Staying healthy through the ages

Did you know that even people over 65 need to worry about HIV infection? And that while cancer is a concern throughout your lifetime, the types of cancer and the preventative steps you should take vary depending on your age and sometimes, your gender? According to Consumer Reports on Health, risks for your health change across your life span and can affect men and women differently.

Some of the information is not unexpected: People in middle age have an increased risk of poisoning from misuse of medications, while older people need to be especially concerned about bone health and fall prevention. And everyone, no matter what the age, should buckle up and drive sober: car crashes remain one of the biggest causes of death across all age groups.

Here’s a look at what Zoomers need to know to reduce common health risks as they age, according to the report.

Cancer. Cancer is the main cause of death among people 45 to 64 and for other age groups, it is the second-leading killer. But the risks for certain kinds of cancer shift over time and sometimes, depending on gender.

Breast cancer continues to be a special concern for women 20 to 59, particularly around menopause when the levels of estrogen and progesterone change.

Colon and lung cancers become major threats for both men and women after about 40, as smoking and other unhealthy lifestyle factors (such as poor diet and exercise habits) adopted earlier in life take their toll.

By the time men reach their 90s, most have some malignant cells in their prostate. But those tumors tend to be relatively unaggressive. In fact, most of these men will die of other causes, which is why prostate-cancer screening and treatment, particularly in people older than 75, is controversial.

Preventative measures: Zoomers should continue with healthy habits such as regular exercise, a nutritious diet, wearing sunscreen and not smoking. (Remember it is never too late to reap the benefits of not smoking!) Lose excess weight and consider taking a Vitamin D supplement. (To read more about Vitamin D deficiency, click here.) At age 50, women should have annual mammograms and men should consult with their doctor about prostate cancer screening. Both men and women should be screened for colon cancer.

Cardiovascular disease. While certainly a risk for people 50+, cardiovascular disease is also a leading killer of younger people. For people under 30, such deaths often occur during vigorous exercise among people with previously undiagnosed heart abnormalities.

It is important to keep in mind that while most deaths from heart attack and stroke occur after 60, the underlying disease usually starts far sooner, making it important to establish healthy eating and exercise habits early in life. Even so, controlling coronary risk factors continues to be important even into your 90s.

For example, doctors used to let systolic blood pressure (the higher number) rise with age as long as the diastolic (lower) number stayed normal. But more recent evidence suggests that systolic pressure predicts the complications of hypertension better than diastolic pressure in older people. Other research shows that high cholesterol levels can still harm older people and should often be treated.

Gender influences also changes with age. More men than women die from heart disease up to age 65, but after that men and women are affected equally. Symptoms for a heart attack also shift with age, especially for women. The classic ‘chest-clutching’ heart attack is typical only before 75 or so, particularly among men. Women, on the other hand, tend to experience vague symptoms such as fatigue, weakness, and palpitations.

And while heart disease kills more people than stroke, the gap between the two narrows as people age. By 80, stroke rises to the third leading cause of death in the United States. And according to Stroke Recovery Canada, an estimated 50,000 Canadians have a stroke every year, and of these, about a third die within a year and most survivors are left with permanent disabilities. This means that people need to pay attention to risk factors for stroke, including certain heartbeat abnormalities and clogged carotid arteries that particularly threaten the brain.

Preventative measures: These basic recommendations remain the same throughout your lifetime: Don’t smoke. Engage in healthy eating and exercise habits. As for screening, check cholesterol at least every five years and blood pressure regularly. People over 40 may also want to consider measuring C-reactive protein, a marker of arterial inflammation. People over 70 should ask their doctor to check pulses in the feet for peripheral artery disease and assess stroke risk by checking for an abnormal heartbeat and clogged carotid arteries.

HIV, hospital-induced infections, and flu and pneumonia. While childhood vaccines have all but eliminated one-time killers such as measles and polio in North America, certain risks from infections become more common with age.

According to recent data, HIV infection is a concern not only for young people, but for people of all ages if they are sexually active, and particularly if they have a new partner.

Influenza and pneumonia are on the list of top 10 killers after about 60. And septicemia, or infection of the blood, is a leading killer of people over 65. Those deaths often stem from hospital-borne infections caused by unsanitary practices or the spread of antibiotic-resistant bacteria.

Preventative measures: Make sure you are up to date with your vaccines, particularly if you are travelling abroad. Get your annual flu shot. Get a shingles vaccine if you are over 60 — and continue to practice safe sex no matter your age.

Avoid hospital-based infections by: insisting health care providers wash their hands, keeping your hands away from your face and getting appropriate antibiotics.

Mental health. At every age, people who have suffered from depression or other mental illnesses or experience substance abuse are more likely to die by suicide. This is why it’s important to treat depression and other mental illnesses as soon as possible. Older people, however, are less likely to exhibit classic symptoms of depression, including thoughts about suicide, according to research. They are also more likely to be irritable or agitated.

Substance abuse is also a considerable problem. More than 1.7 million adults older than 50 in the US abuse or are dependent on alcohol or drugs.

Preventive measures: Adequate mental health screening is important for people of all ages. Zoomers who take antidepressants should also take steps to protect their bones because antidepressants could weaken them. Non-drug measures such as yoga and exercise can ease depression regardless of age.

Diabetes, COPD, kidney disease. Type 2 diabetes, while more common in middle age, is beginning to affect more children as childhood obesity becomes more of a problem. And while it remains a leading cause of death in adults over 65, diabetes also contributes to death by heart attack, stroke, kidney disease, and possibly some cancers.

Emphysema and chronic bronchitis — which together are known as chronic obstructive pulmonary disease, or COPD — become particular concerns after the age of 70. But like cardiovascular disease, they get their start much sooner (usually when people start smoking). And while asthma tends to strike more children than adults, the disease kills older people, in part because they are less likely to have asthma properly diagnosed and treated.

Another killer in later life is kidney disease. But because it causes few early symptoms, many people are unaware of the problem until it’s advanced, increasing the risk of complications. People over 60 are more vulnerable because they tend to take more medications which can overtax the organs. Also kidney function normally declines somewhat with age.

Preventative measures: As with other conditions, healthy lifestyle habits are key. After age 40, ask for a fasting-glucose test every 3 years. Have your kidney function checked at 60 or if you have diabetes, heart disease or high blood pressure. Lung problems? Stop smoking immediately, and if you have a persistent cough, shortness of breath or wheezing ask for a spirometry test.

Sources: Consumer Report on Health (August 2008); Centers for Disease Control and Prevention; Stroke Recovery Canada.

Photo © Mamluke

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