Aging Well

The Keys to Healthy Aging                                                 

Many factors that play a role in healthy aging. Some factors you can control are your diet and exercise routine, as well keeping current on your health maintenance exams and chronic conditions. Other factors are outside of your control, such as your genetics. Some tips for healthy aging include:

• Staying active
• Maintaining a healthy diet
• Getting adequate sleep
• Quitting smoking
• Being cautious with alcohol use
• Staying current on your preventative healthcare
• Managing your chronic health conditions
• Taking care of your mental health
• Staying connected

There are many ways to take charge of your health, but this proactive approach is one key to healthy aging.

Maintaining a Healthy Mind as You Age

While some memory changes and slowing are normal as you age, there are steps you can take to maintain a healthy mind.

A 2020 review in the Lancet identifies twelve modifiable risk factors that can reduce the risk of dementia during one’s life. These twelve modifiable risk factors account for about 40% of dementia worldwide and include:

• Low educational status
• Hypertension
• Hearing problems
• Smoking
• Obesity
• Depression
• Physical inactivity
• Diabetes
• Low social contact
• Excessive alcohol consumption
• Traumatic brain injury
• Air pollution

While not all of these factors are within an individual’s control, there are some things that you can do. There are many benefits to exercise, and research has found that physical activity protects against dementia, though it isn’t clear whether this is the result of exercise itself or because exercise decreases cardiovascular risk and helps improve obesity, diabetes, and hypertension, which are also risk factors for dementia.

Smoking is another strong independent risk factor for smoking. Smoking increases the risk of dementia by 30%-50%. The good news is that quitting smoking at any time can reduce that risk. The earlier you quit, the better, but quitting at any point in your life is better than not quitting at all. Secondhand smoke can also increase the risk of dementia, heart disease, and stroke, so there are many reasons to quit. There are many options for quitting smoking. Talk to your healthcare provider about what options may be best for you.

Inadequate sleep is another significant risk factor for impaired brain health and dementia. Several studies show that too much and too little sleep can contribute to poor brain health. Sleep plays an instrumental role in how your brain functions. Your brain uses the time you spend sleeping to consolidate the memories you’ve formed. Sleep is also when the brain cleans up plaque-forming proteins associated with Alzheimer’s disease. To improve your sleep, consider the following steps recommended by the American Heart Association:

• Practice good sleep hygiene.
• Limit bright lights in the room, such as lamps, phones, and televisions
• Avoid stimulants such as coffee in the afternoon
• Avoid drinking alcohol too close to bedtime
• Avoid heavy meals before bed
• Don’t rely on sleep aids

Sleep should take priority over other activities, including exercise and diet, because it’s that important.

Diabetes, hypertension, and high cholesterol are all risk factors for worsening cognition as you age. Many of the things that independently help with healthy brain development also help control these conditions. However, frequent diet and exercise aren’t enough to control these conditions completely. Working with your healthcare team to optimize your control of these conditions is essential.

Avoiding Injuries as You Age

Physical activity is important, but often, as you age, the risk of falls and other injuries increases. One of the changes associated with aging is loss of muscle tone, also called sarcopenia. Sarcopenia is associated with an increased risk of physical disability, decreased quality of life, and even death. There are four major categories of conditions that contribute to sarcopenia:

• Metabolic
• Cellular
• Vascular
• Inflammatory

Sarcopenia is one of the major contributors associated with the functional decline and increase in injuries. But the brain also plays a vital role in balance and injury prevention.

The vestibular system and the cerebellum are parts of your nervous system that are important for posture and balance. The brainstem, the cerebellum, and the forebrain are primarily responsible for controlling and commanding your gait. These two systems work in combination to help you stay upright by controlling the muscles and nerves responsible for balance, standing, and walking.

Eyesight, hearing, and reflexes may also decline with age, which can increase your risk of falls and injury. Another risk factor for falls is cognitive decline and dementia. Osteoporosis is a condition that increases with age, and while it doesn’t increase your risk for falls, it certainly increases the risk of serious injury associated with falls.

