Healthy Aging: Tips for staying well and happy in later years

The term "aging" often is associated with an assumed decline in physical and mental health, as well as in overall quality of life. Many of us cross our fingers and hope we’ll be among the lucky few who maintain strength, mental acuity and independence later in life – not realizing that the course of our later years is largely up to us.

Eighty percent of how well we age can be attributed to lifestyle choices. It’s never too late to make changes that will have a significant impact on well-being; or, if you care for an older person, to make changes that will help them live comfortably and happily.

1. What are the most important things a person should do to aid healthy aging?

The healthy lifestyle changes that seem the most obvious really are the most important. The most important step of all is to stop smoking. The second step is to exercise. 

It’s worthwhile to note that factors such as high cholesterol, high blood pressure and smoking all increase a person’s risk of heart disease by 2.1 to 2.5 times that of a person who does not have these risk factors. Lack of regular exercise increases the risk of heart disease 1.9 times – almost the same amount as high cholesterol and the other factors. Increasing physical activity is the easiest, least expensive way to reduce your risk.

Other very important healthy lifestyle factors include maintaining a healthy weight, eating right and moderating your use of alcohol. 

We all know intuitively what changes we should make to take better care of ourselves. Ask yourself honestly, ‘What could I be doing to take better care of myself?’ And follow your own advice. 

2. Is there ever an age at which it’s too late to make positive lifestyle changes? 

No. Let’s look at smoking as an example. Even among people who quit smoking at age 75, we see fewer episodes of upper respiratory infections and influenza and fewer days spent sick in bed. 

If a 75-year-old person does not have disease, they have an average life expectancy of another 12 years. If you stop smoking, your risk of getting lung cancer as a result of smoking will, over the next five years, revert to that of a non-smoker. So even if you’re 75, with a life expectancy of 12 years, that will make a big difference. 

The same holds true for exercise. A study was done in 90-year-old nursing home patients who were put on a high-intensity weight-training program. These people used small, two-pound weights, but they increased their strength by 300 percent. The more important result was that their functional problems decreased; they were able to get out of bed easier, for example, and go to the bathroom easier.

So there is never a time where it’s too late to make positive change.

3. Do you have any tips for starting an exercise program at an older age?

Find something that’s fun and enjoyable for you and that provides positive gains beyond the obvious health benefits. For example, if you want to meet people, you could join a group that exercises together. Many shopping malls have walking clubs where older people meet and walk laps inside the mall together.

Also, try to pick something you’ve done and enjoyed in the past. If you haven’t been active before, we recommend that you start with walking or swimming. Swimming is especially good for people who have arthritis. 

Start with 30 minutes of exercise, at whatever pace you want, three times a week. If you’d like to do more, that’s great, but be sure to add more physical activity gradually. 

The idea of "no pain, no gain" is wrong. Pain is bad for you. What you should aim for is what’s called the "sweet tension" threshold, where it feels like a bit of work, but it’s not causing pain.

If you have heart disease, you should have a check-up before starting an exercise program.

4. What steps can older people take to reduce their risk of falling?

This is an important issue. Accidents are the sixth-leading cause of death in older people, and falls account for 80 percent of accidents in old age. Generally, people who fall have already had a series of minor falls and are known to be at risk for falling before they experience a bad fall. So balance problems and near-falls should be seen as medical problems that need evaluation. 

We don’t always have to find the cause of balance problems in order to improve the problem.  Many people get caught in a vicious cycle:  they almost fall, so they reduce their physical activity; then they get weaker and their balance deteriorates, so their risk of falling increases even more. Breaking that cycle is important regardless of the cause.
 
Balance exercise programs, especially tai chi, have been proven to reduce the risk of falls. Physical therapists can assess a person's risk of falling then design a program to improve the person’s balance. Fall risk assessments can evaluate an older person’s sense of balance, as well their ability to function in other areas, and recommend steps for improvement.

5. What measures can be taken to protect against falls in the home? 

Many things can be done to make the home safe once you deal with a person's balance issues.

