Much of Growing Older Gracefully and Healthfully Can Be Up to You
Do you feel 60 years young … or 60 years old? How you age is partly a personal choice, thanks to the enormous body of evidence showing that a healthy lifestyle and preventive health care can reduce or prevent health problems associated with aging. Even if you've had some unhealthy habits throughout your lifetime, it's never too late to begin activities that will enhance your health and well-being now and in the years ahead. This advice is also true if you have a chronic medical condition—you often can make lifestyle changes that will improve your health.
We used to think of Medicare, retirement and early bird dinner specials when we thought about seniors over 60. But today women in their 60s are returning to college, starting businesses, running marathons and enjoying healthy sex lives.
But the reality is that after six decades of wear and tear on your body, you can expect some decline in physical well-being. You'll need to take greater care of your body—but not just your physical health. Your emotional, sexual and mental well-being need attention, too. Unfortunately, we live in a culture that worships youth and doesn't always value maturity, especially in women. At this age, you may have to work harder than ever to preserve your sense of self-worth, potential and sexuality.
How you feel about getting older plays an important role in how you age. Researchers at Yale University found that people who feel positive about aging live longer than those who don't and are more likely to take control and responsibility for their health.
The Consequences of Life's Choices
Many of the diseases associated with aging are caused by lifestyle choices, including smoking, lack of exercise, chronic stress and obesity. Family history of a medical disorder, such as diabetes, heart disease, overweight or cancer, also can play a significant part. Typically women in their 60s will be concerned with these leading health issues:
Heart disease: Heart disease is a leading cause of death and disability in women. High blood pressure and high cholesterol can lead to heart attacks and strokes, so having your blood pressure and cholesterol checked regularly is essential. If you're at risk, it's important to maintain a healthy diet low in sodium and saturated fat, reduce alcohol consumption to no more than one drink per day and refrain from smoking.
Cancer: The good news is more people are surviving many forms of cancer for five years or more, and deaths from cancer are declining. But as you age, your risk for certain cancers increases, including endometrial, ovarian, colon, breast and lung cancers. Early detection and treatment are essential, so be diligent about regular pelvic and breast exams (including mammography). Unfortunately, some cancers have few or no early warning signs, such as ovarian cancer. Talk about your risk for certain cancers with your health care professional, especially if you are a smoker. Even after years of smoking, it's not too late to reverse some of the damage.
Osteoporosis: If you haven't had a bone density scan, you should have one by the time you are 65 to assess your risk for osteoporosis, which can lead to fractures. If you are under age 65 but have suffered a fracture or have other risk factors of osteoporosis, you should have a bone density scan as soon as possible. As a normal part of aging, you've been losing some bone mass for decades now—especially in the years immediately after menopause. By your 60s this rate may have started to slow, but you still could be at significant risk. The good news is that calcium, exercise, vitamins and medications can help strengthen your bones at any age.
Sensory decline: As you age, it's normal for your vision, hearing and senses of smell and taste to gradually decline a bit. The American Academy of Ophthalmology now recommends that between the ages of 40 and 64, adults with no risk factors or signs of eye disease get a baseline screening. Then based on the results of that initial screening, an ophthalmologist will prescribe the necessary follow-up exams. If you are age 65 or over, the American Academy of Ophthalmology suggests you have complete eye exams by your eye doctor every one to two years to check for cataracts, glaucoma, age-related macular degeneration, diabetic retinopathy and other eye conditions.
Treatable eye conditions common in older age include cataracts, which cloud the lens of the eye, dry eye conditions and glaucoma, in which the eye builds up pressure that can cause blindness. Ask your health care professional about which screening tests make sense for you.
Other conditions: There's a whole range of medical conditions that could begin in your 60s, or some health problems that you've managed over the years may become more frequent or bothersome. Not all conditions are inevitable symptoms of aging, however, and could be signs of a serious problem. A wise approach is to ask your health care professional what's normal and associated with aging and what's not, with your personal medical history and age in mind.