There are several steps you can take to prevent falls and injury. The National Institute on Aging recommends some tips for decreasing your risk of falls and injury:

• Stay physically active to improve your muscle strength and decrease your risk of osteoporosis. Balance and strength training exercises such as yoga, Pilates, and tai chi are particularly good at helping with both. Resistance training is also beneficial.
• Check your home for fall risks. Avoid area rugs, which can be a tripping hazard. Don’t leave things such as books, clothes, or shoes on the floor. Make sure that the lighting in your home is adequate. Use grab bars in the shower or near the toilet. Put non-slip materials in areas at high risk for falls, such as in the shower or outdoor areas.
• Get your eyes and hearing tested. If your healthcare team recommends glasses, contacts, or hearing aids, ensure they fit well and wear them regularly.
• Monitor for medication side effects. You can ask your doctor or pharmacist if you have any concerns.
• Get adequate sleep.
• Avoid or limit your alcohol consumption.
• Stand up and move slowly. Take extra precautions if you are moving on wet, icy, or uneven surfaces. Consider staying inside in bad weather.
• Use assistive devices such as a cane or walker if you feel unsteady. A walking pole may be beneficial if you walk outside on uneven surfaces.
• Try to avoid having your hands full. Freeing your hands can help you reach for a rail or wall if you feel unsteady.
• Wear proper footwear. Non-skid, rubber-soled, low-heeled shoes are best.
• Tell your healthcare team if you have had any falls since your last visit, even if you haven’t been injured. This may prompt them to look for medical conditions that may increase your fall risk.

Falls occur in one in four people over age 65 each year. They are one of the most common causes of injury and disability in people in this age group. Being proactive about injury prevention is key to helping you age well.

Staying Active as You Age

Physical activity has multiple benefits for everyone, but especially as you age. Some of the benefits of physical activity include:

• Decreased risk of heart disease, stroke, type 2 diabetes, and some forms of cancer
• Improved strength and balance to decrease injury risk and maintain independence
• Decreased pain
• Improved mood, including improved symptoms of depression or anxiety
• Improved cognition

Moderate activity gets your heart rate up and is categorized as an activity that is brisk enough to make you breathe harder, but not so hard that you can’t carry on a conversation. Experts recommend 150 minutes of moderate-intensity activity per week. Examples of moderate activity include:

• Walking at least 2.5 miles per hour
• Water aerobics
• Dancing
• Gardening
• Tennis
• Biking slower than 10 miles per hour

Before starting any exercise program, you should consult your healthcare team to ensure you are healthy enough for physical activity. As long as your healthcare provider feels that you’re healthy enough for physical activity, there is no wrong time to start. If you haven’t been physically active for a while, it’s important to start slowly and build up over time. Some tips for getting started include:

• Choosing activities that increase your heart rate, including walking quickly, dancing, swimming, biking, or even chores like raking leaves
• Adding muscle-strengthening activities such as weights or resistance bands at least twice a week
• Practicing your balance
• Choosing activities that you find enjoying
• Exercising with friends or family
• Building activity into your daily routine
• Listening to your body. If you are dizzy or short of breath, slow down, take a break, and if symptoms persist, follow up with your healthcare team

Even if you exercise for only 5-10 minutes at a time to start, getting up and getting active has multiple health benefits throughout your life.

Eating Healthy As You Age

A healthy diet is important for your mental health at any age, but as you age, your diet can play a role in maintaining healthy brain function, improving depression and anxiety symptoms, supporting healthy muscle and bone strength, and controlling chronic health conditions.

Dietary recommendations change based on your individual health concerns as well as your age, gender, weight, and level of physical activity. There are many options for eating healthy, but some tips include:

• Getting enough protein to help support your muscles
• Avoiding or limiting alcohol use to no more than two drinks a day for men or one drink a day for women
• Eating a balanced diet, including different food groups such as vegetables, fruits, grains, and protein-containing foods
• Increasing your vitamin B₁₂ intake. Vitamin B₁₂ is important because your ability to absorb it decreases as you age. This vitamin is important in supporting red blood cell development and nervous system support
• Drinking enough fluids to stay hydrated

The U.S. Department of Agriculture and the U.S. Department of Health and Human Services have developed a set of guidelines to help you determine how much of each food group you may need during the day.

Aging and Relationships

Social isolation is a significant public health risk in older adults. Isolation and loneliness are associated with increased risks of:

• Depression and anxiety
• Cardiovascular disease and stroke
• Dementia and cognitive decline
• Poor outcomes during illness and hospitalization

Social isolation significantly increases the risk of premature death from all causes. Some aging adults may be more vulnerable to social isolation than others. These include people from groups such as immigrants, the LGBTQA+ population, minorities, and victims of elder abuse. A 2023 study in General Psychiatry noted a relationship between social relationship satisfaction and the accumulation of multiple health conditions. It found that the higher the satisfaction in interpersonal relationships, the fewer complications from chronic health conditions were present.

