Here are 6 common issues and how to stay ahead of them.
Difficulty performing everyday tasks impedes independent and joyous living. A functional assessment can help you and your healthcare provider understand how lifestyle factors impact your abilities. This is particularly important for older adults, says David Donohue, M.D., Delaware’s first board-certified lifestyle medicine physician and the chief medical officer at Progressive Health of Delaware. “My philosophy is if we can measure it, we can improve it. If you don’t measure it, you don’t know it’s happening,” he says. “The exciting thing is that we can reverse the aging process at the level of many of our vital organs. You can reverse the aging process with muscle. You can reverse the trend of cognitive decline. We are finding that these assessments have been a missing link in primary care.”
Eating well and getting adequate sleep and exercise can play a significant role in delaying cognitive impairment and promoting overall brain health. “When people live for decades with poor sleep, or an unhealthy diet, or lack of physical activity, it drives them toward a cognitive decline by not fostering the growth and health of the brain,” Donohue says. “But we can move the dial back by eating healthier, reversing prediabetes, reversing the clogging of the arteries and preserving the blood flow to the brain.” According to Donohue, there is a good amount of research about the myriad benefits of the Mediterranean diet, which emphasizes plant-based foods and healthy fats. When combined with an otherwise healthy lifestyle, it has the potential to prevent cognitive decline and reduce the risk of conditions like Alzheimer’s.
Heart disease refers to a variety of conditions that affect the organ’s structure and how it works. It is the leading cause of death among men and women in the United States, according to the American Heart Association. Such risk factors as high blood pressure, elevated cholesterol, smoking, obesity, poor diet and lack of physical activity are leading contributors. “Heart disease is very much a disease of Western civilization that we get exclusively because of our lifestyle, especially our diet,” Donohue points out. “In parts of the world that are still developing, where people eat more indigenous and simpler foods, they do not develop heart disease. … [It’s] an almost completely preventable disease if we live a healthy enough lifestyle.”
A common joint disorder that affects more than 58 million people in the U.S., osteoarthritis is the degeneration of the protective cartilage that cushions the ends of your bones. It is most commonly found in the knees, hips, hands and spine. “While genetics play a role in osteoarthritis, a healthy lifestyle can do a lot toward preventing it,” Donohue says. Maintaining a healthy weight, exercising regularly and getting proper nutrition are all ways to help preserve your joints. But if you are already facing potential joint disease, it is not too late to come back. “Research shows that osteoarthritis sufferers can reduce pain by strengthening the area around the joints, which can dramatically reduce the joint pain and dysfunction,” Donohue explains. “Many osteoarthritis patients have a narrative in their head that they can’t exercise—we [must] try to dispel this narrative. These patients really can be much more functional than they think.”
More than 10 million people 50 and over have osteoporosis, a weakening of the bones that leads to an increased risk of fractures or breaks, and another 43.3 million have low enough bone density to be considered at risk for eventually having osteoporosis. “One important thing we can do is work on strength training leading into those years and having an exercise regime that includes loaded weight-bearing exercises,” explains Anne Duch, owner of Physical Therapy for Women in Wilmington. “Muscle mass matters in keeping bone health good. In the absence of not doing anything about osteoporosis, it’s going to happen to 1 in 2 women and 1 in 4 men. The best thing to do is to prevent it instead of fighting against it.” If a patient has already been diagnosed with osteoporosis, Duch stresses the importance of maintaining bone health to reduce the risk of fractures, including exercises that will improve balance and flexibility, as well as increase mobility.
Most women reach menopause in their early to late 50s—though it can happen much earlier or later—suffering from symptoms like hot flashes, mood changes, sleep disturbance, fatigue, cognitive changes, weight gain, vulvar and vaginal issues, and decreased libido due to a dramatic drop in estrogen levels. Low estrogen levels can also increase severe health risks, such as cardiovascular disease and osteoporosis. But this poses a special problem for women over 60, says Dawn Moore in Wilmington, owner of Sunrise Mental Health and Midwifery serving multiple states. A Women’s Health Initiative (WHI) study, published in the early 2000s, led to reduced use of hormone replacement therapy (HRT) to treat menopause symptoms because of perceived health risks like stroke and breast cancer. “However, that study was eventually shown to have many flaws [and] more [recent] studies debunked what the WHI reported,” Moore says, noting that for the majority of women, there are more benefits than risks. But the WHI significantly set back women’s health, causing unnecessary fear of using hormone replacement therapy to help treat symptoms of menopause. “So now we are dealing with an entire generation that might have missed out on the potential benefits, including decreased cardiovascular disease, osteoporosis and cognitive decline,” Donohue says, adding that the benefits of HRT are greater when introduced around age 50. “It can be harmful if started at an older age, or years after menopause has set in, which is important to take into consideration,” he cautions. “We see more complications like heart attacks, clots and breast cancer when started later in life.”