For instance, you may begin to have problems with bladder control, which can be caused by the weakening of muscles and ligaments in the pelvic region. Often this is successfully treated with special exercises and changes in diet. Gastrointestinal complaints such as constipation and heartburn may become more troublesome and should be checked if they occur frequently. Some women in their 60s complain of memory loss. You can help keep your mind sharp with activities like crossword puzzles and playing a musical instrument. Aches and pains could be the signs of arthritis or another autoimmune disorder, which primarily strike women.
Questions to Ask Your Health Care Professional
Make the most of your next appointment by being prepared with questions and concerns. Sometimes it's not easy to remember your thoughts when you're in the medical office, so it's a good idea to make a list of questions when you think of them. A small notebook tucked into your pocketbook will come in handy at those times. Take it with you to all your appointments so you are sure to discuss what's on your mind. Include these questions if they pertain to you:
- Based on my personal medical history and age (60 or older), how often should I have regular checkups, and which screening tests should I have and when?
- Will a colonoscopy hurt? What can I do to get ready for this procedure?
- How do I prepare for a bone density test? What can I do if the test shows bone mass deficiency? Does this mean I will get osteoporosis?
- Is it safe to continue the same exercise program I've had for years? Do I need any special precautions at my age?
- Intercourse has become painful. What's wrong and what should I do?
- Women friends my age have breast and other cancers, and I am terrified that I'm next. Is this normal? What can I do to ease my mind?
- I used to pass urine when sneezing or coughing. Now I'm having trouble controlling my bladder at night. What can I do to control this problem?
- Over-the-counter medicines aren't helping the pain of arthritis, but I'm concerned about the risks associated with prescription medicines. What choices do I have?
- If I need a test or treatment, what is it designed to do and why is it recommended? What are the dangers and side effects? What must I do to get ready for the procedure? Are there other treatments or options? Will insurance pay for the test or treatment?
- Whom should I call to find out test results (such as a Pap test or mammogram) and when? (Always get a complete report on any tests you have had.)
Preventive Health Screenings You Need
Because you're at greater risk for medical problems as you age, your health care routine should include more frequent preventive tests and screenings. This is especially true if you are at high risk or have a family history of medical problems, or you have serious medical conditions. You should have a routine physical and gynecological exam yearly. In addition, these guidelines are recommended for healthy women in their 60s. If you have health problems, be sure to get the specialized care and additional tests prescribed by your health care professional.
Blood pressure test for hypertension: Have your blood pressure taken at least every two years if normal, more often if it is at or above 120/80.
Bone mineral density exam/bone mass measurement: Recommended for women who have sustained a fracture, are at increased risk due to certain medications and for patients with diseases or conditions that are known to be associated with bone loss. Once you reach age 65, you should be screened regardless of risk factors, and follow-up scans should be performed about every one to two years.
Cholesterol: Have your blood cholesterol tested every five years or more frequently if you have risk factors for heart disease.
Clinical breast exam: Have this exam every year. Your doctor or other health care professional will examine your breasts for any abnormalities. This exam often is part of the annual gynecologic examination. Breast self-exam (BSE) is an option to consider in addition to these clinical exams; however, research has shown that BSE plays a small role in finding breast cancer compared with finding a breast lump by chance or simply knowing what is normal. If you choose to perform a monthly BSE, ask your health care professional to show you how to perform one.
Colorectal cancer screening: You should be screened for colorectal cancer using any of several different screening methods. There are a number of tests that screen for colorectal cancer, and they are divided into two groups: tests that find both colorectal cancer and polyps, and those that mainly find cancer. The American Cancer Society recommends that women at average risk of colorectal cancer have one of the following screening tests beginning at age 50:
Tests that find polyps and cancer:
- Colonoscopy every 10 years
- Flexible sigmoidoscopy every five years
- CT colonography (virtual colonoscopy) every five years
- Double contrast barium enema every five years
(If any of the above tests are positive, a colonoscopy should be done.)
