Rediscover Your Healthy Self After 65

While researchers chase the 'magic pill' or the fountain of youth, there are very intentional actions that those 65 and older can take to rediscover their health. Getting back to the basics in terms of exercise, moderation in diet and alcohol, keeping up with wellness exams, and maintaining healthy sleep habits and social connections can not only delay the onset of certain chronic diseases but can extend longevity as well.

Key takeaways:

1. Using the knowledge we have about nutrition, exercise, sleep, and health screenings can help you manage your health and improve your quality of life even at age 65 and older.
2. There is no magic cure for aging, but diet and exercise can help you decrease the effects of muscle loss and improve your strength and balance.
3. Health after age 65 is within your reach by taking control of your health screenings and focusing on eating well, exercising regularly, and getting enough sleep.

There are 10,000 people in the United States turning 65 every day. By 2050, older adults will make up 20% of the population. With the rapid growth and increased longevity of the older population, it is important to ensure that these years are spent as healthy as possible.

Unfortunately, 80% of Americans aged 60 and older currently have one chronic disease, such as cardiovascular disease, dementia, chronic obstructive pulmonary disease, diabetes, depression, neurological disorders, or arthritis.

We cannot control our genetics, but there are a few things that we can do to help us stay as healthy as possible after age 65.

Healthy exercise

We lose skeletal muscle mass at the rate of 3% to 8% per year after age 30. With aging, sarcopenia accelerates the loss of muscle mass by thinning and destroying muscle fibers. Regular exercise can significantly slow or prevent sarcopenia.

Those who exercise regularly not only live longer, but they maintain more independence and the ability to do the things they like to do. One study found that taking 8,000 steps a day reduced your risk of death by 51%. Maintaining a physically active lifestyle reduces your risk for obesity, cardiovascular disease, certain cancers, and diabetes. Such activity also improves sleep and balance.

Exercise can be done in short segments throughout the day. One of the best forms of exercise is walking. If you have arthritis and walking is painful, swimming or water exercises create less stress on your joints. Chair yoga or Tai chi may also increase muscle strength without straining the joints. Senior centers have many physical activities geared towards those 65 and older that provide a safe workout and encourage social interactions.

Diet moderation

It is important to note that smart eating is not just about how much you weigh; it is also about how you fuel your body.

The 2020–2025 Dietary Guidelines for Americans make recommendations for what you should be eating at each stage of life. Recommendations as you age include fresh vegetables and fruits, healthy fats, whole grains, and lean proteins.

The Mediterranean diet follows these guidelines but encourages eating less dairy and more fish. Studies have found that following the Mediterranean diet can significantly reduce the risk of cardiovascular disease and mortality. One study found a reduction in the risk of cardiovascular disease in women by as much as 25%. When combined with smaller portion sizes and a reduction in calories, healthy weight reduction can also be accomplished.

Another diet that has been shown to have significant health benefits is the Dietary Approaches to Stop Hypertension or the DASH diet. The DASH diet encourages the consumption of vegetables, fruits, whole grains, and fat-free or low-fat dairy, poultry, beans, fish, and nuts. Foods that are high in salt, sugar, or saturated fats are limited. Studies have found that the DASH diet decreases blood pressure, reduces weight, and decreases the risk of type 2 diabetes and cardiovascular disease.

A third diet that can support healthy aging is a combination of the Mediterranean and Dash diets. With dementia being the sixth leading cause of death in the United States, the MIND diet targets the health of the aging brain. It encourages green leafy vegetables in addition to other vegetables, fruits, nuts, beans, poultry, berries, whole grains, and fish. It discourages red meat. Researchers have found that following the MIND diet has improved overall cognition in study subjects.

Dietary changes are hard at any age. Starting with small improvements in your diet, like substituting salmon once a week for red meat and filling half your plate with non-starchy vegetables, will go a long way to helping you eat better.

There is some evidence that moderate calorie restriction may also slow the onset of chronic disease as we age. Additionally, certain supplements like resveratrol are being studied for their potential to mimic the effects of calorie restriction and promote healthy aging. 

If you're considering adding supplements to your diet, it's important to consult with your healthcare provider to find the resveratrol supplements that are appropriate for your health needs. However, one of the key considerations with calorie restriction is making sure that those 65 and older get sufficient protein and other nutrients to help prevent the destruction of skeletal muscles that occurs in sarcopenia.

The impact of sleep on health and mood

Older adults need 7 to 9 hours of sleep per night to be healthy and alert. Studies have shown that adults over 65 who did not sleep well had difficulty solving problems and focusing. More disturbing is the data that showed that study participants in their 50s and 60s who slept 6 hours or less per night had a higher risk of developing dementia in later life. It is thought that the lack of sleep may be associated with the deposit of beta-amyloid plaque, a sticky protein that collects between nerve cells in the brains of those with Alzheimer’s disease.

Poor sleep also worsened symptoms of depression in older adults. Depression when combined with social isolation due to mobility issues or chronic illness can significantly reduce the quality of life as we age.

Sleep apnea results in the reduction of oxygen to the brain and deep rapid eye movement sleep. Besides snoring and daytime sleepiness, sleep apnea can decrease the ability to think clearly, elevate blood pressure, and increase the risk of developing pulmonary and cardiovascular disease. It results from upper airway obstruction due to anatomical abnormalities, obesity, aging, and genetics.

