General Principles and Guidelines
Gerard Kerins, M.D., F.A.C.P.
To provide guidance in health promotion and disease prevention activities for those who are providing supports and services to people who are aging.
This advisory applies to all individuals of the department regardless of the facility or region in which they are served.
GENERAL PRINCIPLES and GUIDELINES
The following is a list of health promotion and disease prevention activities which should be incorporated into the general care of older adults including those persons with Down Syndrome who are aging. These principles can be incorporated into specific protocol development, and there are detailed references available for each of these recommendations should they be required as part of further program development.
- Frailty or the state of reduced physiological reserve has been shown in older adults to increase susceptibility to becoming disabled. A significant cause of frail health is physical inactivity potentiated by episodes of physiological loss due to illness and injury. Based on this, it is recommended that a low level exercise program, even a brief walking program be incorporated into the general care of all older adults.
- Cognitive decline is not a normal part of aging and although cognitive deficits and dementia are more common with older persons, many of the conditions that cause dementia and loss of cognitive ability can be prevented. We would recommend that any changes in cognitive capability and related functional decline be fully evaluated not only for reversible causes but also to explore modalities to slow decline should no reversible cause be found.
- Cancer screening should be an integral part of all health programs of older adults including those with Down Syndrome. Routine cancer screening should include:
- Colonoscopy once every 5 years after the age of 50
- Yearly fecal occult blood testing
- Yearly breast examination
- Annual Mammography
- Full GYN exam and Pap smears as indicated
- Yearly prostate examination
- Evaluation of prostatic specific antigen
The above are some brief broad guidelines to be incorporated into the routine care of older adults. As stated, they can be further elaborated to specific protocols which should be individualized as needed.