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Richard W. Besdine, M.D. Headshot

Healthy Aging: A Cheat Sheet

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When it comes to your health, it's a jungle out there. If you are over 65, the predators include chronic diseases such as cancer, diabetes, heart disease and arthritis. Even with modern medicine behind you, they can disable and kill you before your time -- unless you take evasive action.

Sadly, this is not news. Benjamin Franklin's 1735 aphorism -- that an ounce of prevention is worth a pound of cure -- is as true as ever.

The dark side of prevention is that most of these deadly and disabling conditions can be delayed and even prevented and are essentially self-inflicted. In fact, your major risk factor for death from a preventable disease is not the quality of your health care (about 10 percent of your risk), your social circumstances (about 15 percent) or even your genetic makeup (about 30 percent). Your single biggest risk is your own behavior (40 percent).

How can you turn the tables and make the power of prevention work for you? You need a clear sense of what's at stake, your own determination and, importantly, some support from family and friends. For certain other steps, you'll need some professional help, as I'll discuss later.

As a geriatrician and health services researcher, I offer my list of the top five things you can do, on your own, to stay fit at 50, be sexy at 70 and feel great during the whole aging process.

1) Quit smoking. Cigarette smoking makes many chronic diseases, from emphysema to cancer, more likely and more severe. It can also interfere with medicines, such as insulin. The good news: Older people quit more successfully than anyone else and Medicare covers tobacco cessation counseling. Take them up on it. Explore this HHS booklet on quitting or call 1-800-QUIT NOW (784-8669) to be connected to the quitline in your state.

2) Watch your weight. America leads the world in obesity, and while you might prefer the term pleasingly plump, that extra weight is overtaxing your heart and joints, hardening your arteries and inviting diabetes. Six out of 10 seniors are overweight to the point of health risk. They also suffer more harm from their obesity than younger people.

Losing weight, even when your health is at stake, can be a real struggle. Try thinking of it as a gift that only you can give -- to yourself, your spouse, or your grandchildren.

"The idea," says William Hall, M.D., director of the Center for Healthy Aging at the University of Rochester School of Medicine and scientific advisory board member at the Health Promotion Institute of AARP and the American Federation for Aging Research, "is to preserve your health so that you can give back in a unique way that only somebody who has aged can give back."

3) Get moving. You don't have to run marathons, but consistent physical activity is crucial to maintaining your vitality and fending off disease. Gardening, walking in a mall or even housecleaning can provide most of the benefit of a more vigorous workout, especially for older people. Active people get fewer fractures, less depression, less heart disease and diabetes, fewer cancers and less cognitive decline. And a recent study in the New England Journal of Medicine found that the combination of exercise and diet was far more effective than either one on its own. For help getting started, click here.

4) Keep an eye on the booze. Problems with alcohol can creep up later in life as the aging body becomes less able to process alcohol. You may find those same two drinks take a more severe toll than they used to. For a self-assessment of how much at is too much, try this test.

5) Stay in touch. Maintaining a good social network is actually good for your health, as it can decrease stress, prevent all-too-common late life depression, and reduce the very real health risks associated with isolation.

These strategies are not simple to implement, but they can help you avoid costly medications and disability. If there were a pill that did all this, you'd probably buy it.

You also should not fight these battles alone. Enlist support from friends and family and your doctor, who should be prescribing exercise and healthy eating just as readily as drugs.
Also investigate programs in your community, often offered at a senior center, YM/WCA or gym. All the programs mentioned here are backed by the U.S. Administration on Aging (AoA) because they have been proven to help promote healthier aging. For physical activity, look at Enhance Fitness, Active Living Every Day, or Fit and Strong.

For people who want peer support and coaching on living healthier and meeting personal goals, Better Choices, Better Health, an online version of Stanford University's Chronic Disease Self-Management program, is now available nationwide. Click here for a complete list of AoA-approved evidence-based programs.

Finally, a few preventive measures do require professional help. Happily, under the new Medicare annual wellness visit, all are free with no co-pay. For more detail, check out Your Guide to Medicare's Preventive Services here.

1. A one-time pneumococcal vaccination can prevent deadly pneumonia.
2. An annual flu vaccine can cut a senior's risk of death from the flu in half.
3. An annual mammogram and pap smear are important for women.
4. For men and women, an initial colonoscopy at age 50, with follow-up as needed.
5. An annual fecal blood test for colorectal cancer.
6. Seniors and their doctors should both examine the skin, breasts, and mouth regularly, with a rectal exam at the annual appointment. Don't overlook high blood pressure and oral health as well.

So find a program or call a friend and go for that walk together. You could be saving your own life. And it's never too late to start.