Tips for aging with vitality well into your golden years.
When you were young and seemingly indestructible, did anyone ever wag his/her finger at you and say these words: “Just wait until you hit your 40s.” And did you subsequently ignore that “ridiculous” warning because 40 seemed eons away? Now you’re in your 40s (or beyond) and things, well, they are a-changin’. In fact, they’ve been changing since your 30s, thanks to inevitable drops in hormone levels. Maybe you’ve noticed your energy is not what it used to be, your midsection has gotten a little thicker, or your sex drive is sinking. These are all standard signs of aging.
Below the surface on the cellular level, diseases that your body might genetically be prone to could be brewing, particularly if you don’t get enough sleep, make poor food choices, have a sedentary lifestyle, are continuously stressed out and partake of bad habits (smoking and alcohol consumption). In fact, you may have a disease forming in your body right now that won’t show signs for another 10 years!
“Inevitably Father Time takes away what Mother Nature gave us. We wait for disease to strike and then try to take control. But we don’t get diabetes or heart disease overnight,” said Florence Comite, MD, who is a leader in the emerging field of personalized Precision Medicine, maintains a private practice in New York City and also authored the book, Keep It Up: The Power of Precision Medicine to Conquer Low T and Revitalize Your Life (Rodale 2013).
It is no big secret that Western Medicine has and still operates on a reactionary basis to symptoms of illness. Rather than teaching patients how to prevent disease, most doctors spend their packed-to-the-max days putting out fires for patients in the throes of sickness. But prevention is everything. If you want to live a long—and, more importantly, healthy—life, then you must be proactive now.
How? Know your family history and what your genetic code can tell you about your health. Know and understand your health stats. Get screened for disease at age appropriate times. Eat healthy, exercise much and sleep at least seven hours a night. These are the keys to aging with vitality.
The Heart of the Matter
“Heart disease is the number one cause of death for both men and women in the United States,” said James Underberg, MD, a clinical assistant professor of medicine and clinical lipidologist at New York University Medical School and the NYU Center for Prevention of Cardiovascular Disease. “While the passage of time guarantees changes to the heart, it’s important to remember lifestyle choices are largely controllable, and choices made throughout a lifetime ultimately affect the health of the heart in older age.”
Dr. Underberg recommends everyone begin basic screening tests (such as blood pressure and cholesterol) around age 20. As you age, weight and blood glucose levels should also be monitored. “I strongly advocate for everyone [older than] 40 to have a routine cardiovascular risk assessment and engage in a frank conversation with their healthcare provider,” he said. “Test results, including blood pressure, blood glucose, fasting lipoprotein profile (cholesterol and triglycerides) and body weight should all be topics of conversation.”
Health Span Vs. Life Span
You might live until you are 95, but what if your quality of life is thwarted because of multiple illnesses that might have been avoided if you’d taken charge of your health in your 30s and 40s? “Life Span (a.k.a. ‘longevity’) is the length of your life, measured in years. Health Span is the quality of your life, measured in vitality and vigor; it is about experiencing optimal health, free of disease, for as long as you live,” explained Dr. Comite.
The idea is to detect underlying disorders and diseases of aging—including heart disease, stroke and paralysis, diabetes, cancer, Alzheimer’s or other forms of dementia, and osteoporosis with hip fractures or a “buffalo hump” where the body is hunched over due to bone loss in the spine—long before symptoms emerge to create havoc, disabilities, pain and compromised quality of life. “By addressing these conditions years or even decades before the symptoms emerge, it is possible to avert and/or prevent these disorders,” she said.
By analyzing a patient’s current and future health based on genetics and DNA, family history, lifestyle choices, blood panels and other screening tests, suggestions can be made to help patients prevent disease through diet, exercise, medications, supplementation and other healthy lifestyle choices, such as avoiding stress and getting the recommended amount of sleep each night. But taking some common sense steps will also help to lengthen your health span.
“Move it or lose it,” said Marshall Robert, M.D., a family doctor at Denton Family Medicine, a Texas Health Physicians Group practice. “Lots of people sit on the couch with the remote and think they will be happy. Activity makes you happier and healthier,” he continued, “Even a 30-minute walk each day can do a lot for you. It can help control weight, improve overall health and increase energy. Lots of people who ‘feel tired all the time’ actually need more exercise. Keep that blood pumping to have a more full life.”
“Eat clean,” advised Shaun Kretzschmar, D.O., a family doctor at Aledo Family Medicine, a Texas Health Physicians Group practice. “It’s simple, really. Leading a healthy lifestyle betters your chances of maintaining a high quality of life. This lifestyle includes eating good foods, avoiding saturated fats and taking a multivitamin. Eat a balanced diet with more fruits and vegetables, fewer fats and drink more water.”
Additionally, be happy. Studies have also shown that people who live longer often have positive attitudes and close-knit family structure. These people are also engaged with their community and other things that help to stimulate the mind and keep them active physically and mentally.
When Do I Need That Screening Test?
Physicals, paps and prostate exams, oh my! Do you need to do them? “Despite the recent hew and cry that routine physicals are worthless, my 40 years of experience has found pathology in asymptomatic people many, many times over these years,” said Marc I. Leavey, MD (stringofmedicalpearls.blogspot.com), a primary care specialist at Lutherville Personal Physicians, a Mercy Medical Center Community Physician Site in Baltimore. “Waiting for symptoms may mean loss of an opportunity.”
Beyond a yearly physical, here is a general guideline from Dr. Leavey for what screening tests are important and when you should get them.
Mammograms: Age 40; possibly 10 years prior if family history of breast cancer is present, or if you know that you have one of the genetic markers for breast cancer.
Pap smear: Age 21, or within three years of first sexual activity. If you have consistent normal paps, then the recommendation is to get one every three years.
DEXA Scan: Upon the first signs of post menopause. If normal, this scan may be repeated some 3 to 5 years later. If not normal, it is often done every two years to monitor therapy.
Prostate Exam: Age 40; 10 years prior if family history is present. “For most men, a combination of digital prostate examination and serum PSA is likely the best combination,” Dr. Leavey said.
Colonoscopy: Age 50; 10 years prior if family history is present. “If the results are negative, this test may not be repeated for 10 years,” Dr. Leavey said.
Blood Tests: Age 20. Begin screening for blood sugar, cholesterol, anemia, hormone levels and thyroid conditions early so you know what your body’s healthy base is versus later on in life. These can be revisited every two or three years as long as everything is normal.
Eye Examination: Annually at any age. “Screen for refractory errors as well as diseases of the eye, including cataracts, glaucoma, and signs of disease on the retina, which can range from macular degeneration to diabetes,” he said.
Skin Examination: Annually at any age. Skin cancer can be deadly if not found early. Visit your dermatologist once or twice yearly to be screened for any abnormalities.
Routine Physical: For individuals ages 60 and older, “an annual visit to the physician to check all of the above, as well as to survey for signs of cognitive impairment, social issues (such as the illness or death of a spouse), or other needs is clearly of benefit,” he said.
Adam Splaver, MD, a Hollywood, Florida board-certified cardiologist, said in addition to these annual screenings, for people older than 65, “be sure to get immunized against shingles…and get the pneumovax vaccination.” He also recommends getting a CT scan of your chest and an ultrasound of your abdominal aorta starting at age 50 if you have ever smoked.
By LaRue V. Baber