With age comes an ever-greater concern for one's health. In spite of older adults enjoying longer and more fulfilling life spans, they remain at a greater risk of contracting disease due to a number of factors. These factors include a weakened immune system, decrease in overall activity and use of medications that impact the body's immune system response. Disease prevention should be at the forefront of any healthcare strategy for older adults, with the ultimate goal of postponing dependency for as long as possible.
- Older adults are at greater risk of contracting diseases.
- Older adults can prevent most diseases through a healthy lifestyle, including diet, exercise and lack of risky activity.
- Early detection of certain diseases lowers the possibility of mortality while increasing the success rates of treatment and care.
- Comprehensive geriatric assessment may be necessary for those already coping with certain diseases.
The Importance of Disease Prevention in Older Adults
Recent statistics show that approximately 40 percent of deaths in older adults are the result of infectious disease. Infections often exacerbate underlying illnesses, leading to hospital stays and other emergency medical services. Lifestyle choices, including smoking, obesity, drinking and other risky behaviors can also have a negative effect on the overall health and well-being of seniors as they become older.
Disease prevention involves three levels of preventative measures, each taking into account the health, mobility and safety of older adults and their current level of care. The earlier diseases are detected, the more likely the possibility of treatment and recovery.
The best way to stop disease is to prevent it from taking hold in the first place. First-level prevention does just that by lowering an older adult's risk of contracting a disease. Preventative measures usually include changes in one's lifestyle, from increased exercise to quitting smoking and alcohol consumption. In terms of medical expenses, first-level prevention represents a much lower cost than treatment and other forms of comprehensive care.
The following have proven effective in first-level prevention of diseases:
Exercise - Exercise is perhaps one of the most important ways of preventing a wide variety of health problems, from diabetes and cardiovascular disease to depression and excess weight. Older adults can benefit tremendously from regular exercise and it should be part of their daily routine. Exercise does not have to be a strenuous affair - in fact, walking for approximately 30 minutes a day can have significant health benefits for older adults.
Smoking – According to the Centers for Disease Control, cigarette smoking is the single leading preventable cause of death in the U.S. among both men and women. Over time, smoking causes significant reductions in lung function and blood circulation, placing older adults at a greater risk of developing heart disease and lung cancer. Quitting can vastly reduce these risks while improving lung function and life expectancy.
Many older adults who've quit smoking found the following strategies to be beneficial:
- Setting a quit date
- Using patches and other self-help tools
- Joining support groups for those trying to quit
- Receiving reinforcement from concerned parties
Diet – A well-balanced diet is always important for individuals of all ages, but maintaining the proper diet takes on an even greater importance as one ages. Certain foods are beneficial for combating a wide variety of diseases and ailments, while limiting intake of others can help prevent weight gain and other health issues. Older adults should keep the following in mind as they strive towards a healthier diet:
- Omega-3, a compound found in certain fatty fish as well as flaxseed, canola and soybean oils, is beneficial for preventing heart attacks and stroke.
- Whole grains, fruits and vegetables are rich in fiber as well as vitamins and minerals. Dietary fiber helps reduce blood cholesterol levels, and aids with digestion and weight management.
- Lean meats, fish, skinless chicken and low-fat dairy products offer reduced amounts of saturated fat.
- Older adults need more calcium as they age. Men between the ages of 51 and 70 years need at least 1,000 mg per day, while women require 1,200 mg per day. Older adults can increase their intake of calcium through foods such as milk, yogurt and cheeses. Multivitamins and mineral supplements are also effective ways of ensuring calcium intake.
- Cutting down on canned and pre-packaged foods can help reduce one's salt intake. High sodium levels can lead to a greater risk of high blood pressure.
- Nutritionists and dietitians are often tasked with creating a healthy diet that closely matches their patient's caloric and nutritional needs.
Vaccination – Vaccination takes on a more prominent role for many older adults. Aging and the use of medications that lower immune system function often leave seniors at greater risk of contracting infectious diseases. To lower the likelihood of health complications from infections, older adults are encouraged to receive vaccinations for the following:
- Influenza (flu): Once per year during September to mid-November, as the flu virus changes constantly. Those allergic to eggs or the vaccine itself should not be vaccinated.
- Pneumonia: All adults age 65 and over should be vaccinated. Those who haven't been vaccinated for five or more years and received vaccination before age 65 should be vaccinated again.
