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ASK THE EXPERTS

SUZANNE FIELDS, MD.

Patient Question

What Can I Do to Age More Healthfully?


SUZANNE FIELDS, MD.
SUZANNE FIELDS, MD.

Chief, Division of Geriatrics and General Internal Medicine
Department of Medicine

Expert Answer

There are three general categories that you can control: diet, exercise, and boosting the immune system. These three things are critical in disease prevention. A healthful diet and regular exercise-even if it is as simple as a daily walk-are important to maintaining a healthy weight. As you age, being overweight can lead to a number of other impairments, including high blood pressure, high cholesterol, diabetes, and back pain, to name just a few. In addition, there are certain vitamins that people need more of when they get older, including calcium and vitamin D. Some studies have shown that vitamin D, in particular, helps strengthen bones and prevent falls, which in turn can prevent debilitating fractures. Ask your doctor to check your vitamin D levels. If they are low, you can boost them with supplements and exposure to sunlight.

As for your immune functioning, there are certain vaccines that can help protect you from disease, or at least diminish the severity of symptoms if you do get sick. Certainly get a flu shot every year. We recommend a pneumonia vaccine for everyone over age 65. Also, there is a new vaccine available that protects against zoster (commonly known as "shingles"), and we recommend that for people over age 60.

What regular screenings should people have as they age?
Pay attention to your individual risk factors and follow up with your doctor regularly. In general, women should continue with mammograms, and men should discuss screenings for prostate cancer and abdominal aortic aneurysms with their physicians. Older women can benefit from bone mineral density testing to detect evidence of osteoporosis. It is now recommended that men and women be tested for high cholesterol, hearing loss, and glaucoma. Unless there is a medical contraindication, older adults should be screened for colon cancer (scheduling your first colonoscopy at either age 40 or 50, depending on family history and risk factors). If you are over age 65 and have not had a full physical or a wellness visit with your doctor in a while, you might want to schedule one. Medicare will cover one "Welcome to Medicare" preventive visit at age 65. You can get a baseline for your health, set up a screening schedule, and start working with a doctor who can follow any changes that might occur as you age.

How can people keep their minds nimble and their brains in shape?
Perhaps the best way is to stay engaged with family and community. Get socially involved. Volunteer. Keep up with current events. Remain passionate and committed to life. It also helps to engage in mental exercises like playing bridge, doing crossword puzzles, reading and writing, learning a new language-anything that challenges your brain with new information.

Is there a new definition of age these days?
Absolutely. Today in geriatrics we tend to look at functional age, not chronological age. We look at how well someone is able to perform activities of daily living, cognitive functioning, mobility and strength, and many other factors. We also look at someone's "active life expectancy," that is, how long they can maintain an active, engaged life. As a result, when someone comes to us with a health problem, we don't just attribute it to "old age." We screen for geriatricsyndromes that can lead to problems and find what is reversible. We're finding that a lot of health issues we thought typical to aging actually are not-they are more attributable to a lifetime of bad habits (poor eating and exercise, for example) and with proper attention, can be reversed. In terms of actual numbers, it used to be that age 65 and over was considered old. That is not necessarily true anymore, so we have categorized 65 to 75 as "young-old," 75 to 85 as "mid-old," and 85 plus as "old-old."

What distinguishes Stony Brook's approach to geriatric medicine?
We provide many educational opportunities. We train five geriatric medicine fellows a year, as well as residents in medicine and psychiatry, faculty, and health education professionals-many of whom work or go on to work in the community. Because we train the next generation in the proper care of the elderly, we stay abreast of best practices, and have held interdisciplinary conferences on such topics as management of infections, cancers, obesity, dementia, health literacy, and cultural differences and nuances of care. Our outpatient geriatric program provides comprehensive evaluation of patients living with common geriatric conditions, including memory loss, urinary incontinence, gait and balance disorders, dizziness, and weight loss. A team of geriatric experts can help develop a plan of care for frail elders with the aim of keeping patients as functional and independent, for as long as possible.


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