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Aging Wisely

Nationally—and globally—the population of aging adults is growing. Research reveals that 8.5 percent of the world's population is 65 and older. That number is projected to expand to almost 17 percent by 2050. Experts predict the population of those 80 and older will more than triple by 2050.

By Cynthia McFarland - Tuesday, October 25, 2016

Nationally—and globally—the population of aging adults is growing. Research reveals that 8.5 percent of the world’s population is 65 and older. That number is projected to expand to almost 17 percent by 2050. Experts predict the population of those 80 and older will more than triple by 2050.

“In the United States, the population of those 85 and above is the most rapidly-growing segment of our society,” observes Michael Wasserman, M.D., a member of the American Geriatrics Society and an expert on aging.

For the average person, peak physical function occurs around age 30.

For some, though, age is just a number it seems. As actress Bette Davis said, “old age ain’t no place for sissies,” but that hardly means it’s all downhill after 30.

“Studies have shown that much of what we used to think of as the inevitable decline in muscle mass, strength and even aerobic capacity that begins in your 40s can be slowed—or even staved off—through exercise and proper diet. This ability to maintain and slow the aging process appears to be for as long as you keep working at it,” notes Wasserman, who has been a geriatrician since 1989.

“The best example is how proper diet and exercise can literally reverse diabetic blood sugar levels,” he adds. But the No. 1 thing anyone can do to improve their health, at any age, is not smoke.

“It drives me nuts when doctors prescribe cholesterol medication for smokers. That’s like trying to shoot down a missile with a bow and arrow,” says Wasserman.

“If someone smokes, to bother with all the other areas—even diet and exercise—is almost nonsensical. I say this with 30 years of experience in caring for people in their 80s and above. It is rare for me to meet 80 and 90 year olds who were smokers. If you smoke, you will probably not live into your 80s or beyond.

“Your 40s, 50s and 60s are really the decades to do everything you can to take better care of yourself,” Wasserman emphasizes. “Treat what has to be treated, but try to reverse what can be changed.”

Your 40s

“In the last decade we’ve seen 80 year olds competing in Ironman,” says Wasserman.“There’s no question the things you start doing in your 40s can carry you on until the end.”

What To Watch For Now

Changes in skin tone and texture. Sun damage becomes more obvious, including wrinkles, dark spots, freckles, discolorations and blotchiness, with duller tone overall. Skin may become drier, pores tend to look larger. Collagen is starting to break down, resulting in loss of fullness.

Hair changes. For many people, this is the decade when those first gray hairs pop up. Hair texture can also become more coarse and color more dull.

Vision changes. Many will start wearing readers or “cheaters,” thanks to a common condition known as presbyopia, in which the lens of the eye stiffens, making it difficult to refocus from distance to close-up vision.

Weight gain. Unless you’ve become a major couch potato, blame that extra pudge around your middle on a slower metabolism.

Decreased muscle mass and tone. Research shows that the average person in their 40s loses about 1 percent of muscle mass each year. That doesn’t sound too bad until you consider it’s possible to lose 10 percent of your muscle mass by the time you hit 50.

Fight Back

Be vigilant with sunscreen. Wear it daily, opting for a minimum of 30 SPF, preferably higher.

Moisturize faithfully. Use skin care products with ingredients that help improve firmness and texture, such as retinoids, antioxidants and alpha hydroxy acids.

Schedule an eye exam if you experience blurriness or changes in vision.

Wear sunglasses faithfully, as long-term exposure to sunlight is blamed for a higher risk of cataracts as you age.

Make over your diet, incorporating lean protein and foods rich in fiber like vegetables, fruit and whole grains, while cutting out processed foods, saturated fats and excess sugar. If your diet doesn’t contain enough essential nutrients, consider taking supplements.

Add weight training to your workout if you’re already exercising, and if you aren’t, start now! Include a combination of cardiovascular activity (walk, run, ride a bike) and strength training.

Include exercises such as yoga or Pilates to strengthen your core.

