Play your cards right, and be healthy in old age

Thursday, July 3, 2014 9:05 PM

Why is that some people ease into their older years with relative ease, while others struggle with a chronic illness or an annoying array of medical problems?

According to Cortez internal medicine specialist Bryant McNeill, MD, part of the difference comes down to luck of the draw. “Something you can’t control is genetics,” said McNeill. Even someone who eats well, exercises, watches their weight, and sees their doctor regularly can end up with, for example, high cholesterol. That condition – along with a variety of others including diabetes and arthritis – is often hereditary.

You can’t choose your parents, but you can choose to play the cards you’re dealt in ways that will help increase the odds feeling well into your 50s, 60s, 70s, and beyond. “A healthy lifestyle and preventive care go a long, long way toward aging gracefully,” said McNeill.

“People come to me and say, ‘I was in really good health until I turned whatever age or until whatever happened, then I started having all these problems’,” said McNeill. For one person that whatever age could be 45 and for another it might be 65. The whatever event could be getting injured and, as a result, not being able to exercise, putting on pounds, and then dealing with health issues related to the extra weight. Or the event might be something more serious like a hip fracture or a cancer diagnosis.

“The challenge is that as we age we tend to start accumulating problems. The systems start to rebel a little bit,” said McNeill. “It can be frustrating. But I’ve also seen a lot of people age amazingly well by doing things that I personally intend to emulate.” Some of these, according to McNeill, include staying active, eating right, spending time with family and friends, learning new things, and generally enjoying life.

McNeill says the patients he sees who tend to do the best as they get older are the ones who also stay on top of preventive health maintenance. Regular checkups, cancer screenings (e.g., mammography and colonoscopy based on age and medical/family history), and keeping blood sugar, blood pressure, and cholesterol levels within a normal range either with diet and exercise or medication, if needed, are all worth paying attention to.

“This kind of housekeeping gets ignored because people are out having fun or traveling or busy doing other things,” said McNeill. If you’ve been putting off tending to health maintenance because you’re too busy, think for a moment about how much time it takes to be sick. The old adage “pay me now or pay me later” comes to mind.

“For women over 50 and for some younger women and even some men with specific risks bone density testing is important,” said McNeill. The incidence of hip fractures increases dramatically as people age. Bones become more porous and the risk of falling goes up for a variety of reasons including loss of flexibility, balance, and mobility or due to being on certain medications. “Both my grandmothers had hip fractures. One bounced and back and one didn’t, and that’s about the norm – 50/50. Close to half of older people who have a hip fracture die within a year or two,” said McNeill. “But this is preventable if we keep an eye on things.”

Older adults should also pay attention to their mental and emotional health and social factors that may impact their lives. Dealing with a chronic health problem, realizing that with aging sometimes comes frailty and limitations, taking care of an ailing spouse or losing friends can all result in stress, anxiety, or depression. McNeill suggests that patients who experience these issues talk to their doctor. “Sometimes it helps for people to understand what really is a normal part of aging, that their peers are going through some of the same things, and that they’re not alone,” he said. “I encourage patients to spend less time worrying about their health and more time doing the things that will help them stay healthy.”

Having close friendships and intimate relationships and linked to good mental and physical health. “Older patients will sometimes come to me sheepishly or a little embarrassed saying that physical intimacy with their spouse isn’t what it once was, but that they’re still interested,” said McNeill. “We can offer help medically for this.”

Two other basic things related to healthy aging are worth mentioning. One is staying on top of vaccinations. Ask your doctor about when you are due for flu, pneumonia, tetanus, pertussis, and shingles vaccinations.

The other is medication management. “Use the right medications for the right issues. If you’re on a lot of medications talk to your doctor about everything you’re taking. I call this the brown bag biopsy,” said McNeill. That means putting all of your medications (including supplements) into a sack and taking them to your doctor for an assessment. “Over time people may end up on too many medications. I can often consolidate or eliminate some of them,” said McNeill.

McNeill says it’s good for all patients – not just older ones – to educate themselves about health and wellness. He warns however, not to assume that everything in the media and online applies directly to you. “Don’t rely only on Dr. Oz and Dr. Google for all of your health information,” said McNeill. “Learn what you can and then discuss that information with your personal physician to see how it applies in your particular situation. It’s good to be informed, but check it out.”

Southwest Health Notes is a public service feature provided by Southwest Memorial Hospital in Cortez, Colorado. The information provided herein is not intended as patient-specific medical advice or as a substitute for consultation with your personal health-care provider.