Tests that mainly find cancer:
- Fecal occult blood test (FOBT) every year
- Fecal immunochemical test (FIT) every year
- Stool DNA (sDNA), interval uncertain
Discuss options and procedures with your health care professional to determine the best screening method for you.
Dental exam: Visit the dentist regularly. Check-ups can detect early signs of oral health problems and bone loss. Professional tooth cleaning is also important for preventing oral problems and should be done every six to 12 months.
Diabetes blood sugar test: You should be screened every three years; more often or earlier if you’re overweight or have other risks for diabetes.
Eye exam: The American Academy of Opthalmology now recommends that starting at age 40, adults with no risk factors or signs of eye disease get a baseline screening. Then based on the results of that initial screening, an ophthalmologist will prescribe the necessary follow-up exams. At age 65 and older, you should be examined every one to two years to check for cataracts, glaucoma, age-related macular degeneration, diabetic retinopathy and other eye conditions. Exception: If you have vision problems, family history of eye problems, history of an eye injury or have diabetes, you should be seen more frequently by an eye care specialist.
Mammography: You should be screened for breast cancer with mammography every one to two years and get a clinical breast exam annually. Guidelines on breast cancer screening vary, so talk to your health care professional about what’s right for you.
Pap test and pelvic exam: Continue getting a Pap test every three years or both a Pap test and an HPV test every five years. If you've been screened and had normal results and are not at high risk for cervical cancer, you may stop getting screened after age 65. Exception: If you have risk factors such as cervical precancer, multiple sex partners, a weakened immune system or HIV infection, you should have a Pap test every year.
If you have had a total hysterectomy (removal of both your uterus and cervix), you may stop having cervical cancer screenings, unless the surgery was done as a treatment for cervical cancer or precancer. If you had a hysterectomy without removal of your cervix, you should continue to follow the guidelines above.
Remember: Don't confuse your annual or semi-annual Pap test with a gynecologic examination. The American College of Obstetricians and Gynecologists (ACOG) recommends that all women your age have a gynecologic examination, including a pelvic exam, annually.
Sexually transmitted diseases: If you have a history of Chlamydia or other sexually transmitted diseases (STDs), or you or your partner have had multiple sex partners, ask your health care professional about whether you need to be screened for STDs, including gonorrhea and HIV.
Skin exam for skin cancer: The American Academy of Dermatology recommends that you have your skin examined every year. Recommendations include doing a monthly mole self-exam and practicing sun safety to reduce your risk of damaging your skin and developing skin cancer. If you have had skin cancer or have a relative with a history of melanoma, ask your health care professional for guidance.
Thyroid test (TSH): Recommendations vary. The American Thyroid Association recommends having a TSH screening test at age 35 and then once every five years. The American Academy of Family Physicians does not recommend screening patients before age 60. And the U.S. Preventive Services Task Force states that there's not enough evidence to recommend for or against thyroid screening in adults. Ask your health care professional for guidance.
Weight: Obesity screening is now considered a preventive checkup. Ask your health care professional for more information on healthy weight guidelines or weight-management strategies.
Immunizations:
Hepatitis A: This vaccine is recommended for adults who live, work or travel in areas where hepatitis A is endemic and periodic outbreaks occur, or users of injection or street drugs, military personnel, institutionalized persons and those working in those institutions.
Hepatitis B: The Hepatitis B vaccine is recommended for all adults at high risk for infection; high-risk individuals include persons who are injection drug users and their sexual partners; anyone with a history of multiple sexual partners in the previous six months or who has recently acquired a sexually transmitted disease; recipients of certain drug products; individuals with a health-related job with frequent exposure to blood or blood products; and travelers to countries where hepatitis B virus (HBV) is of high concern.
Herpes zoster: Get vaccinated once only at age 60 (or older, if not done at 60) to prevent shingles.
Influenza: Have a yearly influenza vaccination.
Pneumonia vaccine: At age 65 and older, you should be immunized against pneumonia. You may need the vaccine at a younger age if you smoke or have certain chronic medical conditions. Talk to your health care professional.
Tetanus: You should have tetanus-diphtheria booster shots every 10 years.