Screenings and Tests

Blood pressure: At least every two years

Cholesterol check: Every five years; more often if you have had high levels in the past or have diabetes, heart disease, kidney problems, etc.

Diabetes screening: Every three years if 45 or older; more often if you are overweight, have high blood pressure or other risk factors

Mammogram (women): Every one to two years starting at age 40

Pap smear (women): Every one to three years

Eye exam: Every two to four years; more often if necessary

Stool occult blood test: Every one to three years

Flu shot: Annually

Tetanus-diphtheria booster vaccination: Every 10 years

 

Your 50s

“Double down on what you did for health in your 40s, and get the recommended cancer screenings, because they can save your life,” advises Wasserman. “Most of these cancers are curable if found early, sothere’s no excuse not to get screened.”

What To Watch For Now

Watch for health concerns from previous decades, plus:

Heart health. Ongoing stress tends to catch up to the heart in your 50s. As arteries and blood vessels become less elastic, your heart has to work harder, often leading to hypertension (high blood pressure).

Bone loss. Both men and women are affected by osteoporosis, which increases the risk of fracture (especially in hips, knees and wrists), but it’s more common in women. Bone density can diminish after menopause, when estrogen levels plummet.

Bowel issues. Constipation may occur, due to medications, diet and decreased physical activity.

Urogenital changes. Both sexes can begin to experience urinary incontinence. The prostate may enlarge in men, while women often experience menopausal changes to the vagina and bladder.

Dental health. Receding gums can make teeth more vulnerable to decay. Dry mouth can often result from medications you’re taking for conditions such as high blood pressure, high cholesterol, etc.

Sexual health. Vaginal dryness and atrophy can make sex uncomfortable for women after menopause, while men may face impotence issues. Medication you’re taking for other health issues may negatively impact libido and sexual performance.

Slower metabolism. What started slowing in your 40s, continues this decade. Like it or not, you have to eat less to maintain the same weight.

Fight Back

Reduce stress!

Don’t smoke—it hardens your arteries and raises blood pressure and heart rate.

Make exercise a regular part of your routine; it lowers blood pressure and can reduce the amount of arterial stiffening. Shoot for 30 minutes per day.

Aim for seven to eight hours of sleep per night—this is when your body repairs itself.

Get enough calcium: 1000mg for men ages 51 to 70 and 1,200mg for women ages 51 and older and men 71 and older. Take a supplement if your diet doesn’t contain adequate amounts.

Get enough vitamin D: 600 IU daily for adults age 19 to 70; 800 IU daily for those 71 and older.

Ask your doctor if medication for osteoporosis is right for you.

Drink plenty of water and eat a high-fiber diet.

Don’t “hold it.” When you have to go, go!

Avoid acidic foods and beverages that can irritate the bladder, such as caffeine, alcohol, soda and carbonated drinks.

Continue skin care routine with extra attention to moisturizing, sun protection and products that address texture and tone.

Brush at least twice daily, and floss daily. Schedule annual dental exams, and visit your hygienist for cleanings twice a year or more frequently if your dentist recommends.

Talk to your health care provider about hormone replacement for vaginal and bladder health and medication for libido and/or erectile dysfunction.

Eat a healthy diet, and, if necessary, consume fewer calories to lose/maintain weight.

Screenings and TestsFollow up on the screenings and tests from previous decades, plus:

Colonoscopy: At least every 10 years, starting at age 50

Your 60s

“Take medication for a condition if you need it, but we underutilize non-pharmaceutical options. Lifestyle changes like diet, exercise and reducing stress are very important,” says Wasserman.

“The problem is that medications we take in our 50s and 60s may not have side effects then, but when we get older, they will. Overmedication of older adults is a growing problem. Many older adults are put on medications to treat the side effects of their other medications,” he adds. “As a geriatrician, I have discontinued more medications than I’ve prescribed because the benefits no longer outweighed the risks.”

What To Watch For Now

Watch for health concerns from previous decades, plus:

Blurriness or vision loss. Glaucoma, cataracts and macular degeneration often show up now.

