Ageing well in Morocco, in good health
Geriatricians, falls prevention, chronic conditions, maintaining autonomy after 65.
Health priorities after 65
Osteoporosis
Densitometry, vitamin D, calcium, bisphosphonates
Memory & Alzheimer's
MMSE test, brain MRI, cognitive stimulation
Polypharmacy
Prescription review, deprescribing, iatrogenesis
Hypertension
Self-measurement, suitable treatment, kidney follow-up
Falls prevention
Home adaptations, balance exercises
Hearing & vision
Audiogram, cataracts, glaucoma, glasses
Senior vaccines
Flu, Covid, shingles, pneumococcal
Undernutrition
MNA assessment, supplements, texture adaptation
Autonomy levels (GIR)
National grid for assessing dependency, used by professionals.
GIR 1-2 — High dependency
Bedridden, severe cognitive impairment. Daily nursing assistance, care home.
GIR 3-4 — Moderate dependency
Help with daily activities. Home help, home nursing.
GIR 5-6 — Relative autonomy
Independent but health vigilance needed. Pharmacy visits, annual geriatrician.
Frequently asked questions
When should I see a geriatrician?+
From age 75, or earlier in case of multiple conditions (diabetes + cardio + memory), repeated falls, polypharmacy (> 5 medicines), cognitive issues. The geriatrician coordinates all specialists and prevents drug-related harm.
How can I prevent falls at home?+
Adapt: remove rugs, fit grab bars in shower/WC, night lighting, closed shoes. Maintain: corrected vision, daily exercise (walking, balance), vitamin D. Review prescription with your doctor (antihypertensives, sleeping pills).
Are medicines dangerous for seniors?+
Drug-related harm causes 10-20% of hospital admissions after 75. Causes: polypharmacy (interactions), slower metabolism, reduced kidney function. See a geriatrician every 6-12 months for a prescription review and deprescribing if possible.
What does CNOPS/CNSS cover for seniors?+
Public schemes cover all chronic conditions at 100% via ALD (hypertension, diabetes, heart failure, Alzheimer's). Home nursing care is reimbursed. Home helpers are not covered. Plan for complementary cover for comfort, orthopaedics and hearing.
How can I help a relative who is losing memory?+
Neurology or geriatric consultation with MMSE/MoCA test. Brain MRI + blood test to rule out treatable causes (B12, thyroid). If Alzheimer's is diagnosed: support associations, day centres, plan legal protection (advance mandate).
Comprehensive geriatric assessment — the 7 pillars
Multidimensional assessment recommended by the French Society of Geriatrics and the WHO for any senior aged ≥ 75.
Cognition
MMSE, MoCA — screening for dementia, Alzheimer's, mild cognitive decline
Mobility & balance
Tinetti test, timed-up-and-go — falls prevention
Vision & hearing
Visual acuity, audiometry — correction is essential
Nutrition
MNA (Mini Nutritional Assessment), albumin — screen for undernutrition
Polypharmacy
Medication review (STOPP/START criteria), iatrogenesis
Mood
GDS (Geriatric Depression Scale) — depression frequent and undertreated
Autonomy (ADL/IADL)
Daily activities + staying at home
Falls prevention — the leading cause of hospitalisation for seniors
1 in 3 Moroccans over 65 has at least one fall a year (Ministry of Health estimate). 15 000 hip fractures/year (20% mortality at 1 year).
Safe home
Lighting (nightlights), non-slip rugs, WC/shower grab bars, stairs with handrails
Footwear
Closed, flat-heeled, non-slip soles — avoid babouches/slippery slippers
Medication
Review: avoid benzodiazepines, hypnotics, some antihypertensives — risk of orthostatic hypotension
Vision & hearing
Up-to-date glasses correction, hearing aids if needed
Physical activity
Tai-chi, Nordic walking, muscle strengthening 2-3x/week — reduces falls by 40%
Vitamin D + calcium
800-1 000 IU/day vit D + 1 000-1 200 mg calcium — reduces fractures
Night-time setup
Urinal by the bed, nightlight to the WC, accessible phone
Tele-assistance
Alarm bracelet/pendant — essential for isolated seniors