News & Politics

Life After 60

You’re only as old as you feel. Here’s what to see your doctor about.

Alok Gupta calls the sixties the new middle age. “There is no reason sixtysomethings should consider themselves senior citizens,” says Gupta, an internist in Gainesville. “Whether they are retired or not, they should lead a very active, healthy lifestyle.”

Exercise is one of the best ways to ward off health problems that come with age. Research shows that physical activity can lower the risk of heart disease and stroke, and it also helps lower the rates of depression and dementia. “There’s a lot of good data that it preserves your body and your mind,” says DC internist James Ramey.

Most sixtysomethings see more than one doctor. “It’s not uncommon for people in their sixties to see several specialists,” says Silver Spring internist Penny Bisk. “It’s important that they have one person who can oversee all these opinions and bring their whole medical situation into focus.”

During an annual physical, your doctor should make sure cancer screenings and other routine tests are on schedule. Vaccines play a bigger role in your medical routine in your sixties. The Centers for Disease Control and Prevention recommends a single dose of shingles vaccine at age 60 and, at 65, a vaccination against pneumonia. Older adults should also get an annual flu shot and a tetanus vaccination every ten years.

The American Cancer Society recommends that, beginning at age 50, men and women be screened for colorectal cancer and that colonoscopies be repeated every ten years. Ramey tells his patients to have a colonoscopy every five to six years. “Even the best colonoscopers miss an occasional polyp,” says Ramey. “If you miss it, then it’s got ten years to grow and become malignant.”

Women in their sixties should continue to get an annual Pap smear, which includes a check for cervical cancer. American Cancer Society guidelines say women who have had three normal Pap tests in a row can get screened every two to three years. Bisk also recommends annual pelvic exams for sixtysomething women to check for signs of uterine, ovarian, and vulvar cancers.

Despite recent controversy, the American Cancer Society has stuck by its long-standing recommendation that sixtysomething women have a yearly mammogram and clinical breast exam and perform self exams at home.

The debate over mammograms highlights the importance of talking about screenings and tests with your doctor. The American Cancer Society doesn’t formally recommend prostate-cancer screening for men, but many physicians recommend regular PSA blood tests and digital rectal exams after age 50.

Bethesda internist Thomas McNamara says recommended screening timetables are valuable but limited. “The most important time with your physician is when you are able to interact based on complaints and concerns,” he says. “The complaints should generate the testing.”

Some of the most common health problems doctors see among sixtysomethings—diabetes, high cholesterol, hypertension—are related to weight. Because a person’s metabolism slows with age, pounds can creep up. “Sixtysomethings don’t have as much muscle mass as they used to,” says Bisk. “So they need fewer calories to maintain their weight. If you don’t reduce calories as time goes on, you’re going to pick up weight.”

The government’s exercise guidelines for older adults are the same as for younger ones: Each week, sixtysomethings need at least 2½ hours of aerobic activity plus strength-training exercises.

Recommendations for sixtysomethings from the US Preventive Services Task Force include routine osteoporosis screening for women 65 and older, regular screenings for lipid disorders and high blood pressure, and talking to a doctor about taking a daily aspirin to reduce the risk of heart attack and stroke.

Ramey says all postmenopausal women should take 1,500 milligrams of calcium a day. Many doctors say they’re seeing more patients with vitamin D deficiencies. “Universally in the people I test—male and female—everybody is low,” says McNamara, who recommends that patients talk to their doctors about taking vitamin D supplements.

People in their sixties should visit an ophthalmologist or optometrist every two years to screen for glaucoma and cataracts as well as a dentist twice a year for cleaning and screening for cavities and gum disease. Doctors also recommend regular visits to a dermatologist to check for suspicious-looking moles or other signs of cancer.

Doctors say one of the most effective ways to stay healthy as you age is to try new things—take a class, socialize, open yourself to new experiences. “The brain is an evolving organ,” says McNamara. “The more you exercise it, the better it functions. And that’s your independence.”

This article first appeared in the January 2010 issue of The Washingtonian. For more articles from that issue, click here.