By Jimmy Magahern
Some handy tips on staying healthy long into your later years
The ragtime pianist and composer Eubie Blake, when asked by the New York Times for a comment on the occasion of his 96th birthday, memorably quipped, “If I’d known I was going to live so long, I would have taken better care of myself.”
That aphorism is no longer a joke for many of us, who are now living longer than our grandparents’ and parents’ generations but are perhaps not preparing for those years as well as we should. As we begin a new year, Lovin’ Life offers a few pointers on the basic things everyone over 50 should be doing in 2018 in preparation for all those years still ahead.
Shots seniors need in 2018
The U.S. Department of Health and Human Services offers a handy online tool called the Adult Immunization Vaccine Finder that will generate a list of personalized vaccine recommendations based on your answers to 11 simple questions regarding your age, health status, location and other factors. Go to www2.cdc.gov/nip/adultimmsched/ to take the short quiz.
As a general rule, however, most physicians swear by the following four shots for adults over 50:
- Flu shot. The seasonal flu shot protecting against the most common influenza viruses is recommended annually by the Centers for Disease Control and Prevention (CDC) for everyone over 6 months old, but for people age 65 and older, there is now a new three-component, or trivalent, shot formulated with an added ingredient (the adjuvant MF59) that helps create a stronger immune response to vaccination. This new flu vaccine, with the brand name FLUAD, was licensed by the U.S. Food and Drug Administration (FDA) in late 2015. As an alternative, adults 65 and older can also go with the previous option, a high-dose vaccine containing four times the amount of antigen as the regular flu shot. The CDC says either formulation is good for this age group.
- Tetanus shot. Few people die from tetanus anymore (in 2015, only two deaths out of a total of 29 tetanus cases were reported in the U.S.), but that’s mainly because of the widespread use of tetanus vaccines since the late 1940s. It’s recommended that everyone from adolescents on up gets a routine tetanus booster vaccination every 10 years to protect against tetanus and diphtheria. On one of those visits, the booster shot should be replaced with a Tdap shot, which covers tetanus, diphtheria and pertussis (more commonly known as whooping cough).
- Pneumonia shots. Adults 65 or older (and possibly younger, if your doctor recommends it) should be immunized against pneumococcal pneumonia annually. Two vaccines are recommended, given on alternating years: one dose of PCV13 (conjugate vaccine) followed by one dose of PPSV23 (polysaccharide vaccine), each given one year apart.
- Shingles vaccine. One out of every three people aged 60 or older will get the painful, sometimes debilitating skin rash known as shingles, caused by the same virus that causes chickenpox. The basic rule of thumb is, if you’ve had chickenpox some time in your life, you are at risk of getting shingles. Getting the shingles shot just once after age 65 reduces the risk of getting shingles by about half.
However, doctors say you may want to wait a few months until a new vaccine that was just approved by the FDA and CDC is available. The new vaccine, called Shingrix, will be a two-part shot that has tested as more effective than the current single-dose shot.
There may be additional shots your doctor recommends, says Sarah Payne, DO, Banner Hospice medical director and a board-certified geriatric-medicine specialist. “You should also ask your health care provider if there are any disease-specific vaccines you should get,” she says. “Meaning if you have diabetes or other chronic conditions such as end-stage renal disease, there may be other vaccines recommended. Your health care provider will know.”
Age-appropriate exercise and nutrition
If you’re in your 60s or 70s and are not feeling up to running the latest 10K marathon, don’t sweat it.
“Walking is the most important exercise you can do,” says Amit Shah, MD, associate dean of faculty affairs at the Mayo Clinic School of Medicine. “Activities such as running can be hard on the joints. If arthritis is a problem, consider water aerobics or walking in a pool.”
Payne agrees. “If you like to do tai chi but you have severe arthritis, don’t worry,” she says. “There are a lot of places that offer ‘chair chi,’ a modified form of tai chi. Just find the right program to suit your specific needs. The ideal thing is to keep moving!”
