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Healthy Aging: What Older Adults Need to Discuss with their Doctor

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By Lorna Stewart, MD

Healthcare providers know that age is an important factor when considering an appropriate wellness plan for patients. And while primary care providers are typically either pediatricians (focusing on children) or adult internal medicine/family medicine providers, when it comes to healthcare, the difference between 8, 18, 48 and 88 is vast.

Adults experience physical changes throughout their lifetime that can impact their overall health and wellness. One branch of medicine, geriatrics, focuses on medical care for older adults. Although “older” is not clearly defined, in general, the medical community considers 65 and older as those who might need or consider geriatric care. Our healthcare needs can vary greatly from our 50s, 60s, 70s, 80s and beyond. Here are things to consider as we age, and what’s important to discuss with your physician.

Screenings:

In your 50s and 60s (and possibly earlier depending on family history and other factors,) your doctor will likely begin screening for conditions that are more common in mid-life and beyond, such as high cholesterol, hypertension, diabetes, and certain cancers, such as skin, colon, breast and prostate (in men). Depending on your heart health and family history, your physician might also suggest an electrocardiogram (or EKG) to establish a baseline and/or detect any heart conditions. Midlife women might also be screened for calcium/vitamin D to try to detect early stages of osteoporosis.

Be sure to provide your physician with a complete picture of your family disease history, be honest about your lifestyle (how much alcohol you consume, how frequently you exercise, how well you manage stress) and talk about any symptoms you might be experiencing. The more information your doctor knows about you, the better she can help create a wellness plan for you. 

Mental health:

While many physicians today will start screening for anxiety, depression and other mental disorders in their young adult patients, mental health is important – and changing – at all stages of our lives. For example, as women reach midlife and the menopause transition (in their 40s and 50s), they experience changes in hormone levels, which means anxiety and depression can become more prevalent. Cognitive impairment becomes more common in 60s and 70s.

And, research continues to show the importance between human connection and mental health—people who are lonely, especially elderly adults, are more likely to experience depression. Throughout our various life stages, major changes can cause disruptions that might cause stress—from becoming an empty-nester, to losing a parent, to requiring more help as we age. Managing stress across the lifespan is as important to our physical well-being as proper diet, exercise and sleep.

Immunizations:

Number one on the list for anyone aged six months or older is the flu vaccine. It is simply the best way to prevent contracting the common, contagious virus that can be deadly. The elderly and those considered at high risk should be especially vigilant about receiving a flu vaccine every autumn. Flu season typically runs from October – March, so getting your flu shot in late September to mid- October is best (at least before Halloween). It won’t provide 100% protection, but in most years, it can reduce risk of contracting the flu by 40 – 60%, and those who do still get sick tend to have much milder symptoms.

There are now two types of pneumonia vaccines, and adults need both of them. Prevnar, is also for adults 50 and up. Pneumovax protects against 23 strains of the bacteria. In order to be fully protected, adults should receive both vaccines. And sometimes it makes sense for an additional dose of both vaccines later in life to prevent this respiratory disease that’s contracted by more than one million people each year.

Shingles, or herpes zoster, is a painful, blistering rash that develops as the result of the reactivation of the varicella zoster virus, the virus that causes chickenpox. Shingles can develop decades after the initial chickenpox infection and is most common in adults over 50. The Shingrix vaccine, introduced a few years ago, shows strong efficacy– an average of 91%. It is indicated for adults 50 and older. Adults require two doses of the vaccine, two to six months after the initial shot.

Sexual Health:

Sexual health IS health, yet so many patients and providers are reluctant to discuss sexual health concerns. Both women and men experience hormonal changes as they age that can impact sexual health, including issues ranging from lack of desire, erectile dysfunction (in men) and painful sex—all of which have available, evidence-based treatments. Other issues include sexually transmitted diseases—which appear on the rise among seniors. Patients should discuss their sexual health with their provider and be sure to protect themselves from sexually transmitted diseases. A healthy sex life is important to patients’ overall health and wellbeing across their lifespan. There are things patients can do to ensure healthy aging. Work with your provider to make sure you’re taking a comprehensive picture of your health and wellness.

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