Exercise, a healthy diet, reducing alcohol consumption, and limiting caffeine, including coffee, tea, soda, or chocolate at bedtime can help with sleep quality. For those who snore or awaken feeling tired, a sleep study evaluation by a pulmonologist may help to rule out sleep apnea. Various devices such as CPAP machines, dental devices, or implantable devices can help restore normal sleep patterns if a sleep apnea diagnosis is made.

Getting quality sleep is associated with less insulin resistance, obesity, and cardiovascular disease.

Effects of smoking and alcohol

Research shows that if your 60 or older and have smoked for decades, quitting will improve your health, including:

• Decreasing the risk of cancer, stroke, lung disease, and heart attack.
• Improving circulation.
• Enhancing your ability to exercise.

Today, there are many nicotine replacement therapies that can be prescribed or are available over the counter to help you stop smoking.

Alcohol can be healthy in moderate consumption. However, excessive alcohol consumption can lead to premature aging of the brain, the development of cardiovascular disease, and the worsening of depression. Stopping or limiting the consumption of alcohol can improve your cardiovascular status and prevent the progression of brain aging that occurs with heavy alcohol use.

Another consideration before you drink is whether alcohol interacts with any of the medications that you are taking.

Maintaining sexual health

Despite the fact that attitudes towards sex have become more liberal over the years, there is still discomfort and a lack of discussion of sex by older adults and their physicians. A 2018 national poll reported that 54% of older couples said that they still have sex, with 61% of those surveyed stating that sex significantly contributed to their quality of life.

As we live longer, and hopefully healthier, sexual intimacy will continue to be a significant part of life for those 65 and older. This means that physicians must make sexual health part of their assessment. Questions should be asked about sexual activity, protection taken against sexually transmitted diseases, and whether there are any physical issues occurring during sex that may be treatable.

Regular check-ups

Going to your doctor for regular check-ups is especially important as we age. Health screenings will allow your physician to catch chronic diseases in the early stage and monitor your risk factors.

The following is a list of health screenings you should maintain after age 65.

For women

1. Bone density. Women should be screened for osteoporosis with a bone mineral density test.
2. Breast exam and mammogram. Screening should occur at least once every two years until age 75, depending upon your risk factors. Talk to your physician about screening after 75.
3. Pelvic exam. If you have received three negative Pap tests in the last 10 years, or you no longer have a cervix, you can stop getting Pap tests at age 65. Pelvic exams should be continued if you are sexually active or have other issues such as pain, discharge, or bleeding.
4. Colorectal screening. Regular screening should be done until age 75, and as recommended by your physician thereafter.

For men

1. Prostate cancer screening. Men should undergo a PSA blood test annually until at least age 70, and as recommended by your physician thereafter.
2. Abdominal aortic aneurysm screening. If you are between age of 65 and 75 and have smoked, an ultrasound should be done.

For men & women

1. Eye exam. Have your eyes examined every 1 to 2 years to screen for cataracts, retinal disorders, and increased pressure in the eye, which can cause blindness (glaucoma).
2. Vaccines. Older adults should receive a pneumococcal vaccine to prevent pneumonia at 65 and every 5 years thereafter, an influenza vaccine annually, and a tetanus-diphtheria booster every 10 years. The COVID-19 vaccine is recommended if you are at high risk for hospitalization or death if you contract the disease.
3. Dental exam. Your teeth should be cleaned at least every 1 to 2 years to ensure that you are not developing periodontal disease, which increases the risk of heart disease.
4. Hearing testing. If you are having symptoms of hearing loss, screening should be done, as hearing loss can be associated with the development of dementia.
5. Hepatitis C screening. The CDC recommends a one-time screening for those 18 and older.
6. Lung cancer screening. Annual screening with a low-dose CT scan should be performed if you are between 50 and 80 and have smoked for 20 years, are currently smoking, or have quit smoking in the last 15 years.
7. Cholesterol and diabetes testing annually. Measuring your total cholesterol ("good" HDL and "bad" LDL cholesterol levels) should be done as part of your annual physical exam. The American Diabetes Association recommends a fasting blood sugar test every 3 years.
8. Skin assessment for signs of skin cancer. The National Institutes of Health recommends that those with a risk factor for skin cancer, such as a history of melanoma, being a carrier of certain genes, a family history of melanoma, being immunocompromised, and history of blistering sunburns, should be screened by a dermatologist annually.
9. Blood pressure screening. The U.S. Preventive Services Task Force recommends screening annually.

Knowing that you can still positively influence your health when you reach age 65 and beyond is empowering. Managing your diet, exercise, sleep, and health care can not only extend how long you live but can help you maintain your independence and quality of life.

9 resources

1. Harvard T.H. Chan School of Public Health. Diet Review: MIND Diet.
2. Harvard T.H. Chan School of Public Health. Diet Review: Mediterranean Diet.
3. Harvard T.H. Chan School of Public Health. Diet Review: DASH.
4. Nutr Today. Dietary Guidelines for Americans, 2020-2025: Understanding the Scientific Process, Guidelines, and Key Recommendations.
5. Aging. Examining sleep deficiency and disturbance and their risk for incident dementia and all-cause mortality in older adults across 5 years in the United States.
6. Drugs Aging. Sleep apnea in the older adult : pathophysiology, epidemiology, consequences and management.
7. Harvard Health Publishing. Rising alcohol use among older adults.
8. University of Michigan: Michigan Medicine. Sex after 65: Poll of older adults finds links to health, gender differences, lack of communication with doctors.
9. JAMA. General Health Checks in Adult Primary Care: A Review.