Healthy at Every Age

January 01, 2013

Providence experts offer healthy advice for today so you can live well tomorrow. Great health requires more than annual physical exams— although that’s a good place to start. Great health is built on a foundation of smart choices.

“Between 70 to 80 percent of wellness is lifestyle. It gradually and consistently adds up,” says Steven A. Rabin, M.D., FACOG, a gynecologist affiliated with Providence Saint Joseph Medical Center.

When you need screenings, advanced diagnostics or leading-edge care, Providence Health & Services, Southern California, is here to partner with you. Here’s a decade-by-decade look at which screenings to add to your annual exam and when. And remember to talk to your doctor about your specific needs.

In Your 20s

Retirement accounts started in your 20s add up to huge savings in your 70s. Likewise, it’s time to pay your health forward, starting with your bone mass.

“This is the time to be building bone. The rest of your life, you’re just trying to keep it,” Dr. Rabin says. Focus on getting plenty of weight-bearing exercise, such as walking, jogging and dancing, as well as adequate calcium and vitamin D.

But don’t stop there. Adopt a diet of lean meats, chicken and fish, seeds, nuts, vegetables and fruits. Limit alcohol and don’t smoke—quit now if you do.

Why the urgency? Fasten your seat belt for this one: “Cholesterol starts penetrating blood vessel walls at age 2,” says John Armato, M.D., internal medicine physician at Providence Little Company of Mary Medical Center Torrance. “Fifteen percent of teenagers are halfway to a heart attack.”

Screening checklist:

  • Cholesterol testing: Starting at 20; every five years
  • Blood pressure: Starting at 20; every two years
  • Clinical breast exam: Every three years starting at 20; annually at age 40
  • Pap smear: Starting at 21; every three years

In Your 30s

Thirtysomethings are in the thick of life with careers, relationships and children creating both busyness and bliss. “Reproductive health becomes one of the main things in the 30s,” says Dr. Rabin, who encourages all women to take a daily multivitamin to ensure they’re getting enough folic acid—a vitamin that can reduce the risk of birth defects.

Also, women should conduct regular breast self-exams, while testicular self-exams are a must for men.

The 30s also seem to set your social and spiritual template, says Carol Miles, R.N., M.S., education manager for Providence Little Company of Mary Medical Center San Pedro. “In your 30s you make choices,” she says. “Am I going to socialize or isolate myself? Am I going to volunteer my time? Am I going to be a member of a spiritual community?”

Screening checklist:

  • TSH (thyroid) screening: Starting at 35; every five years

In Your 40s

They say 40 is the new 30, but your metabolism? It missed the memo. This is partly because men and women in their 40s experience declining muscle mass. Incorporating strength training and interval training into your workout can help.

Women, if menstrual and hormonal changes are colliding in a cacophony of chaos, talk with your doctor. “If it’s something anatomical, sometimes that can be addressed with minimally invasive surgery,” Dr. Rabin says.

Depression may also be on the docket. “This is a big decade. There are marriage and relationship issues, sexual dysfunction, caregiving for kids and parents,” he says. “Sometimes with these changes you feel like you’re losing your mind, losing your marriage, losing your kids, losing your edge at work. How far do you want this to go?” If stress or depression are interfering with your feelings of fulfillment, Dr. Rabin recommends finding a physician who will help you identify the cause rather than reaching first for a prescription pad.

Screening checklist:

  • Mammogram (women only): Annually starting at 40
  • Blood glucose test: Every three years starting at 45

In Your 50s

Feeling not so nifty at 50? If you’re a woman, this may be due to the H-word. “Hormones help optimize the hair, skin, brain, heart, vagina, bladder and bones. Yet, ever since one study came out 10 years ago, everyone is operating from a place of fear regarding hormone replacement therapy. It’s science versus sound bites,” Dr. Rabin says. He encourages menopausal women to have a fact-based discussion with their physicians.

As for men? The 50s give you a controversy, too: to PSA or not to PSA? Again, talk to your doctor about the pros and cons of PSA testing, the screening for prostate cancer.

And both men and women should begin advance care planning, says Manoj Mathew, M.D., FSHM, internal medicine and hospice and palliative care physician at Providence Holy Cross Medical Center. “People avoid the discussion because it’s uncomfortable, and then later don’t have the time because they’re in crisis,” he says.

Establish a medical power of attorney (a legal document that appoints a specific person to make medical decisions when you are unable to) and an advance directive (a document that states the treatments you do and don’t want).

Screening checklist:

  • Colonoscopy: Starting at 50; every 10 years
  • PSA test (men only): At 50 if you and In Your 60s

In Your 60’s

Congratulations, you’ve arrived at your golden years. Now stay busy polishing them. “Exercise your body. Work it and use it. Keep your mind healthy, active and alive. Engage your spirit by participating in things that are meaningful to you,” Miles suggests.

In fact, it’s use-it-or-lose-it time. “If you’re going to get in shape, you need to do it before 65. After 65, your odds of having an injury are greater,” she says.

Dr. Mathew also stresses the importance of continued advance care planning. “This is not a one-time, 15-minute discussion. It’s a process that changes as you change,” he says, noting that updated, accessible records are essential.

Screening checklist:

  • DXA bone density scan (women only): Starting at 65; every one to two years if on osteoporosis medicine .

Vision exam: Annually starting at 65

In Your 70s and beyond

Now is the time to concentrate on exercising your body and your mind. Promote longevity by following these three strategies:

Exercise: Take gentle walks around the neighborhood. Play golf or try water aerobics. If you are chair- or bed-bound, purchase upper-body exercise DVDs.

Volunteer: Research shows that older people benefit enormously from volunteerism. “If people are relying on you, it is less tempting to sit in your own world and not be challenged,” Miles says.

Cultivate cognition: Play Scrabble or bridge. Help your grandchildren memorize state capitals. “Do anything and everything to keep your mind sharp,” she says.

Experts at the Center for Optimal Aging at Providence Little Company of Mary San Pedro can conduct tests to help identify cognitive deficits and offer strategies for overcoming them. Additionally, a driving program in which an occupational therapist rides with older drivers for two hours can identify whether driving is a safe activity.

Screening checklist:

  • DXA bone density test (men only): At age 70