- Diptheria & Tetanus: Older adults who've never been vaccinated should receive two shots at least one to two months apart, followed by a third shot at least six to 12 months later. Booster shots should be given every 10 years. Those with allergic reactions to the shot should not be vaccinated.
Low-Dose Aspirin Therapy – Older adults with two or more heart disease risk factors, including low HDL cholesterol, diabetes, severe obesity and a family history of heart disease, may benefit from low-dose aspirin therapy. Taking one aspirin tablet every other day can significantly lower the risk of heart related ailments and reduce the possibility of a second heart attack.
Dental Checkups – Regular dental visits can help reveal and prevent infectious diseases originating in the mouth, including gum infections and cancer. Older adults who practice good dental hygiene are less likely to develop dental issues as they age.
Accident Prevention – Accidental injuries are a leading cause of death among older adults over the age of 65. Increased frailty, reduced resilience and mobility, and natural reductions in vision, hand-eye coordination and mental acuity all combine to create an elevated risk of serious injury and possible care in a rehabilitation facility or nursing home. Removing potential hazards can help reduce the likelihood of serious injury for older adults.
Older adults who are already suffering from diseases benefit from second-level prevention. This level of disease prevention focuses on early detection and prompt treatment of age-related diseases. Detecting certain diseases early on can help healthcare providers create an effective treatment road map as soon as possible.
Prostate cancer – Prostate cancer is one of the leading causes of death in men over the age of 75. Men over the age of 65 should consult their healthcare provider about being screened for prostate cancer.
Breast cancer – Annual examinations and a mammogram every one to three years can help detect and provide early treatment for breast cancer.
Colon cancer – Those with an elevated risk of colon cancer, including those with a history of other cancers, irritable bowel syndrome or relatives with a history of colon cancer, should undergo yearly fecal occult blood testing and if necessary, a screening colonoscopy.
Cervical cancer – Although women under the age of 65 are encouraged to have normal Pap smears on a regular basis, they're not needed in women 65 and older. Those who've never had Pap smears before age 65 should have two normal annual Pap smears, after which no further testing is needed.
Diabetes – Routine diabetes testing is critical for those with a family history of diabetes, as well as those who are currently obese. Health care providers may test blood sugar levels as a part of blood and urine testing.
Heart Disease – Factors such as cigarette smoking, high blood pressure and high cholesterol play a significant role in increasing risk of heart attack in older adults. An electrocardiogram (ECG) may provide some insight in the heart's current condition, but it should not be relied on as a sole means of testing. Cardiac stress testing may also prove useful prior to starting an exercise regimen.
Depression – Common in many older adults, depression can be diagnosed and treated by heathcare providers. Screening is often as straightforward as answering a "yes" or "no" question regarding a person's mental state over the prior week.
Dementia – Significant decline in mental acuity caused by Alzheimer's disease or other risk factors should be reported as soon as possible. Early detection of dementia in older adults often results in steps taken to counteract its progression. Older adults can maintain mental acuity through regular activities such as reading, learning and problem-solving.
For older adults who are already suffering from chronic diseases, third-level prevention focuses mainly on monitoring and providing treatment, while preventing disabilities stemming from disease progression. Seniors who do not seek out medical care at the first and second levels of disease prevention are usually in need of the third.
Health care providers may perform a comprehensive geriatric assessment (CGA) over the course of third-level prevention. Most CGAs involve a collection of healthcare professionals, from physicians to occupational therapists, tasked with thoroughly assessing a person's complete state of health, creating health arrangements that best benefit older adults and staying abreast of health status changes.
Benefits of an Active Lifestyle
Leading an active lifestyle offers a wide assortment of health benefits for people of all ages. However, staying active is especially important for older adults over the age of 65. Older adults who engage in exercise and other preventative activities are more likely to remain healthy and independent longer than their sedentary counterparts.
Older adults, loved ones and health care providers may find the following additional resources useful for disease prevention and other aspects of elderly care.
AGS Foundation for Health in Aging
40 Fulton Street, 18th Floor
New York, NY 10038
601 E Street, NW
Washington DC 20049
National Clearinghouse for Long Term Care Information
Administration on Aging
One Massachusetts Avenue NW
Washington, DC 20001