As we age, it’s common for social networks to shrink for many reasons. If you’re experiencing loneliness or you just feel that you would like a broader social network, there are many ways to pursue this. Community centers and faith-based social networks such as a church or synagogue are some options that many people turn to for social support. There are also resource centers in many communities that help support older adults who need help around the house. There are also community resources and online networks that can help connect people with similar interests, such as book clubs or athletic interests.

Age-Related Depression

Age-related depression is common in older adults and is associated with many negative health impacts, such as cognitive decline, physical disability, and medical comorbidities. One of the reasons that the risk of depression increases with age is that the risk of depression increases with the presence of other medical problems. About 80% of older adults have at least one chronic health condition, and about 50% have two or more. Depression is also a common symptom of loneliness and social isolation, which is more common as you age.

Though common, depression is not a normal part of aging. Some of the symptoms of depression include:

• Pessimism and feelings of hopelessness
• Feelings of guilt or worthlessness
• Irritability and restlessness
• Loss of interest in activities you once enjoyed
• Fatigue and decreased energy
• Trouble concentrating and making decisions
• Insomnia or excessive sleeping
• Overeating or loss of appetite
• Thoughts of suicide
• Increased aches and pains

Depression is a very treatable condition. If you or someone you know is suffering from the symptoms of depression, talk to a healthcare provider about what options are available.

Mood and Stress

Chronic psychological stress can contribute to more rapid aging. Stress is a risk factor for several diseases, including:

• Cancer
• Cardiovascular disease
• Neurodegenerative disease
• Autoimmune disorders
• Depression
• Post-traumatic stress disorder

The effects of chronic stress on the body are multifactorial and affect multiple body systems. Chronic stress is believed to increase pro-inflammatory substances called cytokines and trigger inflammation. This type of stress is known as oxidative stress and causes cellular damage in the body. Stress also affects the telomeres, which are caps on the end of chromosomes. The telomeres protect the cells, and when they become too short, the cells have decreased protection. Shortened telomeres have been associated with Parkinson’s disease, diabetes, cardiovascular disease, and cancer.

Managing stress levels as you age is one way to decrease stress’s impact on your body. Some of the ways you can do this are to:

• Stay connected with friends and family
• Stay physically active
• Stimulate your mind with books, puzzles, games, and learning new things
• Get good-quality sleep
• Eat a balanced diet
• Avoid stressful situations when possible

Retirement Planning

Eventually, most people want to stop working and enjoy retirement. Financial security is very important for most people as they contemplate retirement.

The earlier you start planning for retirement, the better. The U.S. Department of Labor also offers these ten tips for preparing for retirement:

• Start saving, keep saving, and stick to your goals
• Know what you will need to retire
• Contribute to your employer-based retirement savings plan if there is one
• Learn about your employer-based pension plan if there is one
• Learn more about basic investment principles
• Don’t touch retirement savings
• If your employer doesn’t offer a retirement plan, ask them to start one
• Put money into an individual retirement account
• Find out about your social security benefits
• Ask questions

Navigating the path to retirement can be challenging and confusing. Your employer, bank, union, or financial advisor may be able to help you face this challenge. If you want to see a financial advisor, look for a fiduciary. A fiduciary is required to act in your best interests.

Senior Centers and Assisted Living

There are many reasons people may choose alternate living situations as they age. Sometimes, people struggle to live safely by themselves. Other times, they may be looking for a sense of community and improved social connections.

Senior centers are generally community-based programs that help connect older adults to community services and help increase social connectedness. They may serve as part of an emergency response in the case of a crisis. Senior centers often offer a variety of programs and services, such as:

• Meal and nutrition programs
• Information and assistance
• Health, fitness, and wellness programs
• Transportation assistance
• Public benefits counseling
• Employment assistance
• Volunteer opportunities
• Social and recreational activities
• Educational and arts programs
• Intergenerational programs

Senior centers are a nice option for people who have the ability to live independently but still want to have additional social support or engagement.

Assisted living centers are for people who need some increased help but not the full support that may be available in a nursing home. Assisted living centers allow people to live in their own space but still get help with personal care, meals, medications, housekeeping, or laundry. They also frequently provide security, 24-hour supervision as needed, and social or recreational activities.

Aging on Your Terms

Ultimately, there are many things to consider when you age. Aging is inevitable, but many aspects of how you age are up to you. For many factors that influence aging, the earlier you start, the better. It’s never too late to start thinking about your long-term health.