of preventable chronic diseases for which human behaviors are major contributing factors. An organized and aggressive agenda in health promotion and disease prevention emerges as an important part of the strategy to both promote health and control costs. After reviewing data on determinants of health and contribution of behavioral factors to morbidity and mortality, this paper presents the evidence for efficacy and effectiveness of specific behavioral and clinical interventions to reduce risk for many of the problems accounting for death and disability among elders. We address tobacco use, lack of exercise, inadequate nutrition, hypertension, delirium, obesity, falls, cancer screening, poor oral health, osteoporosis, immunizations and medication safety. Strategies for implementation of effective interventions present an international challenge.
在全球范围内，有很多促进老年人健康和延长健康寿命的机会，但都错失了。当前的医疗保健方法依赖于疾病的晚期检测和治疗，一些最昂贵的医疗系统的人群健康结果也很差或中等。大多数死亡和残疾是由可预防的慢性疾病引起的，而人类行为是这些疾病的主要促成因素。促进健康和控制成本的策略中，出现了一项有组织的、积极主动的健康促进和疾病预防议程。在审查了健康决定因素的数据以及行为因素对发病率和死亡率的贡献之后，本文提出了具体行为和临床干预措施的功效和有效性的证据，这些措施可以降低许多导致老年人死亡和残疾的风险。我们讨论了吸烟、缺乏运动、营养不足、高血压、谵妄、肥胖、跌倒、癌症筛查、口腔健康不良、骨质疏松症、免疫接种和药物安全。实施有效干预措施的策略提出了一个国际挑战。