High blood pressure. Over 50 percent of those 60 and older have this condition, defined as a reading of 140 (systolic) over 90 (diastolic) or higher.

Hearing loss. Approximately 30 percent of adults in this decade experience some loss of hearing, and it’s more common in men than women.

Anemia. If you’re constantly tired, ask your doctor to check for anemia, which is found in one in 10 people over age 65.

Fight Back

Schedule annual eye exams.

Maintain a healthy weight, exercise regularly and watch sodium intake (no more than 1,500 milligrams per day). Take medication, if your doctor prescribes it.

See your doctor if you notice hearing changes, especially if just in one ear.

Take an iron supplement, if your doctor recommends.

Screenings and Tests

Follow up on the screenings and tests from previous decades, plus:

Bone density screening (women): At age 65 and from then on, as recommended by doctor

Eye exam: Every one to three years from age 64 on; more often if you have vision issues

Pneumonia vaccination: Annually, or as recommended by doctor

Shingles vaccination: Once after age 60

 

Your 70s and beyond

“When you hit your 70s, you start entering some gray zones when it comes to cancer prevention, so a lot of earlier preventative recommendations no longer apply,” notes Wasserman. “It’s not because people at this age don’t get cancer, but that as you age, cancer tends to be different.

Cancer cells like to be in a rapid growth environment, which is why they do very well in younger bodies. In older adults, everything’s slower, and you also have to look at the balance of life expectancy and treatment. Cancer is different in 80 and 90 year olds than it is in 50 year olds. You have to balance the effects of treatment with the natural course of the disease.

“For example, if a man lives to be 100, he will invariably have cancer cells in the prostate, but he won’t die of it. Now, if a 50 year old has them, it’s very serious and must be treated,” Wasserman explains.

“I cared for a dear patient for many years, who got prostate cancer in his mid-80s. His urologist treated it aggressively, but when the patient started declining and was hospitalized at 88, I told him, ‘They’re killing the cancer, but they’re also killing you.’ We stopped the treatment, and I put him on testosterone, making a deal with his urologist that if the PSA went above 30, we’d put him back on treatment. This gentleman just had his 98th birthday, and his PSA has never gone above 17.

“If you enter your 80s healthy, you need to maintain a healthy lifestyle and be very cautious about over-treatment,” cautions Wasserman. “Your metabolism is different when you’re older, and you are also more prone to side effects.”

What To Watch For Now

Watch for health concerns from previous decades, plus:

Memory changes. About one in eight adults age 65 to 74 have Alzheimer’s, while 43 percent of those over 85 have the disease.

Social connections. The older you get, the more friends and family pass away, but social interaction is vital to combat depression and stress.

Fight Back

Exercise your brain! Do mental puzzles and games, take up new hobbies, play a musical instrument, read, etc. to keep your brain active.

Stay socially connected.

Eat a diet shown to positively impact brain health, including salmon, walnuts, dark leafy green and berries. Red wine and dark chocolate are also beneficial—in moderation, of course!

Screenings and TestsContinue to follow up on the screenings and tests from previous decades.

Is It Just Forgetfulness?

Mild cognitive impairment: Misplacing things, forgetfulness, difficulty coming up with desired words, more memory problems than normal for their age

Dementia: Loss of thinking, memory and reasoning skills to the point that it affects daily functioning

Alzheimer’s disease: Serious form of dementia in which nerve cells in the brain die; symptoms eventually worsen to the point that the person loses ability to perform regular activities and requires total care

Vascular dementia: Form of dementia caused by strokes or changes in brain’s blood supply, which causes brain tissue to die; can affect memory, language, reasoning, coordination, mood and personality

Source: National Institute on Aging, nia.nih.gov

Learn More

Alzheimer’s Disease Education and Referral (ADEAR) Center(800) 438-4380 adear@nia.nih.govnia.nih.gov/alzheimers

Alzheimer’s Association(800) 272-3900 alz.org

Alzheimer’s Foundation of America(866) 232-8484 alzfdn.org

National Institute on Aging Information Center(800) 222-2225

nia.nih.govnia.nih.gov/espanol




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