Fall prevention tips from Providence Home and Community Services include:
  • Do not use loose throw rugs, runners and mats.
  • Keep clutter, telephone and electrical cords, and oxygen tubing out of walking paths.               
  • Install handrails at a comfortable height along stairwells.  Use them when climbing up and going down.
  • Provide adequate lighting. Use night lights at night.               
  • Make sure the arrangement of furniture is safe and convenient.
Special tips for fall prevention in the bathroom include:
  • Keep the floor dry. Avoid water spills.               
  • Provide a non-slip surface in tub or shower.               
  • Avoid loose bathroom mats. Use mats with rubber backing.               
  • Install tub or shower grab bars and bench as needed.
6. How do mental and social factors affect how well you age?

An increasing amount of evidence suggests that being mentally active and socially involved keeps mental acuity sharp, just as exercise maintains physical functions. "Use it or lose it" appears to apply in situations where mental and social activities are concerned.

Some studies have shown that people who are socially involved, especially in satisfying relationships, have better outcomes after a heart attack.  They develop fewer complications and return more quickly to their normal activities. 

Some interesting studies have also shown the value of mental activity in preventing Alzheimer’s disease. Reading, taking classes and pursuing continuing education throughout your life can significantly reduce your risk of developing Alzheimer’s. Reading has been shown to be the most beneficial mental activity of all. 

7. How serious is the problem of memory loss in older adults?

Most people assume that it is normal for a person to lose memory as he or she ages.  It’s not normal, but it is common.  Memory loss causes real problems for older people. 

If you are experiencing memory loss, it’s important to be evaluated by a doctor.  Some memory loss is the result of a treatable disease, like thyroid conditions or medication side effects. Unfortunately, because people see memory loss as being normal, they often do not get evaluated and treated.

For example, dementia due to Alzheimer’s disease and a number of other causes affects about 45 percent of people above age 80.  According to health insurance organizations, only about seven percent of people over age 80 are actually diagnosed with dementia. 

Many people feel a kind of hopelessness about memory loss, so they don’t bother to have it evaluated. Many things can be done, however, to help the person who has memory loss or dementia and his or her family have a higher quality of life.

8. Can anything be done to prevent Alzheimer’s?

Four main factors appear to increase a person's risk of developing Alzheimer’s disease: low education, head trauma, depression and genes. We can’t do anything about our genes (at least not yet), but we can do something about the other risk factors.

Lifelong pursuit of education is very important in preventing Alzheimer’s. Wearing bicycle helmets and avoiding activities that carry a high risk of head trauma are also very important. 

We don’t totally understand why depression is a risk factor for this disease. Alzheimer’s is probably a genetic disease, but many people have the gene for Alzheimer's, and they don’t develop the disease. Something is triggering the expression of the gene. That may be where depression plays a role.
 
It’s crucial to realize that depression is a medical problem that can be treated. About 70 percent of the time, a person's family and even primary care physicians don’t recognize depression. If you have symptoms of depression, seek evaluation and treatment.

9. What can caregivers do to help loved ones age well?

The biggest issue that caregivers, especially family caregivers, face is finding a balance between safety and risk. Our advice to caregivers is, don’t automatically go for safety. 

Older people do take risks – so do we. But when you’re 75, it seems as if everybody suddenly has a license to control your risks. It would be great to see more open discussion between the generations about what the greatest risks really are. Is it worth moving to a place (such as a nursing home) where the risk of falling and not being found is reduced if the move means completely leaving your neighborhood, your home, and the environment in which you've lived for 50 years?

The ability to make decisions is very important for each person...regardless of age. People need to be in control of their own lives and the decisions that affect them in order to feel good about themselves. It’s also important to talk about advance directives, advance planning, and what your older relative’s wishes are for their end-of-life care.
 
A great deal of medicine is oriented towards keeping people from dying; however, if you look at the top fears of people over the age of 75, the fear of death is not very big. They’re more worried about becoming dependent on other people and becoming burdens to their families

Talk with your parents or older relatives.  Listen to their concerns. Find out whether they want medical interventions if those interventions mean they will become dependent or require nursing home care.