On the nutrition side, it’s important to make changes to our daily eating habits as our bodies get older. The USDA recommends making these small adjustments as we age:
- Watch the salt. Look for low-sodium packaged foods and add flavor to foods with spices and herbs instead of salt;
- Eat your veggies. Add sliced fruits and vegetables to your meals and snacks;
- Got milk? Drink three cups of fat-free or low-fat milk throughout the day. If you cannot tolerate milk, try small amounts of yogurt, butter milk, hard cheese or lactose-free foods;
- Water, water, water. Drink water instead of sugary drinks;
- Check for vitamins. Consume foods fortified with vitamin B12, such as fortified cereals.
“Metabolism slows down with aging due to a variety of changes, including losing muscle mass, called sarcopenia,” Shah says. “Food intake must be reduced to match this or a person will gain weight.”
Payne adds, “The same rules apply at any age – a healthy, Mediterranean diet is the best way to go for a variety of reasons, along with exercise that is appropriate for where you are at functionally. Exercise helps with mood, depression, arthritis — any number of things.’’
A timeline of needed annual checkups
“Even if you are healthy, you should go to your health care provider at least once per year for your annual wellness visit and then a follow-up to go over lab results and any specific conditions,” Payne says. “Sometimes, depending on your health or your provider, these visits can be combined, although you may need to ask for a longer appointment or if your provider does this.’’
Follow-up appointments are particularly important if you have some chronic conditions that require monitoring. In such cases, Payne says, “your provider may want to see you every three to four months. These visits are not only for you but for the provider as well, to keep abreast of any changes that may have happened and to ensure you are still on the right path. Even if you are perfectly healthy but of a certain age, your provider may ask to see you at least twice a year just to ensure all is well.”
As for other recommended annual checkups beyond the wellness visit, Shah points to a 2011 report produced in conjunction with the CDC, Administration on Aging, Agency for Healthcare Research and Quality, and Centers for Medicare and Medicaid Services. The report, Enhancing Use of Clinical Preventive Services Among Older Adults (available at both cdc.gov/aging and aarp.org/healthpros), provides a list of seven important checkups older adults should commit to having annually — along with some alarming statistics on how few actually do:
- Up-to-date vaccinations. More than 31 percent of adults ages 65 and older reported not receiving an influenza vaccination in the past year.
- Breast cancer screening. Nearly 17 percent of women ages 65 to 74 reported not receiving a mammogram within the past two years.
- Colorectal cancer screening. More than 36 percent of adults ages 65 to 74 reported not receiving colorectal cancer screening. Ideally, one of these three colon cancer screenings should be done for adults between the ages of 50 and 75, according to Banner Health: colonoscopy (every 10 years); CT colonography (every 5 years); sigmoidoscopy (every 5 years); fecal occult blood testing (yearly); or FIT DNA (every 3 years). Consult your doctor for the best personal option.
- Diabetes screening. 31 percent of adults ages 65 and older without diagnosed diabetes reported not receiving a test for high blood sugar or diabetes within the past three years. Ultimately a complete diabetes screening will check the following: Hemoglobin A1c (HbA1c); LDL cholesterol; urine test for protein; annual foot exam; and a comprehensive eye exam with dilated retinal screening.
- Osteoporosis screening. A bone density test for osteoporosis should be done initially at age 50, then repeated every two years based on your doctor’s recommendation. 62 percent of black women and 54 percent of American Indian/Alaska Native women reported never receiving osteoporosis screenings compared to 33 percent of white women ages 65 and older.
- Lipid disorder screening. Screening lipids for cardiovascular disease should be done once every three to five years, based on your doctor’s recommendation. Five percent of adults age 65 and older reported not receiving blood cholesterol screening within the past five years.
- Smoking cessation counseling. Thirty percent of women age 65 and older reported not receiving advice to quit smoking during their annual checkup, compared to 24 percent of older men.
Get all of the applicable checkups above annually, and chances are good you’ll be able to remain healthy long into your later years.
“Preventative care continues to be important, even for seniors,” Shah says. “Nationally, fewer than half of older adults are up to date on the preventative services that have been shown to improve health and prevent illness. This is why it is so important to have those